The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
In a decision about ERISA’s fiduciary duties and transparency, the Sixth Circuit in Tiara Yachts, Inc. v. Blue Cross Blue Shield of Michigan held that Blue Cross Blue Shield of Michigan (BCBSM), a third-party administrator...more
I f you’re thinking of hiring your payroll provider to also serve as your 401(k) plan’s third-party administrator (TPA), stop. Think again. Then think again harder. I’ve been an ERISA attorney for more than 25 years. In that...more
Certain transactions between employee benefit plans and “parties in interest” are prohibited under the Employee Retirement Income Security Act of 1974, as amended (ERISA). ...more
Our lives are the sum of our choices, at least that is what the trailer for the next Mission Impossible moving is telling me. When I was a kid, I would read these Choose Your Own Adventure books where the story and outcome...more
I was very lucky that when I started as an ERISA attorney in 1998, I worked as a staff attorney for a third-party administrator (TPA). It gave me insight and experience that I could never have gotten as an attorney working...more
At work and at home, one of the worst things I ever did was make a mistake and not accept responsibility for it. Instead of owning up, I would make excuses, turning the fight over the mistake into a bigger issue than the...more
As I have always said, the most important 401(k) plan provider you can hire is a Third-Party Administrator (TPA). That’s because a TPA does so much work, and their incompetence can lead to you getting penalized or forcing you...more
Friday, I was supposed to attend the New York Comic Con for a special session since I had a wholesale account with the leading comic book distributor. I’m sure the breakfast would have had some free giveaways and I was...more
As a plan fiduciary, I still can’t believe it. A Third Party Administrator (TPA) we terminated was trying to hold us up for valuations and a Form 5500 we paid for, as part of, annual administration. It was $80,000....more
The MTV reality series The Real World ended their opening intro with “to find out what happens… when people stop being polite… and start getting real.” As an ERISA attorney working with retirement plan clients, I often find...more
When I was a kid in day school in Brooklyn, we had a classmate whose shtick was that he was rich. He wasn’t rich, his father was a pa- thologist who worked at a city hospital, his mother didn’t work, and they rented a nice...more
Our “health plan hygiene” series has focused on steps that fiduciaries of employer-sponsored group health plans can take to ensure they meet their fiduciary responsibilities. This issue has been brought to the forefront...more
A health plan’s fiduciaries are responsible for administering the health plan. Because most employers are not in the business of administering health benefits, they outsource the day-to-day health plan administration to a...more
On September 12, the IRS reminded plan sponsors to review and comply with IRS Notice 2024-02 (the “Notice”), which extended and consolidated deadlines for employers and others sponsoring 401(k), 403(b), 457(b) and other...more
When I was at law school, I was the editor-in-chief of the law school’s newsmagazine. My rise to the top probably had a lot to do with the free time I had by not making law review or any other of the law journals. I failed to...more
What makes a good retirement plan financial advisor? Well, it takes attention to detail, an understanding of what the role to entails, and dedication to the client. In addition, what I find is the way a good financial advisor...more
Earlier this month, a Mayo Clinic employee filed a proposed class action against the clinic, arguing that the clinic’s employee health plan and its third-party administrator (TPA) Medica, underpaid for services performed by...more
The U.S. Department of Labor (“DOL”) recently entered into a settlement agreement with a New York-based insurer and third-party administrator (“Company”) of employer group health plans governed by the Employee Retirement...more
Most employers know that if a group health plan provides mental health or substance use disorder (MH/SUD) benefits in any of six specified classifications, the plan must provide MH/SUD benefits in all specified...more
Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more
NOTE: As we were preparing to publish this eAlert, the DOL issued proposed mental health parity regulations. We will provide an update on the proposed regulations in a future eAlert. Nonetheless, group health plans must still...more
Whether it’s a partner in your business or a business partnership with another plan provider, it needs to be the right fit. I worked for two third-party administrators (TPAs) where partnership mismatches helped doom them....more
When working with other plan providers, trust is the biggest underpinning. Without it, you have nothing else. If you can’t trust the plan provider you’re working with, then why are you in business with them?...more
As an ERISA attorney who drafts plan documents at a flat fee, my biggest competitors are not other ERISA attorneys, but third-party administration (TPA) firms. ...more
How much would you get back in your budget if you could save up to 10% on your medical and Rx benefits costs? Employee benefits are the second largest budget item in employee compensation, with medical benefits consuming the...more