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Participant’s Estate Fails to Show a Claim For Failure to Give Notice of Right to Continue Life Insurance Coverage: Estate of...

Providing a practical lesson on determining a duty to give notice to ERISA participants, the U. S. District Court for the Middle District of Florida dismissed the claim by the estate of an ERISA group life insurance plan...more

More ERISA Complications

In passing the Employee Retirement Security Act of 1974 (“ERISA”), Congress sought to make it as easy and economical as possible for employers to provide benefits to their workers; for example, pensions, health insurance,...more

Limited Relief for Certain Employer Health Plan Premium Payments or Reimbursements

Under so-called “employer payment plans” (“EPPs”), an employer pays or reimburses an employee for substantiated premium costs under individual health plan insurance coverage (i.e., nonemployer individual health plan...more

Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform

Abstract - States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by...more

Motor Carriers Are Liable For Injuries to Drivers of Leased Vehicles Who Are Classified As Independent Contractors

Jose Vargas v. FMI, Inc. et al. - In Vargas, California’s Second Appellate District held that the Privette doctrine does not shield a motor carrier operating under a federal franchise from liability for tort injuries...more

Kentucky Court: Depreciating Labor to Get Actual Cash Value Is Like Making the Insured Use a Very Old Roofer With Debilitating...

Surprisingly few states have addressed the question of whether an insurer can depreciate labor – as opposed to materials – to arrive at actual cash value (ACV). ...more

Recent Federal Court Ruling: No ERISA Preemption of Texas Prompt Pay Law Regarding Payment Deadlines; Texas Legislature May Act on...

What's new. A Texas federal district court has ruled that ERISA does not preempt or prohibit application of the Texas Prompt Pay ("TPP") law to Third Party Administrators ("TPAs") of self-funded benefit plans. Judge Lynn...more

Summary of California Appellate Decisions - March 2015

HOW TO USE THIS CASE SERVICE - When you receive your summaries, each page will have an alphabetical letter located in the upper right-hand corner. Each alphabetical letter corresponds to a separate subject matter...more

First Circuit’s RAA-Friendly Ruling Stands

The class plaintiffs’ challenge to a group life insurer’s use of so-called retained asset accounts (RAAs) in Merrimon v. Unum Life Insurance Company of America has come to an unsuccessful end. On January 26, the United...more

SCOTUS Delivers Opinion in Pregnancy Discrimination Battle

Supreme Court Revives Pregnancy Discrimination Suit But Denies Pregnant Employees “Most-Favored-Nation” Status On March 25, 2015, the Supreme Court revived an employee’s pregnancy discrimination suit against UPS, finding that...more

Case Alert: Employee Benefits Insurance – Does Coverage Apply to Employees Working Overseas?

What happened? In Rai v Legal & General Assurance Society [2015] EWHC 170, the English High Court decided that coverage was not available under an employee benefits insurance policy due to the operation of an exclusion in...more

Obama Administration Finalizes Health Insurance Wraparound Coverage Rule

The Departments of Labor, Health and Human Services, and Treasury published a final rule on March 18, 2015 that amends the definition of excepted benefits to allow group health plan sponsors, in limited circumstances, to...more

En Banc Sixth Circuit Rules Against Disgorgement Remedy in Benefits Case

In Rochow v. Life Insurance Company of North America, No. 12-2074 (6th Cir. March 5, 2015), the U.S. Court of Appeals for the Sixth Circuit, sitting en banc, ruled that an insurance company that wrongfully denied benefits to...more

FCA Releases Discussion Paper Under MiFID II

The revised Markets in Financial Instruments Directive (“MiFID II”) came into force on 2 July 2014. It will have effect on 3 January 2017, reflecting the period required for European Union member states to transpose its...more

The Affordable Care Act Part Three – Upcoming Requirements & the Impact Recent Judicial Decisions Have on the ACA

This is the last of our three part series on the Affordable Care Act (“ACA” or “Act”), commonly known as “ObamaCare.” This post discusses upcoming requirements under the ACA and judicial decisions that have impacted or may...more

BEST IN LAW: Employers need to heed Obamacare Reporting Rules

Compliance with reporting obligations is always important for any employer, but the employer reporting requirements under the Affordable Care Act pack a significant penalty that makes compliance particularly...more

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial – This Time

Wrongful denial of employee benefits will not expose plan fiduciaries to equitable remedies – such as disgorgement of profits – where restoration of benefits is adequate to make the claimant whole, says the Sixth Circuit in...more

March 23, 2015 Marks the 5th Anniversary of the Affordable Care Act

On Tuesday, March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. We want to take this opportunity to share with you some highlights of the past five years, and also to thank you for...more

Ninth Circuit Rules That Harmless Procedural Violation Does Not Alter Standard of Review

The Ninth Circuit held that a plan administrator’s failure to render a decision on a long-term disability benefits claim within the period mandated by the plan and ERISA did not alter the standard of review that the court...more

Manatt on Health Reform: Weekly Highlights - March 2015 #3

FEDERAL NEWS: More than 8 in 10 Federal Marketplace Enrollees Receive Tax Credits - According to data released by CMS, 7.7 million consumers, or 87 percent of those on the Federally-facilitated Marketplace with...more

The Sixth Circuit Vindicates the Fourth and Eleventh.

The en banc Sixth Circuit reaffirmed what the Fourth and Eleventh Circuits knew all along. Ever since Cigna v.Amara, 131 S. Ct. 1866 (2011), in which the United States Supreme Court provided fresh theories (e.g.,...more

2014 Pension Plan Regulatory Highlights

The start of the new year is as good a time as any to look back at some of the employee benefits regulatory developments of 2014 that were not previously covered in this column. Originally published in Employee Benefit...more

IRS Provides Temporary Enforcement Relief for Small Employers Offering Employer Payment Plans

The IRS issued guidance providing enforcement relief through June 30, 2015 for small employers who offer employer payment plans to their employees. In the guidance, the IRS reiterated its stance that an employer payment...more

Insights and Strategies on Class Action Litigation from General Counsel and Chief Legal Officers [Video]

To read the full 2015 Class Action Survey report, please visit ClassActionSurvey.com. Across industries, companies spent $2 billion on class action lawsuits in 2014, slightly less than the $2.1 billion they spent in 2013....more

IRS Releases Preliminary Guidance on “Cadillac Plan” Tax under ACA

The IRS released Notice 2015-16, which represents the first piece of guidance issued by a regulatory agency on the excise tax on high cost employer-sponsored health coverage, colloquially known as the “Cadillac plan” tax. The...more

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