Wednesday, February 16, 2011

SUMMARY OF FOUR DIFFERENT RULES (OR PROPOSED RULES) RELATING TO 401(K) FEE DISCLOSURE OR INVESTMENT ADVICE GUIDANCE

Charles C. Shulman, Esq., LLC
Employee Benefits, Employment & Executive Compensation Law
www.ebeclaw.com  www.EmployeeBenefitsLaw.info


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632 Norfolk St., Teaneck, NJ 07666
NJ Tel - 201-357-0577
(rings in office & on cell)
Fax - 201-836-4847
NY Office:
345
Seventh Ave.
, 21 Fl., New York, NY
NY Tel – 212-380-3834
E-mail - cshulman@ebeclaw.com
Admitted in NY & NJ


EBEC (Employee Benefits / Executive Compensation) Law Update

Revised
October , 2010

SUMMARY OF FOUR DIFFERENT RULES (OR PROPOSED RULES) RELATING
TO 401(K) FEE DISCLOSURE OR INVESTMENT ADVICE GUIDANCE

            Recent guidance – some proposed and some final – relate to 401(k) plan fee disclosure and investment advice, as described further below:
  • Service provider disclosure on Form 5500 Schedule C is now required for both direct and indirect compensation.  This became effective with the 5500s for the 2009 plan years.
  • Fee disclosure by service providers to responsible plan fiduciaries to show reasonableness of contract (required by service-provider exemption of ERISA § 408(b)(2)) as specified in interim final DOL regulations published in July of this year will become effective July 16, 2011.
  • Fee disclosure by fiduciaries to participants for participant-directed 401(k) plans regarding investment options with a comparative chart of investment options and with the administrative expenses of each option would be required under proposed DOL regulations issued in July of 2008.  However, these regulations have to date not been finalized.  [FINALIZED OCT 2010]
  • Regulations regarding investment advice arrangements that are permitted by the Pension Protection Act where there is level-fee or computer model arrangements have been reproposed in March 2010.  They were originally finalized in January 2009 but were later withdrawn.  The reproposed regulations are similar to the original regulations but with certain changes as described below.

      1.  Schedule C Service Provider Reporting – Effective for 2009 Plan Years  
            Final guidance for revised Form 5500 Schedule C disclosure provides for expanded requirements for service providers reporting of direct and indirect compensation, and requires fiduciaries to review and approve expenses, effective for 5500s relating to plan years beginning in 2009. 
  • For Schedule C purposes, reportable compensation includes cash and any other items of value (e.g., gifts or awards) received from the plan (including fees charged as a percentage of assets and deducted from investment returns) in connection with services rendered to the plan.  
  • Indirect compensation is compensation received from sources other than the plan or plan sponsor, in connection with services rendered to the plan, and would include, for example, fees and expense reimbursement payments received from a mutual fund, account maintenance fees, 12b–1 distribution fees, etc.[1]

2.  Fee Disclosure for Service Providers – Interim Final Regulations Effective July 16, 2011
ERISA § 406 generally prohibits transactions between an ERISA plan and a party in interest.  A service provider to a plan would be a party in interest, making the arrangement a prohibited transaction.  However, under the service-provider exception, ERISA § 408(b)(2) exempts service contracts or arrangements between a plan and a party in interest if (i) the contract or arrangement is reasonable, (ii) the services are necessary for the establishment or operation of the plan, and (iii) no more than reasonable compensation is paid for the services.[2]
DOL interim final regulations § 2550.408b-2, proposed in December 2007[3] and substantially revised as interim regulations in July 2010[4]  amends DOL Reg. § 2550.408b–2 to clarify the meaning of a ‘‘reasonable’’ contract or arrangement.
Under the interim DOL regulations, to be a reasonable contract, a “covered service provider” (as defined below) must disclose in writing to the “responsible plan fiduciary” (the fiduciary with authority to cause the plan to enter into or renew the contract) certain information. 

·         This disclosure is in order for the fiduciary to be able to determine that the services are reasonable. .   

