Hunton Employment & Labor Perspectives

On August 25, 2023, in response to concerns regarding the timely implementation of SECURE 2.0’s Roth catch-up contribution requirement, the IRS issued Notice 2023-62, which provides that 401(k), 403(b) and 457(b) plans now have until December 31, 2025 to comply.  

On November 22, 2022, the U.S. Department of Labor (“DOL”) announced a final rule (the “2022 Final Rule”) that allows plan fiduciaries to consider climate change and other environmental, social, and governance (“ESG”) factors when selecting retirement investments and exercising shareholder rights, such as proxy voting, for ERISA-governed plans.[1]

On April 9, 2022, Maryland became just the tenth state (in addition to the District of Columbia) to enact a paid family and medical leave law that covers private-sector workers, after overriding Governor Larry Hogan’s (R) veto.

On April 16, 2021, Governor Newsom approved S.B. 93, a statewide COVID right-to-recall law that faltered on its first attempt last October.  In the interim, a number of counties and cities (including the Cities of Los Angeles, Oakland, San Francisco, San Diego, and Pasadena, and Los Angeles County) passed almost identical measures, which will remain in effect to the extent they are more generous than the state law.

Like the local ordinances, the state law is time-limited and directed to the industries with workforces most decimated by COVID: hotels, event centers, private clubs, airport hospitality operations, airport service providers and janitorial, maintenance and security services for commercial buildings. Through December 31, 2024, employers in those industries are required to notify those laid off because of COVID about newly-available positions, and offer them to the laid-off employees based on a qualification-based preference system. Post-layoff changes in ownership, the form of the organization, or the location of the business will not excuse an employer from these recall protocols, as long as the business conducts the same or substantially similar operations as it did before the pandemic.

On May 14, 2020, the Department of Health and Human Services (HHS) issued a final rule stating that group health plans, including employer-sponsored health plans, are not required to count the value of drug manufacturer coupons toward participant deductibles and out-of-pocket maximums (the “Final Rule”).  The Final Rule, published in HHS's Notice of Benefit and Payment Parameters for 2021, allows group health plans to exclude the value of drug manufacturer coupons from participant annual cost-sharing amounts even where no medically appropriate generic drug is available.

The Universal Paid Leave Amendment Act of 2016 (the “Act”), which implements the District of Columbia’s new Paid Family Leave (“PFL”) program, kicks-in for employees on July 1, 2020.  However, employers must post a PFL notice in the workplace no later than February 1, 2020.

The IRS has issued final regulations amending the hardship distribution rules for qualified retirement plans, including 401(k) and 403(b) plans. The final regulations are substantially similar to the proposed regulations that were issued in November 2018, but provide a few clarifications.  Plans that have been complying with the proposed regulations will satisfy the final regulations.  Below is a summary of the key changes and action items for plan sponsors.

For at least one more year, health plans, including employer-sponsored plans, will be able to exclude the value of drug manufacturer discounts from participant deductibles and out-of-pocket maximums, even where no medically appropriate generic drug is available.  The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Department of Treasury (collectively, the "Departments") jointly issued a temporary non-enforcement pledge relating to these so-called "accumulator programs" as a result of an apparent catch-22 relating to high-deductible health plans (HDHPs) with health savings accounts (HSAs). 

The current trend at both the state and federal levels is moving in the direction of mandatory paid family leave.  For example, in recent years, 6 states (California, Massachusetts, New Jersey, New York, Rhode Island, and Washington) and the District of Columbia have enacted mandatory paid family leave benefits for employees.  Moreover, at least 18 other states are currently considering some form of paid family leave legislation.

On October 29, 2018, the Internal Revenue Service, Department of Labor and Department of Health and Human Services (the “Departments”) jointly released proposed regulations in response to President Trump’s executive order calling for an expansion of the ability of employers to offer health reimbursement arrangements (“HRAs”) to their employees and to allow HRAs to be used in conjunction with nongroup coverage.

The IRS recently updated the FAQs on its website regarding the employer mandate to provide some details on the process it will use to impose penalties for failure to provide coverage to “ACA full-time” employees (those working 30 or more hours per week) in accordance with Section 4980H of the Code (often referred to as the “employer mandate”).

