Minnesota District Court Dismisses Cross-Plan Offsetting Claim

On May 20, 2021, the U.S. District Court for the District of Minnesota dismissed a breach of fiduciary duty class action against UnitedHealth Group over an overpayment recovery process known as cross-plan offsetting that the plaintiffs claimed is a prohibited transaction under ERISA. The court found that the plaintiffs lacked standing to challenge the practice since none of them had been denied benefits or suffered Read More

IRS Updates FAQs on ARPA-Related Paid Sick and Family Leave Tax Credits

On July 29, 2021, the IRS updated its FAQs on the paid sick and family leave tax credits under the American Rescue Plan Act of 2021 (ARPA). The updated FAQs now include wages paid for leave taken by workers who accompany individuals to COVID-19 vaccination appointments and those who care for individuals recovering from any COVID-19 vaccine-related illness. Following are the FAQs updated by the IRS on paid sick and Read More

Are Captives An Equalizer for Small Employer Health Plan Cost Mitigation?

One of the first lawsuits to be filed over vaccine mandates was dismissed in June by a Texas district court that found limits on employee behavior is “part of the bargain” of employment. The suit challenged Houston Methodist Hospital’s vaccine mandate after the hospital suspended 178 employees for failing to meet the vaccination deadline.  In their claim, Houston Methodist employees argued that taking the vaccine Read More

District Court Ruling Sidesteps Trump-Era Regulations in Favor of Expansive Application of ACA Section 1557 Nondiscrimination Requirements

A federal district court in West Virginia has ruled that an anti-discrimination lawsuit against a health insurer can proceed because the insurer accepts federal funding, making it accountable under the Affordable Care Act’s (ACA) Section 1557 that prohibits discrimination under “any health program or activity, any part of which is receiving federal assistance, including credits, subsidies, or contracts of Read More

Departments Issue Interim Final Rule on Surprise Billing Ban

On July 1, 2021, the U.S. Departments of Health and Human Services, Labor, and Treasury (“the Departments”), and the Office of Personnel Management issued Requirements Related to Surprise Billing; Part I, an interim final rule (IFR) that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing.  Among other provisions, the interim final rule: Bans surprise billing for Read More

DOL Ramps Up Retirement Plan Cybersecurity Policy Investigations

Reports continue to come in concerning an increasing number of DOL requests made to plan sponsors asking for all cybersecurity and information security program policies, procedures and guidelines that relate to retirement plans, whether applied by the plan sponsor or by a provider, as well as detailed documentation of specific actions taken by the plan’s fiduciaries and providers, including many that the DOL Read More

Taco Bell Faces ERISA Suit Alleging Worker Misclassification

A man who worked as a recruiter for Taco Bell for 25 years has filed suit against the company for classifying him as an independent contractor instead of an employee, therefore denying him access to important employee benefits. The case - Alders v. Yum Brands Inc. et al. - was filed in the U.S. District Court for the Central District of California and alleges that Taco Bell and Yum violated ERISA by misclassifying Read More

Immediately Following Recent Guidance, DOL Initiates Cybersecurity Retirement Plan Audit Initiatives

The Employee Retirement Income Security Act of 1974 (ERISA) became law before the computer age, so there are no provisions in the Act dealing with cybersecurity. However, in April 2021, the DOL released its first-ever guidance on cybersecurity for retirement benefit plan sponsors, record keepers, service providers, and participants. That guidance came in three forms: Tips for Hiring a Service Provider with Read More

Supreme Court Rejects Another ACA Challenge and Leaves ACA Intact

On June 17, 2021, the U.S. Supreme Court ruled that Texas - along with 17 other states and two individuals - lacked standing to challenge the Affordable Care Act’s (ACA) individual mandate to purchase health insurance. Congress eliminated the monetary penalty for not complying with the mandate in 2017, effectively making the ACA’s individual mandate provision unenforceable. In a 7-2 decision, the high court found Read More

GAO Releases ERISA Enforcement Report; Highlights COVID-19 Challenges, Fiduciary Breaches, and Prohibited Transactions

On May 27, 2021, the U.S. Government Accountability Office (GAO) released the results of a 15-month investigation into ERISA enforcement by the Department of Labor’s Employee Benefits Security Administration (EBSA).  EBSA is charged with protecting the rights of participants in employer sponsored benefit plans. As of fiscal year 2020, this included about 154 million participants in 722,000 retirement plans and 2.5 Read More