Stay on Top of Legislative Changes

DMEC Legislative UpdatesCompliance with rapidly changing state and federal laws is a challenge for employers across the country. For more than 20 years, DMEC has been monitoring and reporting on decisions and developments that impact absence, disability, and return to work programs.

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Archives

Republicans Cancel Vote to Repeal Parts of ACA

March 24, 2017This afternoon the Republican leadership in the House of Representatives cancelled a vote on the American Health Care Act (AHCA), which would have repealed significant portions of the Affordable Care ... Read More

IRS Will Accept “Silent” Tax Returns

March 20, 2017The Internal Revenue Service (IRS) has announced that it will accept so-called “silent” tax returns, that is, returns that do not answer the question about health coverage. This decision does ... Read More

IRS Memo on Tax Treatment of Fixed Indemnity Health Plans

March 1, 2017The Internal Revenue Service (IRS) has released a memorandum clarifying the tax treatment of benefits paid by Fixed-Indemnity Health Plans. A fixed-indemnity health plan typically pays a set dollar amount ... Read More

6th Circuit: Failure to Provide FMLA Notice is Interference

February 7, 2017The 6th Circuit Court of Appeals has found that failing to provide a notice required under the Family and Medical Leave Act (FMLA) constitutes interference with FMLA rights. The employer ... Read More

3rd Circuit: Honest Belief Defeats Retaliation Claim

February 2, 2017The Third Circuit Court of Appeals has ruled that an employer’s honest belief that an employee was abusing his Family and Medical Leave Act (FMLA) leave was sufficient to defeat ... Read More

10th Circuit Denies Motion in FMLA Interference Claim

January 31, 2017After William Gaige was fired from his job while on leave from work under the Family and Medical Leave Act (FMLA), he sued his former employer, SAIA Motor Freight Line, LLC, for ... Read More

January 2017: State and Local Law Update

January 29, 2017One of the most difficult things for human resource and absence management professionals to do is to keep up with changing state and local laws.  Below is a brief summary ... Read More

Federal Court Blocks Rules with Transgender Protections

January 23, 2017A federal court has issued a nationwide injunction against enforcement of health care reform regulations on gender identity and termination of pregnancy.  These regulations, which were scheduled to go into ... Read More

President Trump Issues Executive Order on Healthcare Reform

January 22, 2017President Trump was not able to keep his campaign promise to repeal health care reform on “Day One” of his administration; however, he did issue the following Executive Order: MINIMIZING ... Read More

New Dollar Amounts: Cost-of-Living Adjustments & Increased Penalties

January 6, 2017A variety of federal agencies have released a number of new dollar amounts reflecting cost-of-living adjustments. The Department of Health and Human Services (HHS) has announced new penalty amounts for ... Read More

FAQs About ACA Implementation, Part 35

January 5, 2017The Departments of Health and Human Services, Labor and Treasury have issued a 35th set of answers to frequently asked questions (FAQs) regarding implementation of the Affordable Care Act (ACA).  ... Read More

IRS Updates Q&As on ACA Reporting

December 28, 2016The Internal Revenue Service (IRS) has updated and expanded its questions and answers regarding the Affordable Care Act (ACA) reporting requirements.  The following information is included in the Q&As: Full ... Read More

Medicare Changes for 2017

December 22, 2016Every year Medicare deductibles and co-payments are adjusted to reflect inflation.  Changes for 2017 are: The Part A hospital deductible is increasing from $1,288 to $1,316. Hospital co-payments for the ... Read More

DOL Issues Final Regulations on Disability Claims

December 21, 2016The Department of Labor (DOL) has issued final regulations on claim procedures for plans providing disability benefits.  The final rule revises the current rules primarily by adopting certain procedural protections ... Read More

21st Century Cures Act Includes Benefit-Related Provisions

December 19, 2016President Obama has signed the 21st Century Cures Act, which includes a number of benefit-related provisions, in addition to providing funding for medical research, mental health resources and other provisions.  ... Read More

Final Regulations on Excepted Benefits and Short-Term Policies

December 1, 2016The Departments of Health and Human Services, Labor and Treasury have issued final regulations on excepted benefits, lifetime and annual limits and short-term limited-duration health insurance.  For the most part, ... Read More

Phishing Email Alert Issued by HHS

November 29, 2016The Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) announced yesterday that a phishing email is being circulated on mock HHS Departmental letterhead under the signature ... Read More

November 2016: State and Local Law Update

November 28, 2016One of the most difficult things for human resource and absence management professionals to do is to keep up with changing state and local laws. Below is a brief summary ... Read More

Federal Judge Issues Injunction Delaying Overtime Rules

November 23, 2016A federal district court judge in Texas has granted a preliminary injunction that temporarily blocks the Department of Labor (DOL) from implementing its regulations on exemptions from the Fair Labor ... Read More

IRS Notice 2016-70 Extended Due Date

November 21, 2016Good news! IRS Notice 2016-70 has extended the due date for distributing Form 1095-C to employees by 30 days to March 2, 2017.  The extension only applies to Form 1095-C ... Read More

What Does the Election Mean for Healthcare Reform?

