Health and Welfare Plans

Keeping COBRA Notices Compliant in an Ever-Changing Landscape

JAHIZ NOEL AGARD, November 24, 2020  2020 has presented several issues requiring urgent attention for employers who sponsor group health plans, including a need to update the notices required under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), in particular the general (or initial) notice and the continuation coverage election (or enrollment) notice. This […]

New Proposed Rule Regarding Grandfathered Plans

SARAH KANTER, October 8, 2020  A new proposed rule (the “Proposed Rule”), released by the Departments of Treasury, Labor, and Health and Human Services (HHS) (the “Departments”) on July 10, 2020, would permit grandfathered group health plans and grandfathered group health insurance coverage (“grandfathered plans”) to make greater increases to certain types of cost-sharing requirements […]

IRS Allows for Temporary Flexibility with Long-Awaited Guidance that Expands Mid-Year Election Change Opportunities for Cafeteria Plans

GISUE MEHDI and BRIANA B. DESCH, July 9, 2020   In response to the COVID-19 pandemic, the U.S. Department of Treasury and the Internal Revenue Service (IRS) issued Notice 2020-29 and Notice 2020-33 (the “Notices”) on May 12, 2020. Notice 2020-29 provides increased flexibility for participants to make mid-year health plan, health flexible spending account […]

COBRA, HIPAA Special Enrollment, Claims and Appeals, and ERISA Notice Related Deadlines Extended

ELIZABETH LOH, May 7, 2020 On April 28, 2020, the Department of Labor (DOL), the Department of the Treasury (“Treasury Department”), and the Internal Revenue Service (IRS), issued several pieces of guidance providing relief to plan participants, COBRA-qualified beneficiaries, claimants, and plan sponsors who are impacted by the COVID-19 pandemic. This guidance includes the following: […]

IRS Notice 2020-23 Extends Deadlines for Employee Benefit Plans

JENNIFER D. TRUONG, May 7, 2020   Under IRS Notice 2020-23, the Internal Revenue Service (IRS) has provided additional relief due to the coronavirus pandemic by extending the deadlines for the time-sensitive actions set forth in Revenue Procedure 2018-58.1 Specifically, the Notice extends the deadlines for filings and other actions that would otherwise be due on […]

COVID-19 — Health and Welfare Provisions in the CARES Act

MARY E. POWELL and LINDSAY R. DOCTO, April, 2020    The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was signed into law on March 27, 2020. The CARES Act makes emergency supplemental appropriations and other changes to law to help the U.S. respond to the COVID-19 pandemic. This article discusses: (1) the […]

Health and Welfare Plans — Guidance for Employers Navigating Challenges of the COVID-19 Pandemic

MARY E. POWELL and LINDSAY R. DOCTO, March, 2020    Due to the urgent crisis the United States is facing because of the COVID-19 pandemic, the President has declared a national emergency, as well as declaring major disasters in California, Washington, New York, Iowa, Louisi­ana, Texas and Florida. Federal and state governments have passed legislation and […]

Groundhog Results Are In: An Early Spring Means It’s Time for Health and Welfare Spring Cleaning!

GISUE MEHDI and CATHERINE L. REAGAN, February, 2020    1. Thought You Were in the Clear? CA’s Individual Mandate Replaces the ACA Individual Mandate for CA Taxpayers Although the federal government effectively removed the individual mandate under the Affordable Care Act by setting the penalty to zero (effective January 1, 2019 under the Tax Cuts […]

Individual Coverage HRAs: Practicalities and Potential Pitfalls for Employers (Part One)

SARAH KANTER, September, 2019 This article is part one of a two-part article examining many of the issues that employers and other plan sponsors may want to consider when deciding whether to offer employees an Individual Coverage Health Reimbursement Arrangement (ICHRA), which was created by final regulations (the “final regulations”) released on June 13, 2019 […]

Two Interesting New Rules Regarding Prescription Drugs — What is Really Going On?

MARY E. POWELL, September, 2019    In the last few months, the Internal Revenue Service (IRS) and the U.S. Department of Health and Human Services (HHS) have issued rules that impact the cost that group health plans (GHPs) can charge participants for certain prescription drugs. This article explains those rules and also takes a critical […]

Final HRA Regulations Issued – Key Highlights

TIFFANY N. SANTOS, July, 2019    On June 13, 2019, the Departments of Labor, Health and Human Services and the Treasury (the “Departments”) released final regulations that will permit employers and other plan sponsors to offer employees two new types of health reimbursement arrangements or “HRAs” (see here for “FAQs”): (1) an Individual Coverage HRA (“ICHRA”)  […]

Improper Delegation of Authority Could Cost a Plan its Deferential Standard of Review

 GISUE MEHDI and MARY E. POWELL, December, 2018   The Employee Retirement Income Security Act (ERISA) gives participants and beneficiaries the right to have plan benefit denials reviewed in federal court. The court reviews a plan claims administrator’s benefit denial decision as “de novo” (looking at the facts anew and reaching its own decision, with no […]

Proposed Regulations for Health Reimbursement Arrangements — Impact of the Trump Administration on the Affordable Care Act

MARY E. POWELL, November, 2018    On October 29, 2018, the U.S. Departments of Labor (DOL), Treasury (“Treasury”) and Health and Human Services (HHS) (together, the “Departments”) issued proposed regulations that would allow a health reimbursement arrangement (HRA) to be used for the purchase of individual health insurance coverage and include an “excepted benefit” HRA that […]

Department of Labor Releases Final Association Health Plan Rule

SARAH KANTER, August, 2018   On June 21, 2018, the Department of Labor (DOL) published its highly anticipated and controversial final rule (the “final rule”) regarding Association Health Plans (AHPs). The final rule significantly expands the kinds of employer groups and associations that are permitted to establish an “employee welfare benefit plan” under the Employee Retirement […]

4 Facts about Medicare that All Employers Should Know

Medicare is a government-funded health insurance program for elderly and disabled individuals.  Employers that offer group health insurance plans to their employees have an interest in learning how employees’ entitlement to Medicare benefits can affect the administration of those plans. This article discusses the coordination of benefits between the two plans.  In other words, it […]

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