The Department of Labor is asking for public comments on a proposed rule that would increase consumer protections when employer-sponsored plans decide claims and appeals for disability benefits. The proposal would better align the rules for disability benefits with the claims requirements already in place for health benefits under the Affordable Care Act, help employees protect against inappropriate denials of disability benefits, and increase public confidence in the fairness of the claims and appeals processes in employer-sponsored plans providing disability benefits. Comments will be accepted through January 19, 2016, and will be considered by EBSA when preparing the final rule. You may submit written comments through the Federal eRulemaking Portal at www.regulations.gov or by email to e-ORI@dol.gov. When commenting by email, please include RIN 1210–AB39 in the subject line of the message. Public comments are posted and made available to the public. You should not include information in a comment that you do not want publicly disclosed. For example, some people do not want personally identifiable information (such as their name, address, or other contact information) or confidential business information posted on a public website or otherwise publicly disclosed. For further information, you can contact Frances P. Steen, Office of Regulations and Interpretations, Employee Benefits Security Administration, (202) 693-8500. This is not a toll free number.
View the proposed rule
This information is from the Department of Labor
Showing posts with label Affordable Care Act. Show all posts
Showing posts with label Affordable Care Act. Show all posts
Monday, January 11, 2016
Monday, July 14, 2014
EEOC Issues Updated Enforcement Guidance On Pregnancy Discrimination And Related Issues
Fact Sheet for Small Businesses and Question and Answer Document Also Released
This is the first comprehensive update of the Commission's guidance on the subject of discrimination against pregnant workers since the 1983 publication of a Compliance Manual chapter on the subject. This guidance supersedes that document and incorporates significant developments in the law during the past 30 years.
In addition to addressing the requirements of the Pregnancy Discrimination Act (PDA), the guidance discusses the application of the Americans with Disabilities Act (ADA) as amended in 2008, to individuals who have pregnancy-related disabilities.
"Pregnancy is not a justification for excluding women from jobs that they are qualified to perform, and it cannot be a basis for denying employment or treating women less favorably than co-workers similar in their ability or inability to work," said EEOC Chair Jacqueline A. Berrien. "Despite much progress, we continue to see a significant number of charges alleging pregnancy discrimination, and our investigations have revealed the persistence of overt pregnancy discrimination, as well as the emergence of more subtle discriminatory practices. This guidance will aid employers, job seekers, and workers in complying with the Pregnancy Discrimination Act and Americans with Disabilities Act, and thus advance EEOC's Strategic Enforcement Plan priority of addressing the emerging issue of the interaction between these two anti-discrimination statutes."
Much of the analysis in the enforcement guidance is an update of longstanding EEOC policy. The guidance sets out the fundamental PDA requirements that an employer may not discriminate against an employee on the basis of pregnancy, childbirth, or related medical conditions; and that women affected by pregnancy, childbirth or related medical conditions must be treated the same as other persons similar in their ability or inability to work. The guidance also explains how the ADA's definition of "disability" might apply to workers with impairments related to pregnancy.
Among other issues, the guidance discusses:
- The fact that the PDA covers not only current pregnancy, but discrimination based on past pregnancy and a woman's potential to become pregnant;
- Lactation as a covered pregnancy-related medical condition;
- The circumstances under which employers may have to provide light duty for pregnant workers;
- Issues related to leave for pregnancy and for medical conditions related to pregnancy;
- The PDA's prohibition against requiring pregnant workers who are able to do their jobs to take leave;
- The requirement that parental leave (which is distinct from medical leave associated with childbearing or recovering from childbirth) be provided to similarly situated men and women on the same terms;
- When employers may have to provide reasonable accommodations for workers with pregnancy-related impairments under the ADA and the types of accommodations that may be necessary; and
- Best practices for employers to avoid unlawful discrimination against pregnant workers.
This information is intended to be
educational and should not be considered legal advice on any specific matter.
Friday, August 23, 2013
US Labor Department Hosts Affordable Care Act webcast
Online event designed to help workers and families understand new law
The U.S. Department of Labor's Employee Benefits Security Administration today announced an upcoming webcast. "The Affordable Care Act: How Will It Affect Me?" will take place Thursday, Aug. 29 from 1-2 p.m. EDT. EBSA staff will be joined on the webcast by colleagues from the Department of Health and Human Services.
The Department of Labor will discuss the impact of the Affordable Care Act on employment-based group health plans. The Department of Health and Human Services will provide information on purchasing coverage through the new Health Insurance Marketplace. The webcast will also cover new consumer protections that will become available in 2014.
Participants can register online.
Press planning to cover the webcast can coordinate with Mike Trupo or Laura McGinnis in the Department of Labor's Office of Public Affairs at the contact information above.
