Interested in training for your team? Click here to learn more

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

A live 90-minute premium CLE video webinar with interactive Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Thursday, January 30, 2025 (in 13 days)

1:00pm-2:30pm EST, 10:00am-11:30am PST

Early Registration Discount Deadline, Friday, January 17, 2025

or call 1-800-926-7926

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 of 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.

READ MORE

Outline

  1. Recent DOL developments
  2. CAA compliance for health and welfare plans
  3. Plan contracts and "gag clauses"
  4. Vendor fees and services
  5. Mental health parity rules
  6. Fiduciary rules and liability
  7. Best practices for plan sponsors and administrators

Benefits

The panel will review these and other key items:

  • What are the administrative challenges for health and welfare plans 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 are the recent DOL developments and plans for enforcement actions?
  • What are the best practices to overcome legal and compliance challenges?

Faculty

Jonas, Elizabeth
Elizabeth J. Jonas

Attorney
Miller & Chevalier

Ms. Jonas' practice focuses on the Employee Retirement Income Security Act (ERISA), complex civil litigation, and...  |  Read More

Roskey, Joanne
Joanne Roskey

Member
Miller & Chevalier

Ms. Roskey has over 25 years of experience representing private clients and federal agencies in a broad spectrum of...  |  Read More

Attend on January 30

Early Discount (through 01/17/25)

Cannot Attend January 30?

Early Discount (through 01/17/25)

You may pre-order a recording to listen at your convenience. Recordings are available 48 hours after the webinar. Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video