November 15, 2019

November 14, 2019

Subscribe to Latest Legal News and Analysis

November 13, 2019

Subscribe to Latest Legal News and Analysis

November 12, 2019

Subscribe to Latest Legal News and Analysis

Court Puts Association Health Plans in Limbo

On March 28, a District of Columbia federal court agreed with a New York-led challenge by a group of 11 states and the District of Columbia and found that the Department of Labor’s (DOL) 2018 association health plan (AHP) rule (the Final Rule):

  1. Is contrary to the Employee Retirement Income Security Act of 1974 (ERISA)’s text and purpose; and 

  2. Circumvents the protections and standards of the Affordable Care Act (ACA).

The decision, penned by Judge Bates, may act to deal a significant blow to the Trump administration’s attempt to expand coverage for small employers. Crafted in response to the October 12, 2017, executive order directing the DOL to promote the availability of AHPs, the Final Rule materially relaxed the standards for qualifying as an AHP under ERISA.

As further described here, the Final Rule sets forth the criteria pursuant to which a “bona fide group or association of employers” may establish a single-employer AHP under ERISA. Under the Final Rule, employers, associations and sole proprietors (referred to as “working owners”) can participate in AHPs provided certain arguably subjective requirements are satisfied. The states challenged the Final Rule, arguing that the DOL unreasonably expanded ERISA’s definition of employer. Applying the Chevron standard, the court agreed with the states to hold that the DOL unlawfully expanded ERISA’s definition of employer by failing to provide a “meaningful limit on the associations that would qualify as ‘bona fide’ ERISA ‘employers.’” The court vacated the bona fide association and working owner provisions of the Final Rule, but also provided some specific critiques and ordered the DOL to determine whether any part of the Final Rule can be salvaged; for now, the Final Rule is in limbo. 

In a set of Questions and Answers issued April 2, 2019, the DOL noted that it disagrees with the court’s decision, and is considering all available options in consultation with the Department of Justice (DOJ). The DOJ has until May 28 to file a notice of appeal. The Trump administration could seek a stay of the order pending resolution of any appeal. Unless a court issues a stay, the regulations in effect prior to the Rule would be in effect. Stay tuned for further guidance and developments.

© 2019 McDermott Will & Emery

TRENDING LEGAL ANALYSIS


About this Author

Megan Mardy Attorney McDermott Will Emery
Associate

Megan Mardy is an associate in the law firm of McDermott Will & Emery LLP and is based in the Firm's Chicago office.  Megan focuses her practice primarily on designing, amending and administering 401(k) plans, profit sharing plans, pension plans, cafeteria plans and welfare benefit plans.  She also has experience counseling clients regarding compliance with HIPAA, the Affordable Care Act, and other federal laws affecting group health plans.  Megan has counseled privately and publicly-held corporations and tax-exempt entities regarding fiduciary issues under ERISA, employee benefits...

312-984-7623
Jacob Mattinson Employee Benefits Attorney
Associate

Jacob M. Mattinson focuses his practice on employee benefits and matters related to 401(k), 403(b), pension, executive compensation, health care reform, and cafeteria and welfare plans.

Jacob assists clients in drafting employee benefit plan documents and amendments. He represents clients in matters before the Internal Revenue Service (IRS), US Department of Labor (DOL) and Pension Benefit Guaranty Corporation with respect to plan qualification issues. He also counsels privately and publicly held corporations and tax-exempt entities on a variety of benefits and Employee Retirement Income Security Act (ERISA) issues, including ERISA fiduciary issues, compliance with the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA), ERISA implications in corporate transactions, ERISA administrative claims and appeals, and executive compensation matters.

While in law school, Jacob was editor in chief of the Penn State Law Review. In addition, Jacob served as a legal intern for the Honorable Judge Renee Cohn Jubelirer of the Commonwealth Court of Pennsylvania. Jacob is the Chairperson of the Young Professionals Board of Equip for Equality. Internally, Jacob serves on the Firm’s Pro Bono and Community Service Committee.

312-984-3263
Judith Wethall, McDermott Law Firm, Chicago, Labor and Employment Law Attorney
Partner

Judith Wethall focuses her practice on employee benefits, specifically health and welfare programs. She counsels employers, plan administrators, insurers and consultants on a wide range of ERISA compliance issues. Judith's clients include sole proprietors to Fortune 100 companies and cover a variety of industries including health care, technology, manufacturing, insurance and financial.

Judith has extensive experience advising clients on health care law reform; wellness programs; Medicare secondary payor rules; fiduciary compliance; disability...

312-984-7577
Emily Rickard, McDermott Will Emery, Employee Benefits Matters Lawyer, ERISA Litigation Attorney
Associate

Emily Rickard is an associate in the law firm of McDermott Will & Emery and is based in the Firm’s Washington D.C. office. She focuses her practice on employee benefits matters.

Outside of the ESOP context, Emily’s practice spans a wide range of national and international employee benefits matters. This includes qualified plans, nonqualified plans, executive compensation, health and welfare arrangements, and Employee Retirement Income Security Act of 1974 (ERISA) litigation. She advises employers in connection with fiduciary issues under...

202 756 8370