A “covered service provider” is a service provider that enters into a contract or arrangement with a covered plan (which is defined as an ERISA pension plan) and reasonably expects $1,000 or more in direct or indirect compensation to be received in connection with providing certain enumerated services, which are services provided as a fiduciary to an investment contract or other entity holding plan assets, services provided as an investment advisor  to the plan, certain recordkeeping and brokerage services and other services for which service provider, affiliate or subcontractor expect to receive indirect compensation . DOL Reg. § 2550.408b-2(c)(1)(iii).

The disclosure must describe:

·         services to be provided (but not including non-fiduciary services to an investment contract or plan investment);

·         if applicable, status as a fiduciary or investment advisor;

·         any direct or indirect compensation the service provider, affiliate, or subcontractor expects to receive, or in certain cases any compensation that will be paid among the service provider, affiliate and a subcontractor in connection with the services (e.g., bundled services such as commissions, 12b-1 fees, soft dollar fees, etc.);

·         compensation expected in connection with termination of the contract;

·         with regard to recordkeeping services a description of direct and indirect compensation that is expected to be received;

·         whether the plan will be billed or the compensation will be deducted directly from the plan’s individual accounts;

·         for fiduciary service providers with respect to plan assets, any compensation that will be charged directly against the amount invested in connection with the acquisition, sale, or withdrawal of the investment (e.g., sales charges, loads, redemption fees, surrender charges, etc.) and operating expenses; and

·         for certain recordkeeping and brokerage services with respect to each designated investment alternative, current accurate disclosure materials of the issuer of the designated investment alternative that includes the information in the previous bullet.[5] 

The service provider must disclose any additional information relating to compensation to the responsible plan fiduciary within the following time periods: (i) reasonably in advance of the date of contract or renewed, (ii) within 30 days of when the investment holds plan assets, and (iii) as soon as an investment alternative is designated.[6]  Changes in the disclosed information must be communicated no later than 60 days for the date of change.[7]  

Upon request, the service provider must furnish other information relating to the compensation received in connection with the contract.[8]  Good faith errors or omission in disclosing the information required will not cause there to be a failure, as long as the service provider discloses the correct information as soon as practicable and no later than 30 days after the service provider knows of such error or omission.[9]

There is an exemption in the form of a prohibited transaction class exemption, and also incorporated into the interim regulations, for the responsible plan fiduciary from the prohibited transaction restrictions for a party in interest providing goods and services to or receiving assets from the plan, for any failure by a covered service provider to disclose the information required above, provided that the following conditions are met: (i) the plan fiduciary did not know that the service provider failed or would fail to make required disclosures and reasonably believed that the covered service provider disclosed the information required above, (ii) the plan fiduciary requests the additional information in writing and notifies  the DOL, and (iii) the service provider terminates the arrangement or complies with the request within 90 days.  DOL Reg. § 2550.408b-2(c)(1)(ix).  The above administrative class exemption was proposed in December 2007[10] and finalized in July 2010.[11]

                The interim regulations also require that for the contract to be reasonable, it must permit termination of the contract without penalty other than for reasonable start-up costs and expenses.[12]  

The interim regulations will not be effective until July 16, 2011. The rules will then apply to all contracts or arrangements, regardless of whether entered into before or after the effective date.

      3.  Fee Disclosure for Participants – Proposed Regulations Not Yet Finalized [FINALIZED OCT  2010]   FINALIZED AT http://www.dol.gov/ebsa/pdf/frparticipantfeerule.pdf  ]
In 2008 the Department of Labor issued proposed regulations requiring fiduciaries of individual account plans to provide specific disclosures to participants concerning plan investment options including fee and expense information.[13]  Under the proposed rules, fiduciaries would have to provide participants in self-directed individual account plans:
  • general information about the plan;
  • information about administrative expenses charged to the plan and to individual participant accounts;
  • investment-related information to participants (such as name and category of investment alternatives, average annual return on the investments for one, five, and 10-year periods); and
  • a model comparative chart of  investment options.[14]  
            The proposed regulations would also integrate new disclosure requirements for qualified default investment alternatives (QDIAs) with the existing requirements of § 404(c).[15]  As stated in the Preamble to the proposed regulations, this proposal is intended to ensure that all participants and beneficiaries in participant-directed individual account plans have the information they need to make informed decisions about the management of their individual accounts and the investment of their retirement savings.  
            The proposed regulations had been put on hold in connection with President Obama’s January 2009 sixty day regulatory moratorium for proposed regulations and regulations not yet effective.[16]  As of yet, these regulations have not yet been finalized.

