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Northwest OH Legal Blog

Monday, September 14, 2020

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 benefit pension plan.

One of the most common mistakes involves incorrect benefit calculations. If the participant was underpaid, the resolution is simple; increase the benefit to the proper amount and repay the participant the wrongfully withheld amount (plus interest) in one lump sum.
Read more . . .


Wednesday, September 9, 2020

New Model COBRA Notices, Emergency Regulations, & Considerations for Health & Welfare Plans


In May of 2020, the Department of Labor (DOL) issued two separate pieces of guidance that both affect how health & welfare plans comply with the COBRA regulations. First, the DOL updated the model COBRA notices that must be provided to participants when they enroll and when they experience a “qualifying event.” Second, and in response to the COVID-19 pandemic, the DOL issued emergency regulations that extends many of the deadlines that apply to ERISA plans, including the ability to elect COBRA continuation coverage. We will discuss both these changes.

Updated Model Notices

The COBRA regulations require ERISA health and welfare plans to give participants two different notices: (1) upon enrollment and (2) after the participant experiences a “qualifying event.
Read more . . .


Monday, July 30, 2018

Are Quarterly Board of Trustee Meetings Enough?


Trustees Should Consider Forming Committees to Meet Fiduciary Duties

 

The majority of all multiemployer employee benefit plans are managed by a Board of Trustees, comprised of an equal number of members from the applicable Union(s) and representatives from Employers who employee union members.  Such Trustees are charged with significant responsibilities that range from overseeing the delegated administrator of their employee benefit plans, monitoring the collection of plan contributions to eligibility for and approval of all types of plan distribution requests by participants and beneficiaries.  Many Boards of Trustees normally meet only once every three months to collectively meet these fiduciary responsibilities. These meetings are often jam-packed, require intense discussions to present important voting issues, may last anywhere from two to 8 hours and can burn out well-intentioned Trustees. 

In an effort to better fulfill their fiduciary commitments while reducing meeting times, retaining high-quality Trustees and prevent rushing into important decisions, many Boards have agreed to form committees to handle the business of their employee benefit plans between full Board of Trustee meetings.
Read more . . .


Tuesday, June 26, 2018

Group Health Plan’s Residential Treatment Exclusion Violates Mental Health Parity Requirements


The Mental Health Parity Act (“MHPA”) was enacted in 1996.  The principal goal of MHPA was to bring parity to the treatment of mental health disorders by imposing the same aggregate lifetime and annual dollar limits for mental health benefits as for medical and surgical benefits.  In Munnelly v. Fordham Univ. Faculty and Admin.
Read more . . .


Tuesday, May 1, 2018

Internal Revenue Service Requests Comments on Expansion of Determination Letter Program for Individually Designed Retirement Plans


The Internal Revenue Service (“IRS”) has asked for comments on whether it should expand the determination letter program for individually designed plans for 2019. Currently, determination letter applications for individually designed tax-qualified retirement plans (including 401(k) plans) may be submitted only for initial plan qualification—i.e., submissions by plans that have never received a determination letter—and for terminating plans. The guidance establishing those rules anticipated that the IRS would annually consider whether to expand the scope of the program; this Notice is the first request for comments on this topic since the current rules were adopted.
Read more . . .


Tuesday, March 27, 2018

Restrictions on Hardship Withdrawals Eased under 2018 Budget Act


On February 9, 2018, Congress passed, and President Trump signed, continuing appropriations legislation (the “Budget Act”) to allow the United States Government to continue to operate.  The Budget Act includes changes to some of the current restrictions on hardship withdrawals from 401(k) plans and similar defined contribution plans.

Background.  Under current rules for 401(k) and similar defined contribution plans, hardship withdrawals are limited to the amount of a participant’s elective deferrals contributed to a plan, and participants are prohibited from making new elective deferral contributions to the plan for six months after they receive a hardship withdrawal.  Pursuant to the Budget Act, however, participants will be permitted to withdraw not only the amount of their elective deferrals but also—

  • the earnings on those deferrals, plus

  • any employer contributions, including matching and profit-sharing contributions

as part of a hardship withdrawal, and the mandatory six-month suspension of elective deferrals to a plan following a hardship withdrawal has been eliminated.
Read more . . .


