Labor & Employment Administrative Agency Insurance

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Executive Labor Summary - June / July 2015

What are the labor implications of Supreme Court’s decision in King v. Burwell? - On June 25, the U.S. Supreme Court upheld the Affordable Care Act (also known as “Obamacare”) in a 6-3 decision written by Chief...more

How Does the King v. Burwell Decision Affect the Affordable Care Act?

The Supreme Court handed the Obama administration a key victory this morning, upholding the tax credits that allow many low-income Americans to purchase health care insurance in states where the federal government is running...more

Ninth Circuit Extends ERISA Deadline, Revives Untimely Appeal

Last week, the Ninth Circuit Court of Appeals issued its opinion in LeGras v. AETNA Life Insurance Company, No. 12-56541 (May 28, 2015), holding that the 180-day period to appeal a denial of a long-term disability claim was...more

ERISA (9th Cir.) A Day Late, But Not A Dollar Short — Counting The 180 Day Appeal Period Gets Easier For Claimants

You know that under ERISA regulations a claimant has at least 180 days to appeal a benefit denial. ERISA plans set out contractual timelines for appeals. But what happens when that 180 day period runs out on a weekend?...more

Federal Court Changes the Playing Field on ‘Agreed’ Civil Penalties in Regulatory Proceedings

The very recent decision of the Full Court of the Federal Court (handed down on 1 May 2015) in Director, Fair Work Building Industry Inspectorate v CFMEU [2015] FCAFC 59 has changed the law in relation to the Court’s approach...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

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

Municipal Legal News - Volume 1 Number 1

Major Freedom of Information Act ("FOIA") Amendments - Public Act 563 of 2014 ("Act 563") amends the FOIA to impose a number of new regulations on public bodies. All municipalities will need to review their FOIA...more

DOL Issues Final Rules on Annual Funding Notice for Defined Benefit Plans

The Department of Labor recently issued final regulations implementing the annual funding notice that defined benefit plans are required to provide under Section 101(f) of ERISA. The final regulations are similar to the...more

DOL Investigations: A Shift in Focus

The Issue: During a recent Department of Labor (“DOL”) investigation for a local California employer, we experienced an increased focus by the DOL on plan expenses. While this isn’t necessarily surprising given the increased...more

The Future of Premium Subsidies under the Affordable Care Act: 'Halbig v. Burwell' and 'King v. Burwell'

Both decisions addressed whether tax credits are available for residents in states that have federally-facilitated health exchanges. The District of Columbia Court of Appeals said “no”; the Fourth Circuit Court of Appeals...more

How Big Is Halbig? The Viability of the ACA’s Employer Mandate Hangs in the Balance

For employers with employees in the 36 states with a federally facilitated exchange, the question arises how the Halbig decision impacts their decision and strategy to provide health coverage to their employees when the...more

I Can’t Get No SATISFACTION-- In the Eleventh Circuit, Is Discretionary Language Still "Satisfactory to Us"?

Ever since the United States Supreme Court addressed the question of whether a wholesale adoption of the "arbitrary and capricious" standard of review would be appropriate for judicial review of denial of benefit...more

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

Australia’s High Court Denies Employee Worker’s Compensation Claim For Sex Injury

Ruling in a 4-2 decision[1], the Australian High Court denied a government employee worker’s compensation claim for an injury the employee sustained while having sex in a motel room during a business trip. The female...more

The Affordable Care Act & the Impact on the C-Suite – Interview with Alden Bianchi, Member, Mintz Levin [Video]

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses why the Affordable Care Act makes health care benefits something that should be top-of-mind to...more

The Affordable Care Act: The Structure of Health Plans – Interview with Alden Bianchi, Member, Mintz Levin  [Video]

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses how health plans will be purchased under PPACA....more

State Insurance Commissioner’s “Non-Binding” Opinion Banning Discretionary Language Has No Effect in Court

An Insurance Commissioner’s non-binding opinion banning discretionary language in an ERISA governed plan has no effect. Here’s the case of Frazier v. Life Insurance Company of North America, __ F.3d __ (6th Cir. August...more

Arizona Court Of Appeals Decision Highlights Employer’s Burden Of Proving Disqualification From Unemployment Benefits

The Arizona Court of Appeals recently issued an opinion overturning the Unemployment Insurance Appeals Board’s denial of unemployment benefits to an employee who was terminated for excessive tardiness. ...more

Subrogation Claims are “Equitable Relief” Governed by ERISA

That subrogation claim you have might be governed by ERISA, at least in some circuits… Here’s the case of Thurber v. Aetna Life Insurance Company, __F.3d__ (2nd Cir. March 13, 2013) (Insurer’s counterclaim for return...more

8th Circuit – Expressing Intent to Appeal in the Future Does Not Constitute an “Appeal.”

How does an ERISA claimant start an administrative appeal? Can a mere request for medical records, and a reference to an “appeal in the future tense,” trigger the appeal? No....more

Labor & Employment Law Update - January 2013 : New Year Employer Checklist

In This Issue: - New Health Care Mandates - I-9's for Immigration in 2013 - A Policies and Procedures Review - Classifying Employees as Exempt or Non-Exempt? - Awareness of National Labor Relations Board...more

Take 5: Views You Can Use - January 2013

In this issue: - Assess the Workforce - Choose Whether to "Pay" or to "Play" - Evaluate Existing Wellness Programs and/or Implement New Wellness Programs to Enhance Employees' Health Profiles and to Avoid or Minimize...more

Health Care Reform: Recent Guidance on "Play or Pay" Rules for Applicable Large Employers in 2014

Many important aspects of the Patient Protection and Affordable Care Act ("ACA") will go into effect in 2014, including the implementation of health insurance exchanges, and the requirement for certain employers to offer...more

Health Care Reform Update: Many Self-Insured Plans Subject to New Annual Fees This Year

New regulations have been issued under the Patient Protection and Affordable Care Act (“PPACA”) implementing annual fees and reporting requirements on self-insured health plans and indirectly on fully insured plans. The...more

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