Compliance Stuff

  As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health plans generally have their compliance obligations satisfied by the insurer, self-insured health plans usually rely on the employer or the plan's third-party administrator (TPA) to meet the compliance requirements. Below is a brief summary of items that employers should be aware of for their health plans and, as appropriate, we have delineated when such compliance is limited only to self-insured health plans. Capitol Bridge Health Plan: Effective 03/01 - 02/28 TDB Communication, Inc. Health Plan: Effective 07/01 - 06/30 Capitol Bridge Health Services Health Plan: Effective 07/01 - 06/30 Capitol Bridge Puerto Rico: Effective (TO BE DETERMINED) 1. HIPAA Privacy Extends Special Protections to Reproductive Health Care: Employer Action Required by 12/23/24 Earlier...

  Last week, the Departments of Labor, Treasury, and Health and Human Services finalized   regulations   implementing the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).  Although the final regulations step back from certain burdensome aspects of the proposed rules (which we blogged about   here ), compliance with the final rules w ill require action from virtually all group health plans that cover mental health and substance use disorder (MH/SUD ) benefits before the end of the year. How did we get here? MHPAEA requires that group health plans that provide MH/SUD benefits cover them in parity with medical and surgical benefits .  Evaluation of whether benefits are in parity is performed for each classification of benefits under the plan, and this analysis requires evaluating: (1) financial and other quantitative treatment limitations, and (2) non-quantitative treatment limitations (NQTLs).   At the end of 2020, Congress added a require...

  On September 13, 2024, the Massachusetts Supreme Judicial Court (the “SJC”) ruled that the Massachusetts Paid Family and Medical Leave Act (the “Act”) does not guarantee the accrual of benefits such as sick leave, vacation leave and length-of-service credit during a period of paid family or medical leave (“PFML”). Instead, the Act mandates only that employees return from leave to the same or equivalent position that they held at the commencement of leave. Summary of the Case In  Bodge & others vs. Commonwealth & others ¸ plaintiffs represented a class of state troopers who sought to take PFML in connection with the birth of a child. The plaintiffs alleged that denying their right to accrue employee benefits while on leave violated the Act . The SJC disagreed, finding that the statutory language says otherwise – it does not confer accrual rights on employees but rather requires that employees be put back to the same or equivalent position that they held when their le...

  September 19, 2024 WASHINGTON—The U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) has issued another  resource  to familiarize small business owners with  beneficial ownership reporting  requirements. T hese reporting requirements are mandated by the Corporate Transparency Act, a bipartisan law enacted to curb illicit finance by supporting law enforcement efforts. This law requires many small businesses to report basic information to the Federal government about the real people who ultimately own or control them. The toolkit contains templates and sample content that has been structured to allow private, public, and non-profit organizations to share and amplify this important information . The toolkit includes general background on the reporting requirements, as well as templates for newsletters, websites, and emails; sample social media posts and images; and information on how to contact FinCEN. The toolkit furthers FinCEN’s o...

  One of the main reasons for a separation agreement with an employee is to obtain an effective release of claims against the employer. However, ensuring release agreements are effective and enforceable is becoming increasingly challenging as more and more states have specific requirements and restrictions. Quick Hits Crafting effective multistate separation agreements can be challenging for employers amid an increasing number of state-specific requirements and restrictions. Employers may want to consider updating their template release agreements, confirming their agreements state sufficient and proper consideration for employees to release claims, and whether their separation agreements properly incorporate any desired restrictive covenants, arbitration agreements, or other agreements. While crafting effective separation agreements is a common issue for employers, they often rush to complete them in the face of a sudden separation or large-scale reduction in force (RIF). Prior pl...

  According to Puerto Rico Secretary of Labor Gabriel Maldonado, neither the Constitution of Puerto Rico nor P uerto Rico Act 379 imposes any limitations on employers requiring overtime work of employees beyond paying a specific premium rate . Secretary Maldonado’s Sept. 13, 2024, Opinion revokes the previous multifactor guidance issued by the Puerto Rico Department of Labor (PRDOL). Previous Guidance The Puerto Rico Constitution mandates that workers have a right to an ordinary work schedule not exceeding eight hours in a day . Any time worked over eight hours must be paid at no less than one and one-half times the rate established by law. Puerto Rico Act 379 provides that any time worked over eight hours in a calendar day and over 40 in a week must be compensated generally at one and one-half times the regular rate of pay. PRDOL guidance had interpreted the law to mean that overtime work should be an exception, and not the norm. Thus, employers could only require workers to work ...

  The start date for payroll withholdings and submissions of quarterly wage reports under the  Maine Paid Family and Medical Leave (MPFML) Program  is January 1, 2025, leaving employers with a sense of urgency as the compliance date nears. Under the current rules, employers may not apply for private plan substitutions until after April 1, 2025, and will be responsible for payroll contributions until their plans are approved. Quick Hits January 1, 2025, is the start date for payroll withholdings and submission of quarterly wage reports under the Maine Paid Family and Medical Leave Program. Employers may not apply for private plan substitutions until after April 1, 2025 , and will be responsible for payroll contributions until their plans are approved. Employers with fifteen or more employees must contribute 1 percent of wages and may deduct up to half of this contribution from employee wages . Employers with fewer than fifteen employees will contribute 0.5 percent of wag...