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Home of the HR Legal Compliance Program!

Welcome to the Law Offices of Scott D. Segal, P.A., a law firm specializing in all of your HR needs, including representing clients in the fields of employment law, employee benefits, executive compensation and ERISA law. Scott D. Segal, its shareholder, has nearly 15 years of experience with global New York and Miami law firms, including Clifford Chance LLP and Holland & Knight PA, counseling clients in all aspects of these fields of law, including advising clients on how to stay compliant with the various issues with employees from hiring through termination of employment, as well as the design, drafting, implementation and administration of qualified and nonqualified retirement plans, flexible compensation programs, welfare benefits plans, and fiduciary law aspects of ERISA.

His clients have included entrepreneurs, small private start-up companies, family-owned businesses, Fortune 100 companies, as well as tax-exempt and governmental entities. Mr. Segal's principal commitment has been to provide superior service to his clients by employing a unique blend of specialized knowledge and expertise, personalized service, and competitive rates. He is dedicated to serving his clients with honesty, integrity, and excellence. A principal focus of Mr. Segal’s practice is to assist corporate directors, executives, plan committee members, management personnel and human resource professionals who serve as ERISA fiduciaries in meeting their fiduciary duties and obligations under ERISA.

The Law Offices of Scott D. Segal, PA has created a unique solution to all of your HR compliance needs: the HR Legal Compliance Program. Clients who sign up for the HR Legal Compliance Program receive three services: first, the client gets unlimited responses to every HR legal question that arises for a year, second, the client gets unlimited document review by the Firm for the year; and third, the client gets a reduced rate for any additional services that don't fall within the first two categories. Clients can rest assured that even if it takes 10 hours of research to determine an answer, or takes 10 hours to review a document, there will be no other monthly invoices. In addition, the client is eligible to receive other HR related work that is not included in the HR Annual Fee Program, such as major drafting of documents, agreements, plans or communications, or representing the client in front of the DOL/IRS/Federal or State Court, at the HR Annual Fee Program rate, which is significantly less than Mr. Segal's regular billing rate. You can get more information on the HR Annual Fee Program by emailing the Firm. Just click the email Scott box to the left.

  • August1st

    The Supreme Court has agreed to hear the case, CIGNA Corp. v Amara, to resolve a dispute among the circuits as to whether a participant must show reliance on a deficient summary plan description or merely “likely harm” when the summary plan description is inconsistent with the plan’s terms. Obviously, a decision by the Supremes for the latter standard will make it more likely that a participant can sue a company over language in the plan’s SPD. We will give you notice of what the Court decides when the decision is rendered.

  • July22nd

    For non-grandfathered plans, one of the requirements under the Health Care Reform Act of 2010 is to implement new claims procedures with respect to its health and welfare plans. The Employee Benefit Security Administration of the U.S. Department of Labor released intermittent final regulations today about how the new claims procedures will work. Here are a few quick tidbits:

    * Consumers in new health plans in every State are given the right to appeal decisions, including claims denials and rescissions, made by their health plans, which include internal appeals through the group health plan as well as external appeals (outside the plan).

    * A $30 million grant program to establish and strengthen consumer assistance offices in States and Territories.

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  • July19th

    This year’s HR Florida Conference & Expo will be held from August 30 through September 1 at the Rosen Shingle Creek Resort in Orlando Florida. The Law Offices of Scott D. Segal, PA will be an exhibitor at the Conference. Stop by BOOTH 431 and learn more about the Annual Fee Program and how your company can get unlimited HR legal compliance assistance for a very reasonable rate. We hope to see you there.
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  • July19th

    The Supreme Court has agreed to review the decision in Amara v. CIGNA Corp, in which the Second Circuit affirmed the district court’s opinion that CIGNA’s cash balance plan conversion violated ERISA § 204(h)’s requirement that plan participants receive advance notice of plan amendments that provide for a significant reduction in the rate of plan participants’ future benefit accrual.

  • July14th

    Florida law now prohibits a Florida employer from restricting group life insurance coverage to only those employees who are covered under the employer’s group health plan.  An employer may, however, require participation in its group health plan as a condition of employment.
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    The law also permits spouses and dependent children to be covered for group life insurance up to the amount in effect on the covered employee.

