In the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization and subsequent state abortion bans, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services issued a Final Rule (Final Rule) modifying the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule in order to support reproductive health care privacy. As with prior HIPAA rules, the Final Rule applies to covered healthcare providers, health plans, or healthcare clearing houses (each, a Covered Entity) and their business associates.Continue Reading New Reproductive Health Care Privacy Final Rule: Key Compliance Steps and Dates
David Thornton
David Thornton helps employers deliver retirement, health and welfare benefits to their executives and employees. With more than 30 years of experience, he has developed a diverse practice counseling hundreds of public and private employers and non-profit organizations in drafting, maintaining and administering retirement plans ranging from $1 million to several billion dollars in assets, including many in the $100 million to $500 million asset range. He has deep experience in ESOP transactions, successfully navigating the significant fiduciary duty considerations and tax code requirements involved with these transactions.
Gender-Affirming Care Remains a Hot Topic in 2024
Our April 9 blog post highlighted several issues to watch during 2024, one of which was gender-affirming care considerations.Continue Reading Gender-Affirming Care Remains a Hot Topic in 2024
New Proposed Mental Health Parity Rules Amid Report of Widespread Failure
On July 25, the Department of Labor, Department of the Treasury, and Department of Health and Human Services (the Departments) released new Proposed Rules (Proposed Rules) that clarify certain requirements imposed by the Mental Health Parity and Addiction Equity Act (MHPAEA). In addition to the new Proposed Rules, the Departments issued their annual MHPAEA report to Congress (Report) to detail recent enforcement efforts.Continue Reading New Proposed Mental Health Parity Rules Amid Report of Widespread Failure
Latest Ruling in Wit v. United Behavioral Health Case
I recently provided insight on the January 26 ruling by the U.S. Court of Appeals, Ninth Circuit holding that although United Behavioral Health violated its fiduciary responsibility as outlined in the Employee Retirement Income Security Act (ERISA) by incorrectly denying behavioral health claims, the patients who were denied coverage had no right to appeal. This case is being closely watched as it could set a precedent for the behavioral health industry and future access to mental health and addiction treatment.Continue Reading Latest Ruling in Wit v. United Behavioral Health Case
2022 Welfare Plan Automatic Participant Disclosures
We authored an article published by BenefitsPRO on November 11 highlighting takeaways from the firm’s “2022 Welfare Plan Automatic Participant Disclosures Checklist.”
Continue Reading 2022 Welfare Plan Automatic Participant Disclosures
Wit v. United Behavioral Health Appeals
I recently discussed the appeals request in Wit v. United Behavioral Health, a case that could set a precedent for the behavioral health industry and access to mental health and addiction treatment, for a Behavioral Health Business article. In February 2019, the U.S. District Court for the Northern District of California ruled that United Behavioral Health violated the Employee Retirement Income Security Act (ERISA) by incorrectly denying behavioral health claims. The company appealed to the 9th Circuit, and in March 2022 a three-judge panel reversed the decision. The plaintiffs are now appealing that decision, requesting that the full panel of judges review the case.
Continue Reading Wit v. United Behavioral Health Appeals
DOL Disaster Relief Notice Offers Guidance on Extension of COVID-19 Outbreak Period Benefits
Plan sponsors and plan fiduciaries, and vendors, advisors and other service providers: Take notice! The end of the special COVID-19 “Outbreak Period,” which began on March 1, 2020 and continues to apply, is nowhere in sight based on recent guidance from the Department of Labor (DOL) in the form of a Disaster Relief Notice (New Guidance).
This means that the “tolling” of a number of participant and plan deadlines did not end on February 28, 2021, as most plan sponsors and others had assumed based on prior guidance. In fact, for some participants, the tolling period could extend far out into the future. In addition, the new guidance reminds plan sponsors and plan fiduciaries of the “guiding principle” for administering employee benefit plans – act reasonably, prudently and in the interest of workers and their families. Good faith compliance with the new guidance will likely be judged on this standard.
Background
Pursuant to joint guidance issued on May 4, 2020 (Joint Guidance), the DOL and Internal Revenue Service (IRS) suspended or “tolled” a number of participant and plan deadlines. The “tolled” deadlines include:
- HIPAA Special Enrollment Notice Obligations – the 30-day period (or 60-day period, as applicable) to request special enrollment in a group health plan.
- COBRA Notices, Elections and Premium Payments – the periods for individuals to notify the plan of certain COBRA events (e.g., a qualifying event, such as a divorce or child losing eligibility), the 60-day period for electing COBRA continuation coverage, and the 45-day (initial) and 30-day (monthly) deadlines for making COBRA premium payments.
- Claims and Appeal Procedures – the date by which an individual may file a claim for benefits or an appeal of an adverse benefit determination (this applies to all ERISA-both welfare and retirement-plans).
Changes to Section 162(m) Affecting Deferred Compensation Arrangements
Public companies maintaining deferred compensation arrangements for their executive officers should consider how recent changes to the regulations under Section 162(m) of the Internal Revenue Code (the Code) may impact the timing of payments to be made to participants and their beneficiaries under such plans – if action is required, the affected plans must be amended before December 31, 2020 to avoid complications or penalties.
Continue Reading Changes to Section 162(m) Affecting Deferred Compensation Arrangements
IRS, EBSA and PBGC Provide Further COVID-19 Relief for Benefit Plans
As part of the federal government’s response to the COVID-19 pandemic, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and Pension Benefit Guaranty Corporation (PBGC) have recently provided relief to benefit plan sponsors by moving back certain upcoming plan compliance deadlines. See further below for a detailed list of the specific relief. IRS Notice 2020-23 provides that if any deadline would occur between April 1 and July 14, that deadline is automatically moved back until July 15, 2020, and this extension applies to a list of 44 employee benefit plan-related deadlines. The IRS notice triggered the PBGC’s disaster relief policy, which automatically extends certain PBGC deadlines that occur in the same April 1 to July 14 time period to July 15, 2020.
Additional relief was announced on April 28, in the form of a joint notice ( Joint Notice) issued by EBSA, IRS and the Treasury Department, which extended a number of deadlines for benefit plans and participants in accordance with CARES Act changes to ERISA Section 518. The Joint Notice’s relief applies to the “Outbreak Period,” the length of time beginning on March 1, 2020, and ending 60 days after the announcement that the COVID-19 National Emergency is over. On the same day, EBSA issued Disaster Relief Notice 2020-01 (Disaster Relief Notice). The Disaster Relief Notice clarified EBSA’s enforcement stance on certain fiduciary duties that plan sponsors have by extending deadlines. The Disaster Relief Notice also stated that the Outbreak Period extension, described in the Joint Notice, also applies to the distribution timelines for notices, disclosures, and other documents that Title I of ERISA requires plans to distribute to participants and beneficiaries. EBSA also released an FAQ which explains some of the relief provided by the Joint Notice and Disaster Relief Notice.Continue Reading IRS, EBSA and PBGC Provide Further COVID-19 Relief for Benefit Plans
DOL Proposes Easing Retirement Plan Regulations
In a Law360 article, I provided insight on the Department of Labor’s (DOL) proposed regulations on retirement plans that would make it easier for companies to join existing retirement plans or join forces to generate new ones – which has the potential to broaden the availability of workplace retirement plans to allowing small businesses. Under the proposed regulations, “a group of unrelated employers could now have a single ERISA plan,” I explained.
Continue Reading DOL Proposes Easing Retirement Plan Regulations