In this episode, Suzanne Spradley and Chase Cannon discuss the rise of value-based care (VBC) arrangements and break down the compliance considerations employers should consider when implementing them. Suzanne begins with a description of ERISA’s fiduciary obligations as they relate to VBC arrangements. Chase and Suzanne then discuss how a fiduciary checklist can assist with those obligations, as well as the other compliance rules that need to be reviewed in connection with VBC arrangements.

In this episode, Chase Cannon and Suzanne Spradley discuss the Department of Labor’s proposed new electronic disclosure safe harbor for ERISA group health plans. Chase begins with some background on the current DOL electronic disclosure rules. Then, the two discuss how the proposal could modernize the delivery of required health plan notices, reduce reliance on paper disclosures, and give employers a new notice-and-access option while preserving important participant protections. They also cover practical considerations for employers, including covered documents, website requirements, bounced electronic notices, privacy concerns, and what the final rule might look like.

In this episode, Suzanne Spradley and Chase Cannon discuss the usage of artificial intelligence (AI) in plan-related administrative tasks. Suzanne begins with an outline of how carriers, vendors, TPAs, and employers as plan sponsors are currently using AI. Suzanne and Chase discuss the impact AI might have on an employer plan sponsor’s ERISA fiduciary obligations, including the duties of prudence, loyalty, and monitoring, particularly in the context of adverse benefit determinations. The two close with a discussion on AI’s impact on other compliance laws, including HIPAA and the mental health parity rules.

In this episode, Chase Cannon and Suzanne Spradley discuss a recent HHS Office for Civil Rights settlement showing that self-insured employer-sponsored group health plans are not outside the reach of HIPAA enforcement — especially when ransomware, electronic PHI, and incomplete risk analysis are involved.

In this episode, Suzanne Spradley and Chase Cannon revisit the history and importance of the tax exclusion for employer-sponsored insurance (ESI) coverage. Suzanne takes us back to the 1940s to understand how the tax exclusion began. The two discuss the reasons for the longevity and stability of the ESI model and how it has impacted the accessibility and affordability of health insurance in the U.S. Suzanne closes by addressing a new U.S. Congressional proposal that could impact employers and the ESI model.

In this episode, Chase Cannon and Suzanne Spradley look at some common blind spots that employers, as plan sponsors, should review with respect to compliance. Chase outlines the first two blind spots that relate to the application of COBRA and COBRA initial notice distribution. Chase and Suzanne then discuss how employee counts can trip up employers when it comes to how certain compliance laws apply. The two close the podcast with a discussion of the impact of remote employees on state paid family and medical leave requirements.

In this episode, Suzanne Spradley and Chase Cannon discuss two recent circuit court decisions and their impact on employer-sponsored group health plans. Suzanne first discusses a Sixth Circuit decision involving a state law that attempts to regulate PBMs. Suzanne and Chase walk through Supreme Court precedent that appears to be driving states to enact PBM laws, and they explain how ERISA preemption is at the heart of it all. Suzanne concludes the podcast by outlining another federal decision relating to a fiduciary breach claim of an employer group health plan.

In this episode, Chase Cannon and Suzanne Spradley review three important upcoming compliance-related deadlines. Chase highlights the three requirements, including ACA reporting, an April 15 deadline related to HSA contributions and distributions, and RxDC reporting. Chase and Suzanne discuss some practical approaches to each of those deadlines and conclude with a summary of how recent DOL enforcement priorities and ERISA fiduciary litigation come into play.

In this episode, Suzanne Spradley and Chase Cannon review the outlook of health policy in the current Washington, DC environment. Suzanne leads off, setting the stage with a description of the narrow House Republican majority and its impact on enacting legislation. Suzanne and Chase discuss several pieces of legislation focused on transparency, including site-neutral payment reform and drug pricing. The two address regulatory activity that potentially targets PBMs and No Surprises Act issues. The episode concludes with a discussion of legislative and regulatory impact on employer group health plans.

In this episode, Chase Cannon and Suzanne Spradley review a recent DOL announcement that outlines the agency’s enforcement priorities for group health plans. Chase provides some background on DOL enforcement and the DOL’s efforts to increase employee benefit plan compliance, address abusive practices, and protect the rights of participants and beneficiaries. Chase and Suzanne go deeper on four of the priorities, including mental health parity, cybersecurity, abuse of contributory benefit plans, and surprise billing, including important takeaways for employers to consider going forward.