The US Department of Labor (DOL) has proposed changes to the Form 5500 and schedules that will affect ERISA Title I group health plans of all sizes, but small group health plans should be especially aware of the changes. Certain small group health plans (fewer than 100 participants) are currently exempt from filing the Form
Understanding Employee Benefits and key developments in the employee benefits field and items of interest to our clients. MORE
Welfare Plans
EEOC Issues New Wellness Guidance
By Stinson LLP on
My colleagues in the Labor and Employment Group have published an Alert on the new wellness guidance from the EEOC. It is linked here.
Time to Review Plan Subrogation Procedures, Part 2
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I blogged a few days ago about the U.S. Supreme Court decision making it harder for plans to recover from a third-party settlement fund for the amount the plan paid when a participant is injured by that third-party. A recent federal district court decision highlights the need to provide appropriate notice of the plan’s reimbursement/subrogation …
Time to Review Plan Subrogation Procedures
By Stinson LLP on
Most self-funded ERISA medical plans provide that participants who have been injured by other people (think car accidents) must reimburse the plan if the participant recovers from the other person for those injuries. In order to obtain that reimbursement, a plan document must contain appropriate reimbursement/subrogation language and the plan must pay attention to the…
What Does the Trust Requirement of ERISA Mean?
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ERISA requires that plan assets be held in trust so that they are protected from claims of the employer. With pension plans, it is generally easy to determine when assets become plan assets and when they should be held in trust. For welfare benefit plans, such as health plans, the situation is more complicated. Employers …
Is Your Severance Policy an ERISA Plan?
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I wrote an Insight article for firm clients on distinguishing an ERISA severance plan from a non-ERISA severance policy. For those of you not on that distribution list, the article is here.
A Summary Plan Description Can be a Plan Document
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In a decision issued a couple of years ago, the United States Supreme Court held that a summary plan description that differed from the plan document could not be enforced as the plan document. The Court said that the summary plan description was supposed to describe the plan and it was the plan that should…
Business As Usual: Supreme Court Upholds ACA Subsidies
By Tom Dowling on
The United States Supreme Court recently held in King v. Burwell that the Affordable Care Act (ACA) permits individuals to receive health insurance premium subsidies through federally-facilitated exchanges (in addition to state-based exchanges). Because this decision is consistent with existing agency interpretation, the decision has little direct effect on employer-sponsored group insurance plans.
In the…
Same Sex Marriage: Effect on Benefits
By Stinson LLP on
The United States Supreme Court recently held in Obergefell v. Hodges http://www.supremecourt.gov/opinions/14pdf/14-556_3204.pdf that all states must recognize and allow marriages between same sex partners. Depending on an employer’s current employee benefits plan, certain provisions may need to be changed in light of this ruling.
For those employers who already provide spousal benefits to same sex…
Standard of Review is Important – Again
By Stinson LLP on
I recently blogged about the importance the standard of review can make when a court decides whether a claims decision made under an employer plan will be upheld. My recent blog post dealt with the standard of review under a top-hat plan, a plan for executives. Another recent case makes the same point in a…