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Recent Litigation on Exclusions of Gender Affirming Care
Click here for a printer-friendly version. Title VII of the Civil Rights Act prohibits employment discrimination on the basis of sex, and in June 2020, the Supreme Court ruled that this includes discrimination based on sexual orientation and gender identity.[1] The Court did not address sex discrimination in a health plan. Increasingly over the past few years, plaintiffs have filed lawsuits arguing that health coverage exclusions of gender affirming care (sometimes also called “gender transition” [...]
Seventh Circuit Confirms DOL’s Authority to Investigate Plan Service Provider’s Cybersecurity
Click here for a printer-friendly version. In Spring 2021, the DOL issued guidance to plans, recordkeepers, and participants on cybersecurity best practices to safeguard plan assets and personal information. Since then, the DOL has begun auditing plans’ cybersecurity practices and requesting documents such as cybersecurity policies, proof of service provider practices, and information on past breaches. A recent Court of Appeals case out of the Seventh Circuit, Walsh v. Alight Solutions LLC, confirms the DOL’s [...]
Legal Developments Impacting Health & Welfare Plans – 2021 Year-End Update
Click here for a printer-friendly version. Various regulations and guidance from the HHS, DOL, and the Department of Treasury (the Departments) address implementation of the surprise billing rules and transparency regulations under the Consolidated Appropriation Act, 2021 (CAA), which include a delay on enforcing certain requirements, such as advance explanations of benefits and prescription drug pricing disclosures. For more information on the enforcement delays, see our article. The Departments confirmed that plans may offer a [...]
Legal Developments Impacting Retirement Plans – 2021 Year-End Update
Click here for a printer-friendly version. In addition to COVID-19 relief provisions, the American Rescue Plan Act (ARPA) enacted in March provided funding relief for multiemployer and single-employer pension plans. The multiemployer plan relief includes: Estimated $90+ billion in financial assistance grants to plans projected to become insolvent by 2051 (using specialized actuarial calculations), Optional accounting adjustments to extend the period for recognition of recent investment losses, and Extensions of time for plans to complete [...]
Delayed Enforcement of Various Health Pricing Transparency Rules
On August 20, 2021, the Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) issued a series of FAQs on certain surprise billing and transparency provisions of the Consolidated Appropriations Act, 2021 (“CAA”) and the 2020 Transparency in Coverage regulations (“TiC”). Pursuant to the FAQs, enforcement of the following TiC and CAA deadlines is deferred or on hold for group health plans: Posting of three machine-readable data files [...]
Consolidated Appropriations Act, 2021
On December 27, 2020, the Consolidated Appropriations Act, 2021Pub. L. No. 116-260, 134 Stat. 1,182 (2020). (the Act) was signed into law. The Act includes COVID-related and other provisions that impact health and retirement plans, including the following. Surprise Billing The Act includes the “No Surprises Act.” Effective for plan years beginning in 2022, health plans must apply in-network cost-sharing to out-of-network emergency services performed in an emergency department (without requiring [...]
Legal Developments Impacting Health and Welfare Plans – 2020 Year-End Update
Congress and agencies issued various relief and rules in response to the COVID-19 pandemic: The Families First Coronavirus Response Act temporarily requires group health plans to cover COVID-19 testing and related services without cost-sharing. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) requires coverage of COVID-19 vaccines without cost-sharing and temporarily allows high deductible health plans to cover telehealth services without a deductible, while permanently expanding the list of reimbursable items [...]
Legal Developments Impacting Retirement Plans – 2020 Year-End Update
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) included several provisions impacting retirement plans, all of which were modeled after prior legislation providing financial relief options to participants in times of national disaster or other emergency. These CARES Act provisions (all optional at the plan sponsor level) include: (1) permitting participants to take “coronavirus-related distributions” of up to $100,000, which receive special tax treatment and the option to recontribute to the [...]
Searching for Missing Participants and Beneficiaries in Ongoing Plans
The payment of benefits to missing participants and beneficiaries has been an area of increased DOL attention in recent years. In 2019, the Employee Benefits Security Administration (a DOL agency) recovered over $2 billion in payments to plans, participants, and beneficiaries from enforcement actions. Yet despite the DOL’s heightened enforcement activity, it has yet to publish guidance addressing how fiduciaries of ongoing plans can satisfy their fiduciary duty to locate missing [...]
LEGAL DEVELOPMENTS IMPACTING RETIREMENT PLANS – 2019 YEAR-END UPDATE
In December 2019, Congress passed the Setting Every Community Up for Retirement Enhancement Act (SECURE Act) as part of the Appropriations Act. See our article for additional information. Pursuant to an Executive Order, the IRS proposed updates to the actuarial tables for required minimum distributions (RMDs) to reflect longer life expectancies, resulting in lower RMD payments. The IRS finalized regulations on hardship distributions from 401(k) plans that implement changes in the 2018 Bipartisan [...]