Employee Benefits

On July 9, 2021, the Pension Benefit Guaranty Corporation (PBGC) issued an interim final rule (IFR) on the process for eligible distressed multiemployer pension plans to calculate and apply for Special Financial Assistance (SFA) awards under the American Rescue Plan Act of 2021 (ARPA). Following is a summary of the key components of the IFR: SFA Award Calculation Plan sponsors that qualify for PBGC assistance may apply for a one-time lump sum payment to cover all benefits due through the 2051 plan year. The IFR establishes a more specific calculation in which the amount of SFA an eligible plan may…
Under the American Rescue Plan Act of 2021 (ARPA), certain financially troubled multiemployer pension plans are eligible for financial assistance from the Pension Benefit Guaranty Corporation (PBGC), which estimates that approximately 11 percent of multiemployer pension plans in the U.S. are in critical condition. Plan sponsors that qualify for PBGC assistance may apply for a one-time lump sum payment to cover all benefits due through 2051 without any reduction in earned benefits for participants if the plan meets one of the following requirements: Is certified as being in critical and declining status for any plan year beginning in 2020, 2021,…
On July 22, 2021, the American Academy of Actuaries (“the Academy”) provided comments to the Department of Treasury and the IRS on temporary funding relief under the American Rescue Plan Act of 2021 (ARPA). The comments pertain to interpretive issues and considerations for the temporary funding relief provisions outlined in sections 9701, 9702, and 9703 of ARPA as follows: Section 9701. Temporary Delay of Designation of Multiemployer Plans as in Endangered, Critical, or Critical and Declining Status The Academy proposes that the IRS issue future guidance and/or clarification on the following issues: Under section 432 of the Internal Revenue Code,…
California’s labor commissioner has levied fines totaling almost $448,000 against three El Super grocery stores for their failure to comply with California’s COVID-19 paid sick leave policy for 95 workers affected by the coronavirus. The state labor commissioner’s office launched an investigation in September 2020 after receiving complaints from El Super employees and a referral from the labor union that represents the workers. The complaints allege that the grocery stores told sick workers who exhibited COVID-19 symptoms to report to work while awaiting their test results. Other workers who were in quarantine were told to apply for unemployment benefits, and…
The No Surprises Act (NSA), which was part of the Consolidated Appropriations Act, 2021, that became law in December 2020, restricts medical providers from sending consumers surprise medical bills for emergency care, transport by air ambulance, or non-emergency care at an in-network facility when patients are unknowingly treated by an out-of-network doctor or lab. The NSA includes a provision that exempts enforcement in states that already have surprise billing statutes on the books. Currently, there are 33 states that have either partial or comprehensive laws protecting consumers against surprise billing. If state law does not cover a service that is…
On May 20, 2021, the U.S. District Court for the District of Minnesota dismissed a breach of fiduciary duty class action against UnitedHealth Group over an overpayment recovery process known as cross-plan offsetting that the plaintiffs claimed is a prohibited transaction under ERISA. The court found that the plaintiffs lacked standing to challenge the practice since none of them had been denied benefits or suffered any injury due to defendant’s use of cross-plan offsetting. Cross-plan offsetting is a common practice that has been used for years by insurers and third-party administrators (TPAs) to recover overpayments made to health service providers.…
On July 29, 2021, the IRS updated its FAQs on the paid sick and family leave tax credits under the American Rescue Plan Act of 2021 (ARPA). The updated FAQs now include wages paid for leave taken by workers who accompany individuals to COVID-19 vaccination appointments and those who care for individuals recovering from any COVID-19 vaccine-related illness. Following are the FAQs updated by the IRS on paid sick and family leave tax credits: General Information FAQs 8. What are “qualified sick leave wages”? 9. What are “qualified family leave wages”? Determining the Amount of the Tax Credit for Qualified Sick
One of the first lawsuits to be filed over vaccine mandates was dismissed in June by a Texas district court that found limits on employee behavior is “part of the bargain” of employment. The suit challenged Houston Methodist Hospital’s vaccine mandate after the hospital suspended 178 employees for failing to meet the vaccination deadline.  In their claim, Houston Methodist employees argued that taking the vaccine couldn’t be mandatory since the FDA has only authorized COVID-19 vaccines for emergency use. Plaintiffs also alleged wrongful discharge under a public policy exception to the employment at-will doctrine under a Texas law that allows…
A federal district court in West Virginia has ruled that an anti-discrimination lawsuit against a health insurer can proceed because the insurer accepts federal funding, making it accountable under the Affordable Care Act’s (ACA) Section 1557 that prohibits discrimination under “any health program or activity, any part of which is receiving federal assistance, including credits, subsidies, or contracts of insurance….” Background The case – Fain et al v. Crouch et al – was filed by a West Virginia Medicaid recipient, a state employee and the employee’s spouse alleging that West Virginia’s public health insurance program discriminated against transgender people in…
On July 1, 2021, the U.S. Departments of Health and Human Services, Labor, and Treasury (“the Departments”), and the Office of Personnel Management issued Requirements Related to Surprise Billing; Part I, an interim final rule (IFR) that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing.  Among other provisions, the interim final rule: Bans surprise billing for emergency services. Emergency services, regardless of where they are provided, must be treated on an in-network basis without requirements for prior authorization. Bans high out-of-network cost sharing for emergency and non-emergency services. Patient cost-sharing, such as…