On May 4, the House of Representatives passed the American Health Care Act, (AHCA), which is aimed at repealing and replacing portions of the Affordable Care Act (ACA). While many of the changes do not affect employer-sponsored coverage, there are several changes in the bill that are likely to be of interest to employers.

Earlier this year, the Department of Health and Human Services Office of Civil Rights published final rules implementing Section 1557 of the Affordable Care Act (ACA).  Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability by healthcare providers and group health plans that receive federal financial assistance. The rules include restrictions on discrimination relating to gender identity, as well as requirements regarding accessibility for individuals with limited English and with disabilities.

A recent decision from the California Labor Commissioner’s Office found that a former Uber driver was an employee of the company, not an independent contractor as the firm has labeled its motorists.  The implications for Uber, as well as other companies with similar business models, could be far-reaching.

The Equal Employment Opportunity Commission (“EEOC”) has issued proposed rules (“ADA Proposed Rules”) on the extent to which employers may offer incentives to promote participation in wellness programs without violating the Americans with Disabilities Act (“ADA”). The ADA Proposed Rules apply if a wellness program includes disability-related inquiries or medical examinations, including inquiries or examinations that are part of a health risk assessment.  Health risk assessments are reported to be the most common form of incentivized employee wellness programs.¹ Thus, many employers would likely be impacted by these new rules if finalized.

The Affordable Care Act (ACA) requires the state and federal health care exchanges to notify employers if an employee has been determined to be eligible for a premium tax credit or cost-sharing reduction for exchange coverage. The notices are issued for those individuals who have been determined to be eligible for such a subsidy. As employers begin receiving notices, they should consider how best to track this information and whether it would be worthwhile to appeal the subsidy eligibility determinations where the information is incorrect.

The government has continued to issue a number of regulations and other guidance on the Patient Protection and Affordable Care Act (PPACA) and related health care laws, including the following:

• Final regulations on the use of “bona fide orientation periods” in coordination with waiting periods for health care coverage;
• IRS forms and instructions regarding reporting of health care coverage by health plans and large employers;
• Updated proposed rules on the required Summary of Benefits and Coverage;
• Guidance regarding use of “skinny plans”; and
• Preliminary guidance on ...

The IRS recently issued Notice 2015-16 addressing the excise tax on high cost employer-sponsored health coverage enacted under the Affordable Care Act. This tax, which is commonly referred to as the "Cadillac" tax, will take effect in 2018. While it does not provide definitive guidance on which employers can rely, the Notice does provide some useful insights as to the agency's intended approach regarding key aspects of the tax.

The IRS recently issued final versions of the new Forms 1094-B, 1095-B, 1094-C and 1095-C, along with related final Instructions.  These forms are for reporting of coverage in 2014, but are expected to be similar for reporting for 2015.

In December 2014, the government issued new proposed rules regarding the requirements for providing a summary of benefits and coverage (SBC). Simultaneous with the proposed rules, the government also published an updated SBC template and uniform glossary.

On January 4, 2015, Illinois Governor Pat Quinn signed into law the Illinois Secure Choice Savings Program Act, which will require private sector employers to make automatic payroll deductions, and place the deductions into a state-run savings plan for the benefit of employees.

The IRS recently issued draft versions of the new Forms 1094-B, 1094-C, 1095-B and 1095-C (the “Forms”) along with related draft Instructions.

The Affordable Care Act required the Department of Health and Human Services (HHS) to establish a national health plan identifier (HPID) program under the HIPAA standard transactions rules. The resulting HHS rules generally require all HIPAA-covered entities, including self-insured plans with more than $5 million in annual claims, to obtain a HPID by November 5, 2014. Small self-insured health plans (i.e., those with annual claims of $5 million or less) will be required to obtain a HPID by November 5, 2015.

Starting September 30, 2014, many employers in the greater San Francisco Bay Area will be required to provide commuter benefits to their employees as part of the “Bay Area Commuter Benefits Program.” 

On June 25, the government issued final rules regarding the use of “bona fide employment-based orientation periods” in connection with the Affordable Care Act’s 90 day waiting period limits. These final rules largely track the proposed rules issued in February.

