Health & Welfare Benefits

Health and welfare benefit programs are an important component of an employer’s compensation, recruitment and retention package. Done properly, they serve to attract top candidates and retain employees and executives, while remaining compliant with federal laws such as the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code (IRC), the Affordable Care Act (ACA), the Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA) and more.

HOW WE HELP

Our Health and Welfare Benefits group focuses on tracking and responding to ever-changing regulatory guidance and litigation trends. We support employers, health plans, vendors, insurers and plan fiduciaries in navigating the complex requirements of federal and state laws that impact benefits. This enables our clients to better focus on everyday business concerns.

We assist companies in designing health and welfare benefit programs, drafting necessary plan documents and plan communications, making benefit appeal determinations, assessing fiduciary obligations, as well as negotiating third-party administration agreements, insurance contracts, direct-contracting arrangements, and other vendor agreements. We also advise clients establishing on-site clinics or implementing telemedicine programs.

Clients turn to our team for advice on how to structure a flexible benefit arrangement or redesign a health program as a cost-efficient consumer driven health (CDH) arrangement for active employees or retirees through the use of health spending accounts (HSAs) or health reimbursement arrangements (HRAs). For companies interested in consolidating plan documents and streamlining annual reporting with the DOL and IRS, we help implement a consolidated or “wraparound” welfare benefit program. We can also help our clients determine whether funding any welfare benefit programs through a voluntary employee beneficiary association (VEBA) would be advantageous.

As employers seek ways to control and contain their spiraling health costs, wellness programs have emerged as an important element in the health care plan model.  The attention to wellness programs has resulted in legal challenges, administrative agency concerns and new regulations. We are able to help our clients navigate these evolving rules to structure a compliant program that achieves the sponsor’s goals.

Our Health and Welfare Benefits group includes attorneys throughout the US.  In harnessing our size and experience, we are committed to sharing ideas, strategies and solutions to the unique issues our clients face. This collaborative approach allows us to be thought leaders in our practice area.

OUR SERVICES

Affordable Care Act. Our employee benefits attorneys are familiar with all elements of the ACA, and have worked with the oversight agencies on proposed rulemaking in this area. We provide guidance to employers on the employer shared responsibility reporting requirements, controlled group rules, nondiscrimination requirements, state-based exchanges, developments in “essential health benefit” benchmarks, retiree medical benefits, taxes and fees, reporting requirements and employee communications, and payroll implications as these topics relate to employer-sponsored group health plans. We continuously monitor the new guidance issued by the governmental agencies to assist our clients with understanding and planning for health care reform.

HIPAA Privacy and Security. Employers look to us for guidance with respect to the rules governing the use of an individual’s protected health information under HIPAA and state data privacy laws. To help our clients ensure they are in compliance with privacy and security regulations, we draft privacy policies, privacy notices, related plan amendments, and draft and negotiate business associate agreements. We also conduct targeted HIPAA privacy training for employees whose roles require access to protected health information regularly or from time to time.

Retiree Benefits. We advise on all aspects of retiree welfare benefits, including strategies for reducing or eliminating retiree medical obligations, navigating potential litigation and collective bargaining implications, and maximizing tax-advantaged funding vehicles for retiree plans. We also help clients analyze the delivery of retiree benefits involving, for example, the migration from traditional health plan designs to health reimbursement accounts and private exchanges.

Fringe Benefits Plans. We regularly assist clients with qualified transportation plans, adoption assistance programs, educational assistance plans, vacation pay plans, employee assistance programs, on-site medical clinics, and other taxable and non-taxable fringe benefits. Clients turn to our team for advice on how to structure these programs, analyze relevant tax considerations, and for ongoing support on the compliance aspects of these benefit offerings.

Business Reorganizations/Mergers & Acquisitions. When organizations buy or sell other organizations, we can help employers during the negotiation process determine what will happen with existing health and welfare programs.  We can help draft the merger documents, transition service agreements, and vendor agreements, as well as the plan documents.

COBRA. We help employers comply with the COBRA rules on a day-to-day basis, as well as during reductions in force or business reorganizations.