Health & Welfare Plans Newsletter

May 20, 2020

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View Coronavirus (COVID-19) News and Resources

[Guidance Overview]

Determining COVID-19 Leaves of Absence: A Guide for New York City Employers (PDF)

This flowchart applies to New York City employers with fewer than 500 workers and covers leave requests through the end of 2020. It is designed to help businesses navigate intersecting city, state and federal leave laws and regulations such as the FFCRA, the New York State COVID-19 Quarantine Leave Law and the New York City Earned Safe and Sick Time Act.

Fox Rothschild LLP

[Guidance Overview]

Massachusetts Proposed Regs Affect Private Plan Exemptions to Paid Family and Medical Leave Act

"The proposed amendments would allow employers to apply for 'partial exemptions,' meaning, family leave only or medical leave only, as well as for both types of leave.... [T]he regulations also provide that, while employers can choose to cover one or both types of leave through a private plan, employers cannot apply for a private plan exemption on behalf of a portion of its workforce. All private plans must cover the employer's entire workforce."

Jackson Lewis P.C.

[Guidance Overview]

Massachusetts Again Proposes Amendments to Paid Family and Medical Leave Regs

"The proposal includes several new defined terms, while augmenting others.... [T]he proposed amendments would [1] exclude properly classified independent contractors from workforce calculations ... [2] expand upon the existing the requirements for exemptions ... [3] clarify the rights for individuals covered by private plans ... [4] clarify filing requirements ... [5] further clarify how benefits determinations will be made ... [6] allow for benefits to be reduced if the covered individual has outstanding tax or child support obligations."

Fisher Phillips

[Guidance Overview]

Navigating the COBRA Rules Under the Latest DOL and IRS COVID-19 Relief

"Many employers may not be staffed to process payments other than through payroll deduction, and it may be especially difficult to set up a procedure for doing so when the staff that might handle the payments is either not working or working remotely. Moreover, if the employer is collecting premium payments from a furloughed employee who is not receiving compensation, and the individual does not make a payment, he or she may be considered to have a COBRA qualifying event at that point, and the tolling period provided by the DOL/IRS Notice would apply."

Lathrop GPM

Editor's Pick The Cost of Health Care During Retirement: Expectations and Concerns of Older Workers

"Across wealth levels, many workers are concerned about their ability to pay for health expenses in retirement. Yet most individuals have not saved specifically for such costs, nor have they reviewed their employer-provided retiree health care benefits. Those who are unfamiliar with their benefits exhibit higher levels of concern about retiree health care costs. Most people expect to rely primarily on Social Security and/or their retirement plan assets to fund health care costs in retirement."

TIAA Institute

Fifth Circuit Revives Claim Against Humana for Denial of Eating Disorder Treatment

"Katherine P. argued that the district court erred in disregarding evidence that the Humana reviewers were conflicted and improperly used the Mihalik Criteria. The court specifically did not address those issues. Instead, the court found that summary judgment was improper because the administrative record showed a genuine dispute as to whether Katherine satisfied one of the Mihalik Criteria[.]" [Katherine P. v. Humana Health Plan, Inc., No. 19-50276 (5th Cir. May 14, 2020)]

Kantor & Kantor

Benefits in General

[Guidance Overview]

Editor's Pick COVID-19: Implementing Claims-Related Deadline Extensions

"Plan sponsors and claim fiduciaries have different roles to play in implementing the Joint Notice requirements. Plan sponsors can assist by ensuring that the plan's procedures account for the Joint Notice's requirements. Claim fiduciaries must be cognizant of their fiduciary duties in implementing the Joint Notice requirements. [This article describes] some considerations to bear in mind when making the mandated changes to a plan's administrative procedures."

Faegre Drinker

2019 in Review: DOL ERISA Enforcement

"Total monetary recoveries increased for the fourth year in a row, due to another year of historically high recoveries from EBSA's civil enforcement actions. Although civil enforcement recoveries reached a historic high -- the second largest in over fifteen years -- the trend of increased criminal investigations and decreased civil investigations continued in FY 2019."

Eversheds Sutherland

How to Create an Employee Benefits Communication Strategy for Short Attention Spans

"The key is creativity.... [1] Break up lengthy emails into a mini email series. [2] Supplement lengthy content with short, fun videos.... [3] Eliminate jargon. [6] Use interesting examples to make it memorable. [4] Use images (infographics, charts, diagrams, etc.). [5] Switch to intuitive, easy-to-use benefits decision support software.... [6] Consider offering fun in-person sessions, such as benefit fairs with prizes or giveaways."

Tango Health

Checklist of Employee and Benefits Considerations for International Companies Expanding Business Into the United States

"Expanding your international business into the United States is an exciting but sometimes daunting venture when it comes to the myriad rules and regulations at play governing employees and benefits. This alert endeavors to simplify those complex rules and regulations in the fields of employment, employee benefits and executive compensation law.... This checklist will guide your company through a multitude of considerations, including identifying essential parties, processes and compliance concerns in employee and benefits."

Holland & Knight

Selected Discussions
on the BenefitsLink Message Boards

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Retiree Premium Reimbursement Program -- Constitutes an HRA?

"Say a mid-size employer has a written policy, or a series of individual agreements, that applies to executives (say VP or above) who retire with 10 years of service at age 55 or later. Once they retire, the employer will reimburse them up to a fixed dollar amount per month for the retired executive's personal payment of individual health insurance premiums. Reimbursement will last until Medicare eligibility. Substantiation is required. No other medical benefits are provided; just a capped premium reimbursement for a fixed amount of time. What, exactly, is this? An HRA or something less?"

BenefitsLink Message Boards

Does Employer Payment of President's Health Insurance Violate IRC 125?

"Corporate employer pays its president's family coverage under group health insurance plan per an employment agreement. For other employees, employer only pays for employee-only coverage (employees pay for any more on their own). This clearly is discriminatory under IRC 105(h). But does it violate the IRC 125 cafeteria plan rule against discrimination as to contributions and benefits?"

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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