Plan Sponsor Forced to Restore Plan Benefits Due to Intentionally Misleading Communications to Employees

in Fiduciary Issues, Qualified Plans, Retirement Plans

On September 29, 2015, the U.S. District Court for the Southern District of New York issued a decision that emphasizes the importance of accurate communications to employees regarding changes in qualified retirement plan benefits. In Osberg v. Foot Locker, Inc., the plaintiffs in the class action consisted of nearly 16,000 participants in a defined benefit pension plan sponsored by Foot Locker. Prior to 1996, Foot Locker sponsored a traditional defined benefit pension plan in which...Continue Reading

The Individual OOP Maximum Really, Really Applies

in Affordable Care Act, Health Benefits

HHS is holding firm on its position regarding the embedded individual out-of-pocket maximum, even though many have questioned whether this position is consistent with the clear language of the statute. Reports indicate that in a recent letter to members of the National Coalition on Benefits, HHS reinforces that, beginning in 2016, consistent with guidance issued in May (at, group health plans, including self-insured plans and grandfathered plans,...Continue Reading

Soliciting SSNs for Information Reporting Requirements

in Affordable Care Act, Health Benefits

Many employers and health plans are sending SSN solicitations to comply with the 6055/6056 information reporting requirements.  One issue that has arisen is whether the $50 penalty under Code Section 6723 applies to the individuals who fail to furnish a SSN to his/her employer or health plan.

Under the SSN solicitation regulations of Code Section 6724,  the regulations provide that when soliciting a SSN in writing that the solicitation should mention the possibility of a $50 IRS penalty. ...Continue Reading

Expanded Protections To Individuals Receiving Health Care

in Affordable Care Act, Health Benefits

Today, proposed regulations were issued under Section 1557 of the Affordable Care Act which prohibits discrimination based on sex, age, race, color, national origin or disability.  The proposed regulations apply to certain health programs and activities which receive Federal financial assistance (such as Medicare and Medicaid), to programs administered by an Executive Agency, and to entities established under Title I of the ACA (which include the Federal and State-based Marketplaces).

The...Continue Reading

Determining Minimum Value

in Affordable Care Act, Health Benefits

On August 31, 2015, the IRS proposed a modification to the definition of what constitutes  minimum value under the Affordable Care Act.  This modification follows IRS Notice 2014-69, which was issued in November of 2014 after the IRS became aware that plans without inpatient hospital coverage and/or physician services were being marketed to employers as providing “minimum value.”

As expected, following that 2014 Notice, the new proposed definition requires that a plan  provide...Continue Reading