November 10, 2016During the campaign, President-elect Trump promised to repeal health care reform on his first day in office.  Full repeal on inauguration day is almost certainly impossible; however, repeal of substantial ... Read More

New 2017 California Insurance Laws

November 7, 2016AB 72 This new law provides that if an insured receives services in an in-network facility from an out-of-network health professional, the insured is only required to pay the out-of-network ... Read More

More Cost-of-Living Adjustments Announced

November 3, 2016Federal agencies have made a number of announcement recently regarding cost-of-living adjustments for 2017.  IRS Revenue Procedure 2016-55 alone covered over 50 different items. Full content is available to DMEC ... Read More

October 2016: State and Local Law Update

October 17, 2016One of the most difficult things for human resource and absence management professionals to do is to keep up with changing state and local laws.  Below is a brief summary ... Read More

District Court Rules Medical Exams are Voluntary

October 13, 2016The Eastern District of Wisconsin has decided the case of Equal Employment Opportunity Commission (EEOC) v. Orion Energy Systems, granting summary judgment in part favoring Orion’s argument that their wellness ... Read More

Medicare Part D Advisory: Sponsors Must Provide Notices Prior to October 15, 2016

October 3, 2016Group health plan sponsors must provide Medicare Part D creditable coverage notices prior to October 15th, the start date of the Medicare annual enrollment period for Part D, Prescription Drug ... Read More

DOL Issues Final Rule on Paid Sick Leave for Federal Contractors

September 30, 2016The U.S. Department of Labor (DOL) has issued a final rule to implement Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors. The EO was signed by President Barack Obama ... Read More

Two-Month Extension for Public Comments on Form 5500

September 26, 2016The U.S. Department of Labor (DOL) has announced a two-month extension of the comment period on the Form 5500 Modernization Proposals. The DOL, the Internal Revenue Service (IRS) and the Pension Benefit Guaranty ... Read More

2nd Circuit Says Managers Can be Liable for FMLA Violations

September 15, 2016The United States Court of Appeals, Second Circuit has ruled that individual managers can be held liable for violations of the Family and Medical Leave Act (FMLA). Under the FMLA ... Read More

Proposed Regulations Clarify ACA Reporting Requirements

September 8, 2016The Internal Revenue Service (IRS) has proposed regulations that clarify the reporting requirements under the Affordable Care Act (ACA) for health reimbursement arrangements (HRAs) and self-funded plans. IRS Notice 2015-68 ... Read More

September 2016: State and Local Law Update

September 2, 2016One of the most difficult things for human resource and absence management professionals to do is to keep up with changing state and local laws.  Below is a brief summary ... Read More

IRS Releases Drafts of Forms for ACA Reporting

August 26, 2016The Internal Revenue Service (IRS) has released drafts of the 1095-C and 1094-C forms and instructions for reporting on calendar year 2016. Applicable large employers (employers with an average of ... Read More

Recent Developments Related to HIPAA Compliance

August 22, 2016There have been a number of recent developments related to compliance with the privacy and security rules under the Health Insurance Portability and Accountability Act (HIPAA). The Office for Civil ... Read More

HHS Issues Appeal Request Form

August 16, 2016The Department of Health and Human Services (HHS) has issued a form employers can use to appeal Marketplace notices. If an employer received a Marketplace notice stating that it may ... Read More

OSHA Puts Brakes on Post-Incident Drug Testing

August 12, 2016The Occupational Safety and Health Administration (OSHA) will publicly post employer injury/illness reports beginning January 1, 2017. The new rule making this change also has two sections already in effect ... Read More

Federal Agencies Increasing Penalties

August 1, 2016Last year, Congress passed the Federal Civil Penalties Inflation Adjustment Act as part of the Bipartisan Budget Act.  In accordance with the provisions of that Act, various federal agencies have ... Read More

July 2016: State and Local Law Update

July 29, 2016One of the most difficult things for human resource and workers’ compensation professionals to do is to keep up with changing state and local laws.  Below is a brief summary ... Read More