      4.  Eligible Investment Advice Arrangements by Fiduciary Advisors Under Pension Protection Act  –Regulations Withdrawn and then Reproposed
Under ERISA § 408, as amended by the Pension Protection Act of 2006, a prohibited transaction statutory exemption is added for the provision of investment advice by a “fiduciary advisor” to participants of participant-directed plans through an “eligible investment advice arrangement.”  ERISA §§ 408(b)(14) & 408(g). 
In January 2009 the Department of Labor finalized regulations implementing the provisions of the statutory exemption for eligible investment advice arrangements for level-fee or computer model arrangements (as described below).[17]  The DOL also provided an administrative class exemption in DOL Reg. § 2550.408g-1(d), pursuant to which the fee-leveling or computer model requirements would be liberalized.  The effective date was to have been March 23, 2009.   The effective date was delayed several times.[18]  The DOL withdrew these regulations entirely effective January 19, 2010 (before the extended effective date of the regulations).[19]
The regulations were reproposed in March of 2010.[20]  Reproposed DOL Reg. § 2550.408g–1 provide guidance on the requirements of ERISA § 408(g) that must be satisfied in order for the investment advice-related arrangements to be exempt from the prohibited transaction restrictions of § 406.  
“Eligible investment advice arrangements” must either:  (i) be based on generally accepted investment theories, taking into account fees and expenses and the participants’ age, other assets, risk tolerance and preferences, and must also provide that fees received by fiduciary advisors providing investment advice do not vary on the basis of the investments chosen (level fee arrangements);[21] or (ii) use a computer model that provides generally accepted investment theories, use relevant information about participants, take into account fees and expenses, use appropriate objective criteria, not favor investment options of the advisor and take into account all of the investment options of the plan, and in addition, the computer model must be certified by an eligible investment expert.[22] 
A plan fiduciary must expressly authorize the investment advice program, and an annual audit of the arrangement must be made.[23]  
The fiduciary advisor must disclose to participants prior to the initial investment advice the following: (i) the role of any party that has a material affiliation, (ii) past performance of the investment options, (iii) fees or compensation that the advisor or affiliate receives for the advice or for a transaction or rollover involving the investment, (iv) any material affiliation the fiduciary or affiliate has in the funds, and (v) certain other matters.[24]  The Appendix to Prop. DOL Reg. § 2550.408g-1 contains a model disclosure form that may be used to satisfy this disclosure requirement. 
A “fiduciary advisor” is a registered investment advisor, bank, insurance company, registered broker dealer or an affiliate or employee of any of the above.[25]   
The proposed regulations address the requirements for electing to be treated as the only fiduciary and fiduciary adviser by reason of developing or marketing a computer model or an investment advice program used in an eligible investment advice arrangement. [26] 

A prohibited transaction class exemption in the original 2009 regulations would have permitted follow-up individual advice subsequent to the computer model, and would have also permitted varying fees as long as the individual employee providing the advice met the level fee requirements.  However, in response to comments questioning the potential for self-dealing, the class exemption has been eliminated in the reproposed regulations.

The regulations will most likely be effective 60 days after finalization and publication of the final regulations in the Federal Register.[27] 

            IRS Circular 230 Disclosure: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. federal tax advice contained in this communication is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter that is contained in this document.



