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Business Insights, Research & Perspectives

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April 3, 2008

Employer Coverage? TRICARE? Beware!

Effective January 1, 2008, secondary payer rules similar to the Medicare rules became applicable to group health plans covering individuals entitled to TRICARE, the health coverage available to families of military personnel, (see New TRICARE Provisions Affect Group Health Plans from Nov. ’06 Benefit Beat). The primary goal of this law is to insure that employers do not unduly shift the risk for health coverage to TRICARE. Specifically, employers, whether sponsoring insured or self-funded health plans, cannot, in any way, incent TRICARE eligible individuals to decline or drop employer-sponsored coverage in favor of TRICARE.

March 11, 2008

Compliance Checklist for Wellness Programs

The DOL has issued a helpful tool, in the form ofField Assistance Bulletin 2008-02, for determining whether a wellness program is subject to the HIPAA nondiscrimination rules. 

March 11, 2008

Safe Harbor for Placing Participant Contributions in Small Plans

The DOL has just issued some proposed regulations that would create a safe harbor for small pension and welfare benefit plans (those with fewer than 100 participants); specifically relating to placement of participant contributions in trust.  Generally, participant contributions to retirement plans must be placed in the plan at the earliest time possible; but, in no event, later than the 15th business day of the month, following the month in which the contribution is withheld.  For welfare benefit plans, contributions must be deposited within 90 days of withholding. 

March 11, 2008

New Proposed FMLA Regulations

The Family and Medical Leave Act (FMLA) top is about to be spun, or, may be turned on its head.  A law that has been in effect nearly 15 years with little legislative or regulatory change, has been hit with both in the first two months of 2008 (see January’s Benefit Beat, FMLA Brings Benefits to Military Families).  On February 11, 2008, the Department of Labor issued proposed regulations that will, if finalized, make some important changes that employers need to know. 

March 11, 2008

Supreme Court: Participant Can Sue for Breach of Fiduciary Duty

Individual account plan officials should take note of a recent Supreme Court opinion.  In the case of LaRuev . DeWolff, Boberg & Assocs., Inc., No. 06-856, 2008 WL 440748 (Feb. 20, 2008), the Supreme Court unanimously granted a plan participant the right to bring an action on his own behalf for the failure of the plan officials to follow his investment instructions.  The important of this Opinion lies in the facts that the participant could bring an action due to the failure, specific to his own account, and not to the plan at large. 

February 6, 2008

FMLA Brings Benefits to Military Families

On January 28, 2008, President Bush signed a law (National Defense Authorization Act for FY 2008, Public Law 110-181) that, in part, broadens the benefits available under the Family Medical Leave Act (FMLA) specifically for employees who have family members called or ordered to active military service. 

February 6, 2008

Benefit Plan Eligibility: Your Opportunity to Clean House

It is always very important, whether a retirement plan, or a welfare benefit plan, and if a welfare benefit plan, whether the plan is insured or self-funded, that plan officials make certain that all terms and conditions of the plan are followed.  Failure to follow the terms and conditions of a plan can result in plan disqualification; of particular note, is eligibility for plan benefits. 

January 10, 2008

New Proposed Regulations

  • Diversification Requirements for DC Plans Investing in Employer Securities.  The IRS recently issued proposed regulations addressing the employer securities diversification aspect of the Pension Protection Act (PPA).  The PPA of 2006 requires that if a defined contribution plan allows investments in publicly-traded employer securities, then plan participants must be allowed to diversify their portfolios (see Employer Securities Diversification from the Sept 2006 edition of the Benefit Beat).  Until final regulations are issued, plans including publicly-traded employer securities can rely on guidance included in Notice 2006-107, which was extended by Notice 2008-07; or, they can rely on the recently issued proposed regulations.
  • Civil Penalties for Failure to Provide Participant Notices.  The DOL has recently issued proposed regulations that would impose significant civil penalties against plan administrators for failure to provide certain PPA-required disclosure notices to participants, including notice of participant’s rights and obligations under automatic contribution arrangements (see the QDIA article from last month’s Benefit Beat).  If finalized, these regulations would impose up to a $1,000 per day penalty for failure to comply with these notice obligations.

 

January 10, 2008

Retiree Health and Age Discrimination…the Final Scene?

On December 26, 2007, the Equal Employment Opportunity Commission (EEOC) issued final regulations supporting the long-standing practice of coordinating retiree health benefits with Medicare.  This matter was challenged several years ago in the Erie County case (see Retiree Health Coordination on the Move Again?, Retiree Health Rules Rolling Again, and Coordination of Retiree Health Benefits with Medicare).  Since then, the pendulum has swung back and forth.  While it may still be swinging, its arc is short and slow. 

January 10, 2008

New Medicare Reporting Obligations

As part of the Medicare, Medicaid and SCHIP Extension Act of 2007 (S. 2499) signed into law by President Bush on December 29, 2007, a new Medicare secondary payor reporting rule is imposed, primarily on insurers and third party administrators (TPAs). 

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