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Northern Mariana Islands Retirement Fund Files For Bankruptcy
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
Last month a NJ Appellate Division panel held in three consolidated appeals that a NJ hospital’s state law claims that a health care plan must pay full price for medical services the hospital provided to plan participants are...more
The Supreme Court recently held that federal law pre-empts state law that attempts to reallocate proceeds accruing to the designated beneficiary of a federal life insurance policy. Hillman v. Maretta, 133 S. Ct. 1943 (2013)...more
Recently, in Hillman v. Maretta, the Supreme Court of the United States affirmed a Virginia Supreme Court ruling that held that federal law preempts a state law that allowed a deceased federal employee’s spouse to sue a...more
In U.S. Airways v. McCutchen, the U.S. Supreme Court upheld the ability of U.S. Airways’ health plan to recover medical expenses that it previously paid to the injured party from a third party settlement, but remanded the...more
In a prior blog, I discussed the importance of including unambiguous reimbursement rights in health plan documents in order to manage healthcare costs. The enforceability of such rights was confirmed by the United States...more
On April 16, 2013, the U.S. Supreme Court issued its decision in US Airways, Inc. v. McCutchen (No. 11–1285), deciding the issue of whether equitable defenses, such as the principle of unjust enrichment, can override the...more
The U.S. Supreme Court yesterday strengthened the ability of employer health insurance plans to recoup payments for medical expenses paid for an injured plan participant who later sues to recover damages from a third...more
The scenario is not difficult to imagine: An employee designates her spouse as the primary beneficiary under her employer’s life insurance and retirement benefit plans. Years later, the couple divorces, and in the marital...more
So yesterday, I made a convincing case that employees who smoke outside the workplace can’t be treated differently than your non-smokers. ...more
In This Issue:
- Editor's Overview
- ERISA Preemption in Provider Misrepresentation Claims: An Overview of the Jurisprudence Leading Up to the Fifth Circuit's En Banc Review of Access Mediquip and What Lies...more
Although the Supreme Court, in a landmark decision earlier this summer, affirmed the constitutionality of the Patient Protection and Affordable Care Act (ACA), the challenges to and controversies surrounding that Act are far...more
When does ERISA govern short term disability payments?
Take a look at this recent case, Behjou v. Bank of America et. al, [PDF] __ F.Supp. 3d __ (N.D. California May 1, 2012).
FACTS: Behjou brought short term...more
The Capital Bank & Trust decision enforcing a fidelity bond's termination provision reflects the majority rule that there is no fidelity coverage for loss from an employee's acts when the employer knows in advance of the loss...more
The new Michigan Health Insurance Claims Assessment Act imposes a 1-percent tax on “paid claims” for health-related services of employer-sponsored health and welfare plans.
Employer plan sponsors with...more
The Supreme Court announced on Monday, November 14, 2011 that it will hear challenges to the Patient Protection and Affordable Care Act (PPACA). President Obama signed PPACA on March 23, 2010, and legal challenges to the...more
Earlier this year, California Shock Trauma Air Rescue (“CALSTAR”), an air ambulance company rendering services primarily in California, filed an action in federal court in Sacramento against more than 75 workers’ compensation...more
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