Regional Sales Director
Fringe Benefit Group
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IRA Expert
Ed Slott and Company, LLC
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Intac Actuarial Services
in NJ, NY

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Pentegra Retirement Services
in NC

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Navigating State and HIPAA Breach Notification Compliance
April 26, 2018 WEBCAST
Davis Wright Tremaine

Employee Benefits Breakfast Briefing
May 1, 2018 in CA
Nixon Peabody LLP

Health Benefits Laws Compliance Assistance Seminar
May 8, 2018 in NH
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Managing FMLA in the Workplace
May 31, 2018 WEBCAST
American Bar Association [ABA]

Onsite Employee Health Clinics Summit
June 28, 2018 in IL
World Conference Forum

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HIPAA in Due Diligence, Part 3: Risk Mitigation Strategies
"Given the uptick in enforcement against both covered entities and business associates and ever-increasing fines, it is important to take a proactive approach to quickly address compliance gaps.... [I]t is important to ensure that any post-close compliance is completed within a specified time, such as 30, 60, 90 or 120 days post-close.... Buyers should consider whether it is appropriate to obtain specific indemnification or escrow of funds to cover potential HIPAA non-compliance.... If the seller is involved in any government or third party investigation or settlement negotiation related to HIPAA compliance, buyers should consider obtaining a waiver of liabilities and rights from the government or third party prior to close."
McGuireWoods, LLP

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Denial of Supplemental Life Benefit Overturned Due to Poor Claims Administration
"This is a case study in how not to administer benefits -- a vague SPD, inconsistent explanations, cryptic claim records filled with acronyms and jargon, and poor coordination among the plan sponsor, TPA, and insurer resulted not only in an award of benefits but potential liability for the wife's attorney fees. Also, the maximum ERISA penalty was awarded for the employer's failure to timely provide certain documents the wife had requested." [ Sepulveda-Rodriguez v. MetLife Group, Inc. , No. 16-507 (D. Neb. Dec. 28, 2017)]
Thomson Reuters / EBIA

No Breach of Fiduciary Duty for Health Plan TPA That Overpaid Claims for Participant Eligible for ESRD-Based Medicare
"A union's health trust fund sued its TPA, claiming that the TPA breached its fiduciary duties under ERISA and its contractual duties under an administrative services agreement (ASA) by continuing to pay benefits for a participant after he became eligible for Medicare based on end stage renal disease (ESRD).... The court dismissed the claims against the TPA, concluding that it was not the TPA's duty to track participants' Medicare eligibility or applicability of the MSP requirements.... [T]he ASA expressly made the employer responsible for investigating participants' Medicare eligibility status." [ Birmingham Plumbers and Steamfitters Local Union No. 91 Health and Welfare Trust Fund v. Blue Cross Blue Shield of Alabama , No. 17-443 (N.D. Ala. Mar. 8, 2018)]
Thomson Reuters / EBIA

Potential Compliance Issues Associated with Offering Employee Benefits Through a Cafeteria Plan
"[These] action steps [are] aimed at helping you navigate often overlooked cafeteria plan compliance issues. [1] Identify. Document. Repeat.... [2] Limit. Administer. Enforce.... [3] Recognize. Consult. Apply.... [4] Ascertain. Conform. Approve."
Arthur J. Gallagher & Co.

How the Opioid Crisis Has Affected People with Employer Coverage
"[O]pioid prescription use and spending among people with large employer coverage increased for several years before reaching a peak in 2009. Since then, use of and spending on prescription opioids in this population has tapered off and is at even lower levels than it had been more than a decade ago.... Meanwhile, though, the cost of treating opioid addiction and overdose ... among people with large employer coverage has increased sharply, rising to $2.6 billion in 2016 from $0.3 billion 12 years earlier, a more than nine-fold increase."
The Peterson-Kaiser Health System Tracker

The New Tax Bill and Its Impact on Employee Benefits

April 9 webinar will help employers understand the impact of the Tax Cuts and Jobs Act on their total rewards packages, including planning opportunities and potential areas of concern. Discount for BenefitsLink readers .

Wide Regional Variation in Consumer-Directed Benefits Offerings
"West leads in HSA contributions, corresponding with rising HDHP offerings ... Midwest leads in HDHP offering and adoption rates ... Employees in the Northeast pay the highest premiums ... South leads in voluntary benefit choice growth, but pays highest deductibles."
Benefitfocus

The Next Onsite Health Benefit Could Be Chiropractic Care
"Twenty-nine percent of companies with 5,000 or more workers offered an on-site or nearby health clinic in 2014, up from 24 percent in 2012 ... [T]he majority of surveyed employers said their employees have expressed interest in chiropractic services at their clinics."
Employee Benefit News

How to Stay Within the Law When Using Biometric Information
"Several states have passed laws that regulate how companies may collect, store and disclose biometric information from employees or other individuals.... State data-breach notification statutes include biometric information in the definition of protected personal information."
Society for Human Resource Management [SHRM]

Researchers Back Outcomes-Based Payments for Medical Devices as Industry Braces for a Shift
"Outcomes-based pricing for devices, similar to performance-driven initiatives taken by Medicare for medical services, are needed to promote accountability, according to a group of health policy researchers.... [O]verprescribing of unnecessary or ill-fitting devices has been a problem for patients under traditional payment models, with critics arguing physicians and device makers are not held accountable for patient outcomes."
FierceHealthcare

What Happens After Breach of Fiduciary Duty Claims Stemming from Denials of Benefits Survive a Motion to Dismiss? (PDF)
"Following the U.S. Supreme Court's decision in CIGNA Corp. v. Amara , plaintiffs have argued, with some success, that ERISA breach of fiduciary duty claims under ERISA Sections 502(a)(2) and (a)(3) may proceed alongside claims for benefits under ERISA Section 502(a)(1)(B) that seek the same relief.... One recent decision ... provides useful insight on how courts approach residual breach of fiduciary duty claims ... after dismissing a claim for benefits ... It demonstrates that, even where a court permits a breach of fiduciary duty claim to outlive a claim for benefits, plaintiffs still may have difficulty establishing an actionable fiduciary breach in the typical claim for benefits context." [ O'Rourke v. Northern California Electrical Workers Pension Plan , No. 16-2007, (N.D. Cal. Nov. 2, 2017)]
Jenner & Block, via Employee Relations Law Journal

Timing of Acquired Company's Final 5500 Due to Health Plan Termination
Say a fully insured group health plan covers 100+ participants. The company (plan sponsor) is sold during 2017 and the group health plan ends. The policy expires on December 31, 2017. The employees are hired by the acquirer effective January 1, 2018. The 5500 instructions say not to check "final return" if "the plan is still liable to pay benefits for claims that were incurred prior to the termination date, but not yet paid." Two questions: [1] Is 2017 the final return, or does the fact that the insurance company may still receive and pay claims require another 5500 for 2018? [2] If the answer above is yes, presumably the active participants at the end of the plan year would be 0, even though the policy ended at 11:59 p.m. on December 31, 2017, correct? One can't file a final return with a participant count >0, so this seems logical.
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