Health & Welfare Benefits

We work directly with clients to develop programs and related administrative procedures that satisfy the various statutory and regulatory requirements governing this complex area under ERISA and the Internal Revenue Code and other related laws, including specific concentration on problems occurring under COBRA, HIPAA, HITECH and GINA. Most recently, we have addressed the unfolding challenges of the Patient Protection and Affordable Care Act (the ACA, or healthcare reform). We closely monitor developments under the ACA and related areas of healthcare reform and provide advice to clients about how they can navigate these significant changes and still maintain their ongoing programs.

We regularly advise plan sponsors and insurance companies on matters relating to the provision of employee benefits through insured programs, including company-owned life insurance, trust-owned life insurance and medical insurance, demutualization issues, taxation of insured benefits, and analyze the comparative benefits of insured versus self-funded arrangements. Our client base includes companies and organizations ranging in size from small start-up businesses to Fortune 100 companies, non-profit organizations and government entities. We can quickly identify issues that affect all employers and focus in on issues that are particular to the employer’s specific structure or industry.

We create practical solutions for clients when dealing with ongoing administration of their health and welfare plans. This may include reviewing employee communication materials for compliance; drafting updates to plan documents and SPDs; assisting with issues during an open enrollment period; or providing on-site training for HIPAA privacy and security rules. Clients often ask us to negotiate with service providers regarding contracts for administrative services.

Our health and welfare team has handled all aspects of retiree health programs from design, implementation and compliance to redesigning programs to save clients significant ongoing costs, while minimizing the risk of claims or litigation. We advise administrative committees on the proper procedures for dealing with claims for all types of health and welfare programs. When required, our experience in ERISA litigation enables us to identify and address potential issues in plan design and administration before they create problems or liabilities.

In conjunction with McGuireWoods’ labor and employment lawyers, we also handle benefits issues arising under the Family and Medical Leave Act (FMLA), the Age Discrimination in Employment Act (ADEA), the Americans with Disabilities Act (ADA), and other federal and state employment laws that affect welfare benefit program benefits. These issues are often integral to mergers and acquisitions, downsizings or corporate restructurings, as well as labor disputes and day-to-day operation of leave programs.

Our team monitors legislative, regulatory and judicial developments under the Internal Revenue Code, ERISA and related laws that affect welfare benefit program benefits. By establishing efficient, cost-effective teams with a well-rounded view of each client’s needs, we help design and implement customized solutions that are practical, comprehensive and compliant. When disputes arise, we work with our seasoned litigators to represent our clients’ interests in federal and state courts across the country and before numerous regulatory agencies.