Client Services / Health / Consumer-Driven Health Care

Consumer-Driven Health Care

McDermott Will & Emery’s Consumer-Driven Health Care (CDHC) Practice Group advises clients on the design and implementation of all varieties of CDHC plans. The team is anchored by partners in the Firm’s Health and Employee Benefits Departments who are uniquely qualified to provide counsel in navigating this complex legal area. CDHC Practice Group assists clients in the following areas:

Regulatory Compliance

The requirements imposed on health plans by ERISA, COBRA, HIPAA, the Internal Revenue Code and other federal laws are significant and far-reaching. Our lawyers have unique insight into how the existing legal framework applies to these innovative health plans. Our lawyers assist clients in determining how COBRA applies to CDHC plans, whether they are subject to the nondiscrimination rules and funding limits under the Internal Revenue Code and how to structure them for ERISA and HIPAA privacy compliance. We review plan documents, contracts and operations for legal compliance, identify compliance gaps, evaluate alternative compliance strategies and implement appropriate compliance measures.

Plan Design and Documentation

Employers frequently evaluate plan design and funding changes to their health plans, including the adoption of new CDHC plan designs (such as health reimbursement arrangements) that use spending accounts as a mechanism to provide employee and retiree medical benefits. We review and evaluate plan design and funding changes for active and retired employees and help our clients incorporate consumer CDHC plans into their existing ERISA welfare plan scheme. We can also assist in reviewing and drafting employee communications for these complex plans.

Contract Review

Providers play a prominent role in CDHC plans. McDermott Will & Emery lawyers provide contract review, evaluation, negotiation support and strategic guidance to providers with respect to CDHC plans and issues. Employers administer consumer CDHC plans primarily through vendor contracts. We can help prepare or review, evaluate and negotiate vendor contracts, including administrative services agreements and business associate agreements required by HIPAA. We also assist employers, insurers and CDHC plans in contracting and collaborative ventures with health information technology companies, disease management companies and decision support companies.

Fiduciary Responsibility

ERISA requires plan fiduciaries to choose service providers carefully and handle health and welfare plan assets appropriately. Employers frequently encounter questions about the payment of plan expenses, whether assets must be held in trust, the permissible uses of commissions and other assets and whether certain arrangements are impacted by the prohibited transaction rules. CDHC plans also raise novel fiduciary issues and potential liabilities. We help our clients avoid fiduciary problems by assuring that they understand their fiduciary responsibilities, and by providing them with a comprehensive process to follow to minimize the risk of liability when making fiduciary decisions.

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Health Client Services

McDermott Will & Emery

McDermott Will and Emery