IRS Issues Proposed Regulations on Opt-Out Payments

July 27, 2016The Internal Revenue Service has released proposed regulations on opt-out payments (sometimes known as waiver bonuses) allowing them to be used to determine affordability under the Affordable Care Act (ACA). The ... Read More

Proposed Changes to 5500s

July 15, 2016The Department of Labor (DOL), the Internal Revenue Service, and the Pension Benefit Guarantee Corporation have proposed revisions to the Form 5500, effective with the 2019 plan year. The proposed ... Read More

City of LA Publishes Paid Sick Leave Regulations

July 11, 2016The City of Los Angeles has published regulations implementing its new minimum wage ordinance, which includes paid sick leave requirements, effective July 1, 2016. Employers with 25 or fewer employees ... Read More

New EEOC Notices and Penalties

June 28, 2016The Equal Employment Opportunities Commission (EEOC) has issued answers to frequently asked questions (FAQs) about the recent wellness program regulations and has issued a sample notice employers can use to ... Read More

State and Local Law Update

June 27, 2016One of the most difficult things for human resource and workers’ compensation professionals to do is to keep up with changing state and local laws. Below is a brief summary ... Read More

Company Agrees to $3.9 Million Settlement for HIPAA Breach

June 24, 2016Feinstein Institute for Medical Research (FIMR) has signed a resolution agreement with the Department of Health and Human Services (HHS) for multiple violations of the Health Insurance Portability and Accountability ... Read More

Los Angeles Passes Paid Sick Time Law Effective July 1, 2016

June 16, 2016Los Angeles has become the 5th city in California to enact a paid sick time law that differs from the California Law, joining Emeryville, Oakland, San Francisco and Santa Monica.  ... Read More

DOL Identifies Suspect Mental Health Plan Provisions

June 14, 2016The Department of Labor (DOL) has released a publication that identifies some plan provisions that may violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act ... Read More

Proposed Rules and Expatriate Plans, Excepted Benefits and More

June 10, 2016The federal agencies with regulatory authority over the Affordable Care Act (ACA) have released new proposed regulations covering a variety of topics. The proposed rule was issued jointly by the ... Read More

HHS Finalizes ACA Nondiscrimination Rules

June 2, 2016This final Affordable Care Act (ACA) rule prohibits discrimination based on race, color, national origin, sex, age or disability; enhances language assistance for individuals with limited English proficiency; and protects ... Read More

California “Time off to Vote” Notices

May 26, 2016The California Elections Code section 14001 requires employers to post a notice to employees advising them of provisions for taking paid leave for the purpose of voting in statewide elections. ... Read More

State and Local Law Update: May 2016

May 25, 2016One of the most difficult things for human resource professionals to do is to keep up with changing state and local laws related to leaves and discrimination. Below is a ... Read More

EEOC Issues Final ADA and GINA Rules on Wellness Programs

May 23, 2016On May 16, 2016, the U.S. Equal Employment Opportunity Commission (EEOC) issued final rules that describe how Title I of the Americans with Disabilities Act (ADA) and Title II of ... Read More

2017 COLAs Announced for Affordability & HSAs

May 19, 2016The Internal Revenue Service has announced cost-of-living adjustments (COLAs) for affordability, Health Savings Accounts (HSAs), and High Deductible Health Plans (HDHPs) for 2017. These early announcements are welcome, allowing employers ... Read More

DOL Updates Overtime Regulations

May 18, 2016The Wage and Hour Division of the Department of Labor (DOL) has updated the regulations defining who can be categorized as an exempt employee under the Fair Labor Standards Act ... Read More

Lowe’s to Pay $8.6 Million to Settle EEOC Disability Discrimination Suit

May 17, 2016On Friday, May 13, the U.S. Equal Employment Opportunity Commission (EEOC) announced the approval of the resolution of a nationwide disability discrimination case against home improvement, appliance, and hardware giant, ... Read More

Supreme Court Sends Contraceptives Cases Back to Circuit Courts

May 16, 2016The U.S. Supreme Court has sent several lawsuits involving contraceptive coverage back to the Circuit Courts based on additional information obtained from the various parties. These cases involve charities and ... Read More

New Paid Family Leave Mandates in CA, SF, and NY

April 12, 2016The states of California and New York and the City and County of San Francisco have all passed new mandates regarding paid family leave. The California and San Francisco laws ... Read More

Departments Finalize New Version of the SBC

April 11, 2016The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury have announced changes to the Summary of Benefits and Coverage (SBC) ... Read More

