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Archive for May, 2019

ERISA Plaintiffs Continue Their Assault on Major Universities, but Every ERISA Fiduciary is Vulnerable

Posted on: May 15th, 2019

By: John H. Goselin II

Beginning in August 2016, the ERISA Plaintiffs’ Bar launched a concerted attack on more than 20 major universities across the country filing class action lawsuits for alleged violations of ERISA fiduciary duties under ERISA Section 404 and alleged participation in ERISA prohibited transactions under Section 406.

Each side has won significant victories. Duke University, the University of Chicago and Vanderbilt University have capitulated and are paying six and seven-figure class action settlements. The University of Rochester and Long Island University fought until the plaintiffs simply walked away earlier this year. Northwestern University, New York University, Washington University and the University of Pennsylvania won impressive victories at the motion to dismiss stage.

But the battle is never over at the district court level. The United States Court of Appeals for the Third Circuit has provided new life to the plaintiffs bringing suit against the University of Pennsylvania, albeit only for 2 of the 7 counts that were originally alleged. Sweda v University of Pennsylvania, 2019 U.S. App. LEXIS 13284 (No. 17-3244, May 2, 2019). Not only does this reversal present new risks for the University of Pennsylvania, but it may put a damper on lower courts willing to dismiss these class action lawsuits.

The Third Circuit rejected a per se rule that would protect plan fiduciaries who provide a “mix and range of investment options” to plan participants. Instead, the Third Circuit held that Plaintiff Sweda had plausibly alleged that the defendants had “failed to conform to the high standard required of plan fiduciaries [under ERISA Section 404(a)(1)]” by alleging that (i) the recordkeeping fees were 6-7 times greater than the fees paid by similar plans, (ii) defendants failed to solicit competitive bids for recordkeeping and other plan services or (iii) defendants failed to hire an independent consultant to assess the plan’s administrative costs. Furthermore, the University of Pennsylvania Plan maintained high-cost investment options with historically poor performance compared to available alternatives, particularly the ongoing use of retail mutual fund shares when lower-cost institutional shares were available, but never adopted by the plan.

It is important to note that the claims being asserted against the universities apply to every business that maintains a 401(k) plan, or other ERISA investment plan, for their employees. The employer as a plan sponsor and the named and functional fiduciaries administering the plan will be held to the “prudent man” standard of care which requires all plan fiduciaries to exercise “the skill, care, prudence, and diligence under the circumstances then prevailing that a prudent man acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims.”

In short, the structure and administration of an ERISA plan must be continually reviewed, evaluated and modified to reflect the prevailing better/best practices. Plan sponsors and individual fiduciaries should develop a process of continuing and ongoing education regarding (i) what is expected of ERISA fiduciaries and (ii) the available options in the market place. Furthermore, plan fiduciaries must have a documented process pursuant to which they periodically evaluate the ERISA plan(s) for which they are responsible and make changes when necessary and appropriate.

Once the ERISA Plaintiffs’ Bar is done with the universities, they will be looking for their next targets.

If you have any questions or would like more information, please contact John Goselin at [email protected].

Are You Prepared To Grant Intermittent Family Medical Leave?

Posted on: May 14th, 2019

By: David Daniels

One of the biggest employer complaints about the Family and Medical Leave Act (FMLA) is the productivity problems caused by employees’ use—and abuse—of FMLA intermittent leave.

The problem: Employees with chronic health problems often take FMLA leave in short increments of an hour or less.

The Department of Labor (DOL) took a big step to help minimize workplace disruptions due to unscheduled FMLA absences in its revised regulations, which took effect in 2009. The DOL says that, in most cases now, employees who take FMLA intermittent leave must follow their employers’ call-in procedures for reporting an absence, unless there are unusual circumstances.

Tracking Intermittent FMLA Leave

Even though managing FMLA intermittent leave can be vexing, the law does give employers some tools to combat leave abuse.

As with leave taken in one block, employees requesting FMLA intermittent leave must provide his or her employer with notice. Employees must give at least 30 days’ notice when their need for FMLA leave is foreseeable. When it’s not, they must notify you “as soon as practicable.”

A. Certify and schedule the leave.

Don’t accept FMLA requests at face value. The law gives employers the right to demand certification from the employee’s doctor of his or her need for leave. An employer can request new medical certification from the employee at the start of each FMLA year. The law also entitles an employer to ask for a second or third opinion, if necessary, before granting leave.

When employees have chronic conditions and their certifications call for FMLA intermittent leave, an employer should attempt to work out leave schedules as far in advance as possible. It’s legal to try to schedule FMLA-related absences, but an employer can’t deny them.

It’s important to immediately nail down the expected frequency and duration of FMLA intermittent leave. An employer can insist on a medical provider’s estimate of how often the employee will need time off. An employer also can wait until the provider gives an estimate to approve intermittent leave.