    The law is already effective.

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  • June23rd

    The DOL has recently clarified and expanded the definition of “son” or daughter” under the Family Medical Leave Act due to the uncertainty that many employers and employees have when there is no legal or biological parent-child relationship.  As you know, among other things, the FMLA allows an employee to take protected leave for the birth or placement of a child, to care for a newborn or newly placed child, or to care for a child with a serious health condition.  The definition of child for these purposes 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.
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    In loco parentis refers to a person who has put himself in the situation of a lawful parent by assuming the obligations incident to the parental relation without going through the formalities necessary to legal adoption.  Whether an employee stands in loco parentis to a child is a fact issue dependent on multiple factors. Courts have enumerated factors to be considered in determining in loco parentis status; these factors include the age of the child; the degree to which the child is dependent on the person claiming to be standing in loco parentis; the amount of support, if any, provided; and the extent to which duties commonly associated with parenthood are exercised.  The FMLA regulations define in loco parentis as including those with day-to-day responsibilities to care for and financially support a child.

    The DOL’s interpretation of the regulations is that an employee who intends to assume the responsibilities of a parent  must only establish that he or she provides day-to-day care OR financial support in order to be found to stand in loco parentis and not have to prove both factors.

    Examples provided by the DOL:  (1)  an employee who will share equally in the raising of an adopted child with a same-sex partner, but who does not have a legal relationship with the child, would be entitled to FMLA leave in the applicable circumstances, because the employee stands in loco parentis to the child, (2)  a grandparent who takes in a grandchild, or an aunt who takes in a niece or nephew because the child’s parents are incapable of giving care or have passed away, even if such circumstances do not lead to a legal relationship with the child; and (3) an employee who cares for a child when the child’s parents are on vacation would not be considered in loco parentis to the child.

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  • June23rd

    Yesterday, the government issued further guidance on annual and lifetime limitations, the prohibition on rescissions of coverage, and pre-existing condition exclusions for children to age 19.

    Based on a recently released fact sheet (see http://healthreform.gov/newsroom/new_patients_bill_of_rights.html), this is what the regulations provide:

    Lifetime Limitations: The regulations prohibit the use of lifetime limits in all health plans the first day of the first plan year (in the individual market, policy year) beginning on or after September 23, 2010.

    Annual Limitations: The rules will phase out the use of annual dollar limits over the next three years until 2014. Plans will be allowed to set annual limits no lower than $750,000 plans the first day of the first plan year (in the individual market, policy year) beginning on or after September 23, 2010. This minimum limit will be raised to $1.25 million beginning September 23, 2011, and to $2 million beginning on September 23, 2012. These limits apply to all employer plans and all new individual market plans. For plans issued or renewed beginning January 1, 2014, all annual dollar limits on coverage of essential health benefits will be prohibited.

    It appears the regulations may provide some relief for plans to retain their current annual limits if it is necessary to prevent a significant loss of coverage or increase in premiums. In order to seek this relief, it appears some sort of application will need to be made to a government agency for approval. This may be applicable to certain limited benefits plans.

    Rescissions of Coverage: Under the regulations, insurers and plans will be prohibited from rescinding coverage – for individuals or groups of people – except in cases involving fraud or an intentional misrepresentation of material facts. Insurers and plans seeking to rescind coverage must provide at least 30 days advance notice to give people time to appeal. There are no exceptions to this policy.

    Pre-existing Condition Exclusions for Children to age 19: The new regulations will prohibit insurance plans from denying coverage to children based on a pre-existing conditions. This ban includes both benefit limitations (e.g., an insurer or employer health plan refusing to pay for chemotherapy for a child with cancer because the child had the cancer before getting insurance) and outright coverage denials (e.g., when the insurer refuses to offer a policy to the family for the child because of the child’s pre-existing medical condition).
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    We will update this information once the regulations have been properly reviewed.

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  • June19th

    In City of Ontario v. Quon, U.S. Supreme Court No.08-1332 (6/17/10), the Supreme Court ruled that an employer’s search of an employee’s text messages on an employer-provided device was reasonable and not in violation of the employee’s Fourth Amendment rights.

