Health & Welfare Plans

Raising the Bar on Health and Welfare Benefits

Rising costs, increased government requirements, and ever-evolving plan designs have made health and welfare programs among the most dynamic of employee benefits. Spiraling health care costs keep challenging employers' efforts to manage plan expenses and, as the Internal Revenue Service (IRS) continues to impose greater restraints on employers, plan administrators face increased regulatory oversight, typified by the strict rules governing Health Savings Accounts (HSAs) and recently issued cafeteria plan regulations. Legislators and regulators are feeling added pressure to tackle the challenge of the nation's uninsured, prompting questions about the potential impact on employers and health plans. Some states are already taking action, often placing new financial and administrative burdens on employers in the process. Public expectations of health care reform under the Obama Administration are adding an extra level of uncertainty.

An Outstanding Blend of Talent and Experience

Miller & Chevalier's unique mix of health and welfare, employee benefits, ERISA litigation, and tax capabilities distinguishes our work, as does the combined strength of our technical resources and government experience.

An integral part of our nationally recognized Employee Benefits practice, our Health and Welfare Plans lawyers address both our clients' planning and policy needs. We advise clients on the range of health and welfare benefit plan issues. We are also their advocates before federal regulatory and legislative bodies and guide them in dealing with important developing issues.

Our clients are among the largest and most sophisticated companies in the world: discerning employers and health plans that value working with a proven leader in the field of employer-sponsored health and welfare benefits. We work with clients to manage all aspects of these plans, helping them reduce costs through strategies that advance their business objectives and mitigate risk. We design plans and practices today that will help avoid litigation tomorrow. To that end, the concrete experience of our litigators is an invaluable benefit to our consulting clients.

Go-To Counsel for Creative Solutions

Our Health and Welfare Plans team is uniquely positioned to help clients design innovative plans and integrate best practices. Our lawyers have reviewed and advised on a multitude of plans across a variety of industries. They are recognized as thought leaders in health and welfare plan issues and are often invited to write and speak on new and emerging issues.

We provide comprehensive assistance to our clients in designing and administering their health and welfare plans. Among other matters, our lawyers regularly:

  • analyze and advise on new regulations and guidance from the IRS and the U.S. Departments of the Treasury, Labor (DOL), and Health and Human Services, Centers for Medicare and Medicaid Services (CMS), and the Equal Employment Opportunity Commission (EEOC);
  • analyze and advise on state health reform initiatives affecting employers;
  • handle plan issues associated with mergers and acquisitions and post-merger integration;
  • advise on consumer-driven health care (CDHC) strategies, including designing and implementing high deductible health plans (HDHPs) and HDHP/HSA/HRA (Health Reimbursement Agreement) combinations;
  • advise on design, compliance, and risk issues associated with retiree health plans and Medicare Part D, including the employer Retiree Drug Subsidy (RDS);
  • advise on the structure and administration of cafeteria plans, including premium-only plans; health, dependent care, and adoption assistance FSAs; and fully-flexible benefit plans;
  • advise on plan-funding vehicles, including voluntary employees' beneficiary association trusts (VEBAs);
  • design and review wellness and disease management programs;
  • advise on educational assistance, tuition reimbursement, and scholarship assistance programs;
  • prepare plan documents, summary plan descriptions (SPDs), and employee communications;
  • evaluate and negotiate vendor service contracts and HIPAA business associate agreements;
  • advise on day-to-day plan administration issues, such as HIPAA, COBRA, FMLA, USERRA, definition of dependent, coverage of domestic partners, fiduciary matters, and other tax and ERISA issues;
  • respond to reporting questions related to Form 5500, W-2, and HSAs;
  • advise on nondiscrimination issues for self-funded medical plans, cafeteria plans, dependent care FSAs, life insurance plans, and HSA comparable contribution requirements; and
  • conduct comprehensive operational compliance reviews ("mock-audits") and design appropriate strategies for correction as needed.

We also have considerable experience advising clients on the Federal Employees Health Benefit Program (FEHBP).

The Value of Government Know-How

Our clients frequently ask us to represent their interests in health and welfare and other employee benefits matters in the federal legislative and regulatory process. We promote their positions before Congress, the Departments of the Treasury, Labor (DOL), and Health and Human Services, the IRS, CMS, and the EEOC. We also provide strategic advice on issues emerging from House Committees on Education and Labor and Ways and Means and Senate Committees on Finance and Health, Education, Labor, and Pensions.

Miller & Chevalier lawyers are recognized in government for their subject matter knowledge, their integrity, and their policy acumen. Moreover, the experience of our many lawyers who have served previously in senior positions in government, including as IRS Commissioner, as Special Assistant for Fringe Benefits in the office of IRS Associate Chief Counsel, as IRS Deputy Chief Counsel (Operations), and as Majority Tax Counsel for the House Committee on Ways and Means, offers a distinct advantage to our clients.

