Advising on Health Care Reform and All Other Health and Welfare Plan Issues

Health Care Reform has created new rules impacting nearly every employer, union, governmental entity and health insurance provider. MMPL’s health and welfare plans practice is there to help our clients navigate the requirements of the full range of laws and regulations affecting health and welfare plans.

Our health and welfare plans practice includes self-funded, insured, Taft-Hartley, corporate and governmental health and welfare plans of every size. It runs the gamut of health, welfare, training, apprenticeship, vacation and other plans.

Our services for health and welfare plans include:

  • Designing and establishing new health and welfare plans
  • Drafting plan amendments to comply with changes in the law and to respond to client needs and objectives
  • Full analysis of the requirements of Health Care Reform for plans, employers and government entities, including required benefit changes, “grandfathered” status, notice obligations, claim and appeal procedures, and potential effects of noncompliance
  • Drafting summary plan descriptions (SPDs) and other participant communications
  • Designing plan terms to comply with continuation of coverage requirements under COBRA
  • Ensuring that health plans and sponsors comply with HIPAA privacy, security and special enrollment rights
  • Appropriate handling of Qualified Medical Child Support Orders
  • Negotiation of contracts that comply with the law and protect the plan’s interests, including investment manager, insurance, stop-loss, pharmacy, third-party administration and investment custody agreements
  • Advising clients regarding specialized legal requirements for retiree medical coverage
  • Responding to participant benefit claims and appeals
  • Drafting of policies and procedures to protect the plan’s rights to subrogation or reimbursement in cases of potential third-party liability, and negotiation of subrogation and reimbursement claims on behalf of plans
  • Analysis of potential “MEWA” (multiple employer welfare arrangement) status
  • Representing plans and plan sponsors in litigation and governmental audits
  • Ensuring that investment and other fiduciary decisions comply with ERISA’s fiduciary standards