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

The recent case of Innis v. Bankers Trust Co. of South Dakota, No. 4:16-cv-00650-RGE-SBJ, United States District Court for the Southern District of Iowa (April 30, 2019) has been watched with interest by businesses who either have, or are considering, an Employee Stock Option Plan (ESOP). A summary judgement decision in Innis explains how the use of employment release agreements can bar an employee from using ERISA Read More

Recently, the SECURE Act (short for Setting Every Community Up for Retirement Enhancement Act) passed the House with a huge majority. The SECURE Act is expected to move to the Senate this year and the SECURE Act, or a similar piece of legislation, will likely soon be law. This would affect many retirement and benefits plans, so it’s important to know what the changes may be up front and to plan for how to handle Read More

The fate of Association Health Plans (AHPs) is still up in the air as the Department of Labor (DOL) litigates against the State of New York regarding the DOL’s Final Rule on AHPs. These regulations were designed to expand the criteria that allowed employers to come together to form AHPs and be treated as a single plan under ERISA. A Federal District Court recently issued a ruling siding with the State of New York Read More

Many individuals have chosen health plans associated with health savings accounts (HSAs), Flexible Spending Accounts (FSAs), or Health Reimbursement Accounts (HRAs) to help supplement their health insurance needs. Recently, the IRS shared an information letter that provided additional insight on what would qualify as a medical expense reimbursable from an HSA, FSA, or other tax-favored accounts. This letter came in Read More

In good news for benefit plan fiduciaries constantly working to keep up with compliance, the Department of Health and Human Services (“HHS”) Office for Civil Rights (OCR) has announced that they are reducing some penalties for HIPAA violations. This includes reducing civil penalties in three of four possible penalty tiers, each of which has an annual limit. These penalties were first introduced in 2013 final Read More

In an effort to keep businesses, accountants, lawyers, and plan fiduciaries informed on policies, the IRS regularly publishes updates that are relevant for the coming year. The 2019 changes to the Operational Compliance List (OCL) were recently published, mainly focusing on changes relating to hardship distributions. The update also extended hurricane relief for victims of the 2018 hurricane season. Hardship Read More

The Affordable Care Act (ACA) has been around long enough that most businesses have settled into meeting its requirements, including mandatory reporting. This is good, since in 2020, the penalties for not complying with the ACA are going to increase. Take the time to review your plan and reporting and ensure you’re not making some basic mistakes that will likely result in fines.   Affordable Care Act Section Read More

Fiduciaries and plan sponsors have a number of important tasks that they’re responsible for each year, from making sure employees have help getting their benefit plans set up to handling the different transactions needed to maintain the plan’s records and sending in all necessary paperwork and compliance reporting. Participant notifications are another important task, as is monitoring the changing legislative and Read More

Recently, the U.S. Department of Justice (DOJ) argued in court in favor of striking down the Affordable Care Act (ACA). In front of the federal appeals court, the DOJ argued that the removal of the individual mandate provision from the ACA renders the entire law unconstitutional. The brief supports the ruling issued by a Texas federal court that declared the ACA unlawful after a challenge by Texas and other Read More