In Euchner-USA, Inc. v. Hartford Cas. Ins. Co., No. 13-2021-cv, 2014 U.S. App. LEXIS 10797 (2d Cir. June 10, 2014), the United States Court of Appeals for the Second Circuit found that an insurer must defend its insured in a case alleging ERISA violations because the facts alleged (as opposed to the embedded legal conclusions) created a reasonable possibility of coverage under the general liability policy’s employee benefits coverage part. Central to the court’s decision was its finding that Euchner’s alleged misclassification of the plaintiff as an independent contractor ...

The government has continued to issue a number of regulations and other guidance on the Patient Protection and Affordable Care Act (PPACA) and related health care laws, including the following:

• The “employer mandate” that will take effect in 2015;
• IRS reporting requirements for health plans and large employers;
• The 90-day waiting period limits;
• Transitional reinsurance contributions required to be made by large employers;
• The Mental Health Parity and Addiction Equity Act; and
• Standard transactions under HIPAA.

On April 3, 2014, the Internal Revenue Service issued guidance (Revenue Ruling 2014 9) that should make it much easier for qualified plans (including section 403(b) plans) to accept direct rollover contributions from other qualified plans and IRAs.  While qualified plans have long been allowed to accept such rollovers, the new guidance should encourage more plans to accept rollovers by simplifying the process of determining whether a proposed rollover is an “eligible” one which the plan can accept without jeopardizing the plan’s on-going compliance.

IRS final regulations issued earlier this year provide guidance on compliance with the employer coverage mandate under the Affordable Care Act (ACA), including determining full-time status and offering coverage with minimum value. In addition, the government has also issued final and proposed regulations regarding 90-day waiting periods under the ACA.

While both sets of final rules largely follow the previously issued proposed rules, there are some key changes of note for employers.

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Plan sponsors now have additional answers to some of their questions about the effect of the Windsor decision on retirement plans. Notice 2014-19, released on April 4, 2014, provides guidance concerning the application (including retroactive application) of Revenue Ruling 2013-17 and the June 26, 2013, Supreme Court decision that invalidated Section 3 of the Defense of Marriage Act (DOMA).

Even before passage of the Affordable Care Act (ACA), group health plan sponsors and administrators faced a significant array of notice and disclosure obligations.  Those obligations have only increased with passage of the ACA, and in many cases existing disclosure requirements have been revised.  For this reason, we are providing a table summarizing the principal notice and disclosure obligations currently applicable to group health plans, including those required under the ACA.  The first part of the table summarizes disclosure rules applicable to all welfare benefit plans ...

On December 11, 2013, the Internal Revenue Service issued Notice 2013-74, which provides additional guidance for 401(k), 403(b) and governmental 457(b) plan sponsors on permitting in-plan Roth conversions (called “rollovers”) of pre-tax amounts.

On October 31, 2013, the Internal Revenue Service issued Notice 2013-71, which modifies the “use or lose” rule for flexible spending accounts (FSAs) and permits employers to amend their section 125 “cafeteria” plans to allow employees to carry over up to $500 in unused FSA contributions to the next plan year.

On Wednesday the Supreme Court agreed to hear two cases involving religious objections made by corporations to a provision of the 2010 Patient Protection and Affordable Care Act (the “Affordable Care Act”), which requires employers to provide health insurance for employees that covers contraceptives.  The central issue in both cases is whether a secular for-profit corporation may be exempt from complying with the contraception mandate under the Constitution because of the owner’s religious views.

Although the employer shared responsibility (“coverage mandate”) rules under the Patient Protection and Affordable Care Act (PPACA) have been delayed one year (to 2015), there are a number of other PPACA requirements that will still be going into effect in 2014.  For example, the one-year delay does not apply to –

• The final wellness rules;
• The 90-day waiting period limits;
• The preventive care changes; and
• The new cost sharing limits

Plus, employers will soon need to focus again on the coverage mandate compliance process and the related reporting requirements (the initial reports for which will be due in early 2015).  In the meantime, the government continues to issue regulations and other guidance on a variety of matters involving PPACA’s implementation.  

The Internal Revenue Service (“Service”) has recently issued guidance promised in the wake of the Supreme Court’s decision in United States v. Windsor. (See the IRS news release containing links to Revenue Ruling 2013-17 and frequently asked questions). Building on the precedent set in Revenue Ruling 58-66 that addressed the treatment of common law marriages (which are recognized in some states but not in others), the Service has ruled that, for purposes of federal tax law, an individual’s spouse will be determined by the law of the state in which the marriage was celebrated.

