I advise clients on a variety of healthcare matters, providing counsel to plan sponsors, insurers, and third party administrators on a broad array of issues relating to ERISA, COBRA, HIPAA, ACA and MHPAEA.I also advise clients on compliance issues related to wellness programs under HIPAA, ADA, and GINA, assist employers in designing health plans and support insurers in designing new products, and counsel employer plan sponsors and issuers through U.S. Department of Labor investigations and other regulatory actions.

I counseled Fortune 500 companies in the local market as well as nationally on all aspects of employee benefit plan compliance with a focus on health and welfare compliance. I provided technical and strategic advice to clients regarding administration, compliance, nondiscrimination testing, reporting and disclosure, plan design and governance, with a constant focus on developing solutions that were both compliant and practical to administer. I provided comprehensive reviews of plan management activities, including establishing or confirming governance structure to help clients mitigate risk and remain audit ready. I collaborated with the actuarial and health management practice groups to create a new revenue stream to Willis Towers Watson’s fee-based compliance services – MHPAEA quantitative and non-quantitative assessments – generating an additional revenue of over $1 million over the course of 16 months. I drafted plan documents and amendments, as well as employee communications including summary plan descriptions and other required notices. I monitored and measured ongoing compliance issues in a fast-paced changing regulatory landscape, including ever-changing state leave law compliance. I advised on ACA, MHPAEA, ERISA, COBRA, the IRC and HIPAA privacy and security compliance requirements. I conducted HIPAA security compliance assessments, trainings, and drafted HIPAA policies and procedures as well as required employee notices. I educated both internal (i.e., brokers, consultants) and external clients with respect to legislative and regulatory updates as well as individual areas of the law (e.g., HIPAA, MHPAEA, wellness, nondiscrimination testing, fiduciary requirements, employee benefit concerns with respect to mergers and acquisitions, ERISA reporting, and plan document requirements) through in-person training sessions as well as webinars.

I initiated, planned, coordinated, and conducted civil and criminal investigations of large and varied employee benefit plans, service providers, trust departments, and other financial entities conducting transactions with tax-qualified retirement and welfare benefit plans. I led investigative teams through complex investigations involving ERISA, HIPAA, COBRA, and ACA. I identified and analyzed prohibited transactions and determined whether they fall within any of the Department’s Prohibited Transaction Exemptions (“PTEs”). I ensured plan investment options and asset allocations were prudent and compliant with Part 4 of ERISA. I drafted reports including investigative findings and recommendations for corrective action, subpoenas, voluntary document request letters, and litigation memoranda. I facilitated voluntary compliance arrangements and actions and served as a technical resource in negotiations with plan officials, fiduciaries and their legal representatives to secure monetary restitution and other remedial actions. I initiated contacts and maintained liaison with representatives of other federal, state, and local agencies on ERISA and related matters pertaining to assigned investigations. I also mentored and trained Investigators/Auditors and law students, continually focused on developmental opportunities; and created a rewarding training program and separate mentoring program for new Investigators/Auditors.

Proposed investigation direction upon analysis of case law, statutes and public policy implications. Drafted and edited legal guidance, including checksheets and questionnaires, analyzing applicable case law, ERISA, Internal Revenue Code, legislative history and regulations for complex investigations of retirement and health plans. Analyzed and measured the effectiveness, efficiency and productivity of national programs; conducted studies, analyzed findings and made recommendations with respect to national initiatives; identified metrics to measure success of national projects; and used quantitative and qualitative data to determine if success had been met.Educated regional offices regarding Sarbanes-Oxley blackout notice requirements, and fiduciary requirements with respect to union and multi-employer benefit plans.Led regional office training workshops on technical issues, case development and investigative strategies. Briefed and provided oral presentations to the Deputy Assistant Secretary of Program Operations and members of the NAIC ERISA subgroup regarding interesting or novel MEWA investigations.

Researched and drafted memoranda on various state and local, corporate and general individual tax issues. Reviewed and prepared complex individual, trust, partnership, S corporate, and C corporate tax returns. Drafted responses to inquiries from the IRS and other tax authorities.

Drafted second level insurance appeals compelling insurance providers to cover cochlear implants for hearing impaired clients. Assisted over three hundred clients in obtaining insurance coverage for bilateral cochlear implants. Drafted appeals to state insurance companies on behalf of plan participants. Informed plan participants of their rights under ERISA. Researched and summarized insurance laws relevant to grievance procedures and cochlear implants. Trained and counseled new interns.