Preventive Care Coverage Requirements Under Health Reform

One consequence of losing grandfathered plan status in an employment-based group health plan is the requirement that specified preventive services must be covered on a "first dollar" basis. This means that the specified preventive care services may not be subject to a deductible, co-payment, or other cost-sharing requirement. The agencies jointly responsible for enforcing the Patient Protection and Affordable Care Act ("Affordable Care Act") -- the Internal Revenue Service, the U.S. Department of Labor Employee Benefit Security Administration, and the Department of Health and Human Services -- jointly published interim final regulations ("Regulations") relating to the coverage of preventive care services on July 19, 2010. The Regulations apply to new plans and to non-grandfathered group health plans for plan years beginning on or after September 23, 2010 (January 1, 2011, for calendar year plans).  Key aspects of the Regulations are explained below.

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Break Time For Nursing Mothers Under the FLSA - Balancing Obligations Under New York Law With New Federal Requirements

Yesterday, the US Department of Labor issued a fact sheet  that provides general information on the break time requirement for nursing mothers, part of the Patient Protection and Affordable Care Act which took effect March 23, 2010. While these amendments to the Fair Labor Standards Act (FLSA) represent a significant change for employers in many states, since 2007, New York employers have been required to provide reasonable unpaid break time, or permit employees to use paid break time or meal time, to express breast milk. See our earlier posts on New York's requirement.

Thus, for New York employers, the most important observation contained in the US DOL's fact sheet is that the FLSA requirement of break time for nursing mothers to express breast milk does not preempt State laws that provide greater protections to employees. New York's protection of nursing mothers provides employees with a number of protections that exceed those provided under the new federal law. For example, New York law protects expression of breast milk up to three years following the birth of the child (federal law is limited to one year) and applies to all employers (federal law does not apply to employers with fewer than 50 employees).

Given that New York's protection of nursing mothers provides greater protection than the recent FLSA amendments, employers complying with existing New York law will be in compliance with the new federal law as well.

 

No COBRA Subsidy in Unemployment Benefits Extension

The emergency jobless benefits bill that cleared Congress today does not revive the COBRA subsidy for involuntary terminations. The subsidy expired with respect to terminations after May 31st.
 

New Regulation Requires Federal Contractors To Disclose Subcontracts And Compensation Of Executives

A new regulation issued jointly by several federal agencies requires many federal contractors to disclose first-tier subcontract awards of $25,000 or more and to disclose the compensation paid to their top five executives. The new regulation was published in the Federal Register on July 8, 2010 and became effective on that date. The regulation was issued by the Department of Defense, the General Services Administration, and the National Aeronautics and Space Administration and implements the Federal Funding Accountability and Transparency Act (“FFATA”). The FFATA’s provisions state that it was enacted to reduce “wasteful and unnecessary spending” by requiring the federal government to “establish a free, public, on-line database containing full disclosure of all federal contract award information.”

The new regulation requires prime contractors to report first-tier subcontract awards of $25,000 or more at http://www.fsrs.gov. The regulation also requires contractors to report, at http://www.ccr.gov, the name and total compensation of each of the contractor’s five most highly compensated executives for the contractor’s preceding completed fiscal year in which the awards were made, and to make a similar report for subcontractors at http://www.fsrs.gov. The required information reported by federal contractors will be made available to the public.
 

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Second Circuit Finds Pharmaceutical Sales Reps Not Exempt Under FLSA

On July 6, 2010, the Second Circuit Court of Appeals held that pharmaceutical sales representatives employed by Novartis Pharmaceuticals Corp. (“Novartis”) are not exempt from the overtime pay requirements of the Fair Labor Standards Act (“FLSA”) as either “outside sales” or “administrative” employees. In so doing, the Court determined that the Secretary of Labor’s interpretations of the regulations promulgated under the FLSA defining “outside sales” and “administrative” employees, as set forth in the Secretary’s amicus brief , were entitled to “controlling” deference.

