Click here to read our April 2024 newsletter! Read More
The Potential Impact of Insurance Carrier and TPA Legal Battles on Self-Funded Plans
The U.S. Department of Labor (DOL) recently filed suit against the Blue Cross and Blue Shield of Minnesota (BCBSM), alleging various violations of the Employee Retirement Income Security Act (ERISA). The outcome of this case is likely to be significant, as it raises issues concerning legal authority and fiduciary responsibility in the context of third-party administrators (TPAs) of self-funded employee welfare Read More
Court Allows Nurse Educator’s Whistleblower Retaliation Claim to Move Forward Against Hospital
A California appeals court recently allowed a nurse educator’s retaliation lawsuit against her former employer to go forward. The court found that the hospital’s stated reason for the plaintiff’s termination was a pretext for its retaliatory motive, and, as a result, her case should proceed to trial. The case is Johnson v. Pasadena Hospital Assn., Calif. Ct. App., No. B321794 (Dec. 28, 2023). On January 8, 2018, Read More
The DOL’s New “Economic Realities” Test to Determine Employee Status: ERISA Considerations for Benefit Plan Sponsors
By Bonita Hatchett-Bodle (April, 2024) The Department of Labor (DOL) Wage and Hour Division issued final regulations, effective March 11, 2024, which are intended to serve as a practical guide to employers on how the DOL determines whether a worker is an employee or independent contractor under the Fair Labor Standards Act (FLSA) [29 CFR part 795]. This new guidance may impact employee classification under the Read More
Reasons to Avoid SECURE 2.0 Emergency Savings Accounts
SECURE 2.0 established various options for individuals to withdraw funds from their retirement accounts without penalties. One such option allows plan sponsors to place funds in a separate emergency savings account for employees making less than $155,000 annually. Plan advisors often refer to these pension-linked emergency savings accounts (PLESAs) as “sidecar” accounts. The Employee Benefits Security Read More
Penalties for Failing to Timely File 2023 Forms 1094/1095
The Affordable Care Act (ACA) requires some employers to file annual information returns with the Internal Revenue Service (IRS) by certain deadlines. These employers also must provide their employees with certain forms related to insurance coverage by a deadline. Failure to meet these deadlines can result in double penalties – one for failure to file an information return and one for failing to provide employees Read More
CA Law Cracks Down on Employer Noncompete Agreements
Last year, California enacted two laws that severely restrict noncompete agreements in the state. First, Senate Bill 699, now codified as Section 16600.5 of the Business & Professions Code, extends the state’s general ban on noncompete agreements to agreements signed out of state. It also creates a private right of action for employees whose agreements include restrictive covenants, including attorney’s fees Read More
What to Expect on Healthcare from a Second Trump Presidency
As former President Donald Trump once again hits the campaign trail, he is doubling down on his previous campaign promise to repeal and replace the Affordable Care Act (ACA), characterizing “Obamacare” as a “catastrophe.” Trump’s insistence on this campaign goal, which failed the first time, comes at a time when the ACA is more popular and widely used than ever among Americans. Despite his fervent campaign promises, Read More
DEI Opponents Mount Legal Challenge to 1866 Civil Rights Law
The American Alliance for Equal Rights spearheaded the lawsuit in which the U.S. Supreme Court ultimately abolished the use of affirmative action in higher education. Now, the conservative activist group headed by Edward Blum has set its sights on prohibiting equity policies and funding to minority-owned businesses, with the larger goal of eliminating workplace diversity programs. American Alliance for Equal Read More
Court Orders Claims Reprocessing After Finding TPA Illegally Excluded Gender-Affirming Care in Violation of ACA Section 1557
A federal district court has awarded injunctive relief, including claims processing, after finding that an insurer acting as a third-party administrator (TPA) for a self-insured plan violated Section 1557 of the Affordable Care Act (ACA). The court ruled that the TPA committed illegal discrimination under the ACA by excluding coverage for gender-affirming care. The case is C.P. v. Blue Cross Blue Shield of Ill., 2023 Read More
