Third Party Administrators

News & Analysis as of

Government Finalizes Religious Accommodation, But What About Health Plans, TPAs and PBMs?

In a set of rules published last week, the government finalized a July 2010 interim final rule (“IFR”) related to coverage of certain preventive services and an August 2014 IFR regarding the definition of an eligible...more

Buying and Selling Your HUD-Financed Long Term Care Project: Navigating the TPA Process

So you have refinanced your long term care facility with Federal Housing Authority (FHA)-insured financing – a nonrecourse, 30-year (or longer) loan at an amazingly low fixed interest rate. Yes, the process may have been...more

Plan Provider Changes Shouldn’t Be Just To Make Someone $$$$$

Everyone has an opinion, but I think the independent opinion that is guided by beliefs and not by pay is far more important than the opinion that is greased by greed. I had lunch with my local neighborhood third party...more

Feds Define Which “Closely Held Corporations” Are Eligible to Opt Out of Contraception Mandate Under ACA

One year ago, the U.S. Supreme Court ruled in the case of Burwell v. Hobby Lobby Stores, Inc. et al, that for-profit closely held corporations must be permitted to opt out of the Affordable Care Act’s contraception mandate on...more

How Retirement Plan Advisors Can Benefit From Any New DOL Fiduciary Rule

One of my favorite companies is Netflix. The first time I came into contact with them, it was through an offer that was in the box of the first DVD player I bought in 2000. Instead of rentals through Blockbuster or Hollywood...more

Things in a 401(k) Plan That Don’t Look Right

They always say that you should never judge a book by its cover, but people do. People say you shouldn’t judge people by their appearance and they do. Just because something doesn’t look right, doesn’t mean it isn’t right....more

Employer’s Excuses About Their Retirement Plan And Why They’re Wrong

When dealing with my children and many adults, I hear many excuses why things don’t get done correctly. No one wants to accept re- sponsibility for their ineptness; they just cling to these excuses. Plan sponsors don’t have...more

As a Retirement Plan Provider, Things You Should Let Go

A few years back, I would hear “Let it Go” from the movie Frozen every 5-7 minutes. It was a great song from a great movie, but it was a little unnerving to hear it 7-10 times on a short car trip. Then it stopped, my children...more

Businesses May Have Until At Least 2017 To Recover Hidden Access Fees Taken By Blue Cross Blue Shield

Great news for the hundreds of businesses from which Blue Cross Blue Shield of Michigan charged hidden fees: a federal court's recent ruling indicates that the businesses have several more years to file claims against BCBSM...more

Cybersecurity: Integral to Overall Risk Management for Insurers and TPAs

Recent data breaches have brought cybersecurity to the attention of insurance companies, and serve as a reminder to third party administrators ("TPAs") that cybersecurity issues are a serious compliance and regulatory...more

A Plan Sponsor’s Foolproof Way To Getting In Trouble

The foolproof method to getting inves- tigated for tax evasion? Stop filing your taxes. The foolproof method to get hit by a car? Run into mid-town traffic. The foolproof method to get the chicken pox? Don’t take the vaccine...more

Sorry Lois or How I Started a Law Firm from Nothing

I always talk about my frustrating experience at a certain semi-prestigious Long Island law firm (sorry, Lois). I do it partly to rub my success in their noses because they never had faith in me, but mostly because the way I...more

DOL Issues Re-Proposed Regulations Defining Investment Advice Fiduciary and Proposes New PTEs

The U.S. Department of Labor (DOL) issued long awaited re-proposed regulations governing fiduciary status and investment advice titled “Definition of the Term ‘Fiduciary’; Conflict of Interest Rule—Investment Advice” for...more

Manatt on Medicaid: Montana Governor Signs Act to Expand Medicaid

On April 29, 2015, Montana Governor Steve Bullock signed Senate Bill 405, referred to as the Montana Health and Economic Livelihood Partnership Act (HELP Act), which expands Medicaid to cover an estimated 70,000 new adults....more

For Retirement Plan Providers, It’s All About Making A Connection

If you’ve read an article or two of mine, then you know I’m a big fan of movies. I’ve a big fan of movies as long as I remember and the movies that are my favorites are the ones that make a personal connection to me. The...more

Stick to what you know

Over the past 5 years as a solo ERISA practitioner, I always get asked if that’s all I do. It’s not some kind of insult, but a question on whether I also do financial advisory work and/or third party administration work. The...more

The Worthlessness Of The 401(k) Fiduciary Warranty

I am a firm believer in the idea that what you see is what you should get. If you’re promised the moon, anything short of that is wrong. Some of the biggest disappointments in my life is when I was sold a bill of goods that...more

A Warning to 401(k) Plan Sponsors Relying on Third-Party Administrators (TPAs)

A recent news bulletin from the IRS serves as a cautionary reminder that plan sponsors retain responsibility for the proper administration of participant hardship distributions and loans, and related recordkeeping...more

Retirement Plan Sponsors Need To Care About Plan Design

If you had your eyes set on a car and one model gave you 25 miles to the gallon and the other model gave you 45 with no difference in features or price, what would you choose? If you can find a coupon for items you were...more

Advisors Advantage - April 2015

In This Issue: - As a Retirement Plan Provider, Don't Turn Into A Bureaucracy - An RFP Process should not be a sham. - A Great Idea isn't Everything. - Sometimes, Networking can be bad. - Trust is an important...more

Recent Federal Court Ruling: No ERISA Preemption of Texas Prompt Pay Law Regarding Payment Deadlines; Texas Legislature May Act on...

What's new. A Texas federal district court has ruled that ERISA does not preempt or prohibit application of the Texas Prompt Pay ("TPP") law to Third Party Administrators ("TPAs") of self-funded benefit plans. Judge Lynn...more

Recent Federal Court Ruling on Application of Texas Prompt Pay Laws to Self-Funded, Medicaid and Out-of-State Plans and Their...

What's new? A Dallas federal district court recently ruled that the Texas Prompt Pay Law does not apply to employer-funded health plans, Medicaid plans, or out of state patients that use Texas providers, or to a Third Party...more

Divorcing that TPA can be a problem

The MTV reality series The Real World ends their opening intro by stating the show tries “to find out what happens… when people stop being polite… and start getting real.” As an ERISA attorney working with retirement plan...more

Another 10 Wrong Ideas That Plan Sponsors Have About Their Retirement Plans

Most of the time, sequels suck. Except for perhaps Terminator 2 and The Godfather Part II, most sequels are like such bombs as Caddyshack II and Beyond the Poseidon Adventure. Despite this dislike of sequels, giving Plan...more

The Top 10 Wrong Ideas That Plan Sponsors Have About Their Retirement Plans

People can get the wrong idea at times. I’ll never understand what Fred Silverman was thinking when he made Jean Doumanian the successor to Lorne Michaels as Executive Producer of Saturday Night Live or when he imported Pink...more

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