Law stated as of 23 Feb 2016 • USA (National/Federal)
New from Practical Law Employee Benefits & Executive Compensation! A collection of the top Health and Welfare Plan resources we added or significantly updated during January and February of 2016.
We are constantly expanding and updating our Health and Welfare Plan resources to reflect the latest developments in employee benefits law. This list reflects some of the most important Health and Welfare Plan resources we added or substantially revised during January and February of 2016:
Asset Purchase Agreement Employee Covenants (Pro-Buyer). These entirely new standard clauses, consisting of pre-closing and post-closing employee covenants drafted in favor of the buyer for an initial draft, address issues including the impact of grandfathered health plans under the ACA.
ERISA Litigation: Attorney's Fees. This practice note is substantially revised to reflect several 2015 decisions involving ERISA attorney's fees. We also expanded this resource to address the catalyst theory of recovery, prejudgment interest, and how the common fund doctrine applies in the ERISA attorney's fees context. In addition, we added a recent case in which a district court permitted a generous hourly rate, on the theory that a national market (not the local community) applies regarding the rate for ERISA litigators.
Expatriate Health Plans Under EHCCA and the ACA. We updated this resource for IRS Notice 2016-14 (January 2016), which addresses how the definition of expatriate health plans under the Expatriate Health Coverage Clarification Act of 2014 (EHCCA) applies for fees imposed under Section 9010 of the Patient Protection and Affordable Care Act, as amended, for fee year 2016.
HIPAA Enforcement Penalties and Investigations. We expanded this resource to address several recent resolution agreements between HHS and HIPAA covered entities, and a 2016 administrative law judge ruling upholding civil money penalties of nearly $240,000 that were sought by HHS against a HIPAA covered entity.
Internal Claims and Appeals Under the ACA. We substantially updated this resource to reflect final regulations issued in November 2015. Among other changes, the final regulations include clarifications involving the requirement that plans and insurers send claimants new or additional evidence or rationales as part of the internal claims process.
GINA Compliance for Health and Welfare Plans. We substantially revised this practice note to reflect recent EEOC regulations addressing genetic information, wellness programs, and health risk assessments, and new cases involving the scope of genetic information. The resource is also updated for EEOC Q&A guidance on the meaning of family medical history for GINA purposes, 2015 enforcement statistics, and more.
Multi-State Plans Under the ACA. We updated and expanded this resource to reflect guidance addressing when limited wraparound coverage that coordinates with multi-state plan coverage may qualify as an excepted benefit under ERISA, the Internal Revenue Code, and the Public Health Service Act (PHSA).
Patient Protections and Clinical Trials Under the ACA. This resource is substantially revised to address final regulations under the ACA issued in November 2015, including clarifications involving provider designations for pediatric subspecialties, balance billing, and geographic limits.