Employers that provide health and welfare benefits for their employees have seen costs skyrocket in recent years with no relief in sight. We help our clients find creative ways to deliver valuable health and welfare benefits to employees while managing costs.

Our attorneys provide the following services:

  • Design, implement, operate, and communicate all forms of health and welfare benefit arrangements, including medical, dental, vision, hearing, and prescription drug plans; consumer-driven health arrangements such as HRAs and HSAs; long-term and short-term disability plans; life insurance and AD&D; tuition reimbursement and education assistance programs; and employee assistance programs

  • Coordinate FMLA and state-based leave policies with long-term and short-term disability arrangements

  • Comply with state mandates relating to benefits, including the Massachusetts Health Care Reform Act and similar state and local legal requirements

  • Draft and operate Section 125 cafeteria plans and related health care and dependent care flexible spending accounts (FSAs)

  • Design benefit programs for civil union partners and domestic partners

  • Determine the tax treatment of various health and welfare benefits, including the taxation of benefits for same-sex spouses and non-dependents

  • Comply with the HIPAA privacy and electronic security requirements applicable to protected health information arising in health benefit plans and on-site medical clinics

  • Draft and negotiate group insurance contracts, administrative services only (ASO) agreements, managed care agreements, investment manager agreements, and pharmacy benefit manager (PBM) agreements

  • Handle claims for benefits in accordance with the ERISA and state law fiduciary rules, and in anticipation of potential litigation

  • Comply with the continuation health coverage requirements of COBRA and related state continuation laws

  • Coordinate active and retiree health and prescription drug coverage with Medicare Parts B and D, including obtaining Retiree Drug Subsidies (RDS) for certain retiree prescription drug plans

  • Make changes to active and retiree health and welfare benefit plans, in light of constitutional and ERISA vesting requirements

  • Develop on-site medical clinic arrangements in light of the ERISA requirements for health benefit plans

  • Establish, maintain, and amend health and welfare benefit funding mechanisms, including voluntary employees' beneficiary association (VEBA) and Section 115 government trusts

  • Communicate with health and welfare plan participants through summary plan descriptions (SPDs) and other required and┬árecommended communications vehicles

contact

Brian M. Pinheiro
Practice Leader
Tel 215.864.8511
pinheiro@ballardspahr.com