Tim focuses his practice on employee benefits, specifically Affordable Care Act compliance, data privacy and security, and benefit plan administration. His clients range from closely held to publicly traded companies. They include the U.S. divisions of global companies in industries ranging from insurance and other financial services to manufacturing, and from pharmaceuticals to retailers and wholesalers and transportation.
Tim works closely with clients to help them understand and navigate the ACA. He advises clients on employer shared responsibility penalty risks and mitigation strategies, ACA reporting challenges, and the evolving nondiscrimination requirements. Specific representations include:
- Representing a national health care provider in challenging approximately $10 million in employer shared responsibility penalties from 40-plus subsidiaries over four years. To date, we have secured waivers of more than $2 million in penalties.
- Providing weekly/daily compliance advice and support to a national retailer’s benefits and legal staff in formulating and implementing its ACA compliance strategies over a period of three years.
- Revising and negotiating dozens of staffing company agreements to maximize protections for employer clients from the risks of misclassification and related ACA penalties.
- Advising and counseling employers on the rapidly evolving federal civil rights law and ACA regulation regarding transgender benefits.
Data Privacy and Security
Tim provides ongoing compliance advice, risk mitigation strategies, and training on HIPAA privacy and security to a range of employers. He develops policies and procedures, counsels companies on medical data disclosure issues in the workplace safety and M&A contexts, and advises clients including manufacturers, financial services companies and colleges and on how to handle data breaches by third-party service providers. Specific representations include:
- Ongoing counseling on strategy for handling data breaches under HIPAA and various state privacy laws involving wellness programs, third-party administrators, and employers’ internal staff.
- Counseling companies on disclosure of COVID-19 test results and other employee and family medical information throughout the pandemic.
- Advising clients on the potential administrative burdens and notice obligations that state privacy laws such as the California Consumer Privacy Act could have on the administration of employer-sponsored health plans.
- Ongoing training, service agreement negotiation, and development of internal privacy and security policies and procedures.
Benefit Plan Administration
Clients regularly turn to Tim for advice regarding complex and new benefit administration challenges. He counsel clients on administering COBRA and HIPAA special enrollment during the COVID-19 pandemic, as well as expanding telehealth programs and covering COVID-19 testing. Tim helps negotiate complex pharmacy benefit management and other service agreements, and design account-based plans such as health reimbursement arrangements and health savings accounts. Specific representations include:
- Advising a national insurer on overhauling its welfare plan structure and documentation. Key features included a retiree exchange program using an internal platform, a retiree HRA program, and multiple consumer-directed options for active employees.
- Advising a national wholesaler and retailer about a MEWA arrangement for unrelated owners and funding through a captive insurer.
- Counseling a transportation company on risk mitigation and transitioning away from a reference-based pricing program that caused significant friction with employees, families and providers.
- Advising clients in services, energy and other industries on ERISA and COBRA compliance strategies and options related to on-site clinics, wellness programs, and EAPs.
- Revising and restructuring multiple separation pay plan documents and administrative processes ahead of major restructurings at a large property casualty insurer.
Tim takes pride in anticipating client needs and in writing and speaking clearly and concisely, abilities honed over years of work as a newspaper and magazine reporter and editor.
Tim and his wife Mimi live in a newly empty nest in Elmhurst, Ill.