Archives: ERISA

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Eighth Circuit Rules on ERISA’s “Church Plan” Exemption

Background On March 27, 2020, the Eighth Circuit in Sanzone v. Mercy Health, 2020 U.S. App. LEXIS 9537 (8th Cir. March 27, 2020), ruled on several key issues on the “church plan” exemption to ERISA.  As background, beginning in 2013, plaintiff’s counsel filed ERISA class-action cases across the country challenging the application of ERISA’s “church … Continue Reading

Special COVID-19 Health Insurance Enrollment Windows and Waivers

As a result of the ongoing COVID-19 pandemic, we are observing all sorts of never-before-seen changes in the fully-insured group health plan space.  Many insurers are liberally waiving their normal rules to accommodate the continuation of coverage to employers and employees in their time of need.  Although the accommodations are welcome, employers need to exercise … Continue Reading

CalSavers Not Preempted by ERISA

With an alarming number of American workers lacking adequate retirement savings, California and a handful of other states began implementing state-sponsored retirement savings programs.  The CalSavers Retirement Savings Program (CalSavers) was first launched as a pilot program in 2018 and then expanded to all eligible employers in the state in July 2019 in order to … Continue Reading

The IRS Addresses Expenses Related to COVID-19

Like many other areas, employers are grappling with issues in response to the pandemic growth of the 2019 Novel Coronavirus (aka, “COVID-19”) in the workplace.  One newer topic has been related to the desire to ensure employees and their families are proactively being diagnosed once symptoms present, to ensure proper care management for the employee … Continue Reading

The Supreme Court Defines Actual Knowledge

In a closely watched decision, Intel Corporation Investment Policy Committee v. Sulyma, Slip Op. No. 18-1116 (U.S. S. Ct., Feb. 26, 2020), construing ERISA’s three-year statute of limitations, see ERISA § 413(2), 29 U.S.C. § 1113(2), the Supreme Court held unanimously (J. Alito) that “actual knowledge” means “. . . when a plaintiff actually is … Continue Reading

2nd Circuit Pension Liability Ruling Is A Big Win For Employers

As published by Law360 (January 13, 2020, 5:43 PM EST) — Following oral arguments that were held in February 2018, in a long-anticipated decision in the National Retirement Fund v. Metz Culinary Management Inc., the U.S. Court of Appeals for the Second Circuit held that a multiemployer pension fund’s use of a lower interest rate that was … Continue Reading

The SECURE Act, at Last

On December 19, 2019, the Senate passed, as part of the Further Consolidated Appropriations Act 2020 (Public Law No. 116-94), the Setting Every Community Up for Retirement Enhancement (SECURE) Act (Division O pg. H.R. 1865-604).  It is touted as the most significant retirement act since the Pension Protection Act of 2006.  President Trump signed the … Continue Reading

Employers in Union-Related Group Health Plans Must Still Comply with ACA Reporting Requirements

Employers who provide health benefits to their union workforce through a multiemployer group health plan must satisfy all the Affordable Care Act (ACA) reporting requirements regarding their union employees… More… Continue Reading

Building and Construction Industry Exemption from Withdrawal Liability

Since its passage late in 1980, the Multiemployer Pension Plan Amendments Act (MPPAA) has proven to be a hindrance to the profitable operations of employers that contribute to multiemployer pension funds by imposing a surprise, and often expensive, obligation (the “withdrawal liability”) on employers across many industries. However, the construction industry is one of a … Continue Reading

PBGC Approves Revisions to AAA’s Withdrawal Liability Arbitration Rules; Employer Fees Reduced

For years, steep arbitration fees have made many employers think twice about contesting a questionable withdrawal liability determination. The Pension Benefit Guaranty Corporation’s (PBGC) approval of a lower fee schedule may ease that hurdle. ERISA, as amended by the Multiemployer Pension Plan Amendment Act of 1980 (MPPAA), requires all disputes between an employer and a … Continue Reading

Does Your Company Have to File Forms 1094/1095 in New Jersey?

Last week, the IRS issued it updated Form 1094-C and 1095-C instructions for 2019. Employers that employ New Jersey residents, however, may have more reading to do. New Jersey responded to the federal repeal of the Affordable Care Act’s (ACA) individual mandate, by enacting a mandate of its own. The New Jersey Health Insurance Market … Continue Reading

Court Rejects Equitable Exception to MPPAA’s ‘Pay Now, Dispute Later’ Regime

A withdrawing employer must make withdrawal liability installment payments during the pendency of an arbitration proceeding contesting the existence of withdrawal liability, a federal court has affirmed, rejecting the employer’s attempt to recognize an equitable exception to the general “pay now, dispute later” requirement. Boilermaker-Blacksmith National Pension Trust v. PSF Industries, No. 18-2467-JWL (D. Kan. Nov. … Continue Reading

Judicial Trend Away from Recognizing Equitable Remedies for Benefit Claims under ERISA.

