As we prepare for another change in Administration in the White House, it is crucial for employers and plan sponsors to stay informed and prepared. While much of what lies ahead is speculative, understanding these possible changes can help employers navigate the uncharted waters of employee benefits. Following is an overview of potential changes we
Employer Health and Welfare Plan
Conjuring Health Plan Hygiene: The Final Chapter
As we conclude our “Health Plan Hygiene” blog series, we reflect on the important insights shared about fiduciary responsibilities under the Employee Retirement Income Security Act of 1974 (ERISA) and highlight the risk posed by recent group health plan fiduciary litigation and offered strategies for mitigating these risks by meeting ERISA obligations. We have explored…
Health Plan Coverage Mandate for Over-the-Counter Contraception Proposed by Biden Administration
With just a couple of weeks before election day, the Biden Administration announced on October 21, 2024, that it was issuing proposed rules designed, in part, to require health plans to cover over-the-counter contraception without cost sharing, including birth control, the morning-after pill, and the male condom. The proposed rules are the latest in a…
Health Plan Hygiene Part 4 – Show Me the Money
Our “health plan hygiene” series has focused on steps that fiduciaries of employer-sponsored group health plans can take to ensure they meet their fiduciary responsibilities. This issue has been brought to the forefront recently due to a wave of class action lawsuits that have been brought against group health plan fiduciaries. In our last post…
Health Plan Hygiene Part 3 – Best Practices for TPA Evaluation, Selection, and Contracting
A health plan’s fiduciaries are responsible for administering the health plan. Because most employers are not in the business of administering health benefits, they outsource the day-to-day health plan administration to a third-party health plan administrator (TPA). This outsourcing does not mean the employer is off the hook for their fiduciary obligations under ERISA. Even…
Health Plan Hygiene Part 2: ERISA Fiduciaries – That May Mean You!
By Sasha Rousseau (Employee Benefits Practice Group summer associate) & Kellie M. Thomas on
The Employee Retirement Income Security Act of 1974 (ERISA) regulates most private employee benefit retirement and welfare plans. This statute’s purview is vast; it governs employer-sponsored defined benefit and defined contribution retirement plans and an array of welfare plans.
Under ERISA, a plan fiduciary is an entity that exercises authority or control over the management…
Health Plan Hygiene Part 1: A Spoonful of Sugar Helps the Medicine Go Down
During the next several weeks, we will publish a series of articles that dive deeply into “health plan hygiene” relating to health and welfare benefit plan fiduciary issues and how employers can protect themselves in this quickly evolving area.
Section 408(b)(2) of the Employee Retirement Income Security Act of 1974 (ERISA) requires certain disclosures regarding…
Employer-Provided Health Coverage During Employee Leaves of Absence
When an employee is on an extended leave of absence, there is often confusion regarding whether and to what extent the employer must continue to provide coverage to the employee under the employer-provided health plan. To determine whether coverage is required, the employer should consider the terms of the plan, COBRA requirements, and whether the…
“Final” Section 1557 Nondiscrimination Regulations – Round 3: Impact on Employer Health Plans
Background
Section 1557 is the non-discrimination provision of the Affordable Care Act (ACA). Section 1557, which has been in effect since 2010, is intended to prevent discrimination in certain health programs or activities that receive federal financial assistance. In May of 2024, the Department of Health and Human Services’ (HHS) Office of Civil Rights…
Happy National Employee Benefits Day 2024!
By Joy M. Napier-Joyce on
Posted in ACA, Dobbs, Employee Health & Welfare Plans, Employer Health and Welfare Plan, fiduciary committee, Fiduciary duties, Health Care Reform, Health Care Reform Legislation, Mental Health Parity, Mental Health Substance Use Disorders, National Employee Benefits Day, Prescription Drug and Healthcare Spending, Uncategorized
To all those who work in the employee benefits arena, whether in legal, finance, benefits administration, payroll, tax, human resources, or many other disciplines, this is our annual reminder to celebrate the valuable and important work done for employees, beneficiaries, and Plan Sponsors alike.
This year, we focus on the increased attention on all things…