The IRS’s Chief Counsel released a memorandum that confirmed the IRS’s position on the substantiation of medical and dependent care expenses. See IRS Chief Counsel Memorandum 202317020. The guidance addressed two questions: (1) How are medical reimbursements treated if they are not properly substantiated and (2) Whether plans can adopt short-cuts to the substantiation rules, such as “sampling,” self-certification, de-minimis rules, or treating certain providers as “favored.” While the...
Continue reading…ESG – Investment Concerns
In November of 2022, the Department of Labor (DOL) published a final rule that allows retirement plan fiduciaries to consider environmental, social, and governance (ESG) factors when selecting retirement investments and exercising shareholder rights (proxy voting). This rule runs contra to the Trump Administration’s rules, which only allowed fiduciaries to consider ESG as a “tiebreaker” between similar investment options. As one may have expected, the new rule has been...
Continue reading…Air Ambulance Reporting Remains in Limbo
On December 27, 2020, the No Surprises Act was signed into law. That Act introduced sweeping changes to how group health plans are allowed to handle payment of non-network providers and balance billing. However, it also required the Departments of Labor, Health and Human Services, and the Treasury to create reporting rules for air ambulance claims. The Act required plans to report the following on air ambulance claims:
- Whether... Continue reading…
Funding Status – Critical Status
What is Critical Status? In 2006, Congress passed the Pension Protection Act of 2006 (PPA). The PPA created four classifications for multi-employer pension plans that relate to the plans funding status: critical (red), seriously endangered (orange), endangered (yellow), and reasonably healthy (green). The plan’s status is determined by an annual valuation of the plan’s assets and liabilities, conducted by the plan’s actuary. The PPA requires the plan’s actuary to submit...
Continue reading…HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (“HIPAA”) COMPLIANCE AND BEST PRACTICES
The Health Insurance Portability and Accountability Act (“HIPAA”) applies not only to healthcare providers, but to health plans, including multiemployer plans. It was established and designed to protect against the unauthorized use and disclosure of personal health information (including any electronic records). In its constantly changing world, HIPAA compliance can prove to be an ominous task. While not exhaustive, this blog provides five “must do” tips for HIPAA compliance:
Prescription Drug and Health Care Spending Delayed
On December 23, 2022, the Departments of the Treasury, Labor, and Health and Human Services provided health plans a small amount of relief in terms of complying with the new Prescription Drug and Health Care Spending reporting rules. These new reporting requirements, which were included in the Consolidated Appropriations Act of 2021, require plans to annual submit several data files related to prescription drug spending and other health care...
Continue reading…New Retirement Plan Laws for 2023 – SECURE Act 2.0
Not one week into the new year and we already have a slew of retirement changes that trustees and plan professionals will have to consider. On December 29, 2022, President Biden signed the 2023 Consolidated Appropriations Act into law. The law, which authorizes $1.7 trillion for government funding, also includes what is commonly called the “SECURE 2.0 Act.” This Act is a multi-year bicameral effort to expand the changes...
Continue reading…Standard Mileage Rates
The Internal Revenue Service (“IRS”) allows taxpayers to deduct expenses related to the use of their personal vehicles (cars, trucks, vans, etc.) for business, medical, moving, and charity purposes. In addition, the IRS also allows employers to reimburse their employees for these expenses. To calculate these amounts, taxpayers and employers may either use (a) the actual expenses incurred through the use of the vehicle or (b) the standard mileage...
Continue reading…Required Minimum Distributions: What They Are, How They are Calculated, and How to Fix a Missed Payment
Introduction What are required minimum distributions? A required minimum distribution (“RMD”) is the minimum amount that must be withdrawn from your retirement account each year when you reach age a certain age. These rules apply to practically all retirement plans, including defined benefit plans, IRAs, SEP IRAs, SIMPLE IRAs, 401(k) plans, 403(b) plans, 457(b) plans, and other defined contribution plans. While the rules affect almost every type of plan, they...
Continue reading…U.S. Supreme Court Upholds Plan’s Decision to Treat Dialysis Services as Out-of-Network, Potentially Savings Thousands of Dollars
In late June, the U.S. Supreme Court issued an opinion on a case that could potentially save health insurance plans thousands of dollars. The case came from the Sixth Circuit Court of Appeals and involved a dispute between a health insurance plan and a dialysis center. In a succinct seven-page opinion the 7-2 majority upheld the Plan’s decision to treat all dialysis claims as out-of-network and rejected the dialysis...
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