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The Supreme Court decision (Windsor v. U.S.) legalizing more than 1,000 federal spousal benefits for same-sex couples will have a major impact on the administration of pensions and health plans for employers throughout the nation. For example, the high court's ruling overturning the benefits provisions of the Defense of Marriage Act (DOMA) means that surviving same-sex spouses under a defined-benefits retirement plan will now be entitled to receive survivor annuity payments. The decision's expanded definition of "marriage" will require companies that offer self-funded health benefits for married spouses to extend this coverage to same-sex couples. The sheer number of benefits under DOMA, together with variations among laws and regulations on the state level - especially in the 38 states that don't recognize same-sex marriage - will make implementing the Windsor decision a challenge for businesses that offer spousal benefits to their workers. To deal with this changing situation, we'd recommend that you: Have your attorney(s) review the benefits that you're providing to employees' spouses for compliance with the new requirements; ask for guidance from federal and state regulators. Implement the administration of new same-sex benefits (for example, amending your payroll procedures to update the federal income tax treatment of qualified benefits programs for spouses) as soon as possible - certainly by the end of this calendar year or the plan year. Provide complete documentation of the revisions to your plans. Before you communicate these changes to your employees, do your homework and be prepared to answer their questions. As Employee Benefits specialists, we can help guide you through this process - just give us a call. 

Third-Party Administrator (TPA) adjusters form the front line of defense against unnecessary claims expenses, including such traditional cost drivers as fraud or opioid pain medication addiction. They're the ones who determine how soon employees will mend and return to the job, the length of claims, and whether closing a claim will require additional resources, such as attorney involvement. It makes sense that the more closely you monitor the adjusters of your company's TPA, the lower your Workers Comp claims costs - and premiums. However, adjusters today are running on overload more than ever. In addition to managing larger caseloads, they face growing real-time information demands, increasing communication speed, and expanding regulations - which distract them from such cost-control practices as staying in contact with injured workers. Says one claims adjustment expert, "The fastest way of getting an injured employee to hire an attorney is making them feel like you don't really care about their injury. So you end up with a lot more claims than necessary going to attorneys, which leads to higher claim costs." It makes sense to work closely with your TPA adjuster by following these guidelines: Interview adjusters before they're assigned to your company. Review the adjuster's claims notes on a regular basis. Audit the TPA's services periodically to make sure that the adjuster is meeting your expectations. Develop close relationships with claims examiners and their supervisors. We'd be happy to work with you and your TPA adjuster on keeping tabs on your Workers Comp claims costs. Please feel free to get in touch with us.

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