B. Intermittent Leave Tips.

  • Ask about the specific condition. Medical certification must relate only to the serious health condition that is causing the leave. An employer can’t ask about the employee’s general health or other conditions.
  • Allow 15 days to respond. After an employer requests certification, the employer should give employees at least 15 calendar days to submit the paperwork. If the employee’s medical certification is incomplete or insufficient, specify in writing what information is lacking and allow the employee seven days to cure the deficiency.
  • If an employer doubts the need for leave, it should investigate the certification. Under the updated FMLA regulations, the employer can contact the employee’s physician directly to clarify the medical certification. The employer’s contact person can be a health care provider, a human resources professional, a leave administrator (including third-party administrators) or a management official, but not the employee’s direct supervisor.
  • If an employer is still not convinced, it can require (and pay for) a second opinion. The employer should use an independent doctor who it selects, not a doctor who works for the employer. If the two opinions conflict, an employer can pay for a third and final, binding medical opinion.

Employees who take FMLA intermittent leave can wreak havoc with work schedules. Because their conditions can flare up at any time, their absences are by nature unpredictable. But there are ways you can legally curtail intermittent leave.

C. Use the Calendar-year Method.

Employees who take FMLA intermittent leave can wreak havoc with work schedules. Because their conditions can flare up at any time, their absences are by nature unpredictable. But there are ways you can legally curtail intermittent leave.

One way is to use the calendar-year method to set FMLA leave eligibility.

Here’s how it works. Sometime during the calendar year, an employee submits medical documentation showing she will need intermittent leave for a chronic condition. If she is eligible for leave at that time, she can take up to 12 weeks of intermittent leave until the end of the calendar year.

Then the process starts again.

If, on Jan. 1, she hasn’t worked 1,250 hours in the preceding 12 months, she’s no longer eligible—and won’t be eligible again until she hits 1,250 hours.

Final tip:  Employees who are approved for FMLA intermittent leave can take that time off as needed. But that doesn’t mean an employer isn’t entitled to some supporting documentation for each absence. An employer can ask for proof that the absence was for the chronic condition—but a simple doctor’s note to that effect should suffice. No new formal certification is required.

Wait until the end of your FMLA leave year to get the new intermittent-leave certification.

This is only a short primer on FMLA leave laws which can be a trap for the unwary employer. David Daniels the managing partner of the FMG Sacramento office. Please feel free to contact him at (916) 765-2570 ([email protected]) should you wish to further discuss the FMLA or any other areas of employment law at your convenience.

DOJ Issues Guidance for Cooperation Credit in False Claim Act Investigations

Posted on: May 10th, 2019

By: Michael Bruyere

The Provider Self-Disclosure Protocol was created in 1998 to encourage providers to voluntarily disclose self-discovered evidence of potential fraud. According to  OIG-HHS, self-disclosure (now commonly referred to as voluntary disclosure) gives providers the opportunity to avoid the costs and disruptions associated with a government-directed investigation and civil or administrative litigation.

From a provider’s perspective, implementing the Protocol initially was fraught with the perils of exposure to significant civil monetary penalties, including  the so-called “Death Penalty” or exclusion of the provider from certain federally funded programs, such as Medicare. Similarly, the original Protocol and subsequent revisions were unclear as to how a disclosing party would receive credit or favorable consideration in exchange for informing DOJ of potential misconduct.

On Tuesday, DOJ released its much-anticipated formal guidance for companies considering voluntary disclosure of potential misconduct. Seehttps://www.justice.gov/jm/jm-4-4000-commercial-litigation#4-4.112. “The Department of Justice has taken important steps to incentivize companies to voluntarily disclose misconduct and cooperate with our  investigations; enforcement of the False Claims Act is no exception,” according to Assistant Attorney General Jody Hunt.

“Cooperation credit,” according to DOJ, may be earned by participating in the disclosure Protocol or taking appropriate remedial measures once a violation has been identified. Examples of credit-earning actions include disclosing misconduct to the government beyond the scope of any ongoing investigation, preserving records and information above minimum requirements set by law or business practices, or facilitating the review by providing access to special or proprietary technologies.

Providers may expect to receive cooperating credit, most commonly, in the form of “a reduction in the damages multiplier and civil penalties.”

Any provider that discovers potential misconduct must immediately and thoroughly investigate the conduct and take whatever remedial steps are necessary to limit or eliminate any consequences to the federal government. DOJ’s guidance announced Tuesday should be scrutinized by compliance personnel and include in ever provider’s compliance program for voluntary disclosures.  The new guidance is a step toward allowing providers to better evaluate the risks versus benefits of essentially inviting the government to examine billing history and practices.  And the new credit opportunities also underscore the need for a provider to fully appreciate whether the suspected misconduct is actually a violation of federal law or simply a practice that requires improvement.

If you have any questions or would like more information, please contact Michael Bruyere at [email protected].

