Compliance Stuff

Employer-sponsored group health plans operate at the intersection of multiple federal regulatory frameworks — ERISA, the ACA, COBRA, HIPAA, the Mental Health Parity and Addiction Equity Act (MHPAEA), and more. Each imposes its own documentation requirements, reporting deadlines, and operational obligations. The challenge for most employers is not a lack of intent to comply, but the sheer complexity of keeping pace with layered and frequently updated rules. A proactive, systematic compliance review conducted with legal guidance is one of the most effective tools employers have to reduce legal exposure, strengthen plan governance, and prepare for regulatory inquiries . The following overview identifies the key compliance areas that such a review should cover. Plan Governance and ERISA Documentation ERISA requires every welfare benefit plan to be maintained pursuant to a written plan document that satisfies specific requirements. Compliance reviews routinely reveal documentation gaps that...

In December 2025, the U.S. Postal Service (USPS) adopted a new rule for postmarks so that they may indicate the processing date, instead of the date the post office took custody of the item. Employers may want to note this new postmark rule so that they don’t violate their legal notice requirements concerning their employee benefit plans. Quick Hits The USPS recently changed a rule so that postmarks may reflect the processing date, rather than the date a post office obtained a letter or package. The new rule could lead to fines for employers if mandatory notices concerning employee benefit plans are deemed late. Electronically sending mandatory notices can help to meet a legal deadline, if the recipient has agreed to electronic communications. Under federal laws like the Employee Retirement Income Security Act (ERISA), the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), the Health Insurance Portability and Accountability Act (HIPAA), and the Affordable Care Act (ACA) ,...

Overview The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers, third-party administrators (TPAs), and individuals covered by employer-sponsored health plans. This article provides an overview of the current landscape, highlighting key updates and strategic considerations for navigating these changes. In Depth Recent legislative updates Telehealth HDHP safe harbor:   Retroactive to January 1, 2025, high-deductible health plans (HDHPs) may continue to cover telehealth and other remote care services without making participants ineligible for health savings account (HSA) contributions. Section 1557 and gender-affirming care:   Federal rules may soon reduce healthcare nondiscrimination protections that apply to gender-affirming care. State policies vary widely. Some require coverage while others restrict it, dependin...

Here are the top ten items you should tackle in August, based on the latest workplace law developments and upcoming critical compliance dates: _____ Learn how the big budget bill impacts your workplace.  Don’t have time to slog through 1,000+ pages of the final “Big Beautiful Bill” signed by President Trump on July 4? Here’s an  overview of the ways that the legislation impacts employers . _____ Paddle into the wave of deregulation.  The US Department of Labor  unveiled a broad set of proposed regulatory rollbacks  in July, and key proposals will impact workplace safety, employee benefits compliance, the healthcare and agriculture industries, federal contractors, and more. OSHA alone  issued more than 20 new initiatives , and MSHA also  crashed the deregulatory party . _____ But beware of hidden hazards underwater.  Many expected the Federal Trade Commission to drop a Biden-era appeal to keep the agency’s federal non-compete ban alive – but an FTC...

The Centers for Medicare and Medicaid Services (“CMS”) “60-Day” overpayment rule (“60-Day Rule”) was established as part of the Affordable Care Act (“ACA”) in 2010. [i]   I n a nutshell, Section 1128J(d) [ii]  of the ACA provides  that a person who has received an overpayment shall report and return the overpayment to CMS [iii]  in writing, stating the reason for the overpayment, within 60 days after the overpayment was identified (or the date the corresponding cost report is due). To encourage and enforce reporting of overpayments, Section 1128J(d) is clear that any improperly retained overpayments become a potential false claim under the False Claims Act (“FCA”). [iv] The obligation to return overpayments in a timely manner seems deceptively simple, but the mechanics of the process has been the subject of debate since it was enacted in 2010, and CMS again set forth regulatory direction for the 60-Day Rule on December 9, 2024. [v]   This article sets forth the ...