New and Updated in Health and Welfare Plans (Q3 2016) | Practical Law

New and Updated in Health and Welfare Plans (Q3 2016) | Practical Law

New from Practical Law Employee Benefits & Executive Compensation! A collection of the top Health and Welfare Plan resources we published or significantly updated in Q3 of 2016.

New and Updated in Health and Welfare Plans (Q3 2016)

Practical Law Legal Update w-003-6420 (Approx. 4 pages)

New and Updated in Health and Welfare Plans (Q3 2016)

by Practical Law Employee Benefits & Executive Compensation
Published on 27 Sep 2016USA (National/Federal)
New from Practical Law Employee Benefits & Executive Compensation! A collection of the top Health and Welfare Plan resources we published or significantly updated in Q3 of 2016.
At Practical Law, 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 published or substantially revised during Q3 of 2016:
  • Church Plans: Health and Welfare Plan Compliance and Litigation. This entirely new resource addresses the exemption for church health plans from requirements under the Employee Retirement Income Security Act (ERISA). Among other issues, this resource addresses the ability of church health plans to elect to be subject to ERISA under Section 410(d) of the Internal Revenue Code.
  • COBRA Election Notice. We updated and expanded this standard document to address, among other issues, recently litigated disputes challenging employers' delivery of COBRA election notices. We also expanded the COBRA Toolkit to include the following new standard documents: Notice of Termination of COBRA Coverage and Notice of Unavailability of COBRA Coverage.
  • ERISA Litigation: Preemption of State Laws. This new Practice Note addresses ERISA's preemption provision, including how ERISA preemption applies to some of the more common state laws that govern employee benefit plans (or that would otherwise govern plans, but for preemption). The resource analyzes how the courts have applied ERISA's general preemption rule, saving clause exception, and deemer clause to determine whether a particular law is ERISA-preempted.
  • ERISA Litigation: Standard of Review. We expanded this resource to address the burden of proof under the abuse of discretion standard of review, including to reflect a recent decision holding that if a participant makes a prima facie case of benefits entitlement but lacks information in the employer's control to substantiate the claim, the burden shifts to the employer to produce this information (see the related update, In the Ninth Circuit, a New Burden of Proof for Employers in Benefits Litigation).
  • ERISA Litigation Toolkit. This entirely new toolkit includes continuously updated resources to familiarize employers, practitioners, and other advisors with some of the most common issues in litigated disputes under ERISA. Among other topics, these resources address the kinds of actions that may be brought under ERISA, the deadlines for filing benefits disputes, and the judicial standard of review in benefits litigation.
  • External Review Under the ACA. We updated this resource to address recent caselaw and a recent DOL enforcement action involving a health plan that mistakenly believed it was grandfathered and was required to retroactively submit claims that were eligible for external review to an independent review organization.
  • HIPAA Enforcement and Group Health Plans: Penalties and Investigations. We updated this resource to address HHS regulations that increased the civil money penalties related to HHS provisions, including HIPAA violations (see HHS Increases Penalties for HIPAA Noncompliance, Effective August 1). We also expanded this resource to address a recent settlement agreement involving a university (and HIPAA covered entity) that was required to pay $2.7 million and take corrective measures following a breach notification involving information stored with a cloud-based service provider (see Despite Six Risk Analyses, University Must Pay $2.7 Million in HIPAA Settlement). In addition, we reorganized and updated this resource's discussion of resolution agreements.
  • Nondiscrimination in Health Programs and Activities Under the ACA (Section 1557). We updated and expanded this resource to reflect additional HHS guidance, including FAQs and a table, addressing the requirement that Section 1557 covered entities post taglines in the top 15 languages spoken by individuals with limited English proficiency statewide.
  • Wellness Programs: EEOC Rules Under the ADA. We updated this resource to address recent litigation in which a district court concluded that an employer's wellness program did not violate the ADA by requiring participants to complete a health risk assessment or pay 100% of their monthly premiums for health plan coverage (see our related update, EEOC Loses Again in Wellness Litigation).
To view the complete set of Practical Law Health and Welfare Plan resources, please visit Health and Welfare Plans.
For a discussion of other updates to the Health and Welfare Plan resources, see New and Updated in Health and Welfare Plans.