A court in Florida has declined to expand the remedies available under a claim for benefits due under 29 U.S.C. § 1132(a)(1)(B) of ERISA. Keys v. Bell, 2019 U.S. Dist. LEXIS 195505 (M.D. Fla. 2019). The court dismissed the plaintiff’s claim for “equitable estoppel by silence” under that provision of ERISA’s civil remedies. This supports … Continue Reading

Stimulating Consumerism in Health Care By Revealing Costs

When is the last time one of your employees asked how much an in-network physician’s visit would cost?  How much does a blood test cost at the hospital to which your doctor referred you, compared to the same blood test at another facility you could use?  Why haven’t consumers who spend hours shopping for the … Continue Reading

DOL Proposed NEW Electronic Disclosures Rule

Employers frustrated with the cumbersome rules and added expenses for furnishing plan documents, summary plan descriptions, notices, and certain other communications may soon get some added relief, at least with respect to their retirement plans. In response to President Donald J. Trump’s Executive Order 13847, Strengthening Retirement Security in America, the U.S. Department of Labor … Continue Reading

North Carolina Court Awards $41 Thousand-Plus Penalty for Failure to Produce Documents Requested by Plan Participants

Section 104(b)(4) of ERISA provides that a plan administrator must respond to a written request for certain documents (including the plan documents and summary plan description) by a participant or beneficiary by providing the requested documents.  Section 502(c)(1) of ERISA and Regulation § 2575.502(c)-1 provide that a plan administrator who fails to do so within … Continue Reading

The Final Regulations For 401(k)/403(b) Hardship Distributions

On September 23, 2019, the Treasury Department and IRS published final regulations for hardship distributions from both 401(k) and 403(b) plans (the “Final Regulations”).  Essentially the hardship distributions changes relax the hardship distribution requirements (i.e., making it easier for participants to obtain hardship distributions) and eliminate many burdens following a hardship distribution (i.e., allowing participants … Continue Reading

COBRA Notice Litigation Resulting in Big Dollar Claims

Can you imagine something as simple as a COBRA Notice missing a few technical requirements resulting in an employer needing to pay a 6 or 7-digit damages award?  That is happening in Florida.  Employers in and out of Florida should pay attention to this news, as what doesn’t start in California often starts in Florida. … Continue Reading

Third Circuit Joins Majority in Rejecting “De Facto Administrator” ERISA Theory

The U.S. Court of Appeals for the Third Circuit joins the Second, Seventh, Eighth, Ninth, and Tenth Circuits in declining to impose liability on alleged de facto plan administrators.  Under Section 502(c) of ERISA, a plan administrator may be liable and subject to penalties for failing to comply with a participant’s request for information which … Continue Reading

A Deadline is a Bright Line: How Fessenden Narrows “Substantial Compliance” in the Seventh Circuit

Last week the U.S. Court of Appeals for the Seventh Circuit ruled that the deadline imposed under ERISA for plan administrators to decide on benefit claims is a “bright line” rule. The court held that when a plan administrator misses this deadline, the “substantial compliance” exception to statutory compliance does not apply and the plan … Continue Reading

Required Minimum Distributions

The aging of the baby boomer generation has increased the level of scrutiny with which the Department of Labor, Employee Benefits Security Administration (“EBSA”) will review the efforts of pension plans to locate missing plan participants who did not receive reported benefits.  The focus of the EBSA which began with a review of the efforts … Continue Reading

EASTERN DISTRICT OF NEW YORK REFUSES TO ENFORCE AN ERISA ANTI-ASSIGNMENT PROVISION

The list of the federal courts of appeals enforcing unambiguous anti-assignment provisions in ERISA health benefit plans continues to grow:  almost exactly one year ago, the Third Circuit joined its sister circuits in holding “that anti-assignment clauses in ERISA-governed health insurance plans as a general matter are enforceable.” As the Third Circuit opinion noted, every … Continue Reading

Changes to Employee Benefit Plans May Create Unforeseen Disclosure Deadlines

Believe it or not, it may be time to distribute a new Summary Plan Description (SPD) to include all changes made since the last issuance or a Summary of Material Modifications (SMM) for any amendments adopted during the 2018 plan year. The Rules:  The Department of Labor (DOL) regulations and Employee Retirement Income Security Act … Continue Reading
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