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128 Matching News Items

1.  Text: Nixon Peabody's September 2004 Benefits Briefs: Legal Developments for Employee Benefits (PDF)
Nixon Peabody LLP Link to more items from this source
Oct. 5, 2004
7 pages. Articles include: What's discrimination in the design of ERISA plans?; Elect-it-yourself tax treatment for disability benefits; Insurance companies as plan fiduciaries; Retiree health benefits--Vested or not?
2.  Text: Nixon Peabody's August 2004 Benefits Briefs: Legal Developments for Employee Benefits (PDF)
Nixon Peabody LLP Link to more items from this source
Oct. 5, 2004
6 pages. Articles include: Getting burned by ignoring people with 'colorable' claims to plan participation; Court holds that ERISA forbids a plan from recouping excess benefit payments in court; Anti-cutback rule KOs suspension of benefits amendment.
3.  California Employers Required to Grant Up to 40 Hours of Sick Time in 2024
Nixon Peabody LLP Link to more items from this source
Jan. 2, 2024
"California's sick time entitlements will increase significantly under both the 'frontloading' and 'accrual' methods. The law specifies calculation formulas for both exempt and non-exempt employees, as well as posting and notification requirements. Employers do not need separate PTO and sick time policies, but combined policies can create compliance complications with sick time laws."
4.  Health and Welfare Plan Fiduciary Compliance Reviews: Benefits and Best Practices
Nixon Peabody LLP Link to more items from this source
Nov. 17, 2023
"Fiduciaries should strive to mitigate risks proactively by formalizing a fiduciary compliance review process. A solid process involves evaluating plan documents, participant communications, service provider agreements, and service provider performance to identify potential risks. Making corrections and taking steps to minimize risk can help reduce the chance of costly litigation in the future."
5.  Health Plan Fiduciary Governance: Participant Claims and Appeals, and Provider Disputes
Nixon Peabody LLP Link to more items from this source
Nov. 6, 2023
"Plan and claims administrators should follow the plan's claims and appeals provisions to avoid inadvertently triggering complainant-friendly review standards. Minimize risk in disputes by understanding how healthcare providers can assert ERISA rights against a plan. Exercise caution when handling document requests and/or disputing plan reimbursements -- failure to properly handle these requests can result in liability."
6.  Fiduciary Governance: HIPAA and Cybersecurity Best Practices
Nixon Peabody LLP Link to more items from this source
Oct. 20, 2023
"Plans considered 'covered entities' under HIPAA are subject to privacy and security rules governing individually identifiable health information. Plan sponsors must implement their plans' physical, administrative, and technical safeguards to protect e-PHI against cyberthreats. Fiduciaries should not stop at HIPAA-covered health data but should equally safeguard any personally identifiable information of employees in connection with their welfare benefit plans."
7.  Fiduciary Oversight of Pharmacy Benefit Managers
Nixon Peabody LLP Link to more items from this source
Oct. 15, 2023
"Health plan fiduciaries should retain a qualified independent pharmacy consultant, specialized auditor, and ERISA legal counsel to assist with PBM monitoring. Various audits are recommended to assess compliance, market changes, claims data, pricing, and performance, among other factors. Consider conducting RFPs every few years to adjust to market changes and business needs."
8.  Fiduciary Governance: Evaluating, Selecting, and Contracting with Pharmacy Benefit Managers
Nixon Peabody LLP Link to more items from this source
Oct. 5, 2023
"Although selecting and evaluating PBMs follows the same general process used in selecting medical plan TPAs, knowing the nuanced differences will help tailor your RFP process. Understanding the key factors to consider during the evaluation process will help decision-makers inform their choices and realize cost-savings. PBM agreements are undoubtedly one of the most complicated benefits-related services agreements and should be negotiated carefully."
9.  Fiduciary Governance: Monitoring and Auditing Medical TPAs, Insurers, and Other Service Providers
Nixon Peabody LLP Link to more items from this source
Sept. 28, 2023
"[1] Engage appropriate experts to help review service providers' compliance with contract terms and performance. [2] Negotiate and include detailed contract provisions related to audit rights and ongoing compliance check-ins with service providers. [3] Identify, retain, and contract with a qualified, independent auditing company that has specialized expertise in the area(s) to be audited. [4] Take corrective actions to address deficiencies and document those efforts."
10.  Managing Increasing Health and Welfare Fiduciary Risks
Nixon Peabody LLP Link to more items from this source
Sept. 14, 2023
"Take action now to stave off the pending surge in class action litigation against health and welfare plan sponsors and fiduciaries.... Plaintiffs' firms are actively looking for potential employee plaintiffs who participate in group health plans.... Manage risks by establishing a health and welfare plan fiduciary committee to conduct formal, well-documented processes to monitor health plan activities and service provider performance and fees."
