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Health & Welfare Plans Newsletter April 30, 2020 |
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Newly Posted DOL and IRS Health and Welfare Plan Audits: Latest Examination Initiatives, Key Legal Provisions, Avoiding Triggers
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview] DOL Provides Major Group Health Plan Timeframe Extensions for COVID-19 National Emergency "The new final rule extends [certain] timeframes to assist employers and employees in the process of maintaining employer-sponsored group health plan coverage.... [1] The HIPAA special enrollment period ... [2] The COBRA election period ... [3] The COBRA premium payment period ... [4] COBRA Notices from employees re divorce/legal separation, child reaching age 26, and disability ... [5] The plan's benefit claim filing deadline ... [6] The ERISA adverse benefit determination appeal deadline ... [7] The ERISA external review request deadline ... [8] The deadline to submit additional information related to external review request." ABD Insurance & Financial Services |
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[Guidance Overview] Reopening America: Employers Facing Paid Leave Issues Under the FFCRA "If you are not bringing all of your employees back to work, make sure that you have a documented legitimate business reason to explain why some employees are being treated differently. This is especially important in instances where some of the workforce took paid leave under the FFCRA and could now make a prima facie case for retaliation if they are treated differently from similarly situated employees in being returned to work." FordHarrison |
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[Guidance Overview] Supplemental Paid Sick Leave (Immediately) Required in Unincorporated Los Angeles County, California "On April 28, 2020, the Los Angeles County Board of Supervisors voted unanimously to enact an interim urgency ordinance to require employers with 500 or more employees within the United States to provide supplemental paid sick leave (SPSL) to covered employees immediately until December 31, 2020 ... This development represents the fourth local emergency paid leave ordinance in California, including one in the City of Los Angeles[.]" Littler |
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"Investigators found that [the employer] failed to pay the employee for what qualified as paid sick leave covering the hours he spent at home after the company received documentation of his doctor's instructions to self-quarantine. The employer denied the complainant's request for paid leave under the EPSLA, mistakenly believing that the complainant had to submit proof of a positive coronavirus test to qualify for the paid leave." Wage and Hour Division [WHD], U.S. Department of Labor [DOL] |
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"An employer's liability for monetary losses suffered by an employee wrongfully denied EPSL or EFML may seem deceptively small because of the daily and per employee aggregate caps set by FFCRA.... But the class and collective action vehicles, plus the potential for attorney fees and liquidated damages awards, should make these suits attractive to plaintiffs' lawyers and very costly for employers who fail to comply with the FFCRA. Indeed, well-funded and prominent plaintiffs' firms have already filed COVID-19 lawsuits and are advertising for class representatives." Nixon Peabody LLP |
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Supreme Court Finds Insurers Entitled to Millions in ACA Payments "Justice Alito's lone dissent warns that this decision will 'have a massive immediate impact,' in that 'billions of taxpayer dollars will be turned over to insurance companies that bet unsuccessfully on the successes of the program in question.' In addition, 'its potential consequences go much further'; the phrase the 'Secretary shall pay,' which the Court construes as creating a cause of action, 'appears in many other federal statutes.' " [Maine Community Health Options v. U.S., No. 18-1023 (S. Ct. Apr. 27, 2020)] Pepper Hamilton LLP |
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Temporary Expansion of Educational Assistance Programs to Cover Employees' Student Loan Debt "Any payments for student loan debt would count against the $5,250 annual benefit under the educational assistance program. To implement this feature, an employer should amend its educational assistance program, or adopt a program, and notify employees of the availability of the new benefit." Dickinson Wright |
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Answers to COVID-19 Prescription Drug Plan Questions "Who needs to take action here? Does anyone need to change their plans? Is that even allowed mid plan year? ... I've seen some reports of drugs already in existence that can help prevent COVID-19. Is that true? ... After all is said and done, what will be the cost impact on an employer's plan? ... I'm an employee. I'm an HR Director. I'm a CEO/CFO. What are my biggest concerns at each level?" CBIZ |
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Benefits Advising in the Age of COVID-19 "From both a tactical and strategic perspective, [advisors] will have to make changes to meet our clients where they are now in order to bring that value. In doing so, advisors should be asking themselves the following three key questions: [1] How has the changing world impacted each individual client specifically, and how has that changed their benefit needs? ... [2] How has the changing world impacted the needs that benefit plans are designed to meet, and how does that impact conventional wisdom regarding those plans? ... [3] How has the changing world not changed things, and how do we rely on tried and true strategies and advice to continue to bring value to our clients?" InsuranceNewsNet.com |
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Benefits in General |
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ERISA Fee Motions After COVID-19 "One decision presents a refresher course on the merits of ERISA fee motions and the other used the novel procedural approach of conducting a Zoom video hearing in lieu of live appearances.... The post-COVID-19 world will present many new ways of doing business, and we can foresee federal judges experimenting with Zoom hearings in lieu of expensive and now unwelcome travel. A good place to start may be with fee motions, as they are ancillary to the merits of the case." Seyfarth |
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Eleventh Circuit Renders Landmark Decision on ERISA Sanctions "[T]he Eleventh Circuit ruled that the penalties available under Section 1132(c) 'cannot be imposed for failure to provide documents other than those specifically enumerated in Section 1024(b)(4).' In so holding, the court rejected the plaintiff's contention that sanctions were available for failures to produce claims-specific and employment history document requests, including alleged violations of ERISA Section 209(a), 29 U.S.C. Section 1059(a) and [DOL] regulations." [Williamson v. Travelport, LP, No. 18-10449 (11th Cir. Mar. 27, 2020)] Littler |
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Press Releases |
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Most Popular Items in the Previous Issue |
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Text of EBSA Disaster Relief Notice 2020-01: Guidance and Relief for Employee Benefit Plans Due to the COVID-19 (Novel Coronavirus) Outbreak
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Text of EBSA and IRS Final Regs: Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID-19 Outbreak
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Text of EBSA COVID-19 FAQs for Participants and Beneficiaries (PDF)
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