New Disability Claims Regulations Take Effect for All Plans April 1, 2018

Matthew P. Chiarello • January 18, 2018

As noted in our previous blog post, The New Disability Claims Regulations: They Don’t Only Apply to Disability Plans , the Department of Labor (“DOL”) issued regulations that revise the ERISA claims procedure regulations for all employee benefit plans that provide disability benefits (the “New Regulations”).  These rules can impact not only short-term and long-term disability plans but also qualified retirement plans (e.g., a 401(k) plan), nonqualified retirement plans, and health and welfare plans.  The New Regulations were published in the Federal Register on December 19, 2016, and are based on the Affordable Care Act’s enhanced claims and appeals regulations for group health plans.  They originally were scheduled to take effect for all claims for disability benefits filed on or after January 1, 2018.

After DOL announced it was considering amending or delaying the New Regulations, it issued a final rule , published on November 29, 2017, formally delaying the effective date to April 1, 2018.

On January 5, 2018, DOL announced in an EBSA News Release   that the New Regulations will take effect without modification on April 1, 2018.  Despite receiving around 200 comment letters, DOL determined that the comments ultimately did not establish that the New Regulations impose unnecessary regulatory burdens or significantly impair workers’ access to disability insurance benefits.

Now that we know the New Regulations will take effect April 1, 2018, employers may wish to refocus on these New Regulations as soon as possible to ensure that they meet this deadline. As we previously explained here , it may take some time for an employer to comply.  After an employer determines which plans (if any) might be subject to the New Regulations, it must decide whether to comply with the new requirements, or to amend its definition of disability so that the determination of disability is made by a third party.  Either way, plan amendments, as well as coordination with various service providers and insurers, may be required.

Employee burnout: what it is and how to prevent it

By Mardy Gould • May 24, 2024
Employee burnout has become an epidemic in today’s modern workplace. So much so that the World Health Organization (WHO) officially recognizes it as an “occupational phenomenon.”1 While many used to consider mounting workplace stress an individual employee problem, these days, it’s become an employer’s responsibility to prevent burnout before it hurts productivity and business performance—not to mention your employees’ physical and mental health. Luckily, you can prevent burnout from affecting your workforce in several ways. This article will explore the causes and signs of employee burnout and the steps you can take to create a positive work environment where employees feel safe from toxic stress levels.

Form 720 and PCORI fee FAQs

By Mardy Gould • May 23, 2024
If you're a small business owner, you may have heard of the acronym PCORI and the fees that come with it. But what is PCORI, and how does it apply to your organization? Under the Affordable Care Act (ACA), sponsors of self-insured health plans must pay a fee to fund the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI is an independent organization the ACA created to conduct research to help healthcare consumers make better decisions for their specific needs and outcomes. It also performs research related to clinical effectiveness. Employers offering a self-insured medical reimbursement health plan, such as a health reimbursement arrangement (HRA), must pay this fee by July 31 each year via Form 7201. This fee was initially set to expire in 2019, but Congress extended it through September 30, 20292, due to the Further Consolidated Appropriations Act of 20203.
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