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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
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.
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.
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.
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.
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.
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.
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).
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.
New Proposed Regulations