California District Court Deems Independent Review Organization Functional Health Plan ERISA Fiduciary

A recent case before the U.S. District Court for the Northern District of California recently ruled that an Independent Review Organization would be considered a functional fiduciary in regard to ERISA regulations. Independent Review Organization In the case at hand, the independent review organization was a business that conducted independent medical review of records and made determinations regarding claim Read More

Supreme Court Agrees to Hear Ninth Circuit “Actual Knowledge” Requirement for ERISA Statute of Limitations

Recently, the Ninth Circuit ruled that the three-year statute of limitations contained in ERISA requires the plaintiff to read the plan documents before the statute begins to run. The U.S. Supreme court has agreed to hear arguments on this issue. Specifically, the court will be deciding whether the plaintiff must have “actual knowledge” from having read the plan documents before the statute of limitations can Read More

Agencies Expand HRA Coverage to Excepted Benefits and Individual Health Plans

A Health Reimbursement Arrangement (HRA) is a type of employer-funded savings account designed to help employees pay qualified medical expenses. Generally, it is set up to cover expenses beyond those which are covered by the employer’s health insurance plan. President Trump issued an executive order calling for the expansion of a variety of healthcare options, including HRAs, and the new regulations are in response Read More

EBSA Issues New Guidance on Electronic Filings for Top Hat Plans

The Employee Benefits Security Administration (EBSA) under the U.S. Department of Labor (DOL) recently finalized regulations to revise the filing procedures for a variety of notices and plan statements. These revisions mainly focus on electronic submission of documents such as apprenticeship and training plan notices and “top hat” plan statements. A “top hat” plan is a nonqualified deferred compensation (NQDC) plan Read More

Recent Case Indicates Situs of Benefit Plan’s Signing May Be Key in Determining Class Action Forum

Forum selection is an important part of litigation strategy, as some jurisdictions are more friendly to class actions and plaintiffs than others. A lawyer considering a class action lawsuit is going to look at the different states they may be able to bring the action in as well as the choice between state and federal courts. Since this decision can have a major impact, the recent ruling by a Washington federal court Read More

Employee Agreements: A Method for Mitigating ERISA Fiduciary Exposure?

Employment agreements cover a wide range of topics, from setting the compensation terms to protecting a company’s intellectual property rights. It’s not surprising, then, that plan fiduciaries put terms in employment agreements aimed at limiting their exposure. The goal is to limit litigation and instead require arbitration for resolving ERISA claims. They may also choose to try to limit the claims period or set the Read More

The DOL’s New Fiduciary Rule: What Are Some Likely Outcomes?

The Department of Labor (DOL) is set to finalize its new fiduciary rule by the end of 2019. The rule covers those giving advice regarding retirement accounts regulated by the Employee Retirement Income Security Act (ERISA). At this point, we have little information on what the rule is likely to look like, but there are some clues in place. We know, for example, that the DOL is collaborating with the Securities and Read More

How Does a Plan Sponsor Know When a Participant Makes a Claim for Benefits?

When it comes to retirement plans, plan sponsors want to know when a plan participant makes a benefit claim. ERISA requirements for response and processing of claims include specific timing, as well as rules for claim denials, which must be followed by plan sponsors in order to remain in compliance. It can be difficult, however, to know when a claim was made and whether an individual has submitted a Read More

Employment Agreement Release Proves a Buffer to ESOP Fiduciary Claim

The recent case of Innis v. Bankers Trust Co. of South Dakota, No. 4:16-cv-00650-RGE-SBJ, United States District Court for the Southern District of Iowa (April 30, 2019) has been watched with interest by businesses who either have, or are considering, an Employee Stock Option Plan (ESOP). A summary judgement decision in Innis explains how the use of employment release agreements can bar an employee from using ERISA Read More

SECURE Act Passes House: How Could These Changes Impact Your Retirement Plan?

Recently, the SECURE Act (short for Setting Every Community Up for Retirement Enhancement Act) passed the House with a huge majority. The SECURE Act is expected to move to the Senate this year and the SECURE Act, or a similar piece of legislation, will likely soon be law. This would affect many retirement and benefits plans, so it’s important to know what the changes may be up front and to plan for how to handle Read More