President Trump has been in the news promoting his promise to take steps to protect conscience and religious liberty of individuals and health care entities. He signed an executive order to this effect in May 2017, and 2017 the Department of Justice directed the U.S. Department of Health and Human Services (HHS) to implement religious freedom laws. Recently, the HHS Office for Civil Rights (OCR) issued a final Read More

In a recent blog, we discussed the court’s ruling regarding Association Health Plans (AHPs). In the month following the court’s ruling on AHPs, the Department of Labor (DOL) decided to appeal the court’s decision and filed a notice of intent to appeal the March ruling that they exceeded their statutory authority based on ERISA. The court also found that the DOL rule that defines “employer” to include associations of Read More

Since regulations and laws change regularly, the IRS keeps an Operational Compliance List (OCL) plan administrators can use to ensure the benefit plans they’re responsible for overseeing are in compliance with the latest rules. Recently, they released the changes that will be in effect this calendar year, which include the following important items:   Bipartisan Budget Act of 2018, Sections 41113 and 41114 Read More

COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, generally gives employees who are leaving a company that has 20 or more employees the right to continue their health benefits for themselves and their dependents for a period after their departure. A recent court decision, Morehouse v. Steak ‘n Shake, Inc. out of the Southern District of Ohio, highlighted the importance of having a clear Read More

A recent, comprehensive court ruling in the Southern District of New York upheld an anti-assignment clause in a health plan. The court made a point of addressing each of the arguments advanced in Medical Society of the State of New York vs. UnitedHealth Group, (SDNY, March 28, 2019) to ensure clear precedent was set for future cases. While this isn’t the first court to rule in favor of the health plan on this issue, Read More

Between the “Setting Every Community Up for Retirement Enhancement Act of 2019" (the SECURE Act) currently under review in the House and the similar Retirement Enhancement and Savings Act of 2019 from the Senate, the stage is being set for small businesses to have more access to multiple employer plans (MEPs). MEPs allow unrelated employers, who would otherwise be too small to access competitive benefits packages, to Read More

Short for "Setting Every Community Up for Retirement Enhancement," the SECURE Act of 2019 (the “Act”) that recently passed through the House Ways and Means Committee, and the similar Retirement Enhancement and Savings Act of 2019 from the Senate, aim to make significant retirement plan upgrades. The bill passed through committee unanimously and quickly, and it contains a handful of improvements for 401(k) plans and a Read More

ERISA fiduciary breach cases regarding plan fees and other fiduciary problems have been in the news lately, especially as cases come up for trial and settle. Benefit plan administrators are watching these cases closely and trying to make proactive changes to the plans they administer to avoid future litigation. Recently, Tussey v. ABB, Inc., a long-standing case that was the first ERISA case to go to trial regarding Read More

In October 2017, President Trump signed an executive order that included a directive to the Department of Labor (DOL) to expand Association Health Plans (AHPs). AHPs are health plans that are offered to employer groups and professional associations in an effort to provide more coverage for small businesses. The DOL published a final rule governing AHPs in June 2018, expanding access to AHPs to small and single-person Read More

Health insurance providers recently won a number of cases on summary judgement against the federal government regarding cost-sharing reduction reimbursements. The Court of Federal Claims in four recent cases ruled that health insurance providers were entitled to recover unpaid cost-sharing reduction reimbursements from the government. The federal government argued that neither the Affordable Care Act, nor any of the Read More