Tuesday, March 20, 2018

Should You Ever Invest in Bitcoin?


Chances are good that most of us will never have a logical reason to use Bitcoin. Certainly, it would never be recommended as an investment in a qualified retirement or health and welfare benefits plan. Boards of Trustees and corporate Retirement Committees would be greatly weakening their vow of due diligence by even considering Bitcoin in their plans. It would even be unusual for Bitcoin to be part of non-qualified executive compensation benefit plans unless such executives were heavy-duty risk seekers.  But that doesn’t eliminate the need for some basic Bitcoin savvy or whether it should ever factor into our updated financial investments or short-term retirement goals.
Read more . . .


Tuesday, February 6, 2018

You Have the Right to Choose Your Own Doctor in a Workers Compensation Case


One right that every Workers’ Compensation claimant should be aware of is the right to choose his or her own doctor (or other treating provider). In several states, an injured worker is required to see the doctor their employer sends them to or must select their doctor from an approved list. This is not the case in Ohio, as the injured worker is free to choose the doctor of his or her choosing.

However, there is a requirement that the doctor be BWC certified. This is necessary in order to receive treatment, or fill out necessary forms that the BWC requires, particularly the MEDCO-14 which is necessary to take someone off of work for their injury.
Read more . . .


Tuesday, January 30, 2018

United States Department of Labor Announces April 1, 2018 as Effective Date for Disability Claims Procedures Amendments


On January 5, 2018, the United States Department of Labor (“DOL”) announced that April 1, 2018 will be the effective date for benefit plans governed by the Employee Retirement Income Security Act of 1974 (“ERISA”) to comply with a final rule amending the claims procedure requirements applicable to disability benefits.  These changes in claims procedure requirements were part of ERISA regulations governing disability plan administration (“Disability Claims Regulations”) published by the DOL on December 19, 2016.

Background.  For most Taft-Hartley plans, the changes under the Disability Claims Regulations center on how the plan determines whether a participant is totally and permanently disabled.  If the plan does not rely on a third-party’s definition of total and permanent disability, such as that of the Social Security Administration or an outsourced long-term disability plan, the discretionary way in which total and permanent disability is determined, including the use of impartial and specific parameters with scientific judgements, must be disclosed when a disability claim is denied.
Read more . . .


Tuesday, January 16, 2018

UPDATE: WILL AMENDMENTS TO ERISA CLAIMS AND APPEALS’ PROCEDURES FOR DISABILITY BENEFITS STICK FOR 2018?


Actually, not at the moment.  The Department of Labor (“DOL”) recently delayed the applicability date of amendments to the ERISA (Employee Retirement Income Security Act) claims and appeals procedures for disability benefit provisions within employee benefit plans until at least April 2018.

The final rule, 81 FR 92316, initially released on December 16, 2016 to take effect on January 18, 2017 for claims filed on or after January 1, 2018 has been delayed so the DOL can allow careful consideration of public comments and data to compare them with the initial goal of this regulation.  The DOL is now focused on examining all regulatory alternatives to ensure full and fair review of disability claims without imposing unnecessary costs and adverse consequences on employee benefit plans and their participants (Executive Order 13777).  

Many of the 110 public comments (received by the DOL) that disagreed with the implementation of this regulatory amendment pertained to the overreach by the DOL to apply Affordable Care Act (ACA) protections to disability benefit claims in the first place.


Read more . . .


Tuesday, January 9, 2018

Your Self-Insured Workers’ Compensation Claim Should be Filed with the BWC


Recently, we encountered a health provider that, as a policy, is not filing Workers’ Compensation claims with the Bureau of Workers’ Compensation (BWC) when the Employer is self-insured. Although lawful, this can cause problems for the Injured Workers’ claim.

For background, we should examine the difference between a self-insured and state-fund employer. The state-fund employer pays what is essentially an insurance premium to the BWC, who covers medical expenses and disability payments in the event one of their employees suffers a workplace injury. The self-insured employer chooses not to cover Workers’ Compensation claims through the BWC and cover them on their own.
Read more . . .


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