Congress Continues to Debate the American Rescue Plan Act of 2021: When it Comes to Pension Reform, the Plot Thickens

Whether Congress finally enacts pension reform, and how that reform will look, looms in the background as Congress continues to debate (and modify), the $1.9 trillion COVID-19 relief bill currently floating around Capitol Hill. The bill, called the “American Rescue Plan Act of 2021,” was recently modified by the Senate and is with the House of Representatives for final approval. If the House does what is expected and passes...

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Flexible Spending Account Relief Adopted by the IRS in 2020 Extended Under the Consolidated Appropriations Act of 2021

Flexible Spending Account Relief Adopted by the IRS in 2020 Extended Under the Consolidated Appropriations Act of 2021 The Consolidated Appropriations Act of 2021 (“CAA”) extended the relief provided to health care and dependent care flexible spending accounts under IRS Notice 2020-29 for the 2021 and, in some cases, 2022 Plan Years. This relief was largely expected and essentially extended the rules provided by the IRS under IRS Notice 2020-29....

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Congress Finally Tackles “Surprise” Out-of-Network Medical Billing & Also Adds New Rx Benefit Reporting Requirements

The Consolidated Appropriations Act of 2021 (the “Appropriations Act”) that was recently signed into law on December 28, 2020 by President Trump is mostly famous for two things: (1) it extended unemployment benefits and rental assistance for those impacted by the COVID-19 pandemic and (2) it provides a second round of stimulus payments to most Americans, though less then the earlier payments issued under the CARES Act. However, the Appropriations...

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Close Counts in Horseshoes & Hand Grenades: But Not ERISA

ERISA is full of statutory deadlines, includes those related to disclosing Summary Plan Descriptions, changes enacted through Plan Amendments, required financial information, and governmental filings. Perhaps none of those deadlines is more critical than those related to the claims and appeals rules. Participants that are denied benefits are likely to sue. And as shown in the case of Fessenden v. Reliance Standard Life Insurance Co and Oracle USA, Inc.,...

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Public Employees and the Use of Social Media

Are political posts shared on social medical by Ohio public employees protected speech under the law? In short, it is unclear. The answer ultimately depends on how the activity is categorized under the Ohio Administrative Code (“OAC”). OAC section 123:1-46-02 separates protected (subsection B) and prohibited (subsection C) political activities. Although government employees do not completely forfeit their First Amendment rights at work, their employers can impose restrictions that...

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Insurance 101 – Understanding the Nuts and Bolts of Your Health Plan

Health insurance is a complex and confusing topic; one that most people are reluctant to approach. This is especially true for trustees and administrator who must understand their own plan design, how that design differs from other available options, and be prepared to answer questions from participants and beneficiaries. In this installment, we will discuss the ins-and-outs of deductibles. Most participants understand that a deductible is the amount of money...

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Cross-Plan Offsetting: What Health & Welfare Plans Must Know

Cross-plan offsetting is becoming increasingly problematic and has become the subject of litigation. This practice involves a network provider shorting one out-of-network claim to make up for an overpayment made to the same provider on services to a different participant in a different plan! The United States Court of Appeals for the Eighth addressed this issue in Peterson v. UnitedHealth Group, Inc., 913 F.3d 769 (2019). The case was...

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Why Beneficiary Forms are Not Static

Filing out a beneficiary designation form seems like a simple task. And in all honesty, it is; you simply list the name of the person or persons you want to inherit the account, designate percentages, make sure they add up to 100%, and then sign and date the form. However, getting this message across to participants is different story. And any plan administrator or trustee of a...

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Are PCORI fees refundable?

By now, I am sure you have heard or read that the Supreme Court of the United States has recently agreed to revisit the Affordable Care Act to determine its constitutionality. If you have not, the Court agreed to hear the case of California, et al., Petitioners v. Texas, et al., No. 19-840 to determine whether the Patient Protection and Affordable Care Act...

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Defined Benefit Plans & Collecting Overpayments

Richardson vs. IBEW Pacific Coast Pension Fund - District Court bars a pension plan from recovering overpayments made as a result a benefit miscalculation Anyone that works with defined benefit pensions plans, whether it be as an administrator, fund counsel, trustee, or actuary, knows just how complicated these plans can be. And like any complicated task, mistakes and errors occur in the administration of a defined...

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