Law stated as of 30 Nov 2016 • USA (National/Federal)
New from Practical Law Employee Benefits & Executive Compensation! A collection of the top Health and Welfare Plan resources we have published or significantly updated so far in Q4 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 extensively revised so far during Q4 of 2016:
ACA Information Reporting: Forms 1095-C and 1094-C (Overview). We updated this resource to reflect IRS guidance that provides an automatic 30-day extension of the due date for providing 2016 employee statements to individuals (that is, the 2016 Forms 1095-B and 1095-C). This resource also is updated to address related good-faith relief from penalties under Code Sections 6721 and 6722.
Claims Procedure Requirements for Disability Claims Checklist. We updated this resource to reflect DOL proposed regulations that would expand the claims procedures for disability benefits to add certain enhancements that already apply to claims for group health plans under the Affordable Care Act (ACA). The regulations would require plans to satisfy additional procedural and notice requirements regarding disability claims.
ERISA Litigation: Exhaustion of Plan Claims Procedures. We extensively maintained this resource to reflect several recent court decisions involving the exhaustion requirement, including one in which a court rejected an employee's argument that the plan's exhaustion requirement was ambiguous regarding whether benefits claims needed to be filed in writing rather than submitted orally.
Leave Sharing and Vacation Donation Policy for Medical Emergencies. We updated this standard document for IRS income and employment tax guidance addressing the treatment of employer cash payments under leave-based donation programs for the relief of Hurricane Matthew victims.
Patient Protections and Clinical Trials Under the ACA. We updated this resource to address recent litigation addressing the scope of the ACA's emergency services provision in a benefits dispute under an employer's self-insured health plan. The participant in this case argued that the plan was required to cover the expenses under the ACA's emergency services provisions.
Small Business Health Care Tax Credit Under the ACA. We updated this resource to reflect IRS guidance (Notice 2016-75) available for certain small employers that cannot offer a qualified health plan (QHP) through the SHOP Exchange because the employer's principal business address is in a Wisconsin county in which a SHOP QHP is unavailable for all or part of the 2016 calendar year.
What's Market: Class Action Settlement Agreement Database (ERISA Litigation). We recently expanded this new What's Market product to include the following ERISA class action settlement: Stephens, et al. v. US Airways Group, Inc.
Whistleblower Complaints Under the ACA. We updated this resource to address final regulations recently issued by the DOL's Occupational Safety and Health Administration (OSHA) addressing ACA whistleblower complaints. The resource includes an expanded analysis of the procedures involved in an ACA whistleblower complaint.
To view the complete set of Practical Law Health and Welfare Plan resources, please visit Health and Welfare Plans.