Legal Update: Court Denies FMLA Leave for Unmarried Father Before Child’s Birth
The 11th Circuit Court of Appeals recently held in Tanner v. Stryker Corp. that an unmarried employee who traveled to be with his pregnant ex-girlfriend for the birth of their baby was not entitled to leave before the child’s birth under the federal Family and Medical Leave Act (FMLA). The 11th Circuit has jurisdiction over Alabama, Florida and Georgia, and its rulings must be followed by employers in those states.
Legal Update: Draft Forms for 2024 ACA Reporting Released
The Internal Revenue Service (IRS) has released draft 2024 forms for reporting under Internal Revenue Code Sections 6055 and 6056. Draft instructions for these forms have not yet been released.
- The 2024 draft Forms 1094-B and 1095-B are draft versions of forms that will be used by providers of minimum essential coverage—including self-insured plan sponsors that are not applicable large employers (ALEs)—to report under Section 6055.
- The 2024 draft Forms 1094-C and 1095-C are draft versions of forms that will be used by ALEs to report under Section 6056 as well as for combined Section 6055 and 6056 reporting by ALEs that sponsor self-insured plans.
No major changes were made to the draft forms for 2024 reporting. However,certain changes may be made once the forms and instructions are finalized.
Legal Update: HHS Provides HIPAA Model Attestation for Reproductive Health Care Privacy
The U.S. Department of Health and Human Services (HHS) has updated its webpage on reproductive health care privacy to provide additional resources,including a HIPAA model attestation form, that covered entities and business associates may use to comply with new protections for reproductive health care privacy. These new privacy protections become effective on Dec. 23, 2024.
Legal Update: Federal Courts Block Enforcement of Certain Section 1557 Nondiscrimination Provisions
On April 26, 2024, the U.S. Department of Health and Human Services’ (HHS)Office of Civil Rights (OCR) issued a final rule under Section 1557 of the Affordable Care Act, which prohibits discrimination based on race, color,national origin, sex, age or disability in certain health programs and activities.
The final rule was to become effective July 5, 2024, with varied applicability dates for certain provisions, but federal courts have blocked portions of the rule from going into effect.
Legal Update: Texas Federal District Court Partially Clocks the FTC’s Noncompete Ban
On July 3, 2024, the U.S. District Court for the Northern District of Texas granted the plaintiffs’ motion in Ryan LLC v. FTC for a preliminary injunction to block the Federal Trade Commission’s (FTC) noncompete ban while the court considers the merit of the case. The injunction applies only to the plaintiffs in the case: a Texas employer, the U.S. Chamber of Commerce and other business
organizations. The court intends to rule on the merits of the case by Aug. 30, 2024, before the ban’s scheduled effective date of Sept. 4, 2024.
Legal Update: U.S. Supreme Court Overrules Chevron Deference
On June 28, 2024, the U.S. Supreme Court issued a decision in Loper Bright Enterprises v. Raimondo and Relentless Inc. v. Department of Commerce. The Court overruled its 1984 decision in Chevron, U.S.A. Inc. v. Natural Resources Defense Council Inc., which held that courts should defer to federal agencies to interpret ambiguities and gaps in the laws that the agencies implement (known as Chevron deference).
Legal Update: OSHA Proposes Heat Injury and Illness Prevention Standard
On July 2, 2024, the U.S. Department of Labor’s (DOL) Occupational Safety and Health Administration (OSHA) announced an unofficial version of the proposed standard to protect workers from heat injury and illness. If finalized, the new standard would apply to all employers conducting indoor and outdoor work in all general industry, construction, maritime and agricultural sectors where OSHA has jurisdiction, subject to limited exceptions.
Legal Update: 5th Circuit Requires Health Plans To Continue Providing Free Preventive Care
On June 21, 2024, the 5th U.S. Circuit Court of Appeals ruled that a key component of the Affordable Care Act’s (ACA) preventive care mandate is unconstitutional. However, in a decision it referred to as a “mixed bag,” the 5th Circuit limited its ruling to the plaintiffs in the case, a small group of individuals and businesses from Texas. This means that, for now, health plans and health insurance issuers must continue to provide first-dollar coverage for the full range of recommended preventive health services.
Legal Update: ERISA Penalties Awarded for Failing to Respond to Request for Information on Mental Health Benefits
The U.S. District Court for the District of Montana recently awarded over $32,000 in penalties against an employer’s self-insured health plan and its third party administrator (TPA) for failing to provide information to a plan participant upon request. This case, which involved a dispute over payment for mental health benefits, highlights the importance of promptly responding to participants’ requests for plan-related information.
If these documents are not provided within 30 days of receiving the written request, the participant or beneficiary may file a lawsuit under ERISA, and a court may impose monetary penalties of up to $110 per day, beginning on the date of the failure.
Legal Update: Federal Court Rules ERISA Preempts Oklahoma State PBM Legislation
On Aug. 15, 2023, the 10th U.S. Circuit Court of Appeals ruled in Pharmaceutical Care Management Association (PCMA) v. Glen Mulready that ERISA preempts certain provisions of an Oklahoma law aimed at regulating pharmacy benefit managers (PBMs). The ruling contrasts with the U.S. Supreme Court’s 2020 rulingin PCMA v. Rutledge, which held that ERISA did not preempt an Arkansas PBM regulation. The Oklahoma Insurance Commissioner has stated their intention to appeal, although the state has not yet filed a petition with the U.S. Supreme Court for review.
Client and Employee Resources
The more your employees understand your benefit plans the more they become educated, empowered consumers. The programs you provide will also gain an enhanced value.
As your strategic partners in employee benefits, we can provide multiple avenues of ongoing support, including:
- Employee Meetings (English and Spanish)
- Webcasts
- Payroll Stuffers
- Poster Campaigns
- Newsletters
Carrier Directories
E-Verify is a web-based system that allows enrolled employers to confirm the eligibility of their employees to work in the United States. Click the image below to begin.
