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DISCLAIMER: This blog is published for general information only - it is not intended to constitute legal advice and cannot be relied upon by any person as legal advice.  U.S. Treasury Regulations require us to notify you that any tax-related material in this blog (including links and attachments) is not intended or written to be used, and cannot be used, for the purpose of avoiding tax penalties, and may not be referred to in any marketing or promotional materials.  While we welcome you to contact our authors, the submission of a comment or question does not create an attorney-client relationship between the Firm and you. 

Entries in Health Plans (59)

Thursday
Mar152018

IRS Reduces 2018 HSA Family Contribution Limit

The IRS has lowered the dollar limit on deductible contributions to health savings accounts (HSAs) for individuals with family coverage under a high deductible health plan.  The new limit for 2018 is $6,850, down from the $6,900 limit announced last fall.

Rev. Proc. 2018-18, issued on March 5, 2018, adjusted the limit to account for changes resulting from the tax reform bill passed in December.  The limit for individuals with self-only coverage remains $3,450.  There is no change to deductible and out-of-pocket expense limits for a plan to qualify as an HDHP.

Employers who have already contributed the maximum amount to employees’ HSAs for 2018 based on the higher limit should correct the contribution as necessary, and employers offering HDHPs may wish to notify employees that may be affected by the change.

Rev. Proc. 2018-18 announces inflation adjustments and modifies a variety of tax-related limitations, including limits on excludable amounts under adoption assistance programs.  The limit for benefits that may be excluded from income under an adoption assistance program is now $13,810, down from $13,840 as previously announced.  The income phase-out for this exclusion now begins at $207,140 and fully phases out at $247,140, down from $207,580 and $247,580.

Thursday
Aug102017

Sound Process and Good Recordkeeping Demonstrate Compliance with COBRA Notice Requirements

Earlier this year the Eleventh Circuit Court of Appeals provided a reminder of how important it is for an employer to establish and follow proper COBRA notice procedures and preserve some type of evidence that the procedures are followed.  Employers who do those things will find that their efforts are rewarded if a COBRA beneficiary claims the employer failed to comply with COBRA's notice requirements.

In DeBene v. BayCare Health System, Inc., the Eleventh Circuit upheld a summary judgment issued against Paul DeBene, a former employee of BayCare Health Systems.  Among other claims, DeBene alleged that he did not receive the required COBRA notice after terminating employment.  In ruling for BayCare the court cited BayCare’s notice procedures, evidence that those procedures were followed, and evidence that other notices sent on the same day successfully reached their intended recipients.  The court determined that such evidence was sufficient to show that BayCare met its obligations under COBRA, regardless of whether DeBene actually received the notice.

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Wednesday
May252016

EEOC Doubles Down: Final Wellness Program Rules Under ADA and GINA – Part II

Last week the Equal Employment Opportunity Commission (EEOC) issued final rules for wellness programs under both the Americans with Disabilities Act (ADA) (the “Final ADA Rule”) and the Genetic Information and Nondiscrimination Act (GINA) (the “Final GINA Rule”). 

Part I of this two-part series addressed the Final ADA Rule.  In Part II, we discuss the Final GINA Rule.  Like the Final ADA Rule, the Final GINA Rule is generally consistent with the proposed rule published by the EEOC in October 2015.  The Final GINA Rule simply clarifies the type of information regulated by the rule and the level of financial incentives that may be offered by an employer in exchange for certain health information about an employee’s spouse and children. 

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Friday
May202016

EEOC Doubles Down: Final Wellness Program Rules Under ADA and GINA – Part I

The Equal Employment Opportunity Commission (EEOC) has issued final rules for wellness programs under both the Americans with Disabilities Act (ADA) (the “Final ADA Rule”) and the Genetic Information and Nondiscrimination Act (GINA) (the “Final GINA Rule”).  The release is accompanied by Frequently Asked Questions posted to the EEOC website, as well as interpretive guidance discussing the Final ADA Rule.  Employers must comply with both sets of rules as of the first group health plan year that begins on or after January 1, 2017.  Despite a torrent of highly critical comments submitted during the comment period and ongoing litigation surrounding the EEOC’s interpretation of the limits imposed on wellness programs by the ADA and GINA, the final rules differ very little from the proposed rules and continue to depart in significant ways from the final regulations issued by the Department of Labor, Department of the Treasury, and the Department of Health and Human Service under the Health Insurance Portability and Accountability Act (HIPAA) (the “Final HIPAA Regulations”).  In this two part series, we discuss the differences between the proposed and final versions of each rule and highlight changes that may be required to existing wellness programs.  Part I concerns the Final ADA Rule.

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Monday
Apr042016

Including Limitations Periods in Denial Letters: From “Best Practice” to Necessity 

Sponsors of group health plans in the First Circuit must now describe any contractual limitations period, if the plan applies one, in the letter advising a participant of a final adverse benefit determination.  In light of the decision of the U.S. Court of Appeals for the First Circuit in Santana-Diaz v. Metro. Life Ins. Co., No. 15-1273, 2016 WL 963830 (March 14, 2016), the failure to include such a description would preclude the application of a contractual limitations period.  ERISA does not prescribe a statute of limitations for initiating a civil action.  However, as discussed in our 2015 Mid-Year Client Advisory, a plan sponsor may limit the amount of time a participant has to initiate a lawsuit under ERISA by adding a contractual limitations period to its plan.  The limitations period should be included in the plan document and the SPD and, until recently, it was a “best practice” to make the limitations period known in adverse benefit determination letters.  Following Santana-Diaz, however, including a description of the applicable limitations period in the final benefit determination is now a necessity for plan sponsors in the First Circuit.

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