In a landmark ruling, United States v. Windsor, the Supreme Court struck down a major provision of the Defense of Marriage Act (“DOMA”).  Since its enactment in 1996, DOMA defined “marriage” to mean “only a union between one man and one woman as a husband and wife” and “spouse” to refer “only to a person of the opposite sex who is a husband or a wife,” which, by their terms, excluded marriages of same-sex couples.  These definitions were applicable to all federal statutes, regulations, rulings and orders, including the Internal Revenue Code (the “Code”) and the Employee Retirement Income Security Act (“ERISA”).

Pundits have written much about the Affordable Care Act’s forthcoming Health Insurance Exchanges, but they have paid little attention to employers’ obligations to notify employees of those Exchanges.  The state-based Exchanges, also known as the Health Insurance Marketplace, are expected to go into effect on January 1, 2014, with open enrollment beginning on October 1, 2013.  Employees may purchase health insurance through these Exchanges.

The Internal Revenue Service recently issued an updated version of the Employee Plans Compliance Resolution System (“EPCRS”), which allows companies to voluntarily correct errors in the administration and documentation of their retirement plans (including 401(k) and 403(b) plans).  IRS Revenue Procedure 2013-12 continues EPCRS, but makes a number of changes and adds clarity to several areas of the program that caused confusion in the past.

The Patient Protection and Affordable Care Act requires that employers report the aggregate cost of “applicable employer-sponsored coverage” on Form W-2.  (See our August 6, 2012, posting entitled “Reminder – 2012 Form W-2 Reporting For Group Health Plans” for an explanation of this requirement.)  Applicable employer-sponsored coverage generally includes coverage under any group health plan made available to employees by an employer that is excludable from gross income.  In providing an enumerated list of the types of coverage that are exempt from the reporting requirement, the Internal Revenue Service explained in Notice 2012-9 (Q&A-12) that the term “applicable employer-sponsored coverage” generally does not include any coverage for HIPAA-excepted benefits, other than coverage for on-site medical clinics.

Beginning in 2014, sponsors of self-insured group health plans (and insurers for insured group health plans) will be required to pay an annual fee to fund the Transitional Reinsurance Program under the Patient Protection and Affordable Care Act.  The Department of Health and Human Services (HHS) recently proposed additional regulations for this program.  Here is a quick overview of how the program will work under the proposed rules.

Implementation of the health care reform law now appears to be a certainty. We have already begun to see a flood of regulations creating new rules around the law’s implementation requirements, most of which will occur in 2013 and 2014.

In order to meet the burgeoning needs and concerns of our clients, the Hunton & Williams Health Care Reform team will be presenting a series of webinars over the coming months.

Please join us for the first in the series
 
Health Care Reform Is Here to Stay – What Do Employers Do Now?

Thursday, January 17, 2013
1:00 – 2:30 p.m. EST

Register Now

The Patient Protection and Affordable Care Act provides that group health plans may not apply a waiting period of more than 90 days for plan years beginning after December 31, 2013 (January 1, 2014 for calendar year plans).  IRS Notice 2012-59, which was issued earlier this year, provides guidance on how employers should apply this rule.

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In an opinion issued on October 18, 2012, the Federal District Court of Massachusetts provided clarity and relief for private equity firms on the significant, but murky, question of whether a private equity fund can be liable for the ERISA pension obligations (including multiemployer withdrawal liability and defined benefit pension plan underfunding) of its portfolio companies.

The employer shared responsibility rules under the Patient Protection and Affordable Care Act will go into effect in 2014.  Government guidance was issued earlier this year on an important aspect of these rules – the determination of who is a full time employee.

The Department of Labor (DOL) takes audits of employee plans very seriously.  Over the past few years, the Employee Benefit Security Administration (EBSA) has increased its civil and criminal audits of plans and, in 2011, collected $1.39 billion in fines in the process.  EBSA has recently added several hundred more auditors to its ranks to increase audits.

Employers, payroll vendors and executives should be planning for the additional Medicare tax that will apply to high wage earners beginning in 2013.  The 2010 Health Care Reform Act imposes an additional Medicare tax of 0.9% on employee’s wages in excess of the applicable dollar amount for the employee’s filing status (as shown below):

• Married, filing jointly —  $250,000
• Married, filing separately — $125,000
• Single — $200,000
• Head of household (with qualifying person) — $200,000
• Qualifying widow(er) with dependent child — $200,000

Thus, for employees above the threshold, the Medicare tax rate will increase from 1.45% to 2.35% (on the employee portion) for wages in excess of the threshold.  The employer portion of the tax will remain unchanged at 1.45%.