[1]      72 Fed. Reg. 64710 (Nov.16, 2007), amending DOL Reg. §§ 2520.103-1 & 2520.104-46. 
      Note that the various references to regulations or proposed regulations in the footnotes below are hyperlinked to the original texts in the Federal Register.
[2]     A related rule also added by the Pension Protection Act of 2006 adds ERISA § 408(b)(17) providing that if a person  is a party-in-interest solely by reason of providing services to the plan, and is not an investment advisor to the plan, then transactions under ERISA § 406(a)(i)(A), (B) or (D) (sale, exchange, lease or loan) will not be prohibited, so long as the plan pays no more than, and receives no less than adequate consideration.  There are currently no regulations regarding § 408(b)(17).
[3]      72 Fed. Reg. 70988 (Dec 13, 2007).
[4]      75 Fed. Reg. 41600 (July 16, 2010).
[5]      DOL Reg. § 2550.408b-2(c)(1)(iv).
[6]     DOL Reg. § 2550.408b-2(c)(1)(v). 
[7]     Id.
[8]     DOL Reg. § 2550.408b-2(c)(1)(vi).
[9]     DOL Reg. § 2550.408b-2(c)(1)(vii).
[10]    72 Fed. Reg. 70893 (Dec. 13, 2007).
[11]    75 Fed. Reg. 41600 (July 16, 2010). 
[12]    DOL Reg. § 2550.408b-2(c)(3).
[13]     Prop. DOL Reg. §§ 2550.404a-5 and 2550.404c-1, 73 Fed. Reg. 43014 (July 23, 2008). 
[14]     Prop. DOL Reg. § 2550.404a-5. 
[15]     Prop. DOL Reg. § 2550.404a-5 & Proposed Amendment to DOL Reg. § 2550.404c-1.
[16]     74 Fed. Reg. 4435 (Jan. 26, 2009).  
[17]    74 Fed. Reg. 3822 (Jan. 21, 2009) (DOL Reg. § 2550.408g-1 & -2), originally proposed in 73 Fed. Reg. 49896 (Aug 22, 2008).
[18]    It was delayed 60 days to May 22, 2009, 74 Fed. Reg. 11847 (March 20, 2009), per President Obama’s regulatory moratorium (74 Fed. Reg. 4435 (Jan. 26, 2009)), it was deferred another 180 days to November 18, 2009, 74 Fed. Reg. 23951 (May 20, 2009), and it was deferred another 180 days until May 17, 2010, 74 Fed. Reg. 59092 (Nov. 17, 2009).
[19]    74 Fed. Reg. 60156 (Nov. 20, 2009).
[20]    75 Fed. Reg. 9360 (March 2, 2010).
[21]    Prop. DOL Reg. § 2550.408g-1(b)(3). See similarly, ERISA § 408(g)(2). 

      The reproposed regulations provide that, as stated in DOL Field Assistance Bulletin 2007-01 (Feb. 2, 2007),  the receipt by a fiduciary adviser of any payment from any party or used for the benefit of such fiduciary adviser that is based on investments selected by participants would be inconsistent with the fee-leveling requirement of the exemption.

[22]    Prop. DOL Reg. § 2550.408g-1(b)(4). See similarly, ERISA § 408(g)(3).
      The reproposed regulation also provide, in connection with investment advice arrangements that use computer models, that a computer model shall be designed and operated to avoid investment recommendations that inappropriately distinguish among investment options within a single asset class on the basis of a factor that cannot confidently be expected to persist in the future.
[23]    Prop. DOL Reg. § 2550.408g-1(b)(5) & (6).  See similarly, ERISA § 408(g)(4) & (5).
[24]    Prop. DOL Reg. § 2550.408g-1(b)(7).  See similarly, ERISA § 408(g)(6).
[25]    Prop. DOL Reg. § 2550.408g-1(c)(2).  See similarly, ERISA § 408(g)(11).
[26]    Prop. DOL Reg. § 2550.408g–2.
[27]     Pending final regulations the statutory exemption for investment advice provided by the PPA is still in effect (for advice after 2006), and a good faith compliance should suffice until regulations are refinalized.     The withdrawal of the regulations and exemption does not negate the statutory exemption in ERISA §§ 408(b)(14) & 408(g) provided for by the PPA for eligible investment advice arrangements.  Note that the guidance in DOL Field Assistance Bulletin 2007-01 can also be be relied upon pending final regulations.

