Lynne Anderson to Speak at Seton Hall Law’s Healthcare Compliance Certification Program

On October 15, Florham Park partner Lynne Anderson will speak at Seton Hall’s U.S. Healthcare Compliance Certification Program. The event, which will take place from October 12-15, offers a comprehensive overview of state, federal and international law governing prescription drugs, medical devices, and healthcare fraud.  Topics include privacy and data protection, anti-kickback laws, the Foreign Corrupt Practices Act and the False Claims Act.  Attendees include representatives from pharmaceutical companies and hospitals.

Lynne will participate in the panel titled, “Being the Focus of a Government Investigation” to provide the perspective of dealing with an employee whistleblower.  She will be joined by Mike Doyle of the Federal Bureau of Investigation; Jacob Elberg of the U.S. Attorney’s Office, District of New Jersey; Maureen Ruane of Lowenstein Sandler P.C.; Jim Sheehan of the Office of the New York Attorney General; and Professor Timothy Glynn of Seton Hall Law School.

Read more information here.

Cheryl Orr and Sarah Millar Quoted in InsideCounsel Labor & Employment Digest: April 2014

Cheryl Orr, partner and co-chair of the Labor & Employment group, and Sarah Millar, partner and vice chair of the Employee Benefits & Executive Compensation group, were both quoted in InsideCounsel’s April 2014 Labor & Employment Digest.  The monthly digest “brings together the voices of labor & employment and employee benefits lawyers to get their take on the issues shaping the policies of workplace compliance and regulation.”  Sarah’s quote looked at how employers can avoid the challenges presented by tobacco cessation programs and Cheryl’s looked at how the anti-drug policies of companies located in states where marijuana is now legal for medical or recreational use are affected.  Both quotes are below in their entirety.

Avoid the challenges of tobacco cessation programs

“Tobacco cessation programs structured outside a health plan can be problematic.  Some state laws prevent employers from making hiring and firing decisions based on someone’s smoking status.  It puts employers between a rock and a hard place.  The law is complicated and ties your hands in some respect, but there are options and creative ways to incentivize healthy behavior.  It’s a matter of walking through the steps and thinking it through, then coming up with an effective communication plan.”

Marijuana legalization and anti-drug policies

“Companies located in one or more of the 21 states that allow the use of medical marijuana need to understand the laws may affect a company’s anti-drug policy.  For employers that have federal contracts or are otherwise subject to federal regulations concerning drug-free workplaces, your practices do not need to change.  Otherwise, employers should expect more challenges from staff that fail drug tests but claim they weren’t impaired while working.  Training programs for managers will help them recognize signs of impairment and answer inquiries regarding the use of medical marijuana.”

Supreme Court Rules Defense of Marriage Act Unconstitutional — What Does this Mean for Plan Sponsors?

Editor’s note: Along with their alert on the IRS recent guidance on confirming the previously announced one-year transition rule for the employer “shared responsibility” mandate and related reporting obligations under the Affordable Care Act, our colleagues in in the Employee Benefits & Executive Compensation Practice Group have put out an alert on the U.S. Supreme Court’s recent ruling in United States vs. WindsorThe complete text of the alert appears below.

Supreme Court Rules Defense of Marriage Act Unconstitutional — What Does this Mean for Plan Sponsors?

By: Frances P. LaFleur and Cristin M. Obsitnik

The U.S. Supreme Court recently paved the way for legally married same-sex spouses to have the same federal rights and benefits as married opposite-sex spouses.  In United States vs. Windsor, the Court struck down as   unconstitutional the federal definition of “marriage” as only between a man and a woman and the definition of “spouse” as a legally married person of the opposite sex.

The Court found that Section 3 of the Defense of Marriage Act (DOMA), which defines “marriage” and “spouse” for purposes of applying federal laws, violates the equal protection guarantees under the Fifth Amendment by not   recognizing a same-sex marriage permitted by a state.  This means that if a same-sex marriage is legal under state law, it must now be recognized   for federal law purposes.  Notably, the Court let stand the states’ right to refuse to recognize same-sex marriages lawfully performed in other states.

The Court’s decision will affect over 1,000 federal laws including the Internal Revenue Code, the Employee Retirement Income Security Act (ERISA), the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance Portability and Accountability Act (HIPAA) and the Family Medical Leave Act (FMLA), and will have a significant impact on employer-sponsored employee benefit plans and policies.

Effect on Plans and Policies

Employer obligations under retirement and health and welfare plans and employee policies will be affected to the extent any rights or benefits are tied to the definition of “spouse.”  As a result, amendments to plan documents and changes to administrative policies may be required.  However, as discussed below, additional guidance is needed on the timing for implementing any related changes and how same-sex spouses, lawfully married in one state but currently living in a non-recognition state, will be treated under federal law.

Significant changes to employee benefit plans include the following:

Health and Welfare Plans 

Imputed Income — The cost of employer provided health, dental and vision benefits for covered same-sex spouses and their covered children will no longer be subject to federal income tax.

Pre-Tax Expense Reimbursements — Reimbursement under a flexible spending account (FSA), health reimbursement account (HRA) or health savings account (HSA) may be made for covered expenses of same-sex spouses and their children on a tax-free basis for federal tax purposes to the same extent as available to opposite-sex spouses.

