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A Framework of Adjusting Medical Claims Involving Possible Experimental Treatment

Modern health insurance policies and ERISA plans exclude coverage for experimental medical treatments. The question of what types of treatments qualify as experimental is problematic.

$4.1 Million Health and Wellness Center Being Built for Chattanooga Employees

[The administrator of personnel for Chattanooga] said the health clinics, the pharmacy and the fitness center all have seen heavy use, and the city has seen savings of more than $10 million over the last five years in health care costs.

Agencies Publish Proposed Revisions to Form 5500 and Schedules (PDF)

"The proposed Form and Schedules have been annotated by the Agencies to note 'New' line items. A rough count of 'New' lines ... [1] Form 5500: 30 line items; [2] Schedule A: 6 line items; [3] Schedule C: 12 line items; [4] Schedule H: Well over 150 lines and sublines -- detailed breakouts of assets and investments; [5] Schedule MB: 11 line items; [6] Schedule R: 25 lines or sub lines; [7] Schedule J: all new -- over 100 line and sublines."

Immediate Annuities Can Help Clients Get Government Benefits They Might Otherwise Price Out Of

Excerpt: People often seek immediate annuities because they want a steady income. However, financial advisors talk up another benefit as well: Such annuities may allow clients to qualify for Medicaid -- a poverty program -- even if they are well-heeled.

How to Sort Out Your Fringe Benefits Before the IRS Does

Excerpt: In this month's column, we begin to identify various fringe benefits the IRS has included for its three-year audit initiative. As with other audit initiatives, the precise focus of the audits will evolve and some of the targeted issues will increase or decrease in importance. Given the timing of the audits and the importance the IRS places on voluntary compliance, as well as the availability of various relief provisions applicable to fringe benefits and payroll taxes, employers should identify the fringe benefits that they offer as potential targets, beginning with the obvious -- those that arise from a specific statutory exemption.

Plaintiffs Allege That $31 Recordkeeper Fee Constitutes Fiduciary Imprudence Based on Contrived $14 Benchmarks

"A $31 recordkeeping per-participant fee is well below the average and median for $1B+ asset plans. But plaintiff law firms continue to file fiduciary malpractice claims with intentionally false comparators ... The plan sponsor community must fight back against frivolous excess fee lawsuits by publishing studies of what large plans actually pay for recordkeeping services and explaining how these services are differentiated by quality and scope." [Winkelman v. Whole Foods Market, Inc., No. 23-1352 (W.D. Tex. complaint filed Nov. 6, 2023)]