June 27, 2022

Volume XII, Number 178

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June 27, 2022

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DOL Delays “Final Rule” for ERISA Disability Benefits

On November 29, 2017, The Department of Labor delayed through April 1, 2018, the applicability of a Final Rule amending the claims procedure requirements applicable to ERISA-covered employee benefit plans that provide disability benefits. The purpose of the Final Rule was to add procedural protections and safeguards similar to those applicable to group health plans under the Affordable Care Act. In a nutshell, the Rule would require that plans providing disability benefits ensure all claims are adjudicated in a manner designed to ensure independence and impartiality, certain disclosure requirements, the right to review and respond to new information before a final decision, and that if a plan fails to adhere to all the claims procedure rules, the claimant would be deemed to have exhausted administrative remedies and may pursue court action (unless a limited exception applies). Finally, the rules amended the definition of adverse benefit determination to include a rescission of disability coverage having a retroactive effect, unless it was due to failure to pay timely premiums.

The Final Rule became effective on January 18, 2017, and was slated to become applicable on January 1, 2018, in order to provide adequate time for disability benefit plans and their affected service providers to adjust to it, as well as for consumers and others to understand the changes made. Not long thereafter, certain stakeholders asserted in writing that the Final Rule would drive up disability benefit plan costs, cause an increase in litigation, and consequently impair workers’ access to disability insurance protections.

The delay now in place is to enable the Department of Labor to consider comments and data as part of its effort, pursuant to Executive Order 13777, to examine regulatory alternatives that meet its objectives of ensuring the full and fair review of disability benefit claims while not imposing unnecessary costs and adverse consequences. The comment period ends on December 11, 2017.

© Copyright 2022 Squire Patton Boggs (US) LLPNational Law Review, Volume VII, Number 335
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About this Author

Kristin Woliver, Labor Attorney, Squire Patton Boggs Law Firm
Associate

Kristine Woliver’s practice focuses primarily on labor and employment matters. Kristine assists clients with complex legal issues involving disability discrimination, wrongful discharge, non-compete agreements, and general employment policies and practices.

614 365 2792
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