State and Local Law Update

March 31, 2016One of the most difficult things for human resource professionals to do is to keep up with changing state and local laws related to leaves and discrimination. Below is a ... Read More

California Employers Face Two April 1 Deadlines

March 28, 2016Just in case the March 31 deadline to send employees Form 1095-Cs wasn’t enough, California employers have two April 1 deadlines. The deadlines are for a new Pregnancy Disability Leave ... Read More

HHS Announces HIPAA Audits

March 25, 2016As a part of its continued efforts to assess compliance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security and Breach Notification Rules, the Department of Health and ... Read More

6th Circuit Holds it is Unreasonable to Keep a Job Open Indefinitely

March 19, 2016The Sixth Circuit Court of Appeals has held that it was an unreasonable accommodation to keep a job open for an employee with no clear prospects of recovery. In the ... Read More

Supreme Court Rules State Law is Pre-Empted

March 14, 2016The United States Supreme Court has held that the Employee Retirement Income Security Act of 1974 (ERISA) preempts a state law requiring self-funded health plans to provide claim data to ... Read More

Court Says EEOC Misinterprets the ADA Safe Harbor Provision

March 6, 2016In the case of Equal Employment Opportunity Commission (EEOC) v. Flambeau, Inc., the US District Court for the Western District of Wisconsin decided that Flambeau was not overstepping any boundaries ... Read More

Dave & Buster’s May Be Busted

February 23, 2016The United States District Court for the Southern District of New York has found that a complaint filed against Dave & Buster’s (D&B) has enough merit that a motion to ... Read More

Denial of ADA Leave for Failure to Provide Medical Records

February 5, 2016The U.S. Court of Appeals for the District of Columbia Circuit affirmed a decision made by the District of Columbia District Court involving a denial of ADA leave. The case: ... Read More

Recent Developments Affect Church Plans

February 4, 2016There have been two recent developments affecting church plans. One has to do with how broad the church plan exemptions is from the Employee Retirement Income Security Act (ERISA) and ... Read More

Supreme Court Limits Subrogation Recoveries

January 27, 2016The Supreme Court of the United States has held that when a participant in a plan covered by the Employee Retirement Income Security Act of 1974 (ERISA) wholly dissipates a ... Read More

HIPAA Settlement Reinforces Lessons for Users of Mobile Devices

January 26, 2016Lahey Hospital and Medical Center has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules with the U.S. Department ... Read More

$3.5 Million HIPAA Settlement

January 14, 2016Triple-S Management Corp. (TSM), a Puerto Rico health insurer, agreed to pay $3.5 million in a Health Insurance Portability and Accountability Act (HIPAA) settlement after the U.S. Department of Health ... Read More

1st Circuit Rules on Own Occupation Definition Under LTD Plan

January 8, 2016The U.S. Court of Appeals for the First Circuit has found that a district court made an error in granting summary judgment to Aetna regarding the cancellation of a long-term ... Read More

FMLA Does Not Protect Poor Job Performance

January 5, 2016Even when an employee is taking periodic FMLA leave, they are not protected from termination for poor job performance. In the case of Burciaga v. Ravago Americas LLC, 2015, the ... Read More

Cadillac Tax and Other Taxes Delayed

December 31, 2015The President has signed the Consolidated Appropriations Act, 2016, which contains several provisions related to employee benefits. Most significantly, the new law delays the so-called “Cadillac tax” from 2018 to ... Read More

IRS Notice 2015-87 Provides Guidance on ACA Issues

December 31, 2015The Treasury Department and the Internal Revenue Service (IRS) have issued Notice 2015-87 which provides guidance on the application of various provisions of the Affordable Care Act (ACA) to employer-provided ... Read More

9th Circuit Rules That Deadlines Can’t Fall on Weekends

December 31, 2015U.S. Court of Appeals for the Ninth Circuit has reversed a district court’s dismissal of an action regarding a plan participant’s application for continued long-term disability (LTD) benefits. The issue ... Read More

3rd Circuit Says Employers Must Allow Employees to Fix Certifications

December 31, 2015The Third Circuit Court of Appeals has ruled that employers must advise employees of deficiencies in medical certifications and provide them with the opportunity to correct the deficiencies. Employers should ... Read More

8th Circuit Says Bad Faith Efforts Highlight Need for FMLA

December 31, 2015The 8th Circuit Court of Appeals has ruled in favor of an employee who claimed her employer interfered with her rights under the Family and Medical Leave Act (FMLA). The ... Read More