It is Time to Clean House – The Client Break-Up

Posted on: May 8th, 2019

By: Nancy Reimer

The end of tax season is an opportune time for certified public accounting firms to review their client roster to ensure existing clients are a good fit with the firm’s mission and culture. CPA’s are taught to exercise due diligence when accepting new clients. For example, a firm will  assess whether it has the required knowledge and skill to perform the work, whether the client’s expectations are reasonable, does its management team exhibit integrity and trustworthiness, had the client changed CPA’s often, is it negotiating down the fee, hesitant to pay a retainer, is the client delinquent in filing or does the client keep its records in poor condition? If satisfied with the answers, a firm will accept the client.

Once clients are in the door, however, should they stay? Is it difficult to get information timely from the client, does the client haggle over fees, fail to pay, act abusive towards staff, fake or inflate numbers to avoid tax payments or penalties, lack proper internal control or consistently fail to follow advice?

What about changes in the firm that may make servicing the client difficult? New technologies may make it difficult for certain clients to keep up, some clients may not be comfortable with online organizers and electronic engagement letters. Perhaps there is a staff-turnover losing technical expertise to perform certain services; or the cost of offering a service may outweigh the revenue generated by the service.

Firms should meet on an annual basis to review the direction of the practice and the client roster. It should determine how many clients it can comfortably serve, what services it performs best or at the highest rate of profit and the profile its ideal clients.  Problem or “toxic” clients should be terminated.

Once a firm has determined which clients it needs to terminate, it should devise a strategic plan for doing so. It is always a good practice to notify the firm’s insurer and liability carrier of its intent to terminate clients. Liability insurers may want to be informed of potential claims if a disgruntled client is terminated. Insurer’s loss prevention teams are experienced in terminating clients and may offer advice as to how to disengage a “problem” or “toxic” client.

Best practices dictate a disengagement letter sent by certified mail, return receipt requested is the best way to terminate a client. If, however, the client has formed a close personal relationship with a member of the firm then a face to face meeting may be warranted. Then a follow-up letter documenting the meeting should be sent.

Prior to notification, the firm should ensure all required documents are copied or scanned, all documents and authorizations are signed, all fees are paid (if possible) and all client documents are packaged and available for pick-up. Also, prepare the transfer authorization letter ahead of time for the client’s signature so the file can immediately be transferred to the successor CPA.

The disengagement letter need not identify any specific reason for the termination. Ideally, there are no impending, or tax filing, deadlines. If there are the firm should list those deadlines and what needs to be done to comply with the deadline. It is also a good idea to list all of the services the firm had performed for the client. If any projects are in progress, identify the stage of the project and what is necessary for completion.  The disengagement letter should identify the client’s responsibilities moving forward and issues to be addressed with the successor CPA. Finally, the firm should state it will assist in transferring the files to the successor CPA in accordance with the firm’s professional obligations.

If you have any questions or would like more information, please contact Nancy Reimer at [email protected].

New Federal Test Relaxes Standards for Unpaid Internships

Posted on: May 6th, 2019

By: Zinnia Khan

In a recent announcement, the U.S. Department of Labor loosened the Obama-era federal test for determining if an intern should be classified as an employee. That is good news for employers, although there still remain other potential risks for employers including inadvertent misclassification of interns and stricter state laws.

The new standard, known as the “primary beneficiary” test, examines whether unpaid interns or their employers get the primary benefit of the internship. If the intern gets the primary benefit, he or she may be unpaid. The test has seven equivalent factors, which include the degree to which both parties recognize the work is unpaid and whether the internship is for academic credit. The DOL has added whether an intern or student is an employee under the Fair Labor Standards Act necessarily depends on the unique circumstances of each case. For a program to satisfy the new test, there must be an emphasis on the educational benefit to the intern, which often means the intern receives academic credit for the internship.

At the same time, unpaid internships for public sector and nonprofit charitable organizations, where the intern volunteers are working without expecting to be paid, are generally acceptable.

Previously, employers were required to look to a six-factor test for determining intern status. Generally speaking, if any single factor went against the employer, it had to pay the intern. One particularly challenging requirement of the old test was that employers could not properly classify a worker as an unpaid intern if the employer derived “immediate advantage” from the individual’s work.

Although the new test is less stringent than its predecessor, there are still risks of misclassification. The FLSA authorizes misclassified interns to bring suit for back pay, liquidated damages and attorney fees. Furthermore, some states may continue to have more rigorous tests for unpaid interns under their own wage and hour laws.  Employers must adhere to the strictest requirements in each state where they have employees.

As a result of these additional considerations, employers need to be comfortable when using interns that they can satisfy their burden in establishing the individual truly is an intern, even under the more relaxed test. Useful steps that could mitigate an adverse determination include hiring interns who receive academic credit, memorializing the unpaid nature of the internship in a written offer letter and creating a formal internship program that coordinates with the intern’s academic schedule.

If you have any questions or would like more information, please contact Zinnia Khan in the National Labor & Employment Practice Section at [email protected].