Author Archives: Jamie Leary

ERISA’S NEW CLAIMS AND APPEALS PROCEDURES FOR DISABILITY BENEFIT CLAIMS

“It’s a New Dawn; It’s a New Day; It’s a New Life for Me; and I’m Feeling [not so] Good”

While Nina Simone’s song captures the power of “feeling good,” the effects of an employee’s disability do not feel good for the employee or employer. And if your organization offers employee benefits that require the plan administrator to determine whether a plan participant is disabled, you should confirm that your plans reflect updated claims and appeal procedures.  Regulations finalized back in 2016 are now in effect.  Read More »

WILL THE FRAMEWORK OF LAWS THAT GOVERN WELLNESS PROGRAMS CHANGE ONCE AGAIN? TAKE TWO ASPIRIN AND CALL ME AFTER MARCH

Wellness programs in the workplace are generally based on the belief that as employees lose weight, stop smoking, eat more healthfully, and lower their cholesterol, their employer will reap a drop in absenteeism and health care costs. With that hope in mind, employers are often willing to offer a financial reward to encourage employees’ participation.  The Equal Employment Opportunity Commission (“EEOC”) has long been concerned about whether the financial reward offered makes such wellness programs “involuntary” such that the wellness programs fail to comply with the Americans with Disabilities Act (“ADA”) and/or the Genetic Information Nondiscrimination Act (“GINA”).  Previous S&J blog posts have reported the EEOC’s actions with respect to wellness programs over the years, including the EEOC’s issuance of final ADA and GINA regulations addressing wellness programs.  Those regulations have been challenged in court by the AARP, and you can expect changes in the regulations as a result.  This post will bring you up to speed on the litigation and what you should watch for going forward.  Read More »

TALK ABOUT A BLACK FRIDAY: THE ACA’S PLAY OR PAY MANDATE MAY HIT EMPLOYERS THIS HOLIDAY SEASON!

Although the ACA Play or Pay mandate was effective in 2015, it has been unclear when or how the IRS would collect any penalties assessed under that mandate.  Earlier this month, however, the IRS quietly provided its answer by updating an online ACA resource and stating that penalty notices for the 2015 year would be issued in “late 2017.”  Under the new procedures, an employer who receives one of these notices will have only 30 days to respond.  Employers should act now to maximize their ability to respond timely and minimize inadvertent penalty assessments. Read More »

LEARNING HOW TO NAVIGATE BY THE STARS: THE “CONSTELLATION OF BENEFITS” RELATED TO SAME-SEX MARRIAGE

Although it has been more than two years since the Supreme Court of the United States (“SCOTUS”) issued its Obergefell v. Hodges opinion and more than four years since its US v. Windsor opinion, the law is still evolving as it concerns same-sex marriage.  It is important for employers who wish to minimize their litigation exposure to determine what “rights, benefits, and responsibilities” same-sex spouses should be extended in the same manner as opposite-sex spouses.  While SCOTUS has indicated its belief that Obergefell’s holding and application are clear, recent rulings indicate otherwise . . . which means employers would be well-advised to stay tuned.  Read More »