• videocam Live Webinar with Live Q&A
  • calendar_month January 19, 2027 @ 1:00 PM ET/10:00 AM PT
  • signal_cellular_alt Intermediate
  • card_travel ERISA
  • schedule 90 minutes

Compliance Issues for Employer Health and Welfare Plans: Fees, Services, Plan Contracts, Reporting, Audits

CAA Challenges, Removal of Gag Clauses, Compliance Attestations, Determining Reasonableness in Vendor Fees and Services

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$297.00
$252.45
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Discount expires 1/5/27

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About the Course

Introduction

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 in 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.

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.

Presented By

Nate Ingraham
Senior Managing Associate
Thompson Hine LLP

Mr. Ingraham is a senior managing associate in the Employee Benefits & Executive Compensation group. He focuses his practice on litigation and counseling related to employee benefits matters. Mr. Ingraham represents benefit plans, employers, and fiduciaries in a wide range of employee benefits cases, including claims for life, health, disability and pension benefits, class action litigation involving 401(k) plans and ESOPs, and multiemployer pension plan disputes. He also regularly advises clients on matters affecting the design and administration of qualified retirement and health and welfare plans. In addition, Mr. Ingraham has significant experience in advising on administrative claims and appeals, responding to government investigations and subpoenas, and representing clients in connection with plan audits. He is a frequent speaker on employee benefits topics and is an editor of Thompson Hine’s ERISA Litigation & Compliance Blog.

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Elizabeth Jonas
Counsel
Thompson Hine LLP

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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Credit Information

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


  • Live Online


    On Demand

Date + Time

  • event

    Tuesday, January 19, 2027

  • schedule

    1:00 PM ET/10:00 AM PT

I. Recent DOL developments

II. CAA compliance for health and welfare plans

III. Plan contracts and "gag clauses"

IV. Vendor fees and services

V. Mental health parity rules

VI. Fiduciary rules and liability

VII. Best practices for plan sponsors and administrators

The panel will review these and other key items:

  • What administrative challenges do health and welfare plans face 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 recent DOL developments and enforcement plans should we watch?
  • What are best practices to overcome legal and compliance challenges?