Modern Healthcare

Faith-based hospitals win ERISA case in high court, but debate isn’t over yet

- By Alex Kacik

With one major win in hand, faithbased hospitals are bracing for the next legal challenge to their pension programs.

The U.S. Supreme Court last week unanimousl­y affirmed that faithbased hospitals are exempt from pension guidelines set by the Employee Retirement Income Security Act, preserving exceptions those organizati­ons have relied on to establish and maintain their pension plans for more than 35 years.

Although the ruling is a significan­t milestone, faith-based health systems aren’t in the clear yet. Lawyers representi­ng the plaintiffs in cases against Advocate Health Care Network, Dignity Health and St. Peter’s Healthcare System said they will continue to challenge the ERISA exemptions by focusing on whether the health systems are “principal purpose” organizati­ons. According to ERISA, a principal purpose organizati­on is a church-associated organizati­on whose “chief purpose or function is to fund or administer a benefits plan for the employees of a church or church-affiliated nonprofit.”

Employees argued in federal District Courts that the hospitals’ pension plans are not “church plans” because their internal benefits committees do not count as principal purpose organizati­ons.

Courts will have to determine what the structure of the internal plan committee is and how it operates, who its members are, what functions the plan performs and the systems’ relationsh­ip to their affiliated churches, said Tess Gee, an ERISA attorney at Miller & Chevalier.

“That question may breed a new wave of litigation to further com- plicate this already complicate­d area of ERISA,” added Michael Graham, chairman of Michael Best & Friedrich’s ERISA litigation practice group in Chicago.

Congress expanded the church plan exemption in the 1980s to include the pension plans of church-affiliated organizati­ons after the Internal Revenue Service denied an exemption to the Little Sisters of the Poor.

In last week’s ruling, the high court dismissed three appellate court rulings that the “church plan” exemption did not apply to faith-based organizati­ons based on the fact that those plans were not establishe­d by a church. The eight justices determined that Congress intended for a broader interpreta­tion of the rule when it amended ERISA. Justice Neil Gorsuch did not participat­e in the decision because he wasn’t yet on the bench when the court heard the case earlier this year.

ERISA—which has been described as “bubble wrap for benefits”—requires companies to fully fund their pensions, pay premiums to the Pension Benefit Guaranty Corp. and comply with the law’s disclosure agreements.

Essentiall­y, employees at faithbased organizati­ons are at risk of losing their pension benefits if their employer becomes insolvent, although the systems involved in the case have assured the courts that their plans are stable and well-funded.

If the ERISA exemptions were overturned, systems collective­ly could have been liable for billions of dollars in additional funding liability and penalties for not complying with ERISA. Health systems argue that complying with ERISA would mean they would have to significan­tly cut back their charity care or drop their pension benefits altogether. “Health systems would’ve been in for a world of hurt,” said Joseph Urwitz, a partner at McDermott Will & Emery. “This is unequivoca­lly positive for health systems.”

The debate is part of a broader discussion surroundin­g tax exemptions that apply to not-for-profit health systems. Critics argue that ERISA and tax exemptions create an unfair competitiv­e advantage, while not-for-profit system executives contend that they use the tax breaks to provide charity care and other community benefits.

The wave of recent lawsuits against faith-based organizati­ons may open the door to future litigation against church plan exemptions, particular­ly through state law, Urwitz said.

Since church plans are exempt from ERISA, they’re also exempt from ERISA’s pre-emptive provisions, so plan sponsors may be exposed to claims made under state law, he said. Some states may evaluate their statutes to determine if action is warranted, Urwitz said.

“There is too much money on the line for litigation to cease,” said Brian Netter, an ERISA attorney for Mayer Brown.

 ?? GETTY IMAGES ?? The eight justices determined that Congress intended for a broader interpreta­tion of the rule when it amended ERISA in the 1980s.
GETTY IMAGES The eight justices determined that Congress intended for a broader interpreta­tion of the rule when it amended ERISA in the 1980s.
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