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California Court Sustains Disclaimer Based on Employment Practices Exclusion

In John Davler, Inc. v. Arch Insurance Company, 2014 Cal. App. LEXIS 837 (Cal. App. Sept. 15, 2014), the California Court of Appeal had the opportunity to consider the application of an employment-related practices exclusion...more

Disparate impact cases against HUD: Illinois federal court issues decision; update on D.C. case

Because of their potential impact on the CFPB’s conclusion that the ECOA and Regulation B encompass disparate impact claims, we have been following two insurance industry lawsuits involving a challenge to HUD’s Federal...more

ERISA self-insured health plan not required to cover same sex spouses

In Roe v. Empire Blue Cross Blue Shield, No. 12–cv–04788 (NSR), 58 EBC 1077, 2014 WL 1760343 (S.D. N.Y. May 1, 2014), the United States District Court for the Southern District of New York held a self-insured health plan that...more

In an Opinion with Far-Reaching Implications, the Second Circuit Finds Insurance Coverage for an ERISA Claim

When a general liability policy expressly provides coverage for employee benefits liability and the plaintiff in the underlying suit alleges a violation of the Employee Retirement Income Security Act of 1974 (“ERISA”), does...more

The Federal Court for the Southern District of New York Rules that Employers with Self-Insured Health Plans Need Not Offer Medical...

The issue of same-sex spousal rights is now largely resolved for qualified retirement plans. However, substantial questions about same-sex spouse health benefits remain unanswered. In Roe v. Empire Blue Cross Blue Shield,...more

Another insurance industry trade association group challenges the HUD disparate impact rule

We have been following the lawsuit in federal district court in D.C. in which two insurance industry trade associations have challenged the HUD disparate impact rule. The complaint in the D.C. action, which was commenced in...more

Questions You Should Be Asking About Employment Practices Liability (EPL) Insurance

Every firm has employees, as well as individuals that it has “failed” to hire, or promote, or recognize and reward to the extent that the individuals believes befitting. This is what makes it difficult to completely avoid...more

Medicare Appeals Panel Invalidates National Coverage Determination Prohibiting Coverage for Gender Reassignment Surgery

On May 30, 2014, the Departmental Appeals Board (DAB) issued a decision invalidating the long-standing National Coverage Determination (NCD) prohibiting Medicare payment for transsexual surgery (now known as gender...more

Health Care Reform Implementation Update

Affordable Care Act (ACA) action on Capitol Hill this past week centered on investigations into improper ACA subsidy payments, a potential constitutional amendment proposal, and support for an appeal of the ACA in favor of a...more

OFCCP Setting Its Sites On TRICARE Providers?

Healthcare providers are waiting anxiously to see the Office of Federal Contract Compliance Programs’ (OFCCP) most recent position on whether it will continue trying to assert jurisdiction over them on the basis of...more

Cost of Insurance Litigation -- District Court Says Stick to Enumerated Factors

In a class action challenging a cost of insurance (COI) rate increase, a New York federal district court has stated that an insurer may only consider factors specifically enumerated in the policy when raising COI rates on a...more

HHS Guidance Clarifies that Insurance Companies Must Make Available Health Insurance Coverage for Same-Sex Spouses

On March 14, 2014, the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) released guidance clarifying the final regulations implementing Section 2702 of the Public Health Service Act...more

Update on disparate impact lawsuit against HUD

The settlement and Supreme Court’s dismissal of Mount Holly v. Mt. Holly Gardens Citizens in Action, Inc. has increased the potential significance of the lawsuit filed in June 2013 in federal district court in Washington,...more

Show Your Work!—The Ninth Circuit Affirms That Courts Must Explain the Math Behind the Calculation of Attorneys’ Fees

It’s an often-repeated adage of high school math teachers: show your work. In three decisions in 2013, the Ninth Circuit has demonstrated that Courts must follow this principle in calculating awards of attorneys’ fees....more

Employee Benefits Developments November 2013

RULINGS, OPINIONS, ETC. - Religious Employers and the Women’s Contraceptive Mandate Background - This past July, the U.S. Departments of Labor, Health and Human Services, and the Treasury released final...more

FIO Focus - November 2013, Issue 43

On November 19, 2013, the House Financial Services Subcommittee on Oversight and Investigations held a hearing entitled "A General Overview of Disparate Impact Theory." The hearing covered the use of disparate impact...more

Health Alert (Australia) - 28 October 2013

In This Issue: - Judgments - Legislation - Reports - Excerpt from Judgments: Commonwealth - 23 October 2013 - Maiocchi v Royal Australian & New Zealand College of Psychiatrists [2013] FCA...more

State and Federal False Claims Act Defendant Seeks to Prevent Use of Claims Documents in Case Filed By Former Employees

United States ex rel. Bahnsen v. Boston Scientific Neuromodulation Corp., No. 11 CV 1210 (SDW) (MCA) (D.N.J.).: Two former employees of Boston Scientific Neuromodulation Corporation (BSNC) – one from its Customer Service...more

Courts Split On Whether Mandatory Contraceptive Coverage Violates Religious Freedoms Of For-Profit Corporations

Under the Patient Protection and Affordable Care Act’s preventive services mandate, non-grandfathered group health plans must provide 100% coverage of contraceptives for women, subject to exemptions and safe harbors for...more

New Wellness Program Rules for 2014

Employers continue to look for ways to manage the cost of employee health care coverage as they navigate the turbulent waters of healthcare reform, and wellness programs continue to be a popular strategy. However, adoption...more

ACA Not Enough to Save Penn State’s Employee Wellness Program

Recent negative media reports caused Pennsylvania State University to modify its employee wellness program, making clear that considering compliance with the Patient Protection and Affordable Care Act of 2010 (ACA) alone is...more

WANTED: EEOC Guidance On Wellness Plans Under The ACA

Employee wellness plans have been in the spotlight lately. This is because new wellness plan rules published in the Patient Protection and the Affordable Care Act (informally called Obamacare) are slated to take effect in...more

The Key to a Healthy Corporate Wellness Program

As employers and lawmakers seek creative solutions to rising health-care costs, corporate wellness programs have exploded in popularity. Many employers have embraced corporate wellness programs as a means of controlling...more

Carrot Or Stick? When Does A Voluntary Wellness Program Become Involuntary?

Employer wellness programs, which are designed to stem rising health care costs by encouraging healthy behaviors among employees, are rising in popularity. Such programs will receive another boost when certain provisions of...more

DOL FAQ Confirms No Penalty For Failure To Distribute Exchange Notice, Obligation Still Remains

On Wednesday, September 12, the Employee Benefits Security Administration (EBSA), which is a division of the Department of Labor (DOL), released another FAQ indicating that no penalty or fine will be applied for failing to...more

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