Children’s Health Insurance Program (CHIP) Annual Notice


Charles C. Shulman, Esq., LLCEmployee Benefits, Employment & Executive Compensation Law
http://www.ebeclaw.com/  – http://www.employeebenefitslaw.info/
NJ Office: 632 Norfolk St., Teaneck, NJ 07666
NY Office:  345 7th Ave., 21 Fl., NY, NY 10001
Admitted in NJ & NY
NJ Tel - 201-357-0577 (office & cell); NY Tel – 212-380-3834 (new #)
Fax - 201-836-4847 cshulman@ebeclaw.com



EBEC (Employee Benefits / Executive Compensation) Law Update

April 28, 2010
Children’s Health Insurance Program (CHIP) Annual Notice
Required by Beginning of Next Plan Year or May 1, 2010

Under the Children’s Health Insurance Program Reauthorization Act of 2009, a Children’s Health Insurance Program notice must be sent out by employers providing group health coverage.   
The State Children’s Health Insurance Program of 1997 (SCHIP or CHIP), was enacted in order to provide medical coverage for children in families that would not qualify for Medicaid but still could not afford health insurance.  The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) increases funding and provides expanded eligibility for this program.
CHIPRA provides that all employers with group health plans and with employees that are in a state with CHIP coverage must provide an annual CHIP notice.  This goes into effect by the later of (i) the first day of the plan year beginning after Feb. 4, 2010, or (ii) May 1, 2010.  (This May 1 date would be relevant if a plan year begins Feb. 4 through April 30.)  If the plan year is the calendar year, the notice will have to be provided by Jan. 1, 2011.  See 75 Fed. Reg. 5808 (Feb. 4, 2010), http://www.dol.gov/federalregister/PdfDisplay.aspx?DocId=23521 which discusses the model notice. 
The notice must be sent annually, and although it can be provided with enrollment packets, open enrollment materials or summary plan description, it must be separate so that employees who would be eligible appreciate its significance.   Also, SPDs for the group health plans should be revised to include the new special enrollment rights at the time children become eligible for CHIP, per Code § 9801(f) and ERISA § 701(f).
The model notice is available at http://www.dol.gov/ebsa/chipmodelnotice.doc .

NEW YORK HEALTH CONTINUATION COVERAGE EXTENDED TO 36 MONTHS AND OTHER STATE MINI-COBRA RULES

Charles C. Shulman, Esq., LLCEmployee Benefits, Employment & Executive Compensation Law
http://www.ebeclaw.com/  – http://www.employeebenefitslaw.info/
NJ Office: 632 Norfolk St., Teaneck, NJ 07666
NY Office:  345 7th Ave., 21 Fl., NY, NY 10001
Admitted in NJ & NY
Tel - 201-357-0577 (rings in NJ, NY & on cell)
Fax - 201-836-4847 cshulman@ebeclaw.com

EBEC (Employee Benefits / Executive Compensation) Law Update

January 5, 2010
NEW YORK HEALTH CONTINUATION COVERAGE EXTENDED
TO 36 MONTHS AND OTHER STATE MINI-COBRA RULES
           
            New York State recently passed a law that extends continuation health coverage to 36 months.  Thus, group insurance plans that are subject to New York insurance law will have to offer continuation coverage for a total of 36 months, even though under the Federal COBRA law continuation coverage on termination of employment would only be required for 18 months.

            COBRA 20-Employee Requirement.  Under Federal COBRA continuation coverage rules, employers with 20 or more employees on a controlled group basis must offer employees and beneficiaries the election to continue group health plan coverage (at up to 102% of company cost) upon the occurrence of certain events such as termination of employment.[1]

