Health and Welfare Plan Design & Administration

Amid the shifting regulatory and compliance landscape, our health and welfare team works with employers of all sizes and across industries to design, implement, and maintain health and welfare plans. Our clients range from small, middle-market, Fortune 500, and multinational companies to financial institutions, startups, tax-exempt organizations, educational institutions, insurers, third-party administrators, and state and local governments. We help clients navigate the myriad regulations and changing environment, and we assist them with managing and operating their health and welfare plans on a day-to-day basis.

Our team is well versed in the laws and regulations that govern health and welfare plans. We consult with our clients to design and implement plans that reflect their businesses’ and employees’ needs, including innovative, cost-saving plan designs. We assist with the daily operations and administration of our clients’ plans, including maintaining plan documents, consulting on operational issues, and assisting with claims and appeals. We represent health and welfare plan clients facing federal agency audits and lawsuits, and help them to limit their liability through comprehensive legal reviews.

We guide clients through compliance with the Employee Retirement Income Security Act (ERISA); the Affordable Care Act (ACA); Internal Revenue Code (IRC) Sections 79, 105, 125, 129, and 223; the Consolidated Omnibus Budget Reconciliation Act (COBRA); the Health Insurance Portability and Accountability Act (HIPAA), regarding nondiscrimination and portability; HIPAA and the Health Information Technology for Economic and Clinical Health (HITECH) Act, regarding privacy and security; the Mental Health Parity and Addiction Equity Act (MHPAEA), regarding mental health parity; the Genetic Information Nondiscrimination Act (GINA); the Americans with Disabilities Act (ADA); and other applicable laws.

We regularly consult with our clients to design and establish consumer-driven plans, cost-saving plan designs, and wellness programs. These plans include high-deductible health plan/health savings account (HDHP/HSA) combinations, health reimbursement arrangements (HRAs), and health flexible spending accounts (FSAs). We help our clients understand and apply the ACA provisions that impact those plan designs. We counsel clients and third-party administrators regarding private exchanges that have become more relevant since the passage of the ACA.