These Boots Are Made For Walking…But If You Quit, You Might Not Get the COBRA Subsidy

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by Brenda Berg

April 8 UPDATE: The COBRA subsidy model notices referenced in this article are now available: https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra/premium-subsidy. Employers should be working with their COBRA administrator on how to notify eligible individuals about the subsidy.

The COBRA subsidy from the most recent COVID-19 stimulus bill – The American Rescue Plan Act of 2021 (ARPA) – is now in effect. An assistance-eligible individual can have 100% of COBRA premiums subsidized for the periods beginning April 1, 2021 through September 30, 2021. All plan sponsors must offer the subsidy – it is not optional.

Eligible former employees and spouses/dependents (qualified beneficiaries) can receive the subsidy if they are already on COBRA. In addition, individuals who declined or dropped COBRA coverage can elect into COBRA under a “second bite at the apple” election process, if they are still in the remaining period of COBRA coverage that would have applied originally. Read more

Like a Surgeon… Got Providers on my Mind

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by Lyn Domenick

The myriad health and welfare plan requirements in the Consolidated Appropriations Act, 2021 include those for a group or individual health plan to maintain a cost comparison tool and an accurate and up-to-date network provider/facility directory for participant use. Each of these requirements is effective for plan years beginning on and after January 1, 2022. While the group health plan is responsible for compliance, in most cases the plan’s TPA will in practice be supplying this information to participants. Read more

If I Could Turn Back Time… And Then Add a Year

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by Leslie Thomson and Brenda Berg

Last October, Brenda Berg posted a blog titled “I’m Just Waiting on an… End to the Extended ERISA Deadline Periods.” In that blog, Brenda explained that the IRS and DOL extended certain deadlines applicable to retirement plans and health and welfare plans.

In sum, under last year’s DOL guidance, employers were required to disregard the period from March 1, 2020 until 60 days after the president declared the COVID Pandemic National Emergency over (the “Outbreak Period”) in calculating employee notices and election deadlines for deadlines including the following:

  • The 30-day period (or 60-day period, if applicable) to request special enrollment under ERISA
  • The 60-day election period for COBRA continuation coverage
  • The date for making COBRA premium payments
  • The date for individuals to notify the plan of a qualifying event or determination of disability under COBRA
  • The date within which individuals may file a benefit claim under the plan’s claims procedures
  • The date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure
  • The date within which claimants may file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination
  • The date within which a claimant may file information to perfect a request for external review upon a finding that the request was not complete
  • With respect to group health plans, and their sponsors and administrators, the date for providing a COBRA election notice

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But I Said No, No, No . . . New Requirement for Mental Health and Substance Abuse Benefits

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By Kevin Selzer

Employee benefit plans are subject to numerous laws that restrict, or at least limit, discrimination within the plans.  Many benefit plan nondiscrimination rules focus on whether highly and non-highly compensated employees are receiving equal treatment under those plans; however, the recently enacted Consolidated Appropriations Act, 2021 (CAA) is bringing some attention to an often-overlooked discrimination rule that prohibits group health plans from discriminating with respect to mental health and substance use disorder benefits (MH/SUD benefits). Read more

Should Auld Acquaintance Be Forgot…Not If They Relate to the Affordable Care Act Reporting Requirements

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by Becky Achten

Should auld acquaintance be forgot…not if they relate to the Affordable Care Act reporting requirements. In the midst of the flurry of health and welfare changes coming from the Consolidated Appropriations Act, employers can’t forget about the “auld” Affordable Care Act. Since the 2015 tax year, large employers of self-insured health plans have been required to report to employees and the IRS information regarding the health insurance offered. Form 1095-C is used to report this information to employees. There have been a few changes to the Form 1095-C for the 2020 tax year that employers should keep in mind: Read more

Bridge Over Troubled Water: 2021 Flexible Spending Account Relief in the Consolidated Appropriations Act, 2021

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by Bret F. Busacker

On December 27, 2020 Congress passed the Consolidated Appropriations Act, 2021 (CAA). The CAA provides relief for employees whose dependent care and health care FSA accounts were impacted by the pandemic. This relief will allow employers to amend their FSAs to essentially eliminate the so called “use it or lose rule” for FSA balances not used by the end of 2020 and 2021. This relief is accomplished by giving participants up to an additional year to use the unspent amounts in their FSA accounts. Please see a more detailed description of this relief here.

In addition, the CAA also permits employers to amend their dependent care and health care FSAs to permit contribution election changes (e.g., to start, stop, increase or decrease FSA elections) throughout 2021 for any reason. Please see a more detailed description of this relief here. Read more

EEOC’s New Stand on Wellness Programs

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This post was originally featured on Holland & Hart’s Employer’s Lawyers Blog.

By Devra Hake

On January 7, 2021, the Equal Employment Opportunity Commission unveiled two Notices of Proposed Rulemaking regarding what employers can do to encourage workers to participate in corporate wellness programs without violating the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act. The proposed rules mandate that employers “offer no more than de minimis incentives” to entice workers to take part in most wellness programs, but that employers can raise or lower workers’ insurance contributions by up to 30% (or 50% to the extent the wellness program is designed to prevent or reduce tobacco use), to encourage employees to take part in “a subset of wellness programs that are part of employer health plans.” Read more

Tell Me More, Tell Me More…Fee Disclosures are Coming for Group Health Plans

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by Brenda Berg

One of the employee benefits items tucked into the recently-passed Consolidated Appropriations Act, 2021 (the “Act”) will soon require group health plan service providers to issue fee disclosures.

Service providers to retirement plans have been required to provide fee disclosures – the ERISA 408(b)(2) disclosures – to plan sponsors for the past 10 years. The disclosures are part of the “reasonable compensation” exemption that keeps the arrangement from being a prohibited transaction. Until now, the 408(b)(2) fee disclosure rules have not applied to health and welfare plans; the “No Surprises Act” portion of the Act changes that next year. Read more

We Didn’t Start the Fire . . . But We Can Make Sure Employees Are Aware of What Benefits We Offer That Might Help Dampen It

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by Leslie Thomson

Are you providing the benefits your employees desire? Many employers are making changes to their benefit programs as the COVID-19 pandemic continues. The pandemic has decreased access to routine health care services, increased mental health issues, and increased employees’ stress levels as a result of financial concerns and/or juggling working from home while caring for and homeschooling children. Many employers have made changes to their benefit programs to help employees cope with these and other issues, such as:

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US District Court Pushes Back on DOL’s ERISA Plan Ruling Finding It Arbitrary and Capricious

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by Bret Busacker

As with many of the issues at stake in the upcoming Presidential election, the future of how Americans will obtain healthcare is a core issue this November. The Trump administration previously outlined its view that healthcare could be provided through Association Health Plans that consist of loosely related employer groups, including self-employed individuals. This Association Health Plan rule was then struck down by the Second Circuit Court of Appeals, which concluded the Rule was too aggressive; and exceeded the scope of the Employee Retirement Income Security Act (ERISA).

A recent US District Court case in Texas throws new fuel on the debate fire of whether healthcare coverage may be offered through ever-more expansive and creative employer sponsored arrangements; or whether ERISA should be interpreted to limit employer coverage to more traditional employer-employee structures.

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