The U.S. Department of Labor (DOL), U.S. Department of the Treasury (Treasury), and the U.S. Department of Health and Human Services (HHS) recently issued 395 pages of proposed rules designed to guide group health plans on compliance with mental health parity laws. These rules clarify that the Biden administration intends to restrict plans’ use of nonquantitative limits on mental health and substance use disorder Read More

The U.S. Department of Labor (DOL) has announced the settlement of a class action Employee Retirement Income Security Act (ERISA) lawsuit for more than $124.6 million on behalf of the more than 9,000 participants in the DST Systems Inc. 401(k) plan. The DOL and private plaintiffs alleged that DST and other defendants, including New York City investment management firm Ruane, Cunniff, & Goldfarb Inc., had failed Read More

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury recently issued joint FAQs (Part 60) concerning the implementation of specific provisions of the Affordable Care Act (ACA) and Title I of Division BB of the Consolidated Appropriations Act, 2021 (the No Surprises Act). The purpose of these FAQs is to address overlap in some areas of the ACA and the No Surprises Act. The first Read More

Kraft Heinz Co. has filed an ERISA lawsuit against Aetna Inc. in a Texas federal court. Aetna provides claims processing and adjudication services for Kraft Heinz, which self-funds its employees’ and retirees’ medical expenses. Under ERISA, Aetna has a fiduciary duty to properly identify, deny, and prevent the payment of any provider claims that are false or improperly submitted. Kraft Heinz claims that Aetna Read More

A group of former Twitter employees laid off after Elon Musk took over the company recently filed a proposed class action lawsuit in a California federal court. The former employees allege that Twitter failed to pay laid-off employees more than $500 million in severance according to the company's ERISA-governed severance plan, which Musk promised would remain in effect. The Twitter severance plan provided Read More

President Joe Biden recently announced initiatives to lower consumer healthcare costs and crack down on “junk” short-term insurance policies. The Biden administration plans to place significant limits on the short-term insurance policies that are supposed to provide temporary coverage as people transition between jobs but often deny basic health care coverage. The goal is to close existing loopholes that currently Read More

After a recent U.S. Supreme Court decision found that the U.S. Department of Health and Human Services (HHS) had wrongfully cut prescription drug prices for 349B-covered hospitals between 2018 and 2022, the Centers for Medicare and Medicaid Services (CMS) is proposing to return $9 billion in underpayments to those 1,600 hospitals. The 340B Drug Pricing Program requires drug companies to offer outpatient Read More

Due to the end of the COVID-19 public health and national emergencies, the Internal Revenue Service (IRS) has issued guidance to high-deductible health plans (HDHPs) in the form of Notice 2023-37. This notice provides guidance on COVID-19 expenses for and clarifies items and services related to preventive care under health savings account (HSA) eligibility rules. Under its 2020 guidance, the IRS allowed HDHPs to Read More

An ERISA-governed employee welfare benefit plan participant filed a request for extended long-term disability benefits. She received a denial of her request from the employer’s benefits department. The participant sued the plan and the plan administrator, arguing that she was entitled to extended benefits. She also claimed the plan failed to provide her with timely copies of the plan and other documents that she Read More

The IRS Office of Chief Counsel recently issued Chief Counsel Advice (CCA) 202323006, which relates to the tax treatment of an employer-funded, insured, fixed-indemnity wellness policy. Although CCAs are not usable or citable as precedent, they provide insight into IRS policy and guidance for employers and wellness plan sponsors, particularly for audits. The policy the Chief Counsel addressed in the memo provided Read More