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“King” of the Road

“King” of the Road

July 6, 2015

Authored by: Chris Rylands and Lisa Van Fleet

ACAIn Roger Miller’s 1964 hit by the above name, he tells the tale of “a man of means by no means,” a man just scraping to get by. While he may not have a phone, a pool, pets, or cigarettes (and really, what does he need that last item for anyway?), after the Supreme Court’s 6-3 decision on June 25, however, such a man might be able to secure a premium tax credit to help pay for health insurance (yes, we realize he’d probably be Medicaid eligible, but just work with us here).

But what does the ruling mean for employers? At first, it might appear that it doesn’t mean very much; life under the Affordable Care Act will continue to move along much as it has for the last few

Tibble: Much Ado About Nothing?

OMG HeadlineEveryone seems to be talking about last month’s Supreme Court decision in Tibble v. Edison International, even though its holding wasn’t all that momentous. But I’m not complaining. As an ERISA lawyer, I love when ERISA developments hit mainstream news because, for at least one brief fleeting moment, there is a connection between the ERISA world in which I dwell and the rest of the world.

That said, some question whether Tibble warrants the level of attention it is generating. Some say Tibble merely affirms a well-known principle of ERISA law—that is that an ERISA fiduciary has an ongoing duty to monitor plan investments. Others see Tibble as a reflection of enhanced scrutiny of the duty to monitor plan investments, as well as recognition of a statute of limitations that facilitates enforcement of that

Are You My Fiduciary?

Are You My Fiduciary?

May 5, 2015

Authored by: Lisa Van Fleet

Baby DuckHow many of you remember the classic children’s’ story “Are you My Mother?” by P.D. Eastman?  In that delightful story, we follow a confused but determined baby bird who is looking for his mother.  He sets off to find her, asking various creatures along the way (a dog, a cow, a plane) whether they are his mother, and in the end happily finds his way beneath her protective wing.

The parallels between this story and the proposed Conflict of Interest Regulations are clear (at least to some of us).  The proposed guidance examines the various service providers encountered by retirement plans and IRA owners, as well as their participants and beneficiaries (“retirement investors”) and evaluates whether or not such service providers are fiduciaries who offer a protective wing.  Moreover, the guidance expands

DOL’s Expansion of the Definition of Investment Advice (or “Fiduciary”)

Who's Holding Your Piggy Bank?Acting on reaction to a proposed and subsequently withdrawn regulation from October 2010 and attempting to address concerns expressed by both interested parties to the initial proposed regulation and an economic analysis by the Council of Economic Advisors (that the Investment Company Institute considers flawed), the Department of Labor has issued a new proposed regulation expanding the definition of investment advice. The DOL’s stated purpose in doing so is to protect retirement plan and IRA investors from practices engaged in by some advisors whose interest in providing investment advice is conflicted and not in the best interest of the participant or IRA owner.

The proposed rule does not expand the definition of fiduciary per se, but instead it expands the areas of advice that are rendered by

EEOC Finally Lets the Wellness Cat Out of the Bag

WellnessOn April 16, the Equal Employment Opportunity Commission (the “EEOC”) finally gave a peek into its thinking about what constitutes a “voluntary” wellness program under the Americans with Disabilities Act (the “ADA”). Recall that, while there are extensive wellness rules under HIPAA and ACA for these types of programs, there was always a gray area with regard to whether these programs were considered “voluntary” for ADA purposes. The EEOC recently started suing companies over their programs and was heavily criticized for doing so without issuing any guidance (aside from a couple of non-binding opinion letters). These proposed regulations are the beginnings of the guidance the critics have requested. While not binding, they are a good starting point for understanding where the EEOC may end up.

Under the proposed rules,

ACA Reporting and Disclosure: The Complexity Continues (Part 3 of 3)

Welcome back to the third and final segment of our 3-part discussion of the ACA reporting and disclosure forms. In Part 1, we focused on the basics: identifying the various forms, the reporting entities (focusing on employer as filers), and deadlines for filing. In Part 2, we discussed the differences between the draft and final forms. In Part 3 we will focus on the penalties for failing to file. For purposes of the following discussion, we will assume the reporting entity is an employer.

Penalties for Non-Compliance: The penalty for failure to comply with the ACA reporting and disclosure requirements is substantial. A separate penalty is assessed for each failure to file a return and each failure to provide information statements on a timely and accurate basis.

465549130These

ACA Reporting and Disclosure: The Complexity Continues (Part 2 of 3)

462876067Welcome back to Part 2 in our 3-part discussion of the ACA reporting and disclosure forms. In Part 1, we focused on the basics: identifying the various forms, the reporting entities (focusing on employer as filers), and deadlines for filing. In Part 2, we will discuss the differences between the draft and final forms. In Part 3 we will focus on the penalties for failing to file.

Deviations from Draft Form: The forms themselves are unchanged from previous drafts. Instructions for the “B Forms” are likewise nearly the same. One minor change is that employers may list a TIN for an employee who does not have a SSN available.

Instructions for the “C Forms” include several changes and clarifications worth noting:

  • As with the 1095-B, a TIN may be used

ACA Reporting and Disclosure: The Complexity Continues (Part 1 of 3)

160298188The unexpected occurred in 2013 when implementation of the Employer Mandate was delayed due to the inability of the IRS to timely issue the requisite reporting and information forms. Now that those forms have finally been issued, we can readily appreciate why it took so long.

The forms, while deceptively simply in appearance, are challenging to complete properly. In fact, the IRS is currently drafting FAQs to address numerous outstanding questions.

This is Part 1 in our 3-part discussion of the ACA reporting and disclosure forms. In this discussion, we focus on the basics: identifying the various forms, the reporting entities, and deadlines for filing. In Part 2, we will discuss the differences between the draft and final forms. In Part 3 we will focus on the penalties for failing comply with these

This Time With Feeling – Employer Paid Individual Policies Violate ACA

February 24, 2015

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Employer payment plans, which include arrangements where an employer pays, or reimburses an employee, for some or all of the premium expenses incurred for an individual health insurance policy, violate market reforms under the Affordable Care Act (“ACA”).

Notice 2015-17 is the latest in a series of IRS guidance on these arrangements (see our earlier post on this topic here). While it reiterates previous conclusions regarding the failure of the arrangements to satisfy the ACA, it also provides excise-tax transition relief for certain small employers.

Limited Transitional Relief for Non-ALEs

Noncompliant group health plans may be liable for a $100/day excise tax for failure to satisfy ACA market reforms. The new Notice, while reiterating that conclusion, provides that the tax will not be asserted under two conditions:

  • Until June 30, 2015, if the plan is not sponsored by an Applicable Large Employer (“ALE”). An ALE, for
  • The Anthem Breach – What Next?

    The Anthem Breach – What Next?

    February 12, 2015

    Authored by: David Zetoony and Lisa Van Fleet

    The facts surrounding the Anthem breach continue to evolve as does Anthem’s handling of the situation.

    Based on the current status of the investigation, and Anthem’s current reactions to the incident, there are steps which group health plan sponsors should consider taking to fulfill their own HIPAA and fiduciary obligations with respect to group health plans affected by the Anthem breach. These steps include the following:

    • Have business associate agreements and other relevant documents reviewed to assess the plan sponsor’s rights and obligations with respect to the breach.
    • Request from Anthem:
      • additional information about the breach;
      • confirmation concerning the steps that will be taken to protect the plan sponsor’s employees and affected individuals;
      • more extensive victim protection, client indemnification, and paid notification than Anthem is currently proposing to offer; and
      • confirmation that any state notification requirements will be satisfied on behalf plans
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