We recognize that getting information early is very helpful to employers in planning and shaping their health and welfare programs. Accordingly, we pay exceptional attention to keeping our clients informed, using up-to-the-minute alerts and timely teleconferences and workshops. We brief clients on the latest regulatory developments and trends, including their impact on employers and service providers, and are often able to alert clients to developments well in advance of their formal publication or announcement.

Unparalleled Experience in Agency Representation

Miller & Chevalier's experience resolving issues at the agency level is unmatched. Our long-standing relationships within the IRS, DOL, and CMS make us particularly effective in negotiating solutions to clients' unique issues. Our lawyers have extensive experience negotiating plan corrections and settlement agreements, resolving important and difficult matters quickly and on terms favorable to our clients.

Handling audits at the agency level is a significant aspect of our core practice. We have a long and successful record helping our clients plan for audits and manage the range of audit issues. We have obtained outstanding results for our clients at every stage of the audit process. Our clients routinely engage us to help them develop strategies for issues that have been raised during an audit, as well as to identify other areas of risk.

We advise our clients on a comprehensive range of issues, including responding to information document requests, complying with formal document requests, and dealing with specific audit adjustments proposed by examining agents. Where an agency program may not be the best option for meeting a client's goals, we are equally experienced addressing issues in other regulatory venues or, where legislative solutions apply, in Congress.

Formidable Litigation Resources

We believe in exploring all relevant options to help our clients avoid the costs and public scrutiny of litigation. However, when litigation is necessary, companies with multi-million dollar amounts in controversy choose Miller & Chevalier for our capabilities, our approach to litigation, and our record of achievement in court. They know that we are forceful advocates who will defend them vigorously and persuasively.

The contributions of two of Miller & Chevalier's leading practices differentiate our Health and Welfare Plans experience and are a considerable asset to our consulting clients:

  • The extensive experience of our ERISA litigators in the fine points of ERISA controversy, including, in particular, ERISA preemption and subrogation, helps us create plans, documents, and administrative practices more likely to withstand scrutiny.
  • Medicare Part D has introduced new risks for plan administrators, with Retiree Drug Subsidy claim inaccuracies triggering potential action by the Department of Justice under the False Claims Act. Our False Claims lawyers help companies steer clear of, mitigate, and resolve these and related issues.

Of course, clients who engage us to defend actions under ERISA or the False Claims Act know that they will have the benefit of a carefully selected team that includes the precise mix of substantive and litigation skills for their particular circumstances.

Finally, our lawyers regularly draft amicus briefs on behalf of our clients in support of important issues before the appellate courts. The lawyers in Miller & Chevalier's Supreme Court and Appellate practice bring considerable experience to this task. Our appellate capabilities, and our record of litigating cases on similar issues, is a marked advantage in developing compelling, effective technical and policy arguments for our clients' positions.

Representative Engagements|View All
  • Currently represent employers and health insurance companies to implement and address compliance questions arising from the American Recovery and Reinvestment Act of 2009 (ARRA) COBRA subsidy. Work closely with the Departments of the Treasury and Labor and the Internal Revenue Service as guidance is being developed to provide insight regarding agency interpretation of client-specific issues.
  • Advised a Fortune 100 company regarding the application of, and implementation of procedures in compliance with, Medicare Secondary Payer mandatory reporting requirements.
  • Provide Washington, D.C. representation for an insurance company during the current health reform debate, including monitoring and analyzing proposed legislation, drafting materials for Capitol Hill briefings, and representing client’s interests in meetings with members of Congress and their staffs.
  • Provide advice to health insurance companies on qualifying and correcting high deductible health plans under Section 223. Helped secure a settlement agreement with the IRS to resolve qualification issue.
  • Helped several health plan and employer clients design wellness programs that comply with HIPAA, ERISA, the Internal Revenue Code, and the Americans with Disabilities Act.
Government Experience
Corporate Experience
Rankings and Recognition
  • Chambers USA: Employee Benefits & Executive Compensation Team of the Year, 2015
  • Legal 500: Employee Benefits & Executive Compensation Team of the Year (U.S.), 2015
  • Chambers USA: Employee Benefits & Executive Compensation (National), 2015 - 2016
  • Chambers USA: ERISA Litigation (National), 2015 - 2016
  • Chambers USA: Employee Benefits & Executive Compensation (District of Columbia), 2008 - 2016
  • Legal 500: Labor & Employment:  Employee Benefits & Executive Compensation (U.S.), 2010 - 2016
  • U.S. News -- Best Lawyers® "Best Law Firms":  Employee Benefits (ERISA) Law (National), 2013 - 2016
  • U.S. News -- Best Lawyers® "Best Law Firms":  Employee Benefits (ERISA) Law (District of Columbia), 2010 - 2016