DOL Provides Post-Hurricane Compliance Relief

November 21, 2012 (PLANSPONSOR.com) – The Department of Labor (DOL) issued compliance information for employee benefit plans adversely affected by Hurricane Sandy.

The agency understands as the implications of Hurricane Sandy unfolds, plan fiduciaries, employers, labor organizations, service providers, as well as participants and beneficiaries, may encounter compliance-related issues over the next few months in connection with employee benefit plans covered by the Employee Retirement Income Security Act (ERISA), Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi said. The guidance applies to employee benefit plans, plan sponsors and service providers to such employers, located in one of the counties or Tribal Nations, on October 26, 2012, that have been identified as covered disaster areas because of Hurricane Sandy. These areas are identified by the IRS at http://www.irs.gov/uac/Newsroom/Help-for-Victims-of-Hurricane-Sandy.

An IRS announcement provided relief from certain verification procedures that may be required under retirement plans with respect to plan loans to participants and beneficiaries, hardship distributions and other pension benefit distributions. The DOL will not treat any person as having violated the provisions of Title I of ERISA solely because they complied with the provisions of the IRS announcement.

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Amounts that a participant or beneficiary pays to an employer or amounts that a participant has withheld from his or her wages by an employer for contribution or repayment of a participant loan to an employee pension benefit plan constitute plan assets, and thereby are required to be forwarded to the plan, on the earliest date on which such amounts can reasonably be segregated from the employer’s general assets, but in no event later than the 15th business day of the month following the month in which the amounts were paid to or withheld by the employer.

The DOL recognizes that some employers and service providers acting on employers’ behalf, such as payroll processing services, located in designated affected areas will not be able to forward participant payments and withholdings to employee pension plans within the prescribed timeframe. In such instances, the agency will not, solely on the basis of a failure attributable to Hurricane Sandy, seek to enforce the provisions of Title I with respect to a temporary delay. In addition, the IRS said it will not seek to assess an excise tax with respect to a prohibited transaction under section 4975 of the Code resulting solely from such a temporary delay.

The regulations provide an exception to the 30-day advance notice requirement to participants and beneficiaries when the inability to provide the advance notice is due to events beyond the reasonable control of the plan administrator and a fiduciary so determines in writing.

With respect to blackout periods related to Hurricane Sandy, the DOL will not allege a violation of the blackout notice requirements solely on the basis that a fiduciary did not make the required written determination.

The agency said it recognizes that plan participants and beneficiaries may encounter difficulties such as meeting certain deadlines for filing benefit claims and COBRA elections. Plan fiduciaries should make reasonable accommodations to prevent the loss of benefits in such cases and should take steps to minimize the possibility of individuals losing benefits because of a failure to comply with pre-established timeframes.

Additionally, the DOL acknowledged there may be instances when full and timely compliance by group health plans and issuers may not be possible. As stated previously by the agency (see http://www.dol.gov/ebsa/faqs/faq-aca.html) its approach to enforcement continues to be marked by an emphasis on compliance assistance and includes grace periods and other relief, where appropriate, including when physical disruption to a plan or service provider’s principal place of business by the hurricane makes compliance with pre-established timeframes for certain claims decisions or disclosures impossible.

Regulators Issue Guidance About Wellness Programs

November 21, 2012 (PLANSPONSOR.com) The Departments of Health and Human Services (HHS), Labor and the Treasury jointly released proposed rules about employer wellness programs.

The proposed rules reflect the changes to existing wellness provisions made by the Affordable Care Act and encourage appropriately designed, consumer-protective wellness programs in group health coverage. The proposed rules would be effective for plan years starting on or after January 1, 2014.

The guidance continues to support workplace wellness programs, including “participatory wellness programs” which generally are available without regard to an individual’s health status. These include, for example, programs that reimburse for the cost of membership in a fitness center; that provide a reward to employees for attending a monthly, no-cost health education seminar; or that provides a reward to employees who complete a health risk assessment without requiring them to take further action.  

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The rules also outline amended standards for nondiscriminatory “health-contingent wellness programs,” which generally require individuals to meet a specific standard related to their health to obtain a reward. Examples of health-contingent wellness programs include programs that provide a reward to those who do not use, or decrease their use of, tobacco, or programs that provide a reward to those who achieve a specified cholesterol level or weight as well as to those who fail to meet that biometric target but take certain additional required actions.

In order to protect consumers from unfair practices, the proposed regulations would require health-contingent wellness programs to follow certain rules, including: 

  • Programs must be reasonably designed to promote health or prevent disease. To be considered such, a program would have to offer a different, reasonable means of qualifying for the reward to any individual who does not meet the standard based on the measurement, test or screening. Programs must have a reasonable chance of improving health or preventing disease and not be overly burdensome for individuals. 
  • Programs must be reasonably designed to be available to all similarly situated individuals. Reasonable alternative means of qualifying for the reward would have to be offered to individuals whose medical conditions make it  unreasonably difficult, or for whom it is medically inadvisable, to meet the specified health-related standard. 
  • Individuals must be given notice of the opportunity to qualify for the same reward through other means. These proposed rules provide new sample language intended to be simpler for individuals to understand and to increase the likelihood that those who qualify for a different means of obtaining a reward will contact the plan or issuer to request it. 

 

The proposed rules also implement changes in the Affordable Care Act that increase the maximum permissible reward under a health-contingent wellness program from 20% to 30% of the cost of health coverage, and that further increase the maximum reward to as much as 50% for programs designed to prevent or reduce tobacco use.  

The proposed rules can be viewed here.

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