Client Services / Employee Benefits / Health and Welfare Benefit Plans

Health and Welfare Benefit Plans

McDermott Will & Emery’s Welfare Benefit Group advises clients on the design and administration of health, welfare and other fringe benefit plans.  The team is anchored by partners who have more than 60 years of collective experience in counseling clients on health and other group benefit plan compliance matters.  They are uniquely qualified to help clients manage the growing legal complexity associated with the design and administration of health, welfare and other fringe benefit plans.

As part of our Employee Benefits, Compensation, Labor & Employment Practice Group, which has been recognized as a leader in this field, our Welfare Benefit Group helps clients navigate the requirements promulgated by a variety of laws and regulations, including the Patient Protection and Affordable Care Act (PPACA), the Employee Retirement Income Security Act (ERISA), COBRA, the Mental Health Parity and Addiction Equity Act, the Health Insurance Portability and Accountability Act (HIPAA), the Internal Revenue Code and other federal laws.  Among our many services we:

  • Audit and identify plan gaps, find alternative strategies and implement appropriate measures
  • Review and evaluate plan design and funding changes, and help limit exposure to litigation through thorough and accurate documentation
  • Evaluate, negotiate and review vendor contracts
  • Advise on fiduciary issues and seek prohibited transaction exemptions
  • Anticipate or manage Internal Revenue Service, Department of Labor or Department of Health and Human Services audits
  • Counsel on successfully managing medical plan costs through wellness programs
  • Provide advice with respect to expatriate and non-resident alien coverages
  • Assist with retiree medical compliance and funding issues
  • Recommend solutions for executive benefit packages
  • Assist clients with the issues raised in the purchase or sale of business operations

Regulatory Compliance
The requirements imposed on health and welfare plans by PPACA, ERISA, COBRA, HIPAA, the Internal Revenue Code and other federal laws are significant and far-reaching.  We review plan documents, contracts and operations for legal compliance, identify compliance gaps, evaluate alternative compliance strategies and implement appropriate compliance measures.

Plan Design and Documentation
Employers frequently evaluate plan design and funding changes to their health and welfare plans, including the adoption of new consumer-driven health plan designs (such as health reimbursement arrangements and health savings accounts) and changes to retiree health plans.  Plan participants increasingly are using the courts to litigate benefit disputes and succeeding when plan documents are unclear or insufficient.  We review and evaluate plan design and funding changes for active and retired employees and, working closely with our ERISA Litigation Group, can limit exposure to spurious litigation by ensuring that plans are accurately documented.

Contract Review
Employers administer their health and welfare plans primarily through vendor contracts.  We can help review, evaluate and negotiate vendor contracts, including business associate agreements required by HIPAA.

Claims Processing
The Department of Labor has significantly changed the framework for processing and responding to benefit claims.  Health and welfare plans are increasingly deluged with difficult benefit claim issues that now must be processed more quickly and with more care.  We can help you review your claim and appeal documents and procedures, and develop strategies that may aid in avoiding costly future litigation.

Business Transactions
The purchase or sale of business operations frequently requires initial, transitional and long-term changes to health and welfare benefit plans.  We can help you conduct due diligence prior to a purchase or sale, and assist you in working through the transitional and long-term changes necessary to adjust your plan designs.  We have unique solutions to difficult issues involving executives, COBRA and transitioning benefits.

Our partners are committed to thoroughly understanding our clients’ business needs and working with them to achieve their goals and to design the best possible benefits plan package for them and their employees.

Contacts

Employee Benefits Client Services

McDermott Will & Emery

McDermott Will and Emery