In Josef K. v. California Physicians’ Service, No. 18-cv-06385-YGR (U.S. District Court for the Northern District of California, June 3, 2019), Judge Yvonne Gonzalez Rogers concluded that an independent medical review (IMR) organization can be subject to a claim under the Employee Retirement Income Security Act of 1974 (ERISA) as amended, 29 U.S.C. 1132(a)(3), for breach of fiduciary duties based on the review of a medical necessity appeal under an ERISA-governed employee welfare benefit plan.
On May 28, 2019, the Internal Revenue Service (IRS) announced in Revenue Procedure 2019-25 the 2020 health savings account (HSA) annual contribution limit and the 2020 high deductible health plan (HDHP) definitional limit per Internal Revenue Code Section 223.
In Gaylor v. Mnuchin, the Seventh Circuit Court of Appeals recently held that a tax code exemption for religious housing of ministers does not violate the Establishment Clause of the First Amendment of the U.S. Constitution. The decision has a direct impact on religious employers and their ministerial employees as well as a potential impact on secular employers that provide housing allowances for their employees.
The U.S. District Court for the Central District of California, applying de novo review due to California’s discretionary clause ban, ruled that an employee of Apple, Inc. was not entitled to long-term disability benefits because he did not satisfy the burden of proving that he was disabled.
The Tax Cuts and Jobs Act of 2017 (TCJA) eliminated the deduction for entertainment purchased as a business expense but left intact the deduction for business meals. Because entertainment and meals are often closely intertwined when purchased in a business context, taxpayers may have difficulty distinguishing deductible meal expenses from nondeductible entertainment expenses.
The Tax Cuts and Jobs Act of 2017 (TCJA) generally eliminated employer deductions for expenses incurred to provide employee parking benefits but left intact deductions for expenses associated with parking provided for customers and the general public. Because nondeductible employee parking expenses are often closely intertwined with deductible general public or customer parking expenses, employers may have difficulty distinguishing between the two under the TCJA.
On March 28, 2019, the U.S. District Court for the District of Columbia struck down key parts of the U.S. Department of Labor’s (DOL) final rule expanding the availability of association health plans (AHPs).
Behavioral health claims administrators and plan sponsors alike may be looking more closely at their care guidelines—and how they are applied—after a federal court ruled in a California class action that a claims administrator had breached its fiduciary duty under the Employee Retirement Income Security Act of 1974 (ERISA) by applying standards of care that were more restrictive than generally accepted standards and by improperly prioritizing cost savings.
Given that a variety of qualified retirement deadlines are approaching, we thought a refresher on the subject would be helpful, especially for plans that utilize a calendar plan year. This article is intended to alert plan sponsors about applicable major qualified retirement plan deadlines that fall in the first half of 2019.
Employers may soon find themselves reviewing and revising health plan master documents and summary plan descriptions (SPDs) and administrative service agreements with respect to an obscure claims administration practice known as “cross-plan offsetting”—following a recent federal appeals court ruling.
The Arizona Court of Appeals, Division One, has ruled that the Arizona State Legislature overstepped its authority in 2016, when it prohibited Arizona cities and other municipalities from enacting their own employee benefits ordinances.
When Arizona’s fifty-third legislature ended last spring, we reported on four new laws that impact Arizona employers and employees. The legislature also passed two additional laws impacting Arizona employers.
In back-to-back decisions, two federal district court judges have blocked implementation of a Trump administration rule that would exempt more employers from the Patient Protection and Affordable Care Act (ACA) requirement that employer-sponsored group health plans cover birth control supplies and services as preventive care without cost-sharing.
In Sulyma v. Intel Corporation Investment Policy Committee, the Ninth Circuit Court of Appeals recently held that having access to documents disclosing an alleged breach of fiduciary duty is not sufficient to trigger the three-year statute of limitations under the Employee Retirement Income Security Act (ERISA) if the plaintiff does not have actual knowledge of the alleged breach.
