Health & Welfare

Beneficiary May Sue Trustees of One ERISA Plan for Fiduciary Breaches Causing Loss of Benefits under Another ERISA Plan

The U.S. District Court for the Southern District of New York, in DeRogatis v. Bd. of Trustees of the Cent. Pension Fund of the Int'l Union of Operating Engineers, has held that ERISA allows a plaintiff to sue the trustees of an ERISA welfare benefit plan for a fiduciary breach that caused her to lose benefits under another, related ERISA pension plan.

Agencies Expand HRA Availability to Provide Coverage

In response to an Executive Order from President Trump, the DOL, HHS, and the IRS proposed new regulations to expand the use of HRAs to pay for certain medical expenses.  They now have released final regulations that will be published in the Federal Register on June 20, 2019.  The final regulations, which will become effective January 1, 2020, provide for two new types of HRAs. Excepted Benefit ...

Massachusetts Delays the Start of Paid Family and Medical Leave Program by Three Months

Delayed Contribution Date: On Friday, June 14, 2019. the Commonwealth of Massachusetts has delayed Paid Family and Medical Leave (PFML) contributions from employers and employees.  The new start date for required PFML contributions is October 1, 2019.  On October 1, 2019 employers are required to begin withholding PFML contributions from employee qualifying earnings.  Extended Notice Requirement: ...

HHS Proposes Revised ACA Section 1557 Regulations

HHS has issued proposed regulations that, if finalized, would significantly revise existing regulations issued under Section 1557 of the Affordable Care Act ("ACA"). The proposed regulations would continue to prohibit discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities, while revising certain provisions of the current ...

IRS and HHS Release Certain Limits for Welfare Benefit Plans in 2020

The IRS and HHS have released some of the 2020 inflation-adjusted limits for certain employee welfare benefit plans and the dollar amounts used for certain discrimination tests. Health Savings Accounts ("HSAs"). The IRS released the inflation-adjusted contribution limits and related amounts for HSAs and HSA-compatible high deductible health plans ("HDHPs") for 2020. The 2020 limit on ...

Forfeiture of Transportation Benefits

In Information Letter 2019-002, the IRS has confirmed that unused transportation benefits will be forfeited when an employee terminates employment.

Guidance on When Employers Can Prorate Bonuses of Employees on FMLA Leave

The Second Circuit Court of Appeals, in Clemens v. Moody's Analytics, Inc., has held that an employer did not unlawfully interfere with an employee's rights under the Family and Medical Leave Act ("FMLA") when it prorated his bonus based on his FMLA leave-related absences. Law. FMLA regulations entitle employees to "unconditional pay increases" that occur during FMLA leave, including cost of ...

HHS Reduces Maximum Penalty Amounts for Certain HIPAA Violations

The Department of Health and Human Services ("HHS") has lowered the maximum civil monetary penalty amounts for most violations of the Health Insurance Portability and Accountability Act ("HIPAA") Privacy and Security Rules. Background. In 2009, Congress enacted the Health Information Technology for Economic and Clinical Health ("HITECH") Act that, among other things, enhanced HIPAA enforcement by ...

Current Association Health Plan Contracts Safe

The Department of Labor ("DOL") has announced that it will not take action against association health plans ("AHPs") that comply with its final regulations, even though these regulations were partially overturned by a federal court in State of New York v. United States Department of Labor. In that case, a federal district court in Washington, D.C. ruled that the regulations are an unreasonable ...

State Law Claims Not Preempted by ERISA

The U.S. Court of Appeals for the Ninth Circuit, in The Depot, Inc. vs. Caring for Montana, has ruled that state law claims of fraud and misrepresentation are not preempted by ERISA. Facts: Three employers provided their employees with health care insurance based on the insurer's representations that the monthly premiums would reflect only the cost of providing benefits. The employers later said ...