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National Federation of Independent Businesses Comment Letter to DOL on Proposed Regs on Association Retirement Plans and MEPs (PDF)

17 pages. "NFIB continues to object to the control and commonality-of-interests tests as a misconstruction of section 3(5) of ERISA. The Department should revise its proposed rule ... to allow an association to demonstrate in ways other than 'control' that the association acts in the interest of the employers in the association and should recognize small business size as itself a commonality of interest."

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American Bankers Association Comment Letter to DOL in Response to RFI on Possible Agency Actions to Protect Life Savings and Pensions from Threats of Climate-Related Financial Risk

"[S]ingling out climate-related financial risk for mandatory consideration and reporting, regardless of the actual presence or degree of its risk, [1] undercuts a plan fiduciary's authority and duty under ERISA to appropriately consider and manage all relevant risks, [2] imposes unnecessary costs to plans and their participants, and [3] undermines ERISA standards and Department regulations on investment duties that require deference to the judgment of the plan fiduciary rather than the substitution of the Department's judgment."  MORE >>

Association of Independent Investors Comment Letter to SEC on Duties of Brokers, Dealers, and Investment Advisers (PDF)

"The Commission can end this ongoing debate once and for all by putting an end to what is known as dual registration, the practice in which brokers and investment advisers are cross licensed. We believe that brokerage and advisory activities should be separated and clearly defined to investors, with no overlap."  MORE >>

Text of Group Letter from 15 Associations to DOL Protesting Brokerage Window FAQ in FAB 2012-02 (PDF)

7 pages. "[The authors] believe the positions set forth in Question and Answer 30 ... have potentially enormous costs and adverse effects on the retirement plan system -- costs and impacts that we believe need to be further developed and considered as part of a public notice and comment process.... [T]he Administrative Procedure Act, Executive Orders 12866 and 13610, as well as the guidance in OMB's Good Guidance Practices Bulletin, require that the Department withdraw the answer to Q&A-30. To the extent that the Department believes that the position set forth in Q&A-30 continues to deserve consideration, it should propose the guidance, in conjunction with a cost/benefit analysis, and invite public comment as is required for any 'supplement' to a regulation."  MORE >>

Text of Agencies' Final Regs: Federal Independent Dispute Resolution Operations

607 pages. "This document sets forth these final rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). These rules finalize new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These final rules also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice (ERA) to an entity that does not have a contractual relationship with the plan or issuer. This document also finalizes amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review process, and the payment and collection of administrative fees and certified IDR entity fees. This document also finalizes the definition of bundled payment arrangements, amends requirements related to batched items and services and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document finalizes provisions that require plans and issuers to register in the Federal IDR portal."  MORE >>

Alabama Launches First-In-The-Nation Tax-Friendly Portable Benefits for Independent Contractors and Gig Workers

"Under a new law taking effect December 31, 2025, companies, including application-based entities, can voluntarily contribute to a contractor's portable benefits -- like health insurance, retirement savings, and life insurance -- with a win-win tax effect: employers can deduct the cost, and workers don't pay taxes on the value received. This novel approach could reshape how businesses support gig workers and freelancers without risking a misclassification finding."  MORE >>

ARA Comment Letter to EBSA on Possible Agency Actions to Protect Life Savings and Pensions from Threats of Climate-Related Financial Risk (PDF)

"The Department's efforts to comply with the Executive Order should focus on ensuring that ERISA plan fiduciaries have prudent processes in place for analyzing all financial risks, including climate-related financial risk, if relevant. The Department should not require ERISA plans to report information relating to climate-related financial risk because it has not explained its rationale or expectations for how doing so would support its mandate to supervise and enforce ERISA, and it will increase administrative burdens on plans and service providers."

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Text of Tri-Agencies Notice Reopening Comment Period on Proposed Regs for Federal Independent Dispute Resolution Operations

"This document reopens the comment period for the proposed rules entitled 'Federal Independent Dispute Resolution Operations' ... The comment period for the proposed rules, which closed on January 2, 2024, is reopened from [the date of publication in the Federal Register, currently scheduled for January 22, 2024,] to [14 days after that publication date]."  MORE >>

Text of Agency Proposed Regs: Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges

77 pages. "This document sets forth proposed rules related to the fees established by the No Surprises Act for the Federal independent dispute resolution (IDR) process ... These proposed rules would amend existing regulations to provide that the administrative fee amount charged ... to participate in the Federal IDR process, and the ranges for certified IDR entity fees for single and batched determinations will be set by the Departments through notice and comment rulemaking. These proposed rules would also set forth the methodology used to calculate the administrative fee and the considerations used to develop the certified IDR entity fee ranges. This document also proposes the amount of the administrative fee ... [and] the certified IDR entity fee ranges for disputes initiated on or after the later of the effective date of these rules or January 1, 2024"  MORE >>

