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What happens if, during the course of the appeals process, the plan administrator comes across information that might impact the decision on appeal that makes the administrator want to grant the appeal?
Under current guidance, affordable health care coverage for a family could get unaffordable fairly quickly, but is total household income even an issue for employers?
I frequently am asked by plan sponsors and plan administrators about how to respond to a request for plan documentation. Under Section 104(b)(4) of ERISA, a plan administrator is obligated to provide certain information when requested by a participant or beneficiary.
All in all, it is fairly clear that the Supreme Court will ultimately have to sort out the issue of birth control coverage in employee health plans under the Patient Protection and Affordable Care Act.
Employers should be using the 2013 plan year as their basis for collecting information relevant to their compliance obligation, according to guidance from the IRS.
Accurately tallying up employees, all the more important in light of PPACA, is not as easy as it may seem for those in businesses under partial or total common control with others.
Diversity in defined contribution plans must be offered in consideration of the risk, not necessarily the type of investment, according to one legal expert.
I recently spoke at a seminar where the question was raised about a plan sponsor's obligations to act when they see participants have made foolish investment choices in their self-directed accounts. Is there a fiduciary obligation to tell participants that they have made an unwise investment choice?
Meeting the legal definition of the parent-child relationship doesnt always mean that beneficiary plan standards have been met as well.
While employers are loath to spend money in a tight economy, it is no longer reasonable for plan sponsors to avoid having specialists assisting them in dealing with their benefit plans.
While retirement plan sponsors do not have a fiduciary obligation to tell participants that they have made an unwise investment choice, they should limit investment options to strategies that meet the acceptable diversification criteria outlined in ERISA.
While there is much anticipation of the impending Supreme Court ruling on the constitutionality of PPACA, good plan sponsors already should be preparing for how they will respond to the health care reform decision. Here are some road-maps to prepare for the possible outcomes.
When making decisions about benefit plans, plan sponsors should take some time to consider what role they are playing. I am working with a company that is terminating its health plan and the distinction between "settlor" functions and "fiduciary" functions became very significant. So I thought I might share some thoughts on the topic.
It's tax time again and I tend to get questions this time of year about reporting of benefits. Health plans that provide coverage to same-sex couples and domestic partners require some special consideration for tax purposes so let's review some of the key issues. The first is verification of status. Some employers voice to me concerns over asking for marital status for fear that requiring enrollees to identify potential same-sex partners is tantamount to discrimination. But
I recently read an article about a company wellness program that consisted primarily of a company health fair. At the health fair, an employee who thought he was otherwise healthy took a Prostate-Specific Antigen test and discovered he had elevated PSA levels. He was encouraged to follow up with his doctor, who discovered he had prostate cancer. He was ultimately cured and his doctor said he probably would have died had it not been for
Although it is probably not high on the list of priorities for plan administrators, the end of a calendar year usually means means the start of the process of preparing 5500s. They may not be due right away, but it is always good to know what information you will have to provide when you eventually file them. The Employee Benefits Security Administration has made an informational copy of the 2011 5500 available, with instructions, on
Do you know what you are? Erisa titles matter. The questions may sound like the title to a Dr. Seuss book, but it has great bearing on how you are treated under ERISA. Knowing your title also creates clarification as to what your duties are, and what they are not.
In case you missed it, the East Coast has had an odd month or so with an earthquake, hurricane and flooding. In trying to find money to pay for repairs and clean up, some folks might look to their retirement plan savings as a resource. Here are the nuts and bolts of "hardship distributions."
New proposed rules for the "uniform summary of coverage" may change the way health insurers and group health plans provide consumers with clear, consistent and comparable information about their health plan benefits and coverage starting in 2012.
If you have former employees receiving subsidies for COBRA coverage, that will end August 31 with no signs of Congress looking to extend the subsidy program further.