Lisa K. Shallue
Lisa has developed a specialty niche within the employee benefits field focusing her practice for the past several years solely on health and welfare benefits. With more than 20 years of employee benefits experience, she routinely assists employers with practical approaches to challenging issues that often arise in the initial implementation and day-to-day administration of H&W benefits. Lisa knows how to navigate the complex regulations and laws impacting employers’ H&W plans, including the ACA, HIPAA, COBRA ERISA, Internal Revenue Code, GINA, and Medicare. Employers turn to her for advice on group health plans for their active and retired employees, cafeteria plans, wellness programs, HRAs, HSAs, and health and dependent care FSAs.
While Lisa focuses her practice on health and welfare benefits, she has also worked on a range of employee benefit matters including tax-qualified retirement plans (401(k) plans, pension plans, ESOPs and cash balance plans), non-qualified deferred compensation plans and other executive compensation matters. She has worked with small and large private and public companies, governmental agencies, and nonprofits.
Before joining Smith Downey, Lisa served as Counsel for three large regional and national law firms. She also has experience as in-house counsel for a national employee benefits brokerage firm, where she assisted insurance producers and consultants with a number of health and welfare compliance matters. Before becoming an attorney, she worked with a national multi-employer pension plan on all aspects of claims administration.
Examples of Lisa’s experience counseling employers regarding the impact of the ACA on group health plan designs and a multitude of compliance issues that pre-date the ACA are illustrated below.
Affordable Care Act
- Represented employers regarding ACA reporting, including responding to IRS proposed assessments of employer shared responsibility payments and coordinating with ACA reporting vendors to implement client reporting processes
- Address ACA affordability issues including impact of wellness incentives, HRAs and spousal surcharges
- Analyze ACA full-time employee definition as applied to employer eligibility criteria
- Represented employers regarding impact of controlled group structures on applicable large employer status.
Non-ACA health and welfare matters
- Review health and welfare plan issues prior to and after merger and acquisition transactions, including implementing transition service agreements and post-transaction consolidation of multiple H&W benefits into uniform benefit platform
- Draft health and welfare wrap documents, summary plan descriptions and amendments to reflect optional and required changes in plan design
- Advise clients regarding COBRA compliance, including interaction with Medicare and severance benefits
- Develop strategies to mitigate state and federal MEWA risks
- Assist with the preparation of HIPAA privacy notices, business associate agreements, policies and procedures and provide routine advice regarding HIPAA compliance
- Assist large employer in the successful navigation of the IRS audit process
- Review claims and drafting communications regarding the outcome of review process
- Represent client in DOL penalty assessments for failure to file complete Form 5500
- Advise clients regarding prohibited discrimination in H&W plan designs that favor highly compensated employees
- The University of Maryland School of Law, JD, with high honors
- The University of Maryland University College, BS
Admitted to Practice
- District of Columbia
- Updated IRS Guidance for Assessment of Employer Shared Responsibility Payments Under the Affordable Care Act, | Troutman Sanders News & Knowledge (2017)
- President Trump’s Affordable Care Act Executive Order – Business As Usual for Employer Sponsored Group Health Plans, | Troutman Sanders News & Knowledge (2017)
- IRS Notice 2016-70 Grants Narrow Extension for ACA Filing Requirement and Penalty Relief for Employers, | Troutman Sanders News & Knowledge (2016)
- Nondiscrimination Protections for Transgender Care under Section 1557 of ACA, | TerraLex Connections (2016)
- EEOC Final Wellness Regulations Under the ADA and GINA Increase Compliance Burden for Wellness Programs” | TerraLex Connections (2016)
- Summary of Benefits and Coverage Update: Release of New Proposed Template, Instructions and Related Materials | Troutman Sanders News & Knowledge (2016)
- US Supreme Court Ruling – ERISA Equitable Relief Not So Equitable? | Troutman Sanders News & Knowledge (2016)
- IRS Notice 2015-17—Employer Payment Plans and the ACA's Market Reforms | Bloomberg BNA, TerraLex Connections (2015)
- DOL Audits – What You Don’t Know Can Hurt You | BB&T Insurance Services White Paper (2014)