Text of Agency FAQs About No Surprises Act Independent Dispute Resolution Administrative Fee (PDF)

"On August 3, 2023, the U.S. District Court for the Eastern District of Texas issued an opinion and order ... [which] vacated the $350 administrative fee per party established by the Amendment to the Calendar Year 2023 Fee Guidance for the Federal Independent Dispute Resolution Process Under the No Surprises Act: Change in Administrative Fee issued on December 23, 2022. The following FAQs explain how [HHS, DOL and the Treasury Departments] will handle the administrative fee in accordance with this order. These FAQs are not announcing the reopening of the Federal IDR portal to submit new disputes. The Departments intend to reopen the portal to permit the submission of new disputes soon and will notify interested parties at that time."

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Text of Agency FAQs Regarding the Federal Independent Dispute Resolution Process (PDF)

11 pages; 47 Q&As covering [1] Independent Dispute Resolution (IDR) entity qualifications and the application process (16 Q&As); [2] Fees (10 Q&As); and [3] The Federal IDR process (21 Q&As).

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Fed Agencies Closely Watching Independent Contractor vs. Employee Debate -- and Plan Sponsors Should, Too (PDF)

"If DOL, the states and IRS truly share information and coordinate compliance efforts as intended, it will not be long before employee benefit plans are targeted for independent contractor treatment.... Excluding eligible employees is a qualification issue that could lead to serious financial consequences for retirement plan sponsors."  MORE >>

Agencies Finalize Portions of Surprise Billing Independent Dispute Resolution Regs

"These final regulations are narrow in scope, addressing only certain issues critical to the implementation of the IDR process. The agencies note that they intend to finalize the remaining provisions of the current interim final regulations 'at a later date.' "

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Text of Agency Final Regs: Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage

237 pages. "This document sets forth final rules that amend the definition of short-term, limited-duration insurance, which is excluded from the definition of individual health insurance coverage under the Public Health Service Act. This document also sets forth final rules that amend the regulations regarding the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets."

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Text of Tri-Agencies Proposed Regs: Federal Independent Dispute Resolution Process

443 pages. "These proposed rules would set forth new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These proposed rules would also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice to an entity that does not have a contractual relationship with the plan or issuer. This document also proposes to amend certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review, and the payment and collection of administrative fees and certified IDR entity fees. This document also proposes to define bundled payment arrangements, amend requirements related to batched items and services, and amend the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document proposes to require plans and issuers to register in the Federal IDR portal."  MORE >>

Text of Agency Proposed Regs: Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; Etc.

182 pages. "This document sets forth proposed rules that would amend the definition of short-term, limited-duration insurance, which is excluded from the definition of individual health insurance coverage under the Public Health Service Act. This document also sets forth proposed amendments to the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets. This document further sets forth proposed amendments to clarify the tax treatment of certain benefit payments in fixed amounts received under employer-provided accident and health plans. Finally, this document solicits comments regarding coverage only for a specified disease or illness that qualifies as excepted benefits, and comments regarding level-funded plan arrangements."

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Federal Agencies Release Final Rule Implementing the No Surprises Act's Independent Dispute Resolution Process

"The Final Rule ... [makes] clear that IDR entities should determine the out-of-network rate during the IDR process by selecting the offer 'that best represents the value of the item or service under dispute after considering the QPA and all permissible information submitted by the parties.' The Final Rule also incorporates new requirements intended to promote transparency, consistency and predictability in the IDR process."  MORE >>

Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

"The effect of the Court's decision is to set aside five portions of the Rule, all of which elevate QPA as a factor over the other circumstances set forth in the [No Surprises Act] as relevant when determining the appropriate rate at which out-of-network providers should be compensated for surprise medical bills.... The primary concern for group health plan sponsors is that the Court's decision could lead to increased costs." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

Agencies Release FAQs and Another Process Guide About Surprise Billing Independent Dispute Resolution

"The federal IDR portal launched with functionalities related to uninsured individuals on January 1, 2022. Functionalities for providers, facilities, plans, and insurers are expected to be available 'in the coming weeks.' ... Plans and insurers should familiarize themselves with the IDR process requirements for disputing parties -- particularly since some timeframes for action are quite short."  MORE >>

Agencies Propose Rules to Implement No Surprises Act Federal Independent Dispute Resolution Process

"[The qualifying payment amount (QPA)] will generally be a payor's median in-network rate for: (a) the same or similar services, (b) furnished in the same or a similar facility, (c) by a provider of the same or similar specialty, (d) in the same or similar geographic area.... [T]he QPA is now the presumptive out-of-network rate that an IDR entity must select absent credible evidence that the payor's QPA would be inappropriate under the circumstances."  MORE >>