DOL Issues Opinion Letter on Whether Health Plan Qualifies as AHP and MEWA

Ace Hardware Company is a retailer cooperative that serves over 2,700 retail store owners operating over 4,400 stores as well as 120 corporate stores. Recently, they requested an opinion from the Department of Labor (DOL) regarding whether its health plan qualified as an association health plan (AHP) and a multiple employer welfare arrangement (MEWA). ACE: Retail and Healthcare Cooperative? The hardware cooperative Read More

Federal District Court Allows Excessive Fee Lawsuit Related to PHI Request

Recently, a federal district court heard a lawsuit where patients argued that healthcare providers and healthcare recordkeepers were charging fees for patients to access their medical records. Under HIPAA, healthcare providers are required to provide an individual a copy of their medical records upon request. They have the right to inspect, transmit copies, or get a copy of the records. The Department of Health and Read More

Supreme Court Seeks Input on Scope of ERISA Preemption of PBMs

Pharmacy benefits management programs (PBMs) are under consideration by the U.S. Supreme Court thanks to a case they are currently hearing in which the court has been asked to define the scope of ERISA preemption regarding PBMs. The state of Arkansas sought and was granted certiorari in Rutledge v. Pharmaceutical Care Management Association. They want to know whether states have the ability, under the ERISA Read More

How to Handle Your Company’s Failure to Submit a Health and Welfare Plan SAR to Participants

Business owners, human resources professionals, and benefit plan administrators work hard to stay on top of the mountain of compliance paperwork necessary to run their programs. Occasionally, benefits legal compliance documentation may fall through the cracks. In most cases, however, a failure to submit the required paperwork just means going back and correcting the mistake, paying a fine, and perhaps some basic Read More

IRS Issues Proposed Regulations on Withholding for Qualified Retirement Plan Participants with Non-U.S. Address

For international companies with operations in many countries, complying with local regulations can be complicated by individuals who are from one country, but living in another and thus have a non-U.S. permanent address. In May, the IRS proposed new regulations regarding the required tax withholding that will impact these individuals specifically. Currently, withholdings are required when distributions are made to Read More

Multiple Employer Plan Proposed Regulations Provide Exception to “One-Bad-Apple” Rule

Recent proposed regulation changes from the IRS include a possible exception to the “unified plan rule” for defined-contribution multiple employer plan. This exception would occur if certain conditions are met and one participating employer fails to meet plan qualification requirements or fails to provide the information necessary to determine compliance with qualification requirements.   Current Read More

Recent Executive Order on Transparency, Expansion of HDHPs, and Health FSA Carryovers

In an executive order dated June 24, 2019 (the “Order”), President Trump chose to focus on transparency in healthcare in general, as well as clarification of regulatory guidance on two types of health insurance programs, HDHPs and FSAs. The goal of the Order is to improve pricing and quality transparency and encourage agencies to create applicable guidance. Healthcare Transparency: The Department of Health and Read More

Are Cash Balance Plans Making a Comeback?

States are looking at legislation that will allow cash balance plans for state worker retirements. While many are in favor of this type of retirement planning, critics are concerned that cash balance plans do not provide sufficient retirement security. Furthermore, there is some concern they could negatively impact state finances. Cash Balance Plans Cash balance plans are like traditional pension plans in that they Read More

Plan with VEBA and MEWA Status Required to Pay ACA’s Annual Health Insurance Provider Fee

Voluntary Employees’ Beneficiary Associations (VEBAs) and Multiple Employer Welfare Arrangements (MEWAs) have been determined to be covered entities by the Court of Federal Claims. The Affordable Care Act (ACA) subjects “covered entities” to an annual health insurance provider fee, meaning that these two types of plans are not exempt from the fee.   Iowa Bankers Benefit Plan Iowa Bankers Insurance and Read More

HHS Issues Proposed Rule to Substantially Revise Civil Rights Provision That Discriminates Based Upon Sex

In May, the U.S. Department of Health and Human Services (“HHS”) issued a new proposed rule on Section 1557. This rule is aimed at revising the Affordable Care Act (ACA) and preventing discrimination based upon sex. Section 1557 is a civil rights provision broadly prohibiting discrimination based on a variety of factors in health programs and activities receiving federal funding. The proposed rule specifically Read More