Learn how to evaluate contracts for compliance with the gag clause attestation.
The Consolidated Appropriations Act of 2021 (‘CAA-21’) prohibits group health plans and health insurance issuers from entering into agreements containing “gag clauses,” and requires them to make an annual attestation of compliance with this prohibition. However, many group health plan sponsors are not sure what a ‘gag clause’ is or how to handle the attestation requirements This presentation will help human resources managers, benefits administrators, business owners and managers, how to evaluate contracts with health care providers, third-party administrators, pharmacy benefit managers, or networks/associations or providers for compliance with the gag clause attestation and how to make the attestation of compliance to the Department of Health and Human Services (‘HHS’).
The presentation also explains the detailed requirements of the Gag Clause Prohibition Attestation webform provided by HHS and where the attestation process can be outsourced to third parties. Plans and issuers that fail to timely submit the attestation may be subject to enforcement action and may also be subject to penalties of up to $100 per day for each day an attestation is not filed. This course is critical for any employer that sponsors a group health plan so they can ensure compliance and understand these significant requirements
Learning Objectives
- You will be able to discuss the process for providing gag clause attestation to HHS.
- You will be able to explain when attestation can be outsourced to third parties.
- You will be able to identify plans responsible for gag clause prohibition attestation.
- You will be able to recognize prohibited gag clauses in provider contracts.
Agenda
Background on the Gag Clause Prohibition
- Prohibition on Entering Agreements That Include Gag Clauses
- When Is the Prohibition Effective?
- What Is a Gag Clause?
- Why Did Congress Enact the Gag Clause Prohibition?
Reviewing Contracts for Compliance and Identifying Gag Clauses
- Determining What Benefits Are Subject to Compliance
- Identifying Gag Clause Language
- Typical Examples of Problematic Language
The Attestation Process
- How to Complete the CMS Webform on the Health Insurance Oversight System
- Coordinating With Service Providers on the Attestation Process
- Documenting Compliance
Consequences for Failure to Comply
- Penalties Under Internal Revenue Code
- Complaints Submitted to the No Surprises Help Desk
Speakers
Eric W. Gregory,
Dickinson Wright PLLC- Attorney in the Troy, Michigan office of Dickinson Wright PLLC
- Practice emphasizes all aspects of employee benefits and executive compensation law, including qualified retirement plans, welfare plans, and nonqualified compensation programs
- Regularly provides strategic advice and analysis on approaches for employers obligated to contribute to multiemployer pension funds to mitigate withdrawal liability risk
- Conducts regular seminars and workshops on numerous employee benefits issues such as pension and withdrawal lability risk during mergers and acquisitions, avoiding litigation risk for sponsors of retirement plans, and employer fiduciary duties under ERISA
- Written several publications related to employee benefits such as Surviving an IRS or DOL Retirement Plan Audit: Failing to Prepare is Preparing to Fail; Here Comes the Department of Labor: Retirement Plan Audits Begin for Code Section 401(a)(9) Compliance; and Avoiding Payroll Tax Traps for Foreign Employees
- Past chair of State Bar of Michigan Taxation Section’s Employee Benefits Committee, and past chair of Oakland County Bar Association Employee Benefits Committee
- Taxation Council Member, State Bar of Michigan Taxation Section
- Best Lawyers in America, Employee Benefits (ERISA) Law, 2020; Michigan Super Lawyers "Rising Star," 2016 – Present; Michigan Lawyers Weekly, Up & Coming Lawyers, Class of 2017; Business Magazine Top Lawyer, Employee Benefits Law, 2016 – Present
- LL.M. degree in taxation, Georgetown University Law Center; J.D. degree, Wayne State University; B.A. degree in political theory and constitutional democracy, Michigan State University, James Madison College; certificate in employee benefits law
- Can be contacted at 248-433-7669 or EGregory@DickinsonWright.com
Who Should Attend
This live webinar is designed for human resource managers, benefits administrators, attorneys, payroll managers, personnel managers, employee relations managers, accountants, controllers, CFOs, business owners and managers, presidents, and vice presidents.