Dependent Care — Dependent care accounts may be used to pay eligible expenses for care provided to the children of same-sex spouses.

COBRA — Same-sex spouses are eligible for continuation coverage under COBRA.

Special Enrollment and Election Changes — Same-sex spouses are eligible for special enrollment rights under HIPAA and applicable change-in-status events under Internal Revenue Code Section 125.

Retirement Plans

Spousal Consent — If federal law requires spousal consent to name a non-spouse beneficiary, a same-sex spouse’s consent will be required.

QDROs — Plan fiduciaries must recognize domestic relations orders obtained by same-sex spouses, subject to plan QDRO procedures.

Surviving Spouse Benefits — If required for opposite-sex spouses, qualified pre-retirement survivor annuities must be paid to same-sex spouses unless coverage has been waived and the same-sex spouse consents to the waiver.

QJSA Payments — Same-sex spouses are entitled to qualified joint and survivor annuity protection unless a different form of payment is elected with the spouse’s consent.

Hardship withdrawals — Hardship withdrawals under the safe-harbor definition will be available for same-sex spouses’ medical, tuition and funeral expenses.

Rollover — Same-sex spouses may roll over a distribution from the plan sponsor’s plan to their own individual retirement account (IRA) or another   employer’s qualified plan.  Previously, a same-sex spouse could only roll over a distribution to an inherited IRA.

Required Minimum Distributions — Same-sex spouses will be permitted to defer required minimum distributions until the deceased participant would   have reached his or her required beginning date after age 70 1/2.

Other Policies

FMLA — Employees will have the right under the FMLA to take a leave of absence to care for a same-sex spouse with a serious health condition.

Applying State Marriage Laws — Who is a Legally Married “Spouse”?

Twelve states [1] and the District of Columbia currently permit same-sex marriage.  It is clear from the Court’s ruling that same-sex spouses who reside in these states, or in states that recognize same-sex marriages legally performed in other states, now are entitled to the same federal benefits and protections afforded to opposite-sex spouses.  What is not clear is how federal laws will be applied if a same-sex spouse, lawfully married in one state, moves to another state that does not recognize same-sex marriage or lives in a state that recognizes same-sex marriage but works in a state that does not.  While there is some precedent for the IRS and other federal government agencies to recognize a marriage validly performed in any state regardless of a person’s current state of residence, the IRS has acknowledged the need for additional guidance on the implications of the Court’s decision, and has stated that it intends to issue such guidance in the near future.

Plan sponsors may still choose to provide equivalent benefits for same-sex partners in states that do not recognize same-sex marriage and those in civil unions or domestic partnerships.  However, as was the case previously for all same-sex spouses, there will be different treatment under certain federal laws (imputed income on health benefits, limitations on rollovers, etc.).  State tax treatment is not affected by the ruling and, as before, may vary from federal tax treatment.

Effective Date

The Court’s decision becomes final on or about July 22, 2013.  Whether its impact on employee benefit plans will be applied retroactively is yet to be determined.  Retroactive application may mean that employee benefit plans could be liable for actions taken before the Windsor decision that were in compliance with DOMA at that time.  For example, if a pension plan provides only a spousal death benefit, could a legally married same-sex spouse of a previously deceased participant have a claim?  Similarly, are employees and employers entitled to claim a refund for taxes paid on imputed income for health benefits provided to a same-sex spouse?  As noted above, the IRS and other federal agencies are reviewing the Court’s decision and intend to provide guidance on when and how these changes should be implemented.

What to Do Now

As we await further guidance, plan sponsors may want to consider taking the following actions:

  • Review how the term “spouse” is used in plan documents and policies.  Consider whether to amend the plan’s definition of spouse or change the criteria for benefits for same-sex spouses and also for domestic partnerships and civil unions.  While some changes will be mandatory, others will be in the plan sponsor’s discretion.
  • Stop imputing income for health, dental and vision coverage for same-sex spouses in states that recognize same-sex marriage.
  • Contact vendors, including recordkeepers, insurers, etc. to determine the cost and time frames necessary to make required system and administrative changes.
  • Assess what payroll system updates and administrative process changes are needed.
  • Review participant communications, including summary plan descriptions, beneficiary designation and consent forms, enrollment forms, etc., to determine what changes need to be made.
  • Determine whether a specific employee communication regarding the implications of the Supreme Court ruling is desired (e.g., to acknowledge the ruling and note what steps the plan sponsor is or may take while awaiting further regulatory guidance).
  • Consider whether to seek a refund for previously paid employment taxes on medical, dental and vision coverage provided to same-sex spouses.

We are following these issues closely and will keep you posted on any agency guidance about the timing or implementation of the changes.

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[1] Connecticut, Delaware (effective July 2013), Iowa, Maine, Maryland, Massachusetts, Minnesota (effective August 2013), New Hampshire, New York, Rhode Island (effective August 2013), Vermont and Washington.  In addition, in Hollingsworth v. Perry the Supreme Court reinstated a California court’s order allowing same-sex marriages.

 

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