State Mini-COBRA Laws.  About 40 states have continuation health coverage requirements for insured group health plans of small employers that would apply even to small employers (e.g., with two or more employees) who do not have the 20 employee threshold to trigger Federal COBRA.  Some states provide for continuation coverage for the full 18 months, while others provide for continuation coverage for lesser periods.[2]  These state statutes are sometimes referred to as mini-COBRA laws. 
v  State mini-COBRA laws are insurance laws and apply only to insured group health plans but not to self-insured plans, and in fact state laws cannot regulate self-insured plans because of the ERISA preemption rule, as discussed below. 
New York Extension of Continuation Coverage to 36 Months.  The NYS continuation coverage mini-COBRA law[3] was expanded in June 2009 to require that insured group health plan continue coverage for a total of 36 months rather than just the 18 months available on termination of employment under COBRA.[4]  California has had this 36 month extension since 2003.[5]   
v  The NYS Insurance Dept. view is that the original NYS mini-COBRA continuation coverage election at the time of termination will suffice for the coverage to extent to 36 months, unless coverage is interrupted (e.g., because of failure to pay premiums). See bullet after next full paragraph.  
v  If continuation coverage has ended prior to July 1, 2009, there would be no entitlement to an additional 18 months.  See below regarding special enrollment period for coverage that has ended between July 1 and November 1, 2009. 
Extension Can be at End of 18 Month Federal COBRA.  The NYS extended continuation coverage rule also provides that even if the participant was receiving Federal COBRA continuation coverage for 18 months (under an insured plan), the participant must be offered the opportunity to continue coverage for an additional 18 month (up to 36 months from termination) under the N.Y. mini-COBRA law.[6]
v  If Federal COBRA coverage is in effect on or after November 1, 2009 (or the renewal date of the policy after June 30, 2009), it would appear from NYS Insurance Department FAQs that the state continuation coverage will continue automatically.   NYS Insurance Law § 3221(m)(6), however, states that when COBRA ends the participant will be given the opportunity to continue NYS coverage, which implies that a new election at that time.  Some practitioners are of the view that the NYS continuation coverage election must be made at the time of termination of employment, and cannot be elected at the expiration of the 18 month period (unless the special enrollment period is still in effect).  It is likely that employers will tie the initial COBRA election together with a New York election, so that there is no question that the 36 months will be available and so that there is no risk that the election has been made too late.  Absent further guidance from the NYS Insurance Department, those who are on COBRA during the special enrollment period discussed below would be wise to specifically communicate their intention to the plan administrator to be continued in the additional New York 18 months extension.   The interaction of the Federal COBRA election and the NYS continuation coverage election is not clear and will likely be addressed by the NYS Insurance Dept.
v  This state wrap-around benefit for Federal COBRA for disability (which is 29 months, but with up to a 150% premium), would be extended an additional 7 months at the 102% premium rate.[7]
NY Continuation Coverage Extension Effective Earlier of 11/1/09 or Amendment to Policy on or after 7/1/09.   The NYS extended continuation coverage law from June 2009 was originally effective for all policies issued, renewed or amended on or after July 1, 2009.[8]  However, an amendment to that law in November of 2009 accelerated the effective date of the NYS extended continuation coverage to no later than November 1, 2009 regardless of date of renewal of contract.[9] 
Special One-Time Enrollment Period for 60 Days From Notice of New Rule.  The November 2009 amendment provides that for those whose COBRA or New York continuation coverage ended between July 1, 2009 and Nov. 1, 2009, there is a 60 day special enrollment period from the date notice of this new rule is provided to participants, during which theNew Yorkextension can be elected.[10]  If no notice is provided, the special enrollment period will end on May 19, 2010.  Elections would be effective within 30 days of election and payment and would apply prospectively. [11]
NY Mini-COBRA (Like Other State Mini-COBRA Rules) Not Applicable to Self-Insured Plans Even if Have Stop-Loss Coverage.  TheNew Yorklaw regulates insurance companies, and in the case of self-insured plans the N.Y. statute would not apply.[12]  Also, ERISA would generally preempt state laws (even if they purport to regulate insurance) with respect to self-insured plans.[13]  Most courts apply this ERISA preemption even where the self-insured plan has stop-loss coverage.[14] 
v   The New York mini-COBRA would not apply to a dental-only, vision-only or prescription-only plan.[15]
v  The NYS continuation extension law applies to insurance contracts delivered in NYS (e.g., employer in NYS), and would presumably apply even to out of state employees.
v  Employers with different types of plans may desire to have parity among all its plans and may offer the additional 18 months even for their self-insured plans.

            COBRA Temporary 65% Subsidy Applicable to State Mini-COBRA Rules. 
The February 2009 stimulus act as amended in December 2009[16] includes a 15 month government subsidy of 65% of the COBRA continuation health coverage premiums for employees who were involuntarily terminated between Sept. 1, 2008 and February 28, 2010.  The subsidy applies not just to Federal COBRA but also to state mini-COBRA laws.[17]

             IRS Circular 230 Disclosure: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. federal tax advice contained in this communication is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter that is contained in this document.


