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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 22 attorneys engaged exclusively in employee benefits, estate planning and employment law. Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

www.wagnerlawgroup.com

 

 

 

 

July 31, 2014

 

 State and Federal Law Alert

 

 

 

DOL Issues FAQs to Address Disclosure Requirement for Reduction of

Contraceptive Coverage 

 

 

 


 

DOL has announced that group health plans sponsored by closely held companies that stop offering coverage for some or all contraceptives must provide participants with notices disclosing the change. This guidance comes in the form of Frequently Asked Questions ("FAQs") issued by DOL in the wake of the Supreme Court's decision in Burwell v. Hobby Lobby. (See the Alert of 7/10/14.) The FAQs clarify that the reduction or elimination of contraceptive coverage triggers an obligation to provide the notice no later than 60 days after the plan's adoption of the modification.

 

Background. PPACA requires all non-grandfathered group health plans to cover certain preventive services at no cost to participants. HHS has identified 20 FDA-approved contraceptives as being covered under PPACA's preventive services mandate.

 

In Hobby Lobby, the Supreme Court decided that PPACA's contraceptive mandate imposed a substantial burden on the religious beliefs of the plaintiffs (i.e., owners of a closely held corporation) by requiring them to engage in conduct that violates their religious beliefs. Accordingly, the Court ruled that the plaintiffs did not have to comply with the contraceptive mandate. However, the Court indicated that the scope of its opinion was very limited and that publicly-traded corporations would probably be unable to claim the exemption.

 

ERISA generally requires group health plans to disclose information relevant to coverage of preventive services, including contraceptive coverage. In particular, DOL regulations provide that the group health plan's summary plan description ("SPD") must include a description of the extent to which preventive services, including contraceptive services, are covered. Thus, if a plan excludes certain contraceptives from coverage, the SPD must describe this limitation.

 

Disclosure Requirements. The FAQs clarify that an amendment to a group health plan that reduces or eliminates contraceptive coverage is a material reduction in covered services that requires expedited disclosure. Specifically, these rules require group health plan administrators to disclose, by means of a new SPD or a Summary of Material Modifications, the reduction in services no later than 60 days after the plan adopts the amendment implementing the change. In the context of the Hobby Lobby decision, a group health plan that is amended to reduce or eliminate contraceptive services must provide notice of this modification to participants and beneficiaries within 60 days after the amendment's adoption.

 

Generally, a 60-day advance notice of the change would not be required because the change would not affect the information in the Summary of Coverage and Benefits.

 

Action Steps for Plan Sponsors. Although the FAQs do not impact most employers subject to PPACA, closely-held employers with religious objections towards providing contraceptive coverage are advised to seek counsel from qualified employee benefits practitioners before eliminating or reducing contraceptive coverage. Employers that do redesign or amend their group health plan to eliminate contraceptive coverage must be sure to timely and adequately disclose the change to plan participants and beneficiaries.

 

The FAQs can be accessed at: http://www.dol.gov/ebsa/pdf/faq-aca20.pdf

 

 

 

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Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.