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Susie Bilbro

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Susie Bilbro advises clients on all aspects of employee benefit plan design and administration including compliance with ERISA, the Patient Protection and Affordable Care Act (healthcare reform), COBRA and the Internal Revenue Code. She has counseled public and private clients on employee welfare and pension benefits issues, both in connection with corporate transactions and on day-to-day administration. In addition, Susie has prepared submissions to the IRS and Department of Labor for qualified retirement and welfare benefit plans. Susie also has experience advising clients on executive compensation arrangements.

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As announced in our previous HR Law Talk blog post, the Paperwork Burden Reduction Act (PBRA) made important changes to employers’ responsibilities to furnish information to employees under the Affordable Care Act (ACA). As part of the changes, employers may now provide “clear, conspicuous, and accessible” notice that individuals may request their Form 1095-B or 1095-C and distribute a Form 1095 only to individuals who request a copy, rather than furnish a Form 1095 annually to each covered individual. Recently, the Internal Revenue Service (IRS) released additional guidance for employers, with more details about satisfying the notice requirement.Continue Reading IRS Guidance Regarding ACA Employer Information Reporting Requirements

In December 2024, Congress and President Biden passed two laws—the Paperwork Burden Reduction Act (PBRA) and the Employer Reporting Improvement Act (ERIA)—that made important changes to employers’ responsibilities regarding furnishing information to employees under the Affordable Care Act (ACA) information reporting provisions as well as the response deadlines and the statute of limitations for the employer shared responsibility penalty assessments.Continue Reading 2025 Changes to ACA Employer Information Reporting Obligations and the Employer Shared Responsibility Penalties

Earlier today, the U.S. Department of Labor (DOL) published in the Federal Register an updated version of the Voluntary Fiduciary Correction Program (VFCP) under Title I of ERISA. Per the DOL, VFCP “is designed to encourage correction of fiduciary breaches and compliance with law by permitted persons to avoid potential [DOL] civil enforcement actions and civil penalties if they voluntarily correct” errors in accordance with the program. Notably, the update expands the current VFCP by adding a much-anticipated self-correction component for delinquent transmittal of participant contributions and loan repayments to retirement plans in specific circumstances. Continue Reading BREAKING: DOL Expands the Voluntary Fiduciary Correction Program

I recently authored an article for BenefitsPRO examining the status of pharmacy benefit manager (PBM) regulation in the states. While benefits professionals have seen the cost of prescription drugs rise, there is a lack of consensus as to what exactly is causing the increase. As PBMs serve as the intermediary between prescription drug manufacturers and insurance or benefit providers to help providers save on prescription drugs, PBMs have found themselves under increased scrutiny and the target of litigation and heightened regulation.Continue Reading Status of PBM Regulation in the States

On June 28, 2024, the Supreme Court issued its opinion in Loper Bright Enterprises v. Raimondo, Secretary of Commerce and Relentless, Inc. v. Department of Commerce (Loper Bright), overturning Chevron U.S.A. Inc v. Natural Resources Defense Council, Inc. (Chevron). In this landmark case, Loper Bright overruled the forty-year doctrine known as “Chevron deference,” whereby courts defer to an administrative agency’s reasonable interpretation of ambiguous federal laws, even if the court disagrees with the agency’s interpretation. Instead, Loper Bright held that courts must exercise independent judgment in deciding whether an administrative agency has acted within its statutory authority, and may not automatically defer to an agency’s legal interpretation when a statute is ambiguous.Continue Reading Chevron No More: The Impact on Benefit Plans

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

This post was updated on February 6, 2024, to reflect the 2024 Federal Poverty Level announced in January 2024.

On August 23, 2023, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable Care Act (ACA) affordability threshold will be 8.39% for plan years beginning in 2024, a substantial decrease from the 9.12% affordability threshold set for plan year 2023. This marks the largest change yet in the affordability thresholds year-over-year. The affordability threshold is used to determine whether employer-sponsored health coverage is affordable for purposes of the ACA’s employer-shared responsibility provisions.Continue Reading UPDATE: Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

NOTE: This post was originally written August 29, 2023, and was updated on September 27, 2023.

Breaking news: On September 19, 2023, the Oklahoma Attorney General filed a Petition for En Banc Rehearing, challenging the Tenth Circuit panel’s decision in this case and requesting a rehearing before the full Tenth Circuit bench. The Oklahoma Attorney General argued in his Petition that the panel’s decision contradicted established Supreme Court precedent and recent circuit court decisions regarding the scope of ERISA preemption, failed to address the ERISA “savings clause,” and was overbroad in its articulation of Medicare Part D preemption. On September 25, 2023, the Tenth Circuit ordered PCMA to respond to the Petition. We will provide further updates as this matter develops.Continue Reading Tenth Circuit Rules ERISA Preempts Oklahoma PBM-Reform Law

From the Bass, Berry & Sims Blog Network
From the Bass, Berry & Sims Blog Network

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