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Course Details

Course Information
  • smart_display Format

    On-Demand

  • signal_cellular_alt Difficulty Level

    Intermediate

  • work Practice Area

    ERISA

Date & Time
  • event Date

    Thursday, January 30, 2025

  • schedule Time

    1:00 p.m. ET./10:00 a.m. PT

  • timer Program Length

    90 minutes

Credit Information

  • This 90-minute webinar is eligible in most states for 1.5 CLE credits.

$347.00
CLE
ALL

This CLE webinar will provide employee benefits counsel a comprehensive analysis of evolving compliance challenges for employer-sponsored health and welfare plans. The panel will discuss key areas of focus of Department of Labor (DOL) audits, significant compliance issues for health plan sponsors under the Consolidated Appropriations Act of 2021 (CAA), plan contracts and the removal of "gag clauses," vendor fees and services, and compliance attestation requirements. The panel will also discuss other key items impacting health and welfare plan administration and compliance.

Faculty

Elizabeth J. Jonas
Counsel
Miller & Chevalier

Ms. Jonas' practice focuses on the Employee Retirement Income Security Act (ERISA), complex civil litigation, and appellate advocacy. She has experience involving the Federal Employees Health Benefits Act (FEHBA), the False Claims Act (FCA), breach of fiduciary duty claims, corporate governance disputes, employment discrimination, and administrative agency appeals. Ms. Jonas has extensive experience litigating before federal and state trial and appellate courts. She has represented clients in matters before the American Arbitration Association (AAA) and in mediations. Ms. Jonas advises on regulatory matters relating to health and welfare plans, including the intersection of state insurance regulation with federal law, such as the extraterritorial reach of state laws. She has authored amicus briefs on behalf of clients on a wide variety of important legal and social issues.

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Joanne Roskey
Member
Miller & Chevalier

Ms. Roskey has over 25 years of experience representing private clients and federal agencies in a broad spectrum of litigation, advice, and administrative law matters. As part of Miller & Chevalier's ERISA & Employee Benefits Litigation team, Ms. Roskey focuses her practice on the fiduciary, prohibited transaction, and health plan provisions of ERISA. She advises clients on compliance issues and in government investigations and litigation across a wide range of employee benefits matters. Prior to joining Miller & Chevalier, Ms. Roskey served as Chief of the Division of Health Investigations for the Department of Labor's (DOL) Employee Benefits Security Administration (EBSA), where she led the strategic planning and oversight of EBSA's health plan enforcement program and implemented, monitored, and assessed compliance with national enforcement priorities carried out by 10 regional offices across the country. Previously, she served in the DOL Office of the Solicitor for 14 years as Deputy Associate Solicitor in the ERISA Litigation, Advice, and Regulations Division, Regional ERISA Counsel, and an employee benefits trial attorney. Ms. Roskey also was Associate General Counsel to the Federal Bureau of Investigation (FBI), where she defended the agency and its officials in civil litigation. 

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Description

The DOL has an active enforcement program focused on health and welfare plans in response to rules provided under the CAA. ERISA counsel, fiduciaries, and administrators must ensure strict compliance with current regulations and implement procedures to overcome administrative challenges.

The administrative challenges and compliance failures for health and welfare plans can lead to lawsuits and significant penalties. The enactment of the CAA significantly impacts the administration and fiduciary obligations for health plans. In particular, the CAA impacts health and welfare plans' compliance obligations with regard to (1) plan contracts and the removal of "gag clauses"; (2) determining "reasonableness" for vendor fees and services; (3) prescription drug reporting; and (4) parity between medical and mental health coverage.

The DOL's key areas of focus for audits and enforcement will encompass the aforementioned items in addition to other critical issues. ERISA counsel must identify potential compliance pitfalls and understand the required documentation and procedures, audit triggers, and plan provisions targeted by the DOL and IRS to minimize these plan administration issues.

Listen as the panel discusses significant compliance issues for health plan sponsors and recent guidance for plan contracts as well as the removal of "gag clauses," vendor fees and services, and compliance attestation requirements.

Outline

  1. Recent DOL developments
  2. CAA compliance for health and welfare plans
  3. Plan contracts and "gag clauses"
  4. Vendor fees and services
  5. Mental health parity rules
  6. Fiduciary rules and liability
  7. Best practices for plan sponsors and administrators

Benefits

The panel will review these and other key items:

  • What are the administrative challenges for health and welfare plans under the CAA?
  • What are the requirements under the mental health parity rules?
  • What are the next steps and pitfalls to avoid for plan contracts and "gag clauses"?
  • What factors must be considered in determining the "reasonableness" of vendor fees and services?
  • What are the fiduciary obligations and rules for health plan sponsors and administrators?
  • What are the recent DOL developments and plans for enforcement actions?
  • What are the best practices to overcome legal and compliance challenges?