ERISA record retention may not be of those sizzling retirement plan topics for some folks. But please don’t stop reading. It’s an important issue in today’s ERISA’s environment in which Plan Administrators and other fiduciaries must meet complicated compliance reporting requirements, oversight from regulatory agencies, and sometimes litigation. So here is some basic information … Continue Reading
Last month, the Department of Labor (DOL), the Internal Revenue Service (IRS), and the Pension Benefit Guaranty Corporation (PBGC) released advance copies of the 2020 Form 5500 Series. When filed, they will join those of prior years’ morphing into the body language of ERISA compliance. Here’s how:… Continue Reading
Is a self-funded group health plan with more than 100 participants required to have an annual audit? There seems to be a difference of opinion among professionals on this question. Let’s start with the rules on group health plans and other “welfare plans.”… Continue Reading
The Department of Labor (“DOL”) will be increasing penalties, in some cases substantially, for violations of ERISA. Here’s why and how it will impact ERISA plans that are not in compliance. Background In 2015, Congress passed the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 as part of the Bipartisan Budget Act of … Continue Reading
The July 31 due date for filing Form 5500 with the Department of Labor (DOL) for calendar year retirement plans is rolling around very quickly unless extended. But what about those welfare benefit plans? Do they also have to file Form 5500? As with all ERISA matters, it depends. Here are the basics in Q&A … Continue Reading
If your employer provides group health coverage, you should have received a detailed booklet, usually prepared by an insurance company that describes your coverage. The booklet is a formidable document that describes your group health benefits and the applicable limitations and restrictions on coverage in great detail. The ERISA Requirements But does this booklet measure … Continue Reading
Actually, it was “only” a potential violation of privacy and data security rules imposed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for which North Memorial Health Care of Minnesota (“NMHC”) agreed to pay $1.55 million. The violation alleged by the Department of Health and Human Services Office for Civil Rights (“OCR”) … Continue Reading
Ir’s not exactly hats and horns for the 2016 Affordable Care Act (ACA) New Year, but there are a few reasons to celebrate regarding compliance matters. Filing Extensions The 2016 ACA reporting deadlines that apply to all subject employers (those with an average workforce of 50 or more full-time employees plus full-time equivalents, or “FTEs”) … Continue Reading
A prohibition on discrimination has applied to self-insured plans for years under Section 105(h) of the Internal Revenue Code. The Affordable Care Act (“ACA”) now extends that ban on discrimination in insured group health plans. What does this mean? Insured health plans can no longer favor highly compensated employees in terms of eligibility for benefits … Continue Reading
Many employers sponsoring welfare benefit plans are understandably now totally focused on what they can see in front of them. Namely, the Affordable Care Act. But lurking just below the surface is ERISA and a host of other laws through which employers have to navigate. Let’s start with ERISA. Most welfare benefit plans are subject … Continue Reading
Every Summary Plan Description has to include one, a claims procedure that set forth the requirements for processing benefit claims and appeals. The underlying ERISA statute was written in a paternalistic manner with explicit provisions intended to offer protection to “the interests of participants in employee benefit plans and their beneficiaries…by providing for appropriate remedies, … Continue Reading
OK, so you sponsor an insured group health plan and employ at least 50 full-time employees including full-time equivalents, or “FTEs” (that’s ACA jargon for 30 hours of work each week performed by more than one employee so that, for example, two employees working 15 hours per week equals one “FTE”). You have made this … Continue Reading
That’s limitations as in “limitation periods”. A recent court case reminds ERISA plans to have such limitation periods and to communicate it to someone claiming a plan benefit. Let’s start with the basics. What’s a “limitation period”? In layman’s terms, it’s a law set forth in a State statute of limitations that sets time limits … Continue Reading
It took nine years in the case of Butler v. United Healthcare of Tennessee to determine who was responsible for a denied group health benefit claim. The patient, covered by her husband’s ERISA health benefit plan, sought treatment for inpatient rehabilitation for substance abuse. Treatment for which was denied by United. The patient ultimately received … Continue Reading
Some of the most difficult and contentious provisions of the Affordable Care Act (“ACA”) are the employer mandate and upcoming reporting requirements effective in 2015. “Difficult” because the employer mandate requires applicable large employers, generally those with 50 or more “full-time” employees, to offer coverage to full-time employees and dependents (other than spouses). If the employer … Continue Reading
There used to be a brief three month respite between October 15, the final due date for extended Form 5500s, and the following January 1, when the annual administrative cycle began again. Not any more. The Affordable Care Act (“ACA”) provides another set of compliance deadlines starting on November 15, 2014. The new deadlines involve: … Continue Reading
There has been a deluge of regulatory activity involving the Affordable Care Act (“Obamacare”), or the ACA. Some developments, such as the general postponement of the employer mandate until 2015 (and the recent postponement until 2016 for employers with 50-99 full time equivalent employees), have received significant press attention. Others involve details of interest primarily … Continue Reading