Header graphic for print
Employee Benefits Legal Blog Employee Benefits Related to Labor & Employment Matters

Category Archives: Welfare Plans

Subscribe to Welfare Plans RSS Feed

New FMLA Rules Recognize Celebration Rule: Managing Benefits

Posted in Plan Administration, Retirement Plans, Welfare Plans

Although the Family and Medical Leave Act of 1993 (“FMLA”) is not something I usually address, the DOL final regulations issued last week did address an issue I have previously written about and that is recognition of same-sex spouses.  The FMLA generally provides that eligible employees can take leaves of absence for certain family- and [&hellip… Continue Reading

Medical Premium Reimbursement: Limited Relief for Some Employers

Posted in Plan Administration, Welfare Plans

Back in November of 2014, the DOL issued FAQ Part 22, which directly addresses some recent efforts by employers to reimburse employees for participation in the exchange through Code Section 105, or through some type of other arrangement.  The gist of the FAQs, consistent with Notice 2013-54, was that employers could not offer employees cash [&hellip… Continue Reading

IRS Releases “Final” Versions and Instructions for Forms 1094 and 1095: Start Collecting Data

Posted in Plan Administration, Welfare Plans

At last, the forms are upon us.  Last week, the IRS issued its “final” versions of the forms 1094-B, 1094-C, 1095-B and 1095-C along with instructions for the “B” forms and instructions for the “C” forms.  The good news is that the forms are pretty much the same.  What has changed is that the instructions [&hellip… Continue Reading

Benefits for “Domestic Partners”: What Does Your Plan Actually Say?

Posted in Plan Administration, Retirement Plans, Welfare Plans

Recently I was working with a client updating some of the plan documents and we ran into an interesting issue.  The plan provides for eligibility for same-sex partners under a provision defining them as “domestic partners.”  The plan sponsor asked “since all of our employees reside in a state that recognizes same-sex marriage, do we [&hellip… Continue Reading

Why Keep Track of Dependents? Wrongful Termination Case and the Ex-Spouse

Posted in Court Cases, Plan Administration, Retirement Plans, Welfare Plans

In the past I have written about the importance of doing regular “dependent eligibility audits” and litigation over payment of retirement benefits to spouses, ex-spouses and other beneficiaries.  But every once in a while, a case comes to my attention that reminds me that one of the hardest parts of maintaining benefit plans is that [&hellip… Continue Reading

Supreme Court Says Health Benefits Don’t Vest: Contract Principle Apply

Posted in Court Cases, Plan Administration, Welfare Plans

For some time, there has been a question about whether health benefits “vest” under a collective bargaining agreement.   Since neither ERISA nor the National Labor Relations Act actually requires employers to provide health-care benefits, employees typically bargain for health benefits that are then memorialized in a collective bargaining agreement.  Over the course of time, employers [&hellip… Continue Reading

Employer Offering Coverage: The Multiemployer Plan Problem

Posted in Plan Administration, Welfare Plans

As we move in to the first phase of ACA compliance, a number of employers have been asking me about unionized employees and how they can know whether the employees are “offered” coverage (as required to avoid penalties) when coverage is provided through a multiemployer plan to which the employer contributes.   The concern is that [&hellip… Continue Reading

Down to the Wire: Some Thoughts on ACA Compliance as We Approach 1/1/15

Posted in Plan Administration, Welfare Plans

As we get closer to the January 1, 2015 compliance deadline for large employers under the ACA, I have been inundated with several “last-minute” compliance items that continue to puzzle employers and professionals alike. Here are a few of the most common: If you are between 50 and 99 FTEs, you might be eligible for [&hellip… Continue Reading

Is Self-Insuring the Answer? It Depends on the Question

Posted in Plan Administration, Welfare Plans

As we bear down on the first date of compliance with the ACA, much has been written about the benefit of shifting coverage to a self-funded plan because self-funded plans are not subject to many of the requirements of the ACA.  The suggestion is that self-funding might actually be more affordable that simply purchasing insured [&hellip… Continue Reading

Can I Have A “Skinny” Plan? ACA and the Minimum Value Plan

Posted in Plan Administration, Welfare Plans

No question that employers have been struggling with how to satisfy the ACA requirements of offering coverage while still avoiding what is perceived to be a heavy burned financially of offering full coverage.  Some employers in this situation have considered offering a new type of plan to full-time employees, called a “minimum value” plan.  From [&hellip… Continue Reading

Can Employers Pay for Employees in Exchanges? No.

