Client Services / Employee Benefits & Pensions / Welfare Benefit Plans

Welfare Benefit Plans

McDermott Will & Emery’s Welfare Benefit Practice Group advises clients on the design and administration of health, welfare and other fringe benefit plans.   The team is anchored by partners who have over sixty years of collective experience in counseling clients on health and other group benefit plan compliance matters.  They are uniquely qualified to help you manage the growing legal complexity associated with the design and administration of your health, welfare and other fringe benefit plans.

As part of our Employee Benefits Department, which has been recognized as a leader in this field, our Welfare Benefit Practice Group helps our clients navigate the requirements promulgated by a variety of laws and regulations, including ERISA, COBRA, HIPAA, the Internal Revenue Code and other federal laws.  Among our many services we:

  • Audit and identify plan gaps, find alternative strategies and implement appropriate measures
  • Review and evaluate plan design and funding changes and help to limit exposure to litigation through thorough and accurate documentation
  • Evaluate, negotiate and review vendor contracts
  • Advise on fiduciary issues and seek prohibited transaction exemptions
  • Anticipate or manage IRS, DOL or HHS audits
  • Assist clients with the issues raised in the purchase or sale of business operations.

Regulatory Compliance

The requirements imposed on health and welfare plans by ERISA, COBRA, HIPAA, the Internal Revenue Code and other federal laws are significant and far-reaching.  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 and welfare plans, including the adoption of new consumer-driven health plan designs (such as health reimbursement arrangements and health savings accounts) and changes to retiree health plans.   Plan participants increasingly are using the courts to litigate benefit disputes and succeeding where plan documents are unclear or insufficient.  We review and evaluate plan design and funding changes for active and retired employees and, working closely with our ERISA Litigation Group, can limit exposure to spurious litigation by ensuring that plans are accurately documented.

Contract Review

Employers administer their health and welfare plans primarily through vendor contracts.  We can help review, evaluate and negotiate vendor contracts, including business associate agreements required by HIPAA.

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, the permissible uses of commissions and other assets (such as insurance company demutualization proceeds) and whether certain arrangements are impacted by the prohibited transaction rules.  We help our clients avoid fiduciary problems by providing them with a comprehensive process to follow when dealing with fiduciary decisions.  If an arrangement is a prohibited transaction, we are well equipped to assist in filing for a prohibited transaction exemption.  For prohibited transactions that may have occurred, we have extensive experience negotiating with the Department of Labor and/or the Internal Revenue Service. 

Government Audits

The federal agencies that regulate health and welfare plans are devoting increasing resources to compliance audits.  These audits are designed to expose compliance gaps and assess monetary penalties.  Given the multitude of regulatory releases in recent years, employers without a dedicated compliance strategy run the risk that government regulators will uncover areas of exposure.  We can identify and correct compliance issues before they are identified by the government.  We also have extensive experience in helping our clients through audits conducted by the Internal Revenue Service, the Department of Labor and the Department of Health and Human Services.

Claims Processing and Litigation Avoidance

The Department of Labor has significantly changed the framework for processing and responding to benefit claims.  Health and welfare plans are increasingly deluged with difficult benefit claim issues that now must be processed more quickly and with more care.  We can help you review your claim and appeal documents and procedures, and develop strategies that may aid in avoiding costly future litigation.

Business Transactions

The purchase or sale of business operations frequently requires initial, transitional and long-term changes to health and welfare benefit plans.  We can help you conduct due diligence prior to a purchase or sale, and assist you in working through the transitional and long-term changes necessary to adjust your plan designs.

Our partners are committed to thoroughly understanding our clients business needs and working with them to achieve their goals. We work with our clients to design the best possible benefits plan package for them and their employees.

Contacts

Employee Benefits & Pensions Client Services

McDermott Will & Emery

McDermott Will and Emery