DOL and IRS Health and Welfare Plan Audits: Latest Examination Initiatives, Key Legal Provisions, Avoiding Triggers

Ms. Campbell is a Health and Welfare Practice Leader. She advises clients on all aspects of the Affordable Care Act (ACA), including the insurance market reforms, qualified health plan standards, exchange rules, consumer assistance programs for the federal marketplace, and ACA section 1557 nondiscrimination rules. Ms. Campbell also works with clients on the Federal Mental Health Parity and Addiction Equity Act (MHPAEA), state insurance law, and Medicare and Medicaid. She represents health insurance companies, employers, consultants, and trade associations on federal and state laws regulating health coverage. Ms. Campbell also provides advice on advocacy with federal and state agencies, compliance programs, government enforcement, and regulatory initiatives. She is the former Director of the Compliance and Enforcement Division for the Oversight Group at the Center for Consumer Information and Insurance Oversight (CCIIO) at the Department of Health & Human Services (HHS), and immediately prior to joining Groom, she was the Group Director for the Consumer Support Group at CCIIO. In her positions at HHS, Ms. Campbell worked closely with all key stakeholders, including health insurance companies, state insurance regulators, the Departments of Labor and the Treasury, trade associations, and consumer groups.

Mr. Shuman focuses his practice in ERISA and employee benefit law, representing welfare benefit and pension plans, plan sponsors, and plan administrators in matters involving plan operation from design and plan drafting to compliance issues and termination. With nearly 25 years of experience, he has provided trusted counsel to clients ranging from small businesses to Fortune 500 companies. Mr. Shuman has represented plans and plan sponsors in both voluntary compliance program submissions and investigations by the IRS and the DOL. He has also worked to abate millions of dollars in proposed penalties, including those arising under the ACA’s employer mandate. Mr. Shuman has represented various insurers and managed care organizations before state and federal courts in civil actions involving billing disputes, benefit claims, allegations of breach of fiduciary duty, discrimination claims, and subrogation claims. He has practiced before the Public Service Commission of West Virginia, representing a range of utilities in administrative hearings, together with obtaining the issuance of siting certificates for exempt wholesale generators powered by renewable energy and natural gas. Mr. Shuman has served as counsel for project developers, buyers, and lenders in renewable energy transactions and other mergers and acquisitions matters, including counseling buyers, sellers, and lenders as to benefit plan issues, due diligence, revising purchasing agreements, and drafting local counsel opinions. He is also an experienced civil litigator and appellate attorney, having represented clients in a broad spectrum of litigation matters before state and federal trial and appellate courts.