The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
In the United States, mental health (“MH”) and substance use disorder (“SUD”) (collectively “MH/SUD”) have continued to represent areas of intense concern. During the COVID-19 pandemic, the MH struggles of essential workers...more
The U.S. Department of Labor (“DOL”) recently entered into a settlement agreement with a New York-based insurer and third-party administrator (“Company”) of employer group health plans governed by the Employee Retirement...more
The U.S. Department of Labor (“DOL”) recently filed a lawsuit against UMR, Inc., a third-party administrator and UnitedHealth Group, Inc. subsidiary. The lawsuit alleges that UMR denied thousands of claims based on diagnosis...more
Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more
NOTE: As we were preparing to publish this eAlert, the DOL issued proposed mental health parity regulations. We will provide an update on the proposed regulations in a future eAlert. Nonetheless, group health plans must still...more
While the Department of Labor (DOL) has been focusing on missing participants, expect them to question plan sponsors about missing participants and the automatic rollover provider that they use...more
Happy Summer from the K&C ESOPs & Employee Benefits practice group. We’ve compiled a short list of employee benefits updates from the second quarter of 2022....more
401(k) Plan Sponsors Should Focus On What The Government Is Focusing On - In the movie Casino, Robert DeNiro as Sam “Ace” Rothstein wanted to take on the Nevada Gaming Board after they denied his request for his license....more
As reported in our January 7, 2022 SW Benefits Blog “The DOL Asks and Answers Questions About the New Welfare Plan Fee Disclosure Rules,” group health plans must now comply with the ERISA Section 408(b)(2) disclosure...more
The snowball effect is a term for a process that starts from something that is small and builds upon itself, becoming larger and also perhaps potentially dangerous or disastrous. The idea is that an avalanche can be started...more
The one drawback in the fee disclosure regulations was that the Department of Labor (DOL) never bothered to develop a model fee disclosure form for plan providers, I understand the hesitancy of the DOL because it’s hard to...more
Last month, we advised readers of this blog to consider efforts to formalize the fiduciary governance of their health and welfare benefit plans. In that post, we described some of the reasons that employers have historically...more
Big Concepts That 401(k) Plan Providers Forget About. Whether it was working for others or working for charitable organizations, it seems that there is a culture out there that seems to forget why these businesses and...more
On October 29, 2020 the United States Departments of Health and Human Services, Labor and Treasury (the Departments) issued a final rule entitled Transparency in Coverage (the Rule). The Rule continues on the Trump...more
I always talk about how plan sponsors need to work with experienced financial advisors, third party administration (TPA) firms, and ERISA attorneys on their plan needs. Like with reasonable fees, I believe that the term...more
It’s great that the Department of Labor (DOL) has finally embraced the electronic disclosure of important ERISA notices. It took them a long time, but when your business is trying to protect participant rights, this is what...more
My experience at law school could probably be summed up by one event. For first-year law students, there is an event that everyone participates in and it’s called Moot Court where students argue a fictional appellate case in...more
As an ERISA attorney, I always have an open phone policy with plan sponsors, financial advisors, accountants, TPAs, and other attorneys from around the country on questions they may have about their plan or a client’s...more
After being on the verge of enactment last spring but failing to pass, the SECURE Act is now law. The Setting Every Community Up for Retirement Enhancement Act of 2019 – the SECURE Act – was enacted on December 20, 2019 as...more
On December 20, 2019, after months of uncertainty, the Setting Every Community Up for Retirement Enhancement (“SECURE”) Act finally became law. The SECURE Act makes numerous changes to both the Internal Revenue Code (IRC) and...more
On December 20, 2019, President Trump signed into law the Further Consolidated Appropriations Act, 2020 (the “Appropriations Act”), a comprehensive government funding bill that includes substantial employee benefits-related...more
The move by some employer plans to a “reference-based” pricing model has created a need for healthcare providers to develop a strategy to confront payment challenges that these plans create. A prevalent model of...more
Retirement plans with more than 100 participants require a CPA audit for their Form 5500. However, small plans with less than 100 participants may sometimes require an audit. This often happens when more than 5% of the Plan’s...more
As an ERISA attorney for almost 21 years (my career can get its own drink), I have seen a lot of strange things that plan sponsors have done to risk the ire of the Internal Revenue Service (IRS) and the Department of Labor...more
In its decision, the Court concluded that UnitedHealth Group, Inc. (“United”) was not authorized to engage in “cross-plan offsetting.” What is cross-plan offsetting? It is a “self-help” practice that third party...more