    In the case, the City of Ontario had a “computer usage, internet and email policy which the employee, Quon, had signed.  There was no explicit policy on text messages, but there was an informal policy that text messages would not be audited provided that the employee paid for any monthly overage charges.  Quon went over four times and paid the overage charges at least three times.  At some point, Quon’s supervisor complained that his job was not to collect bills for the wireless company as well as express concern that officers might be wasting official time and resources in sending personal messages while on duty.  The supervisor requested that the wireless company send transcripts of the text messages of those officers who went over the monthly allowance, including Quon.  An audit of Quon’s  text messages revealed many personal and sexually explicit text messages.

    Quon sued for invasion of privacy under the Fourth Amendment and the federal Stored Communications Act. The city said the purpose of the audit was to determine if the character limit was too low and should be increased for employees’ business needs. The 9th Circuit Court of Appeals ruled that the city and the police department were liable for violating his rights.
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    The Supreme Court overturned the 9th Circuit holding that the search was reasonable, not overly intrusive and that Quon did not have any expectation of privacy.  The Supremes noted, importantly, that “employer policies concerning communications will of course shape the reasonable expectations of their employees, especially to the extent that such policies are clearly communicated.”

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    Therefore, it is important for employers to carefully craft their computer, internet and email usage policies in order to provide exactly what is expected of its employees.  In addition, this policy should clearly address social media, such as the use of LinkedIn, Facebook and Twitter.  The policy needs to be clearly defined in the employee handbook and acknowledged by the employees.

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  • June16th

    Final interim regulations on how a company can maintain a “grandfathered plan” were released on Monday afternoon.   Although I am still reviewing the new rules, I want to share with you some first impressions.
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    Based on a first reading of the new rules, it appears that a plan will lose grandfathered status if any of the following occur:

    · A change in carrier, regardless of whether the plan of benefits stays the same or is improved;

    · A reduction in any annual limits;

    · A change in the co-insurance percentage (the percentage of a particular charge that the employee must pay – e.g. the 8o%/20% split on hospital charges); or

    · A significant cut or reduction in benefits (eliminating coverage for AIDS or diabetes, for example).

    The new rules appear to allow some modest changes in plan features, to reflect increases in medical costs, including:

    · A change in the percentage split of the total premium between the employee and employer, as long as the employer percentage is not reduced by more than 5 percentage points;

    · Changes in deductibles that do not exceed “medical inflation” (described in the regulations as having averaged 4%-5%, annually in recent years), plus 15 percentage points;

    · Changes in co-pays that do not exceed the greater of $5 (adjusted for medical inflation) or medical inflation plus 15 percentage points.

    I continue to believe that grandfathered status is of limited value to most plans since most of the immediate reforms that employers will face either apply to grandfathered plans (e.g. lifetime limit restrictions and age 26 dependent coverage), or are already being complied with for the most part (preventive care coverage, physician choice, non-discrimination, etc.).  There also appears to be some leeway in the new rules that will allow employers that offer multiple plan options to change one option without affecting the grandfathered status of other options.

    I am reviewing the new rules and the above observations may change once I am able to study the regulations in depth.  I will provide you with a more detailed summary soon.

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  • June10th

    buying a research paperhe Law Offices of Scott D. Segal, PA has recently introduced a new method of doing business for some of its clients. It is flat-rate billing. For one very reasonable annual fee, you get unlimited access with respect to all of your employment law and employee benefits related questions as well as unlimited document review.

    Think about it. As the head of HR or someone who is questioning what to do with an employee, or with an employee benefit plan, wouldn’t it be great to know that you can speak to a lawyer who specializes in this area of law for the past 15 years without getting hit with a large bill at the end of the month? No more of that worry! No more worry about whether what you are doing is compliant with the DOL or the IRS or Federal or state law because of the cost involved. Now you can call the Law Offices of Scott D. Segal, PA anytime and the firm will respond to your question quickly and professionally.

    To find out more about this wonderful new product for businesses, contact the Law Offices of Scott D. Segal, PA at scott@sdsegallaw.com. You won’t be disappointed

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