[1]       See ERISA § 601(b) & Code § 4980B(d) regarding the 20-employee requirement.
[2]       A handful of states extend the mini-COBRA coverage for the full 18 months that would be available under Federal COBRA on termination (Colorado, Connecticut, Florida, Kentucky, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, Nevada, North Carolina, Rhode Island, West Virginia and Wisconsin).  See below that California and New York offer more than 18 months.  Some states extend the state-COBRA for only 12 months (Illinois, Louisiana, Maine, Mississippi, Ohio, South Dakota and Wyoming), some for nine months (Iowa, Missouri, North Dakota, Oregon, Pennsylvania and Virginia), some for six months (Kansas, New Mexico, Nebraska, South Carolina, Texas, Utah and Vermont), some for four months (Arkansas and Oklahoma) and some for three months (Georgia, Tennessee and the District of Columbia).  About 10 states do not have mini-COBRA rules (as of 2009, Alabama, Alaska, Arizona, Delaware, Hawaii, Idaho, Indiana, Michigan, Montana and Washington).  See, Hamburger, “Mandated Health Benefits - The COBRA Guide,” ¶ 2020 (Thompson, updated Nov. 2009).  See, also, “The Guide - Health Insurance for the Unemployed - 2009,” at www.healthinsurancefinders.com/unemployed/guide.  These state rules change often, so one should confirm for latest changes.
[3]       Under New York Insurance Law § 3221(m), an insurer’s group health policy that is not covered under COBRA because the employer has less than 20 employees must still provide continuation coverage, which basically mirrors the Federal COBRA rules.
[4]       NYS Insurance Law § 3221(m)(4) as amended by Chapter 236 of Laws of NY 2009, S.5471 (July 29, 2009), codes.lp.findlaw.com/nycode/ISC/32/3221.
[5]       California has a state mini-COBRA law for employers with two or more employees but without the 20 employees needed for Federal COBRA coverage.  California amended its mini-COBRA rule effective Jan. 1, 2003 to require (like New York has done in 2009) that group health plans provide for 36 months of continuation health coverage for any COBRA qualifying event.  California Insurance Code § 10128.27.  In addition, if the Federal 18 months of COBRA on termination are used up, the law requires the group health plan to offer an additional 18 months of continuation health coverage.  Id.  Up to 110% of the premium cost may be charged.  This rule would apply only to insured plans.  Self-funded plans would not be subject to state insurance law, and also have ERISA preemption.
[6]       N.Y. Insurance Law § 3221(m)(6) as amended.
[7]       NYS Insurance Dept. Circular Letter No. 23 (Sept. 30, 2009) - www.ins.state.ny.us/circltr/2009/cl2009_22.htm. 
[8]       Chapter 236 of Laws of NY 2009 (July 29, 2009), www.ins.state.ny.us/cobra/S5471_36_ext_final.pdf. 
[9]       Chapter 498 of Laws of NY 2009 (Nov. 19, 2009),  open.nysenate.gov/legislation/api/html/bill/S66006.
[10]     N.Y. Insurance Law § 3221(m)(8), added by November amendment.
[11]     Id.
[12]     N.Y. Insurance Department FAQs - State Continuation Coverage Extension to 36 Months, www.ins.state.ny.us/cobra/cobra_ext_36.htm.  
[13]     Although the “savings clause” of ERISA § 514(b)(2)(B) provides that laws regulating insurance are not preempted by ERISA, with regard to self-funded plans there would be preemption because under ERISA § 514(b)(2)(B) (the “deemer clause”) states may not “deem” self-funded plans to be insurers.
        Even with regard to insured plans, state laws that purport to regulate conduct with respect to the employer rather than the insurance company, or laws that are overbroad and apply to insured and self-insured plans, may be preempted by ERISA.  See, Kentucky Association of Health Plans, Inc. v. Miller, 538 U.S. 329 (2003) (for a state law to regulate insurance and not be preempted, the law must be specifically directed to entities engaged in insurance, and the state law must substantially affect the risk pooling arrangement with the insurance company).   