Source: DOL
This information is intended to be
educational and should not be considered legal advice on any specific matter.
Thursday, May 9, 2013
Affordable Care Act Update
The
Department of Labor's Employee Benefits Security Administration updated its
Affordable Care Act web page with the following information on the notice to
employees of coverage options:
- Technical
Release 2013-02 - Guidance on the notice to employees of coverage options
under FLSA §18B and updated model election notice under COBRA, available
at http://www.dol.gov/ebsa/newsroom/tr13-02.html
- Model
notice for employers who offer a health plan to some or all employees,
available at http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf
- Model
notice for employers who do not offer a health plan, available at http://www.dol.gov/ebsa/pdf/FLSAwithoutplans.pdf
- COBRA
model election notice, available at http://www.dol.gov/ebsa/modelelectionnotice.doc
- COBRA
model election notice redline version (to show May 2013 changes),
available at http://www.dol.gov/ebsa/modelelectionnoticeredline.doc
This information is intended to be
educational and should not be considered legal advice on any specific matter.
Monday, April 8, 2013
DOL Releases Brief Offering Tips for Healthcare Industry Employers on their Aging Workers
The Department of Labor’s Office of Disability Employment has released a brief – The Aging Workface: Challenges for the Healthcare Industry Workforce – that addresses the aging American workforce, provides examples of current initiatives healthcare employers are using, and discusses strategies and promising practices for employers and policymakers.
Make no mistake, the American workforce is aging. By 2016, one-third of the total U.S. workforce will be 50 years or older. By 2020, that group may reach 115 million individuals. The challenges in healthcare will be even greater, as that workforce is already older than workers in many other industry sectors. The average age of a registered nurse in the U.S. is 50; by 2020, nearly half of all RNs will reach traditional retirement age. Nearly one-quarter of physicians are 60 years or older, according to a 2007 nationwide study.
Combine these trends with a growing older general population and an expanded group of patients covered by the Affordable Care Act, and it is easy to understand the challenges healthcare employers face: More patients needing high quality healthcare services and potentially fewer workers to meet those needs. In addition, an aging healthcare workforce presents its own problems. Healthcare workers with acquired disabilities and other age-related health conditions may reduce a facility’s functional capacity. Over time, the serious challenges facing healthcare employers will become plainly apparent.
The new DOL issue brief offers valuable insights, references to worthwhile resources, concrete examples of how some healthcare systems are addressing the needs of their aging workers, and thoughtful suggestions for employers and policymakers alike.
Source: Craig Brown
Make no mistake, the American workforce is aging. By 2016, one-third of the total U.S. workforce will be 50 years or older. By 2020, that group may reach 115 million individuals. The challenges in healthcare will be even greater, as that workforce is already older than workers in many other industry sectors. The average age of a registered nurse in the U.S. is 50; by 2020, nearly half of all RNs will reach traditional retirement age. Nearly one-quarter of physicians are 60 years or older, according to a 2007 nationwide study.
Combine these trends with a growing older general population and an expanded group of patients covered by the Affordable Care Act, and it is easy to understand the challenges healthcare employers face: More patients needing high quality healthcare services and potentially fewer workers to meet those needs. In addition, an aging healthcare workforce presents its own problems. Healthcare workers with acquired disabilities and other age-related health conditions may reduce a facility’s functional capacity. Over time, the serious challenges facing healthcare employers will become plainly apparent.
The new DOL issue brief offers valuable insights, references to worthwhile resources, concrete examples of how some healthcare systems are addressing the needs of their aging workers, and thoughtful suggestions for employers and policymakers alike.
Source: Craig Brown
This information is intended to be
educational and should not be considered legal advice on any specific matter.
Tuesday, April 2, 2013
US Department of Labor releases Affordable Care Act study on self-insured plans
The U.S. Department of Labor today transmitted to Congress the third annual report on self-insured employee health benefit plans. The report, which is established by the Affordable Care Act, contains general information on self-insured employee health benefit plans and financial information on the employers that sponsor them.
Self-insured plans, unlike fully insured plans, are generally plans in which the sponsor retains the risk associated with paying covered health expenses, rather than paying a premium and transferring the risk to an insurance company. Some sponsors retain the risk for a subset of the benefits, but transfer the risk for the remaining benefits to health insurers – that is, they finance the plans' benefits using a mixture of self-insurance and insurance. Self-insurance is more common among larger sponsors, mainly because the health expenses of larger groups are more predictable and therefore larger sponsors face less risk.
This year's report utilizes a revised algorithm to identify self-insured plans from those that are fully-insured or use a mixed funding arrangement. These revisions, based on a study of Form 5500 filings, indicate that previous reports overstated the number of fully insured and mixed-funded health plans and identified too few self-insured plans. Consequently, this report is not directly comparable to its predecessors and should not be used with them to project trends in health insurance funding. Rather, estimates presented in the 2013 report should be viewed as the department's best estimates of plan funding arrangements for 2010 and earlier years.