Posted in Plan Administration, Welfare Plans

On November 6, the DOL issued FAQ Part 22, which directly addresses some recent efforts by employers to reimburse employees for participation in the exchange through Code Section 105, or through some type of other arrangement.  Here are the questions, with shortened answers.  For a complete copy of the notice, click this link. Q1: My [&hellip… Continue Reading

Thoughts Post-Election: Don’t Count on Changes to the ACA Until They Actually Happen

Posted in Plan Administration, Retirement Plans, Welfare Plans

As soon as the mid-term races were called, I started to get e-mails from people wondering about the potential impact the change to a Republican controlled Congress would have on ACA compliance.  My general response: don’t expect any immediate relief or changes and keep on working toward compliance.  Changes in the law might eventually come, [&hellip… Continue Reading

It’s Not Easy Having Plans: Revising Benefits Can Give Rise to Other Claims

Posted in Plan Administration, Retirement Plans, Welfare Plans

As employers continue preparing for health plan changes that take place in 2015 under the ACA, I have been following a number of developments that remind me of the importance of thinking globally with respect to revisions to benefits.  What I mean by that is just because you can do something does not necessarily mean [&hellip… Continue Reading

Locating Missing Particiants, Or at Least Trying To

Posted in Plan Administration, Retirement Plans, Welfare Plans

One of the most frustrating things about benefit plans is that they have participants, participants are people and people sometimes disappear.  It is unfortunately a fact of plan administration and it can be a problem.  Plan sponsors, and administrators sometimes need to locate missing participants or beneficiaries for things like notice, distributions or even corrective [&hellip… Continue Reading

Who’s in Control? Determining Control Group Status is Important

Posted in Plan Administration, Retirement Plans, Welfare Plans, Withdrawal Liability

The existence of a “control group” is important in a variety of benefit concerns.  From retirement plans to welfare plan, and particularly in withdrawal liability matters, establishing whether companies are under common control is very important.  Under the ACA, it matters for determining whether you are an applicable large employer so as we get closer [&hellip… Continue Reading

The Latest on Cafeteria Plan Elections: Changes that Allow Changes

Posted in Plan Administration, Welfare Plans

What happens if an employee wants to drop out of the company plan and get into the exchange?  Seems like an option except the cafeteria plan rules prevent someone from making a mid-year change in their cafeteria plan election.  Along comes the IRS with Notice 2014-55.  This notice addresses situations in which individuals can change [&hellip… Continue Reading

Draft Instructions for PPACA Reporting Requirements: Get Ready for 2015

Posted in Plan Administration, Welfare Plans

They promised they would be coming and now they have.  On August 28, 2014, the IRS issued draft instructions for Forms 1094-C and 1095-C and Forms 1094-B and 1095-B, which I provided in my July 31, 2014 entry.  These forms were provided in draft format and they are used to satisfy PPACA’s “information reporting requirements.” We also got [&hellip… Continue Reading

COBRA Notice Penalties: Employer Pays Even Though They Also Paid Bills

Posted in Court Cases, Plan Administration, Welfare Plans

The issue of COBRA notices and penalties can create problems when considering who is entitled to the notice and when they have to be issued.  When claims are brought for alleged violations of the provision of COBRA notices, some employers assume that they can just avoid penalties if there are not actual damages, say for [&hellip… Continue Reading

New Rates for “Affordable Coverage” for 2015: Rev. Proc. 2014-37

Posted in Plan Administration, Welfare Plans

Under the terms of the ACA, large employers are required to provide affordable coverage beginning in 2015 or potentially face penalties.  For 2014, the definition of affordability was set at 9.5% of the employee’s income.  Within the definition of affordability, there is also a provision that provides for adjustment of that figure in the future [&hellip… Continue Reading