I recently provided insight for an article in Benefits Pro examining the Tenth Circuit ruling that certain state regulation of pharmacy benefit managers (PBMs) is preempted by ERISA. Continue Reading Insight on Tenth Circuit Ruling in PBM-Reform Law Challenge
Employee Benefits
Amid Concerns, IRS Delays Required Roth Catch-Ups Until 2026 to Allow For Plan Compliance
Late last week, the Internal Revenue Service (IRS) issued guidance on Section 603 of the SECURE 2.0 Act with respect to catch-up contributions. The guidance includes a two-year administrative transition period – until 2026 – to implement the Roth catch-up contribution provisions under SECURE 2.0 and is in response to employer coalitions and industry groups who had voiced concerns about being able to timely implement those provisions. Continue Reading Amid Concerns, IRS Delays Required Roth Catch-Ups Until 2026 to Allow For Plan Compliance
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
Tolling No More: Preparing for the End of COVID-19 Emergency Declarations
On January 30, President Biden announced his intention to end the COVID-19 National Emergency (NE) and Public Health Emergency (PHE) effective May 11, 2023. Both emergency declarations resulted in various forms of relief for employer-sponsored benefit plans, and both have been extended several times since their inception nearly three years ago. While their impact on federal law differs, employee benefit plan sponsors and administrators should take note of the ending emergencies and their associated relief. Below is an overview of the impact that the end of this relief will have on employer-sponsored benefit plans.Continue Reading Tolling No More: Preparing for the End of COVID-19 Emergency Declarations
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
SECURE 2.0 + 1: Retirement Plan Changes and One Notable Health Plan Change
As widely reported, the president recently signed into law the Consolidated Appropriations Act of 2023 (CAA 2023), a $1.7 trillion omnibus spending bill, which contains significant provisions affecting employer-sponsored retirement and welfare benefit plans. The provisions impacting retirement plans are included in a separate section of CAA 2023 referred to as the SECURE 2.0 Act of 2022 (SECURE 2.0 or the Act), which in many ways builds upon the first SECURE Act passed in 2019 (SECURE 1.0). The following items highlight what we believe are the most important changes affecting employer-sponsored retirement and welfare benefit plans and also provide practical advice for plan sponsors.Continue Reading SECURE 2.0 + 1: Retirement Plan Changes and One Notable Health Plan Change
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
2022 ERISA Welfare Plan Automatic Participant Disclosures Checklist
We recognize that many companies sponsor ERISA welfare benefit plans and are currently undergoing their open enrollment process and issuing related participant communications. To assist with that process, we have prepared an Automatic Participant Disclosures Checklist for use during open enrollment and throughout the plan year.
Continue Reading 2022 ERISA Welfare Plan Automatic Participant Disclosures Checklist
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
State Prescription Drug Legislation and ERISA Preemption
We recently authored an article for Washington Legal Foundation examining whether federal law preempts state prescription drug coverage laws that would apply to employer-sponsored group health plans. According to a provision in the Employee Retirement Income Security Act of 1974 (ERISA), state laws that “relate to” employee benefit plans are preempted by ERISA standards. Unfortunately, as we pointed out in the article, this “related to” statement is broad and vague.
Continue Reading State Prescription Drug Legislation and ERISA Preemption