“The District Court ultimately agreed with the employer and found that the severance provisions in the executive’s individual employment agreement established an ERISA plan. The court’s analysis focused on five main points: Intended benefits. … Class of beneficiaries. […]
Historically, employers have looked at generics as a cost saving strategy because the cost of generic medications has been significantly lower than the cost of brand name medications. Surprisingly, however, over the last couple of years, the trend for some generics has not […]
“An employer who elects to use the look back measurement method will have to include the details of the initial measurement period and standard measurement period, including dates, in order to satisfy the SPD requirements if the health plan’s eligibility conditions are properly synchronized…. There is […]
“Former employees who terminate employment after having satisfied the minimal vesting requirements of ERISA, but before satisfying the more restrictive vesting requirements of their former employers’ non-qualified plans, have figured out (actually, their lawyers have figured out) that challenging a non-qualified […]
“The simple idea that greater purchasing volume lowers producers’ per-unit costs thereby permitting price discounting is the foundation of employer health care group purchasing organizations…. You would think that would mean hospitals would contract with specialized group purchasing organizations (GPOs), pay their annual membership fees […]
Recent developments in the Health and Welfare landscape have placed ERISA compliance at the forefront of your clients’ minds. The DOL’s vigorous enforcement efforts have left employers with little room to be non-compliant.
Over the past seven years, ERISA Pros has emerged as a premier professional services firm specializing in providing Welfare Benefit Compliance solutions, focusing […]
Under the ACA, Are Employees Receiving Short-Term or Long-Term Disability Benefits Still Considered Full-Time Employees?
“For purposes of calculating hours of service, an individual receiving payments from a short-term disability (STD) or long-term disability (LTD) arrangement might be treated as a full-time employee. Two of the determining factors are whether the recipient of disability payments retains his or her status as […]
“Beginning in spring 2016, the Affordable Care Act (ACA) Exchanges will begin to send notices to employers whose employees have received government-subsidized health insurance through the Exchanges…
Although CMS has provided these guidelines to apply only to the Federal Exchange, it is likely that the state-based Exchanges will have similar notification programs. Employers should be prepared […]
“BA services include claims processing or administration, data analysis, billing and benefit management. Service providers can include third-party administrators, accountants, attorneys, consultants, cloud data storage companies, and pharmacy benefits managers … Here’s a closer look at Phase 1 and Phase 2 audits and the background […]
“Many employees had been told that they would need these forms to prepare their 2015 income taxes. Many even believed, incorrectly, that Form 1095s were to be filed with their tax returns, along with their Form W-2s… Employers, therefore, should inform workers to expect these forms by March 31, and assure them they may go […]