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New SBC Template Goes Into Effect April 1

The U.S. Department of Labor (DOL) released a new template for the Summary of Benefits and Coverage (SBC) last year. As background, the Affordable Care Act requires health plans and health insurers to annually distribute SBCs...more

ERISA: 7 Things to Know About Limited Discovery in ERISA Long Term Disability Cases

You already know that discovery in ERISA cases is generally limited because of the “significant ERISA policy interests of minimizing costs of claim disputes and ensuring prompt claims-resolution procedures.”...more

Eleventh Circuit Holds Employee Entitled to Permissive User Status Despite Violation of Company Policy

In its recent decision in Great American Alliance Ins. Co. v. Anderson, 2017 U.S. App. LEXIS 2277 (11th Cir. Feb. 8, 2017), the United States Court of Appeals for the Eleventh Circuit, applying Georgia law, had occasion to...more

Indiana Applies Heightened Summary Judgment Standard In Determining Vicarious Liability For An Employee Driving A Provided Company...

For an employee, the opportunity to drive a company vehicle is certainly a job perk. For an employer, however, issuing company vehicles comes with the risk that it may be held liable for any negligence of the employee arising...more

Floundering GOP gets its ACA repeal-replace architect and tries ‘repairs’

Republicans jammed through their health policy guru in the middle of the night, and they and their new HHS Secretary are still trying to figure out what to do with the Affordable Care Act, aka Obamacare. Insurance markets are...more

Three Point Shot - February 2017

Ski Manufacturer Chills Bode Miller's Comeback - World champion skier and six-time Olympic medalist Samuel "Bode" Miller had his eye on coming out of retirement for the 2016-17 season before a contract dispute with his...more

“Repeal and replace” Obamacare? GOP now talking about ‘repairing’ health act

With its furious attack on the Affordable Care Act, aka Obamacare, has the GOP become the proverbial barking dog that finally caught the bus it has chased for so long? Partisans continue to proffer notions for what might be...more

Fourth Circuit Concludes That State Law Claims For Life Insurance Benefits Are Preempted

The Fourth Circuit recently concluded that a Sears employee’s state law claims seeking money damages based on denial of insurance benefits (for failure to submit evidence of insurability questionnaire) was preempted by...more

Employment and Benefits Advisory: 2017 Reminders and Developments

New Relief for Small Employer Health Reimbursement Arrangements - As mentioned in prior advisories, the Departments of Labor, Health and Human Services and Treasury have taken the position that employers cannot reimburse...more

Supreme Court Declines to Hear Appeal to a Michigan Tax on Health Insurance Plans

The Supreme Court of the United States has declined to hear the Self-Insurance Institute of America Inc.’s ERISA preemption challenge to a Michigan tax on health insurance plans....more

Hawai’i Receives Approval for the First State Innovation (Section 1332) Waiver

The federal Department of Health and Human Services and Department of Treasury (the Departments) agreed that certain small employer health insurance coverage provisions of the Affordable Care Act (ACA) would be waived for the...more

New York Bars Insurers from Denying Commercial Crime Coverage Due to Employee’s Prior Criminal Conviction

The New York State Department of Financial Services (NYSDFS) has promulgated a regulation that requires insurance companies to provide Commercial Crime Coverage to employers who have prior knowledge of an employee’s prior...more

Coal Plant Shutdowns: Operators Should Implement Their Document Retention Policies And Protect Against Future Asbestos Claims

As far as contamination concerns go, asbestos-containing materials (ACM) are generally way down the list of issues at a shutdown coal plant. You hire certified contractors, bag the ACM and dispose of it in approved landfills....more

Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more

Legal Alert: 2016 Year in Review

In 2016, the Department of Labor (DOL) continued a curtailed program of interpretive guidance under the Employment Retirement Income Security Act of 1974, as amended (ERISA). As has been the case for several years, the...more

What Does a Trump Presidency Mean for the Affordable Care Act?

President-elect Trump has stated repeatedly that one of his initial goals is to repeal and replace the Affordable Care Act (the "ACA"). Because the Republicans control both houses of Congress, it seems likely that a repeal...more

Researchers see ways Obamacare helped to cut costs, improve patient care

As the already known complications to its demise have increased by the minute, there may be some detectable pauses in the partisan zeal to give the Affordable Care Act, aka Obamacare, the bum’s rush. That’s because the...more

Q&A with Paula Williams: Guidelines allow voluntary employer wellness programs

Guidelines allow voluntary employer wellness programs - Q: A federal court recently heard a case involving a corporate wellness program. What was the basis for the Equal Employment Opportunity Commission (EEOC) lawsuit...more

Pennsylvania District Court Rejects Effort to Certify Retained Asset Account Claims Against Prudential

In Huffman v. Prudential, a federal judge in the Eastern District of Pennsylvania recently rejected the plaintiffs’ effort to certify for class adjudication a claim for alleged breach of ERISA (alternatively, state law)...more

Cures Act Lets Small Employers Reiumburse Premiums

On December 13, 2016, President Obama signed into law the 21st Century Cures Act, which allows small employers to maintain health reimbursement arrangements (HRAs) for the purpose of reimbursing employees for the cost of...more

Small Employers Have New Health Reimbursement Option Under Cures Act

The 21st Century Cures Act (Cures) signed by President Barack Obama on Dec. 13, 2016, contains a smorgasbord of health-related provisions, from reforming federal mental health policies to increasing funding for medical...more

Allocating a Pro Rata Defense Share to the Insured in Continuous Injury Cases

In a matter of first impression, the Louisiana Supreme Court recently held that the duty to defend in a long latency disease case could be prorated between the insurer and insured. (See, Arceneaux v. Amstar Corp. 2016 WL...more

The ERISA Litigation Newsletter - December 2016

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

Retail and Consumer Products Law Roundup - December 2016

How Retailers Can Avoid Regulatory Scrutiny During Holiday Season - With the holiday season often accounting for one-third of a retailer’s annual sales, competition can be fierce. Tempting as it is to grab for every...more

Will the ACA Stay or Will it Go?

After surviving two Supreme Court cases and numerous repeal efforts, the Affordable Care Act (“ACA”) is in jeopardy again. Despite the law’s uncertainty, employers may want to continue their compliance efforts because: (1)...more

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