Insights

On March 7, 2023, in Schuyler v. Sun Life Assurance Co. of Canada (Sun Life), the US District Court for the Southern District of New York found ERISA rights were waived through an employment separation agreement. The plaintiff in this case, Kristen Schuyler, filed a long-term disability (LTD) claim through her employer-sponsored plan insured by Sun Life, following an injury that left her unable to work. Sun Life denied the claim asserting insufficient information to support disability and uphel

The DOL, HHS, and IRS recently issued revised Federal Independent Dispute Resolution (IDR) Process Guidance for certified IDR entities and for disputing parties. The Federal IDR Process Guidance outlines the IDR process used by plans, insurers, providers, and certified IDR entities in resolving claims for payment for out-of-network services that are subject to the federal No Surprises Act surprise billing rules. The Federal IDR Process Guidance was updated mainly to reflect a recent court rulin

On March 17, 2023, the IRS published new frequently asked questions (FAQs) that address whether certain costs related to nutrition, wellness and general health, such as nutritional counseling, weight-loss programs, and mental health-related therapies, are medical expenses that may be paid or reimbursed under a HSA, health FSA, Archer MSA or HRA. As background, IRC Code 213 defines the eligible expenses under a HSA, health FSA, Archer MSA or HRA. Code 213 defines eligible expenses as medical ex

Retirement plan fiduciaries may continue to consider the potential financial benefits of investing in funds that take 'the economic effects of climate change and other environmental, social, and corporate governance factors' ('ESG factors') into account without fear of automatically running afoul of ERISA's fiduciary duty requirements after President Biden's veto of a House resolution on March 20, 2023. The point of controversy was a rule promulgated by the Democratic Biden administration ('the

On March 17, 2023, Director Fox issued Bulletin No. 2023-07-BT/CF/CU/INS, announcing that the state will prohibit health insurance plans from discriminating based on sex, sexual orientation and gender identity. On March 16, 2023, Gov. Whitmer signed into law an amendment to the Elliott-Larsen Civil Rights Act that included sexual orientation and gender identity and expression as legally protected civil rights in the state. Pursuant to the amendment, the bulletin asserts that health insurance p

Update: The United States Environmental Protection Agency (USEPA) recently recognized the ASTM E1527-21 Phase I Environmental Site Assessment (ESA) standard to comply with the All-Appropriate Inquiries (AAI) Rule under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA). Announced on December 15, 2022, in the Federal Register, compliance is effective February 13, 2023. The previous Phase I ESA standard, ASTM E1527-13, will be phased out and no longer recognized as

The COVID-19 emergencies are scheduled to end on May 11, 2023, signaling an end to benefit provisions employers have come to rely on in recent years. In this webinar, the Benefits Compliance team discussed how the end of these emergencies may impact your benefit plans. Topics we covered include: The end of the extension of certain timeframes (the 'Outbreak Period') Certain special enrollment rights under HIPAA Changes to plan documents that may be needed Agenda The White H

In both cases corrections are necessary. Generally, if the corrections are made before the 2022 income tax filing deadline, which is April 18, 2023, for most taxpayers, the process is greatly simplified. We can provide general information regarding the correction process for each situation. However, the employee and employer should consult with a tax advisor or counsel for specific advice and guidance. Correction of Excess HSA Contribution The 2022 contribution limit is $3,650 for self-only c

The Department of Labor's Advisory Council on Employee Welfare and Pension Benefit Plans has issued a report addressing cybersecurity issues affecting health plans. While the Council has issued two reports on cybersecurity issues affecting employee benefit plans in the past (the first in 2011; the second in 2016), this report marks the first time the Council has focused exclusively on cybersecurity regarding health benefit plans alone. This report emphasizes the vast amount of individualized da