On August 20, 2012, the Eleventh Circuit Court of Appeals affirmed the ruling of the U.S. District Court for the Southern District of Florida in Seff v. Broward County, finding that premium surcharge imposed under Broward County’s employee wellness program did not violate the American with Disabilities Act (ADA) because it was part of a bona fide benefit plan.

Is your payroll system ready for the new reporting requirements for group health benefit costs under The Affordable Care Act?  Under IRS guidance, the Form W-2 reporting of group health plan coverage costs will become mandatory this year.  Beginning with the 2012 Forms W-2 due in 2013, employers must report the aggregate value of certain employer-provided health coverage in Box 12 (with Code DD).  For many employers, this will involve substantial groundwork and will generally require that any needed payroll reporting changes be done before year-end.

As the 2013 open enrollment season approaches, group health plan sponsors are trying to hold down health care costs.  Implementing a wellness program may be part of that effort.  The difficulty lies in designing a program that promotes wellness without running afoul of the Equal Employment Opportunity Commission (EEOC).

July 1, 2012 has come and gone and ERISA retirement plans should have received fee disclosures from their covered service providers.  Now plan fiduciaries have to do something with all that information.  Where do you start?

Group health plan sponsors have an additional date to add to their calendars, thanks to the Patient Protection and Affordable Care Act (ACA). The new summary of benefits and coverage (SBC) disclosure rules for group health plans go into effect soon. Disclosures that tell participants what their plan covers and what it costs must be provided starting with enrollment periods and plan years that begin after September 22,  2012. Attached is an overview of what you need to know now about the new SBC requirements.

Is your cafeteria plan ready for the new health care flexible spending account (FSA) employee contribution limit?  Beginning in 2013, the Patient Protection and Affordable Care Act (ACA) limits the maximum amount that an employee can elect to contribute to a health care flexible spending account (FSA) to $2,500 per year.  While plan sponsors could, prior to ACA, impose limits on the amount of elective employee contributions to a health care FSA, there was no statutory limit.

Health plan sponsors should be aware of new fees taking effect soon that are imposed by the Patient Protection and Affordable Care Act (ACA).  Here is a quick review of the fees as described in the recent proposed Treasury Regulations.

With all the recent attention in the press and by the Department of Labor on who is a fiduciary and what a fiduciary needs to do, you may wonder if you have waited too long to focus on this issue.  While the March 2012 opinion by the Federal District Court for the Western District of Missouri in Tussey v. ABB, Inc., found that it was too late for the plan fiduciaries for the two ABB Inc. 401(k) plans to fix their mistakes, the opinion should serve as a wake up call to other 401(k) plan fiduciaries to change their fiduciary ways before it is too late for them.

Set out below is a chart that describes the various notices that are required under government regulations for the group health plan reforms and related requirements that will be in going into effect for plan years beginning on or after September 23, 2010 (e.g., January 1, 2011 for calendar year plans) -- including the special notice requirement for those plans that intend to continue to maintain “grandfathered” status, along with a link to any model notice/language provided by the government.

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The U.S. Court of Appeals for the Ninth Circuit recently held—consistent with other courts that have considered the issue—that “insurance agents are independent contractors and not employees for purposes of various federal employment statutes,” including ERISA, the ADEA, and Title VII.  In Murray v. Principal Financial Group, Inc., case number 09-16664, the panel unanimously affirmed a district court order granting summary judgment in favor of a purported employer because it found that the plaintiff was an independent contractor, not an employee entitled to the protections of Title VII.  The panel’s opinion clarifies the appropriate test for distinguishing between employees and independent contractors in the context of Title VII, and concludes that despite apparent precedent for multiple tests, there is, in fact, only one.

The United States Departments of Health and Human Services, Labor, and the Treasury issued a series of regulations related to the Patient Protection and Affordable Care Act, as amended (the “Health Care Reform Act”).  The regulations provide guidance for group health plans, including new rules for preexisting conditions, annual/lifetime limits, and coverage rescissions.