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HEALTH AND WELFARE PLANS

Regulatory Compliance

 

We help sponsors of welfare benefit plans understand and comply with federal and state laws, including COBRA and HIPAA. We draft and review plan documentation and participant communications, such as summary plan descriptions, summary of material modifications, COBRA and HIPAA notices. We can provide assistance with:

 

  • Section 125 cafeteria plans
  • Self-funded medical plans including active and retiree plans
  • “Wrap plans” to supplement insurance certificates of coverage for fully-insured plans
  • Health reimbursement arrangements
  • Health savings account plans
  • Health flexible spending accounts
  • Dependent care spending accounts
  • Long and short-term disability plans
  • Dental and vision plans

 

Affordable Care Act

 

We work with plan sponsors, their consultants and third party administrators to help them understand how the health care reform legislation affects their welfare benefit plans.

 

Medicare Secondary Payer (MSP)

 

We assist plan sponsors with Medicare Secondary Payer (MSP) rules and coordination of benefits issues.

 

Claims and Appeals

 

We provide support to plan sponsors in their role as claims administrator in initial claims and claim appeals to ensure that the process complies with the requirements under ERISA and protects the plan sponsor in the event of any future litigation on the claim.