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DOL Proposes New Claims Procedures for Disability Benefits

On November 18, 2015, the U.S. Department of Labor (“DOL”) published proposed amendments to the claims procedure regulations under ERISA with respect to claims for disability benefits. Generally, these amendments have the effect of extending to disability benefit claims several of the procedural protections that were added by the Affordable Care Act for health benefit claims, particularly regarding internal claims and appeals under group health plans (e.g., providing expanded benefit denial notices written in a culturally and linguistically appropriate manner). If the proposed regulations are adopted as final, administrators of plans providing disability benefits would be required to implement these enhanced claims and appeals procedures. The proposed regulations are available here.

DOL Proposes New Definition of Fiduciary Regulation Related to Investment Advice

On April 14, 2015, the DOL issued a comprehensive package of proposed regulations and related guidance designed to protect retirement plan sponsors, participants, and IRA owners from perceived conflicts of interest in the retirement investment advice industry. As part of the DOL’s “Conflicts of Interest” proposal, a new regulation defining who is a “fiduciary” by reason of giving investment advice to retirement plan investors (including IRA owners) has been proposed to replace the current regulation defining a fiduciary in the retirement investment advice context, which was issued in 1975. The proposed regulation would significantly broaden the number of advisors subject to a fiduciary standard by expanding the scope of what is considered investment advice. There are some notable “carve-outs” from the definition of investment advice, such as for investment education and sales pitches to fiduciaries of large plans. Links to the proposed regulations, a news release, FAQs, and a fact… Continue Reading

DOL Proposes to Revise “Spouse” Definition for FMLA Purposes

The U.S. Department of Labor (the “DOL”) has issued a notice of proposed rulemaking regarding a revision to the definition of “spouse” under the Family and Medical Leave Act of 1993 (“FMLA”).  The revision is being proposed in light of the U.S. Supreme Court’s decision in United States v. Windsor, which held Section 3 of the federal Defense of Marriage Act, restricting the definition of “marriage” for federal law purposes to opposite-sex spouses, to be unconstitutional.  Under the FMLA, eligible employees are permitted to take a leave of absence to care for a spouse in certain situations.  Current regulations under the FMLA define “spouse” based on the law of the state in which the employee resides; consequently, a same-sex couple who is married in a state or foreign jurisdiction that allows same-sex marriage is not treated as married under the FMLA if they reside in a state that does not recognize… Continue Reading

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