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Health & Welfare Plans Newsletter August 9, 2019 |
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Webcasts, Conferences Employer Experiences With Reference Based Pricing
Creating an Employee-Centric Benefits Strategy
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[Official Guidance]
"As noted [in this opinion letter], 'to care for' a family member with a serious health condition includes 'to make arrangements for changes in care.' ... This includes taking leave to help make medical decisions on behalf of a hospitalized parent or to make arrangements to find suitable childcare for a child with a disability. " Wage and Hour Division [WHD], U.S. Department of Labor [DOL] |
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[Guidance Overview]
DOL Confirms That Certain School Meetings Are FMLA-Protected "While the fact pattern outlined in the opinion letter specifically references Committee on Special Education (CSE) meetings, the USDOL stated in the letter that 'the analysis and conclusion in this opinion letter apply to any meetings held pursuant to the [Individuals with Disabilities Education Act (IDEA)], and any applicable state or local law, regardless of the term used for such meetings.' Therefore, while you have a right to inquire about the purpose of any such meetings to determine whether they fall within the protection of the FMLA, you shouldn’t necessarily deny a leave request just because the school meeting doesn’t meet all of the parameters set forth in this specific fact pattern." Fisher Phillips |
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[Guidance Overview]
DOL Declares That Parent Attendance at School IEP Meetings Are Covered by the FMLA "Employers should [1] treat a request for FMLA leave to attend an IEP meeting consistent with how they handle all other intermittent FMLA leave requests.... [2] closely review the need for attendance specifically at school meetings so that there is some connection to the child’s IEP or issues that implicate the Individuals with Disabilities Education Act (IDEA).... [3] insist that the medical certification contain specific language supporting the need for the employee to attend IEP meetings for the child.... [4] Train your managers about this new obligation so that these requests are not being outright rejected in the context of FMLA leave." FMLA Insights |
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[Guidance Overview]
Digging into the New HRA Regulations: Excepted Benefit HRAs "Addition of the Excepted Benefit HRA gives employers the ability to offer a flexible, limited-scope HRA to employees. Although the amount available for each plan year is limited, amounts in an Excepted Benefit HRA may be rolled over and accumulated from year-to-year ... Further, employees covered by Excepted Benefit HRAs are eligible to make contributions to health savings accounts, assuming the individual does not otherwise have disqualifying coverage." Proskauer |
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Where Tourism Brings Pricey Health Care, Locals Fight Back "Fed up with high hospital prices even after insurers' negotiated discount, more employers are cutting out insurance middlemen and engaging in what is known as 'direct contracting' with medical providers. They cut their own deals.... What Peak did -- starting with painstakingly gathering data about exactly what hospitals in the region were being paid by insurers, employers and consumers -- might be an answer for some." Kaiser Health News |
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Proposed Changes to Health Savings Accounts Could Hurt You in Retirement "The Health Savings for Seniors Act ... would allow Medicare beneficiaries to continue participating in an HSA. But it would also strip beneficiaries the ability to use money in their HSAs toward their Medicare Part B premiums, which is at least $135.50 a month." MarketWatch |
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Benefits in General |
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[Guidance Overview]
Auditor Considerations Under the New Employee Benefit Plan Standard "Statement on Auditing Standards (SAS) No. 136 ... contains detailed guidance on the form and content of an auditor’s opinion on ERISA plan financial statements. There are comprehensive examples and explanations for the structure and presentation of such opinions, including reports for audits in accordance with Generally Accepted Auditing Standards, as well as other auditing standards.." EisnerAmper |
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How Can Auditors NOT Be Responsible for the Financial Statements? "Nonattest services are tasks performed by an auditor for its client outside the scope of ... an audit. Financial statement preparation and cash-to-accrual conversions performed by an auditor for a client are considered nonattest services ... Other common examples ... include preparation of reconciliations (trust statements to payroll and/or recordkeeper statements), preparation of Form 5500, 990s, or other tax returns, valuation and disclosure of investments including methodology and leveling, and proposing journal entries affecting the financial statements[.]" Belfint Lyons Shuman |
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ERISA's Full and Fair Review Requirement Gets a Full and Fair Review by the Tenth Circuit "Prior case law in the Tenth Circuit was less than clear on whether (and under what circumstances) procedural irregularities could cause a reviewing court to conclude that the irregularities are sufficient to justify the imposition of a de novo review. In this case, the Tenth Circuit appears to assume (without formally deciding) that discretionary review can indeed be lost in the event procedural irregularities exist in the record." [Mary D. v. Anthem Blue Cross Blue Shield, Case No. 17-4195 (10th Cir. Jul. 15, 2019)] Littler |
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Plan Administrator Deemed an ERISA Fiduciary "The Fourth Circuit ... determined that the spouse's complaint adequately alleged that the employer was a functional fiduciary because of its status as plan administrator and because of the vice president's individualized advice to the spouse regarding her claim. The Fourth Circuit also noted its prior decisions in which it had held that a plan administrator acts in a fiduciary capacity when it verifies employee eligibility for plan participation." [Dawson-Murdock v. National Counseling Group, Inc., No. 18-1989 (4th Cir. Jul. 24, 2019)] The Wagner Law Group |
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Press Releases |
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Most Popular Items in the Previous Issue |
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Benefits That Engaged Employees Want and Need
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Higher Ed Institutions Now Have More Options with the New HRA Regs
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