General Business Labor & Employment Insurance

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United States Supreme Court Tees Up Sequel to “Hobby Lobby” Decision

As we previously reported, in June 2014, the U.S. Supreme Court confirmed in Burwell v. Hobby Lobby that closely-held corporations with religious owners could “opt out” from the Affordable Care Act’s (“ACA” or “Act”)...more

Eastern District of New York ultimately arrives at right outcome when interpreting “Employer’s Liability” exclusion in CGL policy

In Hastings Development, LLC v. Evanston Insurance Company, No. 14-cv-6203 (ADS)(AKT) (Oct. 30, 2015), the U.S. District Court for the Eastern District of New York correctly determined that an “Employer’s Liability” exclusion...more

New FAQs on Preventive Services, Wellness Program Rewards and Mental Health and Substance Use Treatment: McGuireWoods Healthcare...

This is the 54th in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

Employee Benefits Provisions of the Bipartisan Budget Act of 2015

The Bipartisan Budget Act includes the following important employee-benefit related provisions: - It repeals the automatic enrollment mandate of the Affordable Care Act. Under the ACA, employers with more than 200...more

Checklist for Group Health Plan Participant Disclosure Requirements

There has been an explosion of participant disclosure requirements for group health plans in recent years. While health care reform created some of these new requirements, many of them became effective years earlier. For busy...more

ERISA — ATTORNEY FEES: What Happens When The Plan And The Insurer Don’t Agree On The Benefit Denial?

You already know that under ERISA the court has discretion to award attorney fees to a party that has “some success on the merits.”...more

Michigan Court Dismisses Cross-Claim as Insurer Not Properly Subject to a Claim for Breach of Fiduciary Duty

In Van Loo v. Cajun Operating Co, No. 14-cv-10604 (E.D. Mich. Sept. 17, 2015), the Eastern District of Michigan, a Sixth Circuit district court, held that the requirement for evidence of insurability was triggered based on...more

Washington Healthcare Update

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Potential Penalties Creating Adjustments to Health Care Coverage Plan Offerings

What ACA-related issues have had the most impact on welfare benefit plans and may surface during 2016? JRN: 2015 is the year when the potential to be penalized for not offering employee health care coverage that is both...more

Regulators make whistleblowing rules

FCA and PRA have published their feedback, rules and policy documents on whistleblowing. The rules complement the senior manager regime (SMR) and reforms of remuneration rules. The new rules affect...more

Virginia Supreme Court Expands Scope of UM/UIM Coverage

In an opinion issued on September 17, 2015, Est. of Slone v. Selective Ins. Co. of America, et al., the Virginia Supreme Court effectively expanded the scope of UM/UIM coverage in Virginia. Slone was filed as a declaratory...more

ERISA — 7th Circuit: Illinois State Law Ban On Discretionary Clauses Upheld

You already know about the big trend in states to ban discretionary clauses in insurance policies that fund ERISA benefits. Chalk up another circuit deciding to enforce the ban....more

Plaintiffs’ Misdirected Demand for Documents Fails, and Their Claim for ERISA Civil Penalties Is Dismissed: Boyd v. Sysco...

A federal court dismissed the plaintiffs’ claim to recover civil penalties for failure to provide plan documents requested by the plaintiffs. Boyd v. Sysco Corporation, No. 4:13-cv-00599 (D. S. C. September 3, 2015), provides...more

Seventh Circuit Finds that State Insurance Law Applies, Resulting in De Novo Review of Benefit Claim

On September 4, 2015, the U.S. Court of Appeals for the Seventh Circuit ruled in Fontaine v. Metropolitan Life Insurance Company that the Employee Retirement Income Security Act of 1974, as amended (ERISA), does not preempt...more

Employee Benefits Alert - August 2015

Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more

California Court of Appeal Finds Life Insurance Policy Ambiguous and Rules in Favor of the Insured

Sequeira v. Lincoln Nat’l Life Ins. Co., No. A139639 (Cal. Ct. App. Aug. 31, 2015) - The California Court of Appeal recently reiterated the importance of careful drafting to insurers when it reversed a trial court’s...more

EIOPA updates Solvency 2 reporting webpage

EIOPA has updated its Solvency 2 reporting format webpage with revised information on the data point model (DPM) and XBRL taxonomy design. They have been developed in accordance with its guidelines on the submission of...more

InterConnect - Summer 2015

Shippers who are used to doing business with motor carriers often present freight brokers with a shipper-carrier agreement (often described as a “Motor Carrier Agreement”) of one kind or another to serve as the basis of a...more

Zurich Insurance Decision Underscores Need for Caution in Regulatory Compliance

A recent trial court decision in the Federal District Court demonstrates the importance of taking a conservative approach to regulatory compliance. Zurich Insurance v. Country Villa Service Corp involved esoteric questions...more

Wal-Mart Accused of Gender-Discrimination Because of Anti-Gay Insurance Policies

In Cote v. Wal-Mart Stores, Wal-Mart is facing the possibility of a class action suit from a former employee who claims that the company’s denial of healthcare benefits to her same-sex spouse amounts to sex discrimination....more

Tenth Circuit Addresses ERISA Limitations Provision in Class Action Decision

In Fulghum v. Embarq. Corp., 785 F.3d 395 (10th Cir. 2015), the Tenth Circuit Court of Appeals considered the claims of a class of telephone company retirees whose life and health insurance benefits were reduced or eliminated...more

Post-Employment Covenants: Is an Inducement to Smile An Inducement to Cancel?

A recent Circuit Court case confirms that the term “non-inducement” means just that. In American Family Mutual Insurance Company v. Graham, the Eighth Circuit affirmed a jury verdict against an insurance agent who, the jury...more

Lyft Agrees to Pay $300,000 Settlement for Violating New York Insurance Laws

Recently, commuters across the country have witnessed the emergence of ride-sharing companies, such as Uber and Lyft. These companies have become increasingly popular over the last few months, in large part due to their...more

For Life Insurers and Agents – A Summary of Predicted Litigation Under the DOL’s Proposed Fiduciary Rule

The Department of Labor’s recent Proposed Rule (the “Proposal”), which defines the term “fiduciary” as it applies to persons who provide “investment advice” to ERISA plans and IRAs, will impact the likelihood and severity of...more

What does "will be insured" actually mean?

Balancing obligations to provide health and life insurance benefits to retirees with other legitimate business needs can be tricky. Although retirees depend on the benefits, employers may need to modify benefit plans for...more

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