11.  In Latest Right of Access Initiative Settlement, OCR Reminds Health Plans of HIPAA Compliance Obligations
Nixon Peabody LLP Link to more items from this source
Aug. 27, 2023
"Previously focused on healthcare providers, the settlement with UnitedHealthcare emphasizes the need for health plans to provide members with timely access to their health information.... In the press release describing the settlement, OCR Director Melanie Fontes Rainer emphasized that health plans are not exempt from the access requirement."
12.  Are Online Tracking Technologies Like Pixels HIPAA Compliant?
Nixon Peabody LLP Link to more items from this source
May 15, 2023
"The concern for HIPAA-regulated entities is that the Metas of the world, these tracking technology vendors, often are not business associates to the hospitals or physician practices. They may not be permitted to receive the data as a hospital vendor.... Depending on the facts, it may be a little bit grey as to whether this is a permissible use of that data, and if it's not, healthcare organizations need to analyze whether there's a potential HIPAA breach involved."
13.  COVID Health Emergencies Formally Ending in May: What Health Plan Sponsors Need to Know
Nixon Peabody LLP Link to more items from this source
Feb. 7, 2023
"For most plan sponsors, the end of the Public Health and National Emergencies is a welcome development from a health plan management perspective. First-dollar coverage of COVID-19 tests, particularly at-home tests, has been a significant cost driver under most plans. Additionally, the Outbreak Period administrative deadline delays have been difficult to navigate (especially with respect to COBRA premium payments)."
14.  Illinois Paid Leave Law: What You Need to Know
Nixon Peabody LLP Link to more items from this source
Feb. 2, 2023
"Pursuant to Illinois legislation awaiting the governor's signature, on January 1, 2024, Illinois employers will be required to give employees up to 40 hours of paid leave for any reason. While several states grant employees paid sick leave, Illinois becomes the third state to extend paid leave beyond sickness and family reasons to any reason at the employee's discretion."
15.  DC Employers Must Report Compliance With, or Exemption From, the DC Parking Cashout Law by January 15
Nixon Peabody LLP Link to more items from this source
Jan. 10, 2023
"Unless exempt, employers that offer a parking benefit must provide a Clean-air Transportation Fringe Benefit, develop a transportation demand management plan, pay a fee, or discontinue the parking benefit. All covered employers must submit a compliance report to the DDOT every two years or be subject to fines and penalties."
16.  SEC Adopts New Requirements for Rule 10b5-1 Insider Trading Plans and Related Disclosures
Nixon Peabody LLP Link to more items from this source
Dec. 28, 2022
"Issuers will need to update their existing insider trading policies and procedures, and must comply with new disclosure requirements relating to the material terms of insider trading plans and arrangements established by their directors and executive officers and stock option (and similar) grants to named executive officers."
17.  New 'No Surprises Act' Regs Address 'Downcoding' and Vacated QPA Presumption
Nixon Peabody LLP Link to more items from this source
Aug. 23, 2022
"New regulations require 'downcoding' QPA disclosures, but plan and issuer 'downcoding' policies remain a subject of pending litigation.... [The new final rule] directs certified IDR entities to consider the QPA as well as certain other specific factors when resolving out-of-network rate disputes."
18.  Employer Challenges Post-Dobbs: Travel Benefits for Abortions
Nixon Peabody LLP Link to more items from this source
July 4, 2022
"Travel reimbursement programs that are limited to abortion are more likely to catch the eye of regulators in states that take anti-abortion positions.... [E]mployers should consider whether to offer a broad-scope travel reimbursement program for all medical expenses.... [A]ny paid time off policy available only to women for this purpose (i.e., and not made available to accompany a dependent for the same reason) may violate certain sex and/or gender discrimination laws."
19.  OCR Issues Guidance on HIPAA-Compliant Use of Audio-Only Telehealth
Nixon Peabody LLP Link to more items from this source
June 21, 2022
"[1] OCR emphasizes the important role telehealth plays in expanding access to healthcare and the need to ensure compliance with HIPAA for these arrangements post-PHE. [2] The guidance clarifies when audio-only telehealth services and vendor agreements require compliance with the HIPAA Security Rule. [3] Covered entities should take the opportunity now, prior to the end of the PHE, to analyze changes needed in telehealth arrangements."
20.  Required Notice Deadline Looms as ARPA COBRA Subsidy Comes to an End
Nixon Peabody LLP Link to more items from this source
Sept. 8, 2021
"The purpose of the notice is to give covered individuals enough time to evaluate alternative coverage options before losing the ARPA premium assistance. Although the [DOL] has issued a model notice, it's important for plan sponsors to work with their legal counsel and recordkeepers to customize the notice as appropriate."
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