See, also, Duclos v. General Dynamics Corp. , 12 E.B.C. (BNA) 2648 (D.R.I. 1990) (Rhode Island statute requiring certain divorced spouses to be granted continuation health coverage without additional premiums was preempted by ERISA and the “savings clause” would not apply because the law does not regulate the business of insurance or the benefits under the policy, but rather the conduct with respect to the employer; also the statute as it purported to apply to insured and self-insured plans was invalid); Thompson v. Bridgeport Hospital, 2001 WL 823130 (Super. Ct. Conn. 2001) (claims against employer under a Connecticut continuation health coverage law was preempted by Federal law; Federal and not state courts have exclusive jurisdiction over COBRA notice penalty claims); DOL Adv. Op. 96-04A (Feb. 22, 1996) (that a Connecticut COBRA statute’s requirement that the employer must give notice before canceling a policy would be preempted by ERISA since that part of the rule did not regulate insurance).
[14]     See, e.g., Bill Gray Enterprises Employee Health and Welfare Plan v. Gourley, 248 F.3d 206 (3d Cir. 2001) (purchase of stop-loss coverage does not cause self-insured plan to be an insurance company under savings clause; stop-loss insurance not designed to insure individual participants but to reimburse plan after plan makes benefit payments); Bank of Louisiana v. Aetna U.S. Healthcare Inc., 459 F. 3d 610 (5th Cir. 2006), superseded on other grounds, 468 F.3d 237, cert. denied, 127 S. Ct. 1826  (2007) (employer's claim against insurer which was also stop-loss insurer not preempted by ERISA); American Medical Security, Inc. v. Bartlett, 111 F.3d 358 (4th Cir. 1997) (Maryland insurance law requiring certain mandated benefits and defined stop-loss policies to exclude policies that had specific or aggregate attachment points below certain minimum levels; court held that state effort to regulate content of self-funded plans through the regulation of stop-loss contracts was preempted by ERISA); Bergin v. Wausau Insurance Companies, 863 F. Supp. 34 (D. Mass. 1994) (Massachusetts law requiring that divorced spouse have continuation coverage was preempted with respect to self-funded plans, and stop-loss coverage did not cause it to be like insured plan since no single claim exceeded its retained obligation); Thompson v. Talquin Bldg. Products Co., 928 F.2d 649 (4th Cir. 1991) (health plan was self-funded even though it purchased stop-loss insurance, emphasizing that plan remained directly liable to participants and insurance did not cover employees directly); United Food & Commercial Workers & Employers Arizona Health & Welfare Trust v. Pacyga, 801 F.2d 1157 (9th Cir. 1986) (ERISA preempts state anti-subrogation law for self-insured plan even though it had stop-loss coverage, since the policy proceeds were payable only to the plan); DOL Adv. Op. 91-05A (Jan. 14, 1991) (stop-loss coverage does not make a self-funded plan insured, and therefore is still preempted by ERISA).  But see Northern Kare Facilities/Kingdom Kare, LLC v. Benefirst, LLC, 344 F. Supp. 2d 283, (D. Mass. 2004) (claim that stop-loss insurers breached their contract with health plan sponsor by refusing to make stop-loss payments to plan was not preempted by ERISA since there judicial enforcement of stop-loss insurance contract would not be an alternative enforcement mechanism to ERISA).
[15]     N.Y. Insurance Department FAQs - State Continuation Coverage Extension to 36 Months, www.ins.state.ny.us/cobra/cobra_ext_36.htm.  
[16]     American Recovery and Reinvestment Act of 2009, (the “Stimulus Act”), enacted on Feb. 17, 2009, § 3001, www.dol.gov/ebsa/pdf/COBRAPremiumReductionProvision.pdf , as amended by the Department of Defense Appropriations Act for Fiscal Year 2010, Dec. 19, 2009 (the “DOD Act”), § 1010,  www.dol.gov/ebsa/cobra/COBRAPremiumReductionProvisionExtension.html .   See EB/EC Law Update – Extension of Federal COBRA Subsidy (Dec. 27, 2009).
[17]     Some states have provisions that specifically apply the Federal COBRA subsidy to state continuation coverage (e.g., California, Colorado, Connecticut, Georgia, Illinois, Kansas, Maine, Maryland, Massachusetts, Minnesota, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Wisconsin and District of Columbia).  Also, certain state insurance departments provide guidance that specifies that the Federal COBRA ARRA subsidy applies to the state continuation coverage (e.g., Kentucky, New Hampshire, New Jersey and South Dakota).  See Hamburger, “Mandated Health Benefits – The COBRA Guide” ¶ 2040 (Thompson, updated Nov. 2009).