Voluntary Employees’ Beneficiary Associations (VEBAs) and Multiple Employer Welfare Arrangements (MEWAs) have been determined to be covered entities by the Court of Federal Claims. The Affordable Care Act (ACA) subjects “covered entities” to an annual health insurance provider fee, meaning that these two types of plans are not exempt from the fee.   Iowa Bankers Benefit Plan Iowa Bankers Insurance and Read More

In May, the U.S. Department of Health and Human Services (“HHS”) issued a new proposed rule on Section 1557. This rule is aimed at revising the Affordable Care Act (ACA) and preventing discrimination based upon sex. Section 1557 is a civil rights provision broadly prohibiting discrimination based on a variety of factors in health programs and activities receiving federal funding. The proposed rule specifically Read More

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

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

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

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

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

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 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

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