Health and Welfare Plans Archives | Page 65 of 132

Supreme Court Issues Further Clarification on Equitable Relief Remedies Available Under ERISA

by McDermott Will & Schulte | Jan 28, 2016 | Health and Welfare Plans, Retirement Plans

The Supreme Court of the United States’ recent ruling in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan holds that an ERISA plan cannot enforce an equitable lien against a participant’s general assets when the full amount of the settlement is spent on non-traceable items. This decision should encourage plan fiduciaries to take action on reimbursement and subrogation rights more quickly after learning of a third-party recovery, in order to preserve their right to assert an equitable remedy against an identifiable, traceable fund.

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Flambeau Inc. Wellness Program Testing Falls Within ADA Safe Harbor

by McDermott Will & Schulte | Jan 19, 2016 | Benefit Controversies, Employee Benefits, Health and Welfare Plans

On December 30, 2015, a federal judge in the Western District of Wisconsin ruled in favor of Flambeau, Inc. and against the Equal Employment Opportunity Commission (EEOC) in holding that Flambeau’s medical exams as part of its wellness program and self-insured medical plan did not violate the Americans with Disabilities Act (ADA).

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Senate Finance Committee Considering Telehealth Options to Improve Care and Lower Costs

by Dale C. Van Demark, Lisa Schmitz Mazur and Marshall E. Jackson, Jr. | Jan 15, 2016 | Health and Welfare Plans

On December 18, 2015, the United States Senate Committee on Finance (the Committee) released a Bipartisan Chronic Care Working Group Policy Options Document, which outlines approaches under consideration to improve the care and treatment of Medicare beneficiaries with multiple chronic diseases.

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Cadillac Tax Delayed to January 1, 2020; Extension of ACA Health Plan Information Reporting Due Dates

by McDermott Will & Emery | Jan 7, 2016 | Employment, Health and Welfare Plans

Recent year-end delays to important Affordable Care Act requirements have given employers and other stakeholders much needed reprieve. President Obama signed into law a two-year delay of the Cadillac Tax on December 18, 2015.

This two-year delay is part of Congress’s $1.8 trillion omnibus spending deal, the Consolidated Appropriations Act, 2016. In addition, the IRS recently announced a delay in health information reporting requirements for 2015 Forms 1094 and 1095.

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How to Determine Full-Time Employment Status of Employees for the ACA Employer Shared Responsibility Mandate

by McDermott Will & Emery | Jan 5, 2016 | Employee Benefits, Employment, Health and Welfare Plans

As part of the insurance market reforms enacted under the ACA, large employers are required to maintain a certain level of health insurance for their common law employees (and only their common law employees) or pay a penalty — the so-called pay or play or employer shared responsibility rules. The rules for determining which workers should, or even can, be offered coverage are quite daunting. This article provides a road map for determining which workers must have an offer of health insurance coverage from the employer to avoid triggering penalties under the employer shared responsibility requirements.

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Final Regulations on Affordable Care Act Market Reforms

by Megan Mardy | Dec 29, 2015 | Benefit Controversies, Employment, Health and Welfare Plans

The U.S. Departments of Health and Human Services, Labor and the Treasury have issued final regulations on market reform requirements under the Affordable Care Act (ACA) including grandfathered health plans, preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescissions, coverage of dependent children to age 26, internal claims and appeals and external review processes, and patient protections.

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DOL’s New Disability Claim Rules Add to a Plan Administrator’s Duties under Welfare and Retirement Benefit Plans

by McDermott Will & Emery | Nov 30, 2015 | Benefit Controversies, Employee Benefits, Health and Welfare Plans, Labor, Retirement Plans

Now, faced with an aging baby-boomer generation and increased costs related to disability litigation, the U.S. Department of Labor’s Employee Benefit Security Administration (DOL) has proposed new rules that would revise and strengthen the current rules for claims adjudication of disability claims under welfare and retirement plans.

Read the full article.

Will You Marry Me? The Future of Benefits for Same-Sex Spouses and Partners

by Brian Tiemann | Nov 24, 2015 | Benefit Controversies, Health and Welfare Plans, Retirement Plans

The United States Supreme Court’s recent landmark rulings on same-sex marriage have significantly changed employers’ options and obligations with respect to benefit coverage for employees’ same-sex spouses and partners. Until recently, some employers voluntarily extended benefits to same-sex partners in recognition of the fact that same-sex couples had limited ability to marry. However, now that same-sex marriage is legal in all 50 states and recognized under federal law, employers must extend certain spousal benefits to same-sex spouses and can do so without additional administrative complexity. In addition, some employers are phasing out unmarried partner benefits by requiring partners to marry in order to be eligible for spousal benefit coverage.

Click to read the full article from Pension & Benefits Daily.

HHS Office of Inspector General Calls for Increased Oversight and Enforcement of HIPAA

by Amy C. Pimentel, Edward G. Zacharias and Daniel F. Gottlieb | Nov 19, 2015 | Employment, Health and Welfare Plans, Privacy and Data Security

On September 29, 2015, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), Office of Evaluation and Inspections, released two studies calling on the HHS Office for Civil Rights (OCR) to strengthen its efforts in both general enforcement of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Standards and enforcement of security breach reporting requirements. OIG commissioned both studies out of concern for the increased risk of an invasion of privacy and exposure to fraud, identity theft and other harm that patients face in an ever-expanding digital health environment.

Read the full On the Subject.

EEOC to Clarify and Expand Wellness Program Incentives Related to the Genetic Information Nondiscrimination Act

by McDermott Will & Emery | Nov 13, 2015 | Employee Benefits, Employment, Health and Welfare Plans

On October, 30, 2015, the Equal Employment Opportunity Commission (EEOC) issued a proposed rule that would amend regulations implementing Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA), as they relate to employer wellness programs. Title II of GINA protects employees from employment discrimination based on their genetic information, including the health status of workers’ families.

Read the full article.

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