Health benefit plans covering private-sector employees must file a Form 5500 Annual Return/Report of Employee Benefit Plan – generally, if they cover 100 or more participants or hold assets in trust. This report includes information on self-insured and mixed-insured health benefit plans that are required to file a Form 5500 and presents data on such plans for 2010, the latest year for which complete data are available. The department estimates that nearly 20,000 health plans filing a Form 5500 for 2010 were self-insured and approximately 4,000 were mixed-insured. These plans covered 30 million and 26 million participants respectively. However, because many self-insured health plans do not meet the filing requirements and therefore do not file the Form 5500, this report likely underestimates the total number of self-insured plans.
The full report can be found on the department's Employee Benefits Security Administration Affordable Care Act page, or at http://www.dol.gov/ebsa/healthreform/index.html#5.
Source: DOL
Self-insured plans, unlike fully insured plans, are generally plans in which the sponsor retains the risk associated with paying covered health expenses, rather than paying a premium and transferring the risk to an insurance company. Some sponsors retain the risk for a subset of the benefits, but transfer the risk for the remaining benefits to health insurers – that is, they finance the plans' benefits using a mixture of self-insurance and insurance. Self-insurance is more common among larger sponsors, mainly because the health expenses of larger groups are more predictable and therefore larger sponsors face less risk.
This year's report utilizes a revised algorithm to identify self-insured plans from those that are fully-insured or use a mixed funding arrangement. These revisions, based on a study of Form 5500 filings, indicate that previous reports overstated the number of fully insured and mixed-funded health plans and identified too few self-insured plans. Consequently, this report is not directly comparable to its predecessors and should not be used with them to project trends in health insurance funding. Rather, estimates presented in the 2013 report should be viewed as the department's best estimates of plan funding arrangements for 2010 and earlier years.
Health benefit plans covering private-sector employees must file a Form 5500 Annual Return/Report of Employee Benefit Plan – generally, if they cover 100 or more participants or hold assets in trust. This report includes information on self-insured and mixed-insured health benefit plans that are required to file a Form 5500 and presents data on such plans for 2010, the latest year for which complete data are available. The department estimates that nearly 20,000 health plans filing a Form 5500 for 2010 were self-insured and approximately 4,000 were mixed-insured. These plans covered 30 million and 26 million participants respectively. However, because many self-insured health plans do not meet the filing requirements and therefore do not file the Form 5500, this report likely underestimates the total number of self-insured plans.
The full report can be found on the department's Employee Benefits Security Administration Affordable Care Act page, or at http://www.dol.gov/ebsa/healthreform/index.html#5.
Source: DOL
This information is intended to be
educational and should not be considered legal advice on any specific matter.
Tuesday, March 26, 2013
Employee Benefits Security Administration to host Affordable Care Act webcast in Spanish
Online event will educate workers and families about new law
The one-hour webcast will help workers of all ages and their families understand how the Affordable Care Act will impact their employment-based group health plans. It will cover protections under the ACA that improve health coverage, many of which are already in effect, including the extension of health coverage for dependents until age 26. The webcast also will discuss protections that will become available in 2014. In addition, the U.S. Department of Health and Human Services will provide information on the new health insurance marketplace. Participants will have the opportunity to ask questions throughout the event and will receive contact information for future questions.
Register for the webcast online at:
http://mp163422.cdn.mediaplatform.com/163422/wc/mp/4000/15208/21710/24011/Lobby/default.htm?ref=ProductionTeamEmail.
- Read this news release en Español.
This information is intended to be educational and should not be considered legal advice on any specific matter.
Friday, March 1, 2013
DOL issues final rules for multiple employer health care arrangements
New enforcement tools, streamlined reporting and disclosure to ensure security of health care coverage for consumers
The U.S. Department of Labor's Employee Benefits Security Administration today announced final rules under the Affordable Care Act to protect workers and employers whose health benefits are provided through Multiple Employer Welfare Arrangements. The final rules increase the department's enforcement authority to protect participants in MEWAs and call for such plans to adhere to enhanced filing requirements.
"A MEWA can be a means to offer benefits to workers where none other exists. But too often the individuals operating such arrangements take advantage of employers who want to make health insurance available to workers," said Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi. "Today's final rules give the department more tools to protect the employees of small companies that band together to purchase benefits."
