Health and welfare benefit plans are increasingly becoming a key component of an employer’s overall compensation, retention and recruitment package. Designed to attract top candidates and retain key executives and employees, health and welfare benefit plans also make up a significant portion of a business’ overall human resources-related expenditures. This balancing act is made even more challenging as regulatory oversight and legislative requirements continue to expand under the Affordable Care Act and other federal and state legislation applicable to group health plans.
McDermott’s health and welfare benefits lawyers have deep knowledge and experience advising clients on the design and administration of health, welfare and other fringe benefit plans. We counsel employers, health plans, vendors, insurers and plan fiduciaries, assisting them with navigating the complex requirements of federal and state laws that impact benefits.
Our interdisciplinary team is skilled at helping clients identify and navigate trends in employee benefits and health care reform, develop strategies to overcome new or potential legal hurdles, manage the growing legal complexity associated with the design and administration of health, welfare and other fringe benefit plans, and address the issues that arise from major business transactions.
Clients turn to McDermott for our vast knowledge and capabilities to address the full range of issues, from conducting audits to the reviewing and guiding of plan design strategy, assisting with documentation and funding, negotiating vendor-service agreements, advising on fiduciary issues, and representing clients before government and regulatory agencies to negotiate favorable outcomes.
Our experienced ERISA lawyers help employers, plan administrators and other fiduciaries correct prohibited transactions and fiduciary breaches, ensure compliance with the numerous reporting obligations and notice requirements, review third-party administrator and other service-provider agreements, and draft summary plan descriptions and other participant communications.
Affordable Care Act
We work closely with clients to help them understand, navigate and comply with the sweeping changes brought about by the Affordable Care Act (ACA). From employer shared responsibility requirements and employer reporting to ACA tax and reporting obligations, we advise on the opportunities and challenges facing employers. We understand the law and guide clients regarding benefit design strategies, establishment of onsite employee clinics, development of wellness, prevention and disease management programs and telehealth initiatives, direct contracting between employers and providers to create accountable care, medical home and shared savings strategies, and implementation of account-based plans such as health reimbursement arrangements and health savings accounts.
Health Insurance Portability and Accountability Act (HIPAA)
We help employers understand and ensure compliance with the complex set of limitations and rules governing the use of an individual’s protected health information under the Health Insurance Portability and Accountability Act (HIPAA) and related—and often more stringent—state data privacy laws. As part of our industry-leading best practices, we conduct privacy audits, develop customized compliance plans, draft administrative policies and procedures for privacy and security, deliver training sessions and educational materials, and draft a range of contracts and consent and authorization forms for use with plan participants and business associates. To that end, we have developed HIPAA Privacy Solutions, a comprehensive HIPAA implementation tool that, depending on the organization, may be implemented with minimal or no additional outside legal assistance.
Retiree Medical Benefits
We advise private and public companies, nonprofits and other clients on the design and administration of retiree medical benefit plans, including strategies for reducing or eliminating post-retirement benefit obligations and maximizing tax advantages, including the funding of those arrangements. We are also experienced in establishing novel benefit delivery models for retiree medical benefits, such as private exchanges, account-based plans and employer group waiver plans that enable employers to continue to provide benefits to former employees while maximizing and leveraging other payors in the system.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Elements of the employer-employee relationship can last long after the termination of an employment situation. This is particularly true in the area of health benefits (including onsite medical clinics) and COBRA compliance, in which employees, their spouses, domestic partners and dependents may continue to have access to employer-sponsored health plans for a period of time following an employee’s voluntary or involuntary separation from the company. We advise clients on their responsibilities under COBRA and help resolve disputes involving qualifying events, COBRA eligibility, and coverage periods and elections.