Having settled many of its attacks on pension plans sponsored by several large church-affiliated healthcare organizations, the plaintiff’s bar appears to be shifting focus to pension and welfare benefit plans maintained by a healthcare entity that is at least nominally an instrumentality of a state.
The Patient Protection and Affordable Care Act (ACA) has proven to be quite resistant to attempts to dismantle it, but on December 14, 2018, a federal judge in Fort Worth, Texas, may have finally accomplished what the president, Congress, various state and federal regulators, and assorted other statutory assassins have previously been unable to do.
The Patient Protection and Affordable Care Act (ACA) requires applicable large employers, as well as all employers that sponsor self-funded health plans, to report certain health plan coverage information. Applicable large employers must report the offers of coverage they extend to full-time employees and their dependents.
Otis Redding and the Black Crowes may have proclaimed themselves “hard to handle now,” but thanks to recent guidance from the Internal Revenue Service (IRS), hardship distributions from 401(k) plans are a bit less hard to handle, now.
Section 4960 of the Internal Revenue Code of 1986 (IRC), as amended, imposes an excise tax on compensation of certain highly compensated employees of tax-exempt organizations.
On November 1, 2018, the Internal Revenue Service (IRS) announced the cost-of-living adjustments affecting tax-qualified pension plans for 2019.
Under a proposed rule that the Department of Labor (DOL), Department of the Treasury, and the Department of Health and Human Services (HHS) jointly issued on October 29, 2018, employers may soon have more flexibility to fund health insurance coverage for employees through health reimbursement arrangements (HRAs), other account-based group health plans, and individual health insurance policies.
When the Internal Revenue Service (IRS) determines during an examination that a fringe benefit should have been taxed and the employer accordingly has to pay additional taxes in a later year, how is the subsequent payment treated for tax purposes?
Employers looking for greater transparency on prescription drug pricing and pharmacy benefit manager (PBM) services will soon have a powerful new tool from an unlikely source: California lawmakers.
Recent statistics show that approximately 70 percent of college graduates will leave college with an average of at least $30,000 in student loan debt. Cumulatively, the national student loan debt is approximately $1.5 trillion. This burden is causing millennials to wait longer than previous generations to buy houses, start families, and save for retirement. Although student loan indebtedness is not an issue employers can solve alone, a few are finding ways to recruit and retain talent by offering a helping hand to employees dealing with massive debt burdens.
The U.S. Department of Labor (DOL) recently issued new versions of the Affordable Care Act (ACA) Notices of Exchanges.
The Internal Revenue Service (IRS) recently clarified its position on two fringe benefits provided to employees on global assignments: tax equalization services and tax return preparation services. Memorandum Number 201810007 from the IRS’s Office of Chief Counsel (OCC), released on March 9, 2018, concerned a large American company employing thousands of employees globally.
On July 24, 2018, the Ninth Circuit Court of Appeals ruled in Munro v. University of Southern California, No. 17-55550, that an employer/fiduciary of a 401(k) plan cannot force a fiduciary breach claim under Employee Retirement Income Security Act (ERISA) section 502(a)(2) into arbitration.
Wisconsin employers that have found themselves frustrated by the fact that they can end an employment relationship for legitimate, business-related reasons yet the employee can still collect unemployment benefits were granted some relief by the Wisconsin Supreme Court in one of its final decisions of the 2017–2018 term.
On January 1, 2018, modifications to the rollover distribution rules for certain retirement plan participants with defaulted plan loans went into effect. As a result of a provision in the Tax Cuts and Jobs Act, the rollover distribution rules are now more relaxed for rollovers of defaulted loans resulting from plan terminations or a participant’s failure to repay a loan upon severance from employment.
The U.S. Department of Labor (DOL) recently finalized its much-anticipated rule which expands opportunities for small businesses and certain self-employed individuals to band together to obtain more affordable group health coverage under an association health plan (AHP).