The U.S. Department of Labor (DOL)’s Employee Benefits Security Administration (EBSA) has issued a Notice of Proposed Rulemaking that would rescind a 2018 DOL rule entitled “Definition of Employee – Association Health Plans,” or the 2018 AHP Rule. The purpose of the rule was to expand the availability of AHPs. Before the 2018 AHP rule, a multiple employer welfare arrangement (MEWA) typically constituted a single Read More
Federal Agencies Issue Final Rules on Federal IDR Process Administrative Fee and Certified Entity IDR Fee Ranges
The Internal Revenue Service, Employee Benefits Security Administration, and the Centers for Medicare & Medicaid Services (collectively, “the Departments”) recently issued final rules concerning fees established by the No Surprises Act for the federal Independent Dispute Resolution (IDR) process. The Departments issued these rules through a notice and comment rulemaking process after a federal court overturned Read More
2023 Federal Benefits Policy Developments
In 2023, various federal government agencies, including the U.S. Department of Labor (DOL) and the Internal Revenue Service (IRS), unveiled four significant rules concerning employee benefits. DOL’s Proposed Fiduciary Rule In late October, the Employee Benefits Security Administration (EBSA) issued a proposed rule that would change the definition of an investment advice fiduciary under the Read More
HHS’ Office for Civil Rights Reaches Settlement of First Phishing Cyberattack Under HIPAA
The Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services has announced its first settlement of a HIPAA case involving a phishing cyberattack. In May 2021, Lafourche Medical Group, LLC, filed a HIPAA breach notification with OCR stating that a hacker had obtained electronic patient health information (ePHI) via a phishing cyberattack. OCR's press release states, "Phishing is a type of Read More
5th Circuit Questions Standing in ACA Trans Healthcare Battle
A three-judge panel of the U.S. Court of Appeals of the Fifth Circuit heard oral arguments in the federal government's appeal of a U.S. District Court judge's ruling invalidating Section 1557 of the Affordable Care Act (ACA), which bans healthcare discrimination. The case is Neese v. Becerra, case number 23-10078, U.S. Court of Appeals for the Fifth Circuit. During oral arguments, the appellate panel appeared Read More
IRS Issues Guidance on De Minimis Financial Incentive Benefits, Other Optional Features in SECURE 2.0 Act
Congress passed the SECURE 2.0 Act of 2022 to encourage workers to save for retirement. The Internal Revenue Service (IRS) recently issued additional guidance on various provisions of the SECURE 2.0 Act in the form of IRS Notice 2024-2. Much of this guidance focuses on optional features that employers have been reluctant to utilize without further guidance from the IRS. De Minimis Financial Incentive Read More
Bankrupt Drug Treatment Center Argues Cigna Fee-Forgiving Out-of-Network Case Before 9th Circuit
Bristol SL Holdings Inc. (“Bristol”), a holding company and successor-in-interest for Sure Haven, a now-bankrupt drug and alcohol treatment center, recently urged a panel of the Ninth Circuit to overturn the trial court’s grant of summary judgment in favor of insurance giant Cigna. Bristol sued Cigna in 2019, claiming that it violated the terms of its health plan when it failed to pay more than $8 million in claims Read More
Actuary Co. Reaches $4M Settlement in 401(k) Fee Class Action Suit
Insurance Services Offices Inc. (ISO), an actuarial and underwriting company, has agreed to pay $4 million to settle a proposed class action lawsuit filed by ex-employees concerning its 401(k) Savings and Employee Stock Ownership Plan. The former workers alleged that ISO charged them excessive fees and failed to monitor the plan’s investments in violation of ERISA. The case is Peterson et al. v. Insurance Services Read More
Supreme Court Considers Whether Involuntary Job Transfer Can Constitute Discrimination
The U.S. Supreme Court recently heard arguments in Muldrow v. City of St. Louis. The Court’s decision in Muldrow will determine whether an involuntary job transfer can constitute illegal discrimination in some cases. The main inquiry during oral arguments focused on whether tangible harm is necessary to prove discrimination. Examples of tangible harm include less pay, less favorable hours, or a lower rank. In Read More
Employer Involvement Rendered Disability Insurance Plan Subject to ERISA, Despite Lack of Intent
In Steigleman v. Symetra Life Ins. Co., 2023 WL 7413668 (D. Ariz. 2023), a court considered whether a package of various welfare benefit insurance policies an individual business owner arranged for herself and her employees was subject to ERISA. Ultimately, the court concluded that the business owner’s involvement in the package of insurance policies constituted an “ongoing administrative scheme” that made it subject Read More