The Second Circuit rejected Novartis’ argument that its sales reps “made sales” within the meaning of the “outside sales” regulations because the reps only promoted a drug to a physician. They could not lawfully take an order for its purchase or obtain a binding commitment from the physician to prescribe the drug to a patient. While the sales reps provided physicians with free samples, Novartis sold its drugs to wholesalers, which then sold them to pharmacies, and the pharmacies ultimately sold the drugs to the patients who had prescriptions for them. Accordingly, since the sales reps did not “make sales,” they were not “outside salespeople” within the meaning of the FLSA and the regulations.
 

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New York's Highest Court Limits Ability of Non-Residents to Sue Under New York State and New York City Human Rights Laws

In a 4-3 decision, the New York Court of Appeals ruled on July 1, 2010, that a non-resident cannot sue his employer under the New York State  and City Human Rights Laws, unless he can demonstrate that the alleged discriminatory conduct had an impact within the State or City of New York. The case, Hoffman v. Parade Publications, Inc. resolves a split of authority over the applicability of the State and City Human Rights Laws to non-residents. Prior to Hoffman, some courts had ruled that a non-resident plaintiff could assert a Human Rights Law claim when the termination decision was made in New York, even if the plaintiff otherwise had no connection to New York. The Hoffman case has been closely watched by New York employers who have employees working in other parts of the country. Plaintiffs’ attorneys often seek to take advantage of the State or City Human Rights Laws where possible, because those laws are often broader and more protective of employees than are federal law and the laws of many other states.

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NEW OSHA TASK FORCE WILL CONSIDER UPDATING PERMISSIBLE EXPOSURE LIMITS

The Occupational Safety and Health Administration (OSHA) may be considering an update of its list of permissible exposure limits (PELs) for many regulated chemicals and recognized air contaminants. According to BNA’s Daily Labor Report, at the May 26, 2010 American Industrial Hygiene Conference and Expo in Denver, OSHA Administrator David Michaels told the group that the Agency is in the process of assembling a task force to examine the possibility of updating current PELs. Most of the PELs have remain unchanged since first being set by OSHA in 1971, and revising the limits may be easier said than done. Because of that difficulty, Administrator Michaels urged that “all of us in the occupational safety and health community have to engage in support of this process because it is a very difficult one.”

This is not the Agency’s first attempt at implementing PEL revisions, and a prior attempt was not successful. By way of background, an employer is required under the “General Duty Clause” of the Occupational Safety and Health Act of 1970 to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm.” The Act also requires employers to “comply with occupational safety and health standards promulgated” by OSHA. Pursuant to this authority, OSHA promulgated numerous PELs for air contaminants in 1971; these standards are organized into three industries: general industry, shipyard employment, and the construction industry.
 

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USDOL Interprets FMLA to Apply to Domestic Partners, Grandparents, and Other Individuals Providing Day-to-Day Care for Children

Recently the U.S. Department of Labor’s Wage and Hour Division issued an Administrator’s Interpretation (the “Interpretation”) clarifying the definition of “son or daughter” under Section 101(12) of the Family Medical Leave Act (“FMLA”) as it applies to an employee standing “in loco parentis” to a child. The FMLA allows workers to take up to 12 weeks of unpaid leave during any 12-month period to care for a child after adoption or birth, or to care for a child with a serious health condition. The Interpretation concludes that these rights extend to any individual who assumes the role of caring for a child, regardless of the legal or biological relationship.

The definition of a “son or daughter” under the FMLA includes not only a biological or adopted child, but also a “foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis.” According to the Interpretation, the legislative intent behind this definition was to reflect the reality that often the day-to-day responsibility of caring for a child falls to someone without a biological or legal relationship to the child, and that employees with such a responsibility are therefore entitled to leave under the FMLA.

In loco parentis, or “in the place of a parent,” is commonly understood to mean a person who has assumed obligations typical of a parent without formally adopting the child. Courts have routinely looked to the intent of the person allegedly in loco parentis to determine whether such a relationship is established; such intent is inferred from the acts of the parties. Whether an employee stands in loco parentis depends on multiple factors such as the age of the child, the child’s dependence on the employee, the amount of support provided and to what extent the employee performs duties commonly associated with parenthood.
 

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