By Porter Wright on While in the heat of negotiating, dealmakers can overlook potentially costly exposure in a variety of areas, such as employee benefits. As explained by Becca Kopp in our sister blog, Employer Law Report, in Ohio, buyers may incur unanticipated liability for workers’ compensation obligations, regardless of what is set forth in the documentation. This may … Continue Reading
By Jared Klaus on The Supreme Court last week denied a writ of certiorari to review the Sixth Circuit’s rejection of class certification for a group of self-insured health plans alleging that their plan administrator charged them improper fees.… Continue Reading
By Porter Wright on Beginning January 1, 2013, the Patient Protection and Affordable Care Act ("PPACA") requires plan sponsors to limit pre-tax health flexible spending account ("FSA") contributions to no more than $2,500 per calendar year. There are currently no limits on health FSA contributions. This change is anticipated to be a revenue-raiser, because the new limit is lower than most existing plan-imposed pre-tax FSA contribution limits, and affected employees will pay taxes on more of their salary. … Continue Reading
By Porter Wright on The Patient Protection and Affordable Care Act (“PPACA”) contained a provision that established the Early Retiree Reinsurance Program (“ERRP”), the goal of which was to encourage plan sponsors to retain health care coverage for retirees through at least 2013. The ERRP was designed to provide reimbursement to eligible sponsors of employment-based plans for a portion … Continue Reading
By Greg Daugherty on Employers who maintain health plans may recall from our prior blogs (see "Health Care Plan Annual Enrollment Triage: The Summary of Benefits and Coverage Standards Have Not Been Issued Yet and May Just Have to Wait" and "Health Care Plan Summary of Benefits and Coverage: Still No Final Model, But Substantial Excise Taxes are Looming Anyway") that they would soon need to address the new Summary of Benefits and Coverage ("SBC"), although urgent action would need to wait until the issuance of final guidance. Well, the wait is over.… Continue Reading
By Porter Wright on On our sister blog – Employer Law Report – Sara Hutchins Jodka discusses the IRS Voluntary Compliance Settlement Program. This program was designed to provide eligible employers partial relief from the federal employment taxes and penalties that typically result from misclassifying workers as independent contractors. Given the amount of attention that federal and state agencies … Continue Reading
By Porter Wright on On our sister blog - Employer Law Report - Leigh Anne Benedic discusses important considerations for employers who are considering hiring unpaid summer interns.… Continue Reading
By Porter Wright on In a recent blog, we discussed a case that challenges the constitutionality of the Defense of Marriage Act ("DOMA"), which defines marriage for federal law purposes as a legal union between a man and a woman. DOMA was enacted during the administration of President Bill Clinton. Presuming DOMA is deemed constitutional by the courts and is not repealed by Congress (a possibility that appears remote at this point in time), employers theoretically could comply with federal employee benefits laws contained in ERISA by adopting (or maintaining) the DOMA definition of spouse. … Continue Reading
By Porter Wright on The United States Department of Health and Human Services (“HHS”) recently posted on its website a formal announcement about a new audit program under the Health Insurance Portability and Accountability Act (“HIPAA”) that it was launching. The audits will be run under the Office for Civil Rights (“OCR”), which is the division within HHS that is responsible for enforcing HIPAA's Privacy and Security Rules. … Continue Reading
By Porter Wright on The Patient Protection and Affordable Care Act (PPACA) shared responsibility provisions require speculation about whether health care coverage will be affordable for an individual. Whether affordable coverage was available, whether an individual was eligible for a premium credit, and whether an employer was subject to penalties, cannot be determined until after the individual files a personal tax return. … Continue Reading
By Greg Daugherty on In our prior blog, we explained that under principles of triage, employers may need to focus on the current annual enrollment and wait to take care of the Summary of Benefits and Coverage ("SBC"). Although the SBC does not need immediate attention, we caution employers not to wait too long or take the SBC responsibilities too lightly.… Continue Reading
By Porter Wright on The Patient Protection and Affordable Care Act gave the Secretary of Health and Human Services, Kathleen Sebelius, a hefty to-do list. One of those tasks was to develop at least three actuarially sound long-term care benefit plans that met specified criteria and would remain solvent for 75 years. This was to pave the way for the Community Living Assistance Services and Support ("CLASS") program. … Continue Reading
By Porter Wright on Would you like to spend a morning outside of the office, enjoying free breakfast and continuing education credit? Here's your chance! This month, Porter Wright is sponsoring Employment Relations Seminars in both Cleveland and Columbus. I will be speaking about employee benefits developments and best practices at both session, and would love to see you there. … Continue Reading
By Porter Wright on M*A*S*H* taught us how to do triage, and MacGyver taught us to creatively think our way out of an impossible situation. Both are skills that may come in handy for the many employers who maintain calendar year health plans and who were in the process of preparing for annual enrollment when the Summary of Benefit … Continue Reading
By Porter Wright on We often are asked why plan amendment procedures vary from plan to plan, and why it is important to follow those procedures—however written. Sometimes there are unique reasons for the specified procedures, but very possibly the answer goes back to the 1990’s and a case called Curtiss-Wright Corp. v. Schoonejongen, which took us on an … Continue Reading
By Jim Prior on Most everyone wants to be culturally appropriate. But just what does that mean? The answer to that question became a little clearer for non-grandfathered group health plans in the context of notices to be provided for internal health claims and appeals. Plan sponsors will need to pay attention, as compliance with new guidance is required … Continue Reading
By Jim Prior on Fresh off an extension this past spring of an enforcement grace period with respect to internal health claims and appeals requirements, sponsors of non-grandfathered group health plans received some more welcome news recently with the relaxation of certain group health claims procedure requirements first announced in interim final rules issued in July 2010. Although plan … Continue Reading
By Jim Prior on In Technical Release 2011-01, the Department of Labor has extended the enforcement grace period with respect to certain internal claims and appeals requirements applicable to non-grandfathered health plans under the Patient Protection and Affordable Care Act (PPACA) and its implementing regulations. The internal health claims and appeals requirements generally apply to non-grandfathered plans as of … Continue Reading