A MEWA is an employee welfare plan or other arrangement through which multiple employers might seek to provide health care and other benefits to their workers. Employers are often told that MEWAs are more affordable than traditional forms of coverage, but unscrupulous promoters, marketers and operators of certain MEWAs have taken advantage of gaps in the law to avoid state insurance regulations, putting enrollees at financial risk. These actions include the requirement to maintain sufficient funding and adequate reserves to pay health care claims of workers and their families. EBSA has been involved in many cases where MEWAs have been operated by individuals who drained them of their assets through excessive administrative fees or outright embezzlement, leaving participants and their families with unexpected, unpaid health care bills. The Affordable Care Act includes provisions implemented by today's final rules that are designed to remedy these gaps.
The final rules authorize the secretary of labor to immediately issue a cease and desist order when it is apparent that fraud is taking place within a MEWA. The secretary could also seize assets from a MEWA when there is probable cause that the plan is in a financially hazardous condition. The final rules also require MEWAs to register with the Labor Department prior to operating in a state. To streamline the process, the department is making available a new, all-electronic filing system that also will serve as a searchable registry of MEWAs.
The final rules, and related changes to the Form 5500 Annual Return/Report, also enhance the department's ability to enforce Form M-1 filing requirements. This enhancement is achieved by requiring all employee welfare plans that file a Form M-1 to file a Form 5500 including information on compliance with Form M-1 filing requirements. Complete details on all provisions are included in the final rules and form revision notices, which will be published in the March 1 edition of the Federal Register. They can be read now at http:/www.dol.gov/find/20130228a/ (Ex Parte Cease and Desist and Summary Seizure Orders) and http://www.dol.gov/find/20130228b/ (Filings Required of Multiple Employer Welfare Arrangements and Certain Other Related Entities).
EBSA protects the retirement, health and other workplace-related benefits of America's workers and retirees, and their families. The agency oversees approximately 707,000 private sector retirement plans, 2.3 million health plans and a similar number of other benefit plans that cover more than 141 million Americans. Learn more at http://www.dol.gov/ebsa/. For more information about the Affordable Care Act, visit http://www.healthcare.gov/index.html.
Source: DOL
The U.S. Department of Labor's Employee Benefits Security Administration today announced final rules under the Affordable Care Act to protect workers and employers whose health benefits are provided through Multiple Employer Welfare Arrangements. The final rules increase the department's enforcement authority to protect participants in MEWAs and call for such plans to adhere to enhanced filing requirements.
"A MEWA can be a means to offer benefits to workers where none other exists. But too often the individuals operating such arrangements take advantage of employers who want to make health insurance available to workers," said Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi. "Today's final rules give the department more tools to protect the employees of small companies that band together to purchase benefits."
A MEWA is an employee welfare plan or other arrangement through which multiple employers might seek to provide health care and other benefits to their workers. Employers are often told that MEWAs are more affordable than traditional forms of coverage, but unscrupulous promoters, marketers and operators of certain MEWAs have taken advantage of gaps in the law to avoid state insurance regulations, putting enrollees at financial risk. These actions include the requirement to maintain sufficient funding and adequate reserves to pay health care claims of workers and their families. EBSA has been involved in many cases where MEWAs have been operated by individuals who drained them of their assets through excessive administrative fees or outright embezzlement, leaving participants and their families with unexpected, unpaid health care bills. The Affordable Care Act includes provisions implemented by today's final rules that are designed to remedy these gaps.
The final rules authorize the secretary of labor to immediately issue a cease and desist order when it is apparent that fraud is taking place within a MEWA. The secretary could also seize assets from a MEWA when there is probable cause that the plan is in a financially hazardous condition. The final rules also require MEWAs to register with the Labor Department prior to operating in a state. To streamline the process, the department is making available a new, all-electronic filing system that also will serve as a searchable registry of MEWAs.
The final rules, and related changes to the Form 5500 Annual Return/Report, also enhance the department's ability to enforce Form M-1 filing requirements. This enhancement is achieved by requiring all employee welfare plans that file a Form M-1 to file a Form 5500 including information on compliance with Form M-1 filing requirements. Complete details on all provisions are included in the final rules and form revision notices, which will be published in the March 1 edition of the Federal Register. They can be read now at http:/www.dol.gov/find/20130228a/ (Ex Parte Cease and Desist and Summary Seizure Orders) and http://www.dol.gov/find/20130228b/ (Filings Required of Multiple Employer Welfare Arrangements and Certain Other Related Entities).
EBSA protects the retirement, health and other workplace-related benefits of America's workers and retirees, and their families. The agency oversees approximately 707,000 private sector retirement plans, 2.3 million health plans and a similar number of other benefit plans that cover more than 141 million Americans. Learn more at http://www.dol.gov/ebsa/. For more information about the Affordable Care Act, visit http://www.healthcare.gov/index.html.
Source: DOL
This information is intended to be
educational and should not be considered legal advice on any specific matter.
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