Labor & Employment Insurance

Read need-to-know updates, commentary, and analysis on Labor & Employment issues written by leading professionals.
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Second Circuit Reminds Healthcare Providers to Seek Relief from Insurance Companies Under Their Own Contracts, Not the Insureds’...

In Rojas v. Cigna Health and Life Ins. Co., 793 F.3d 253, 258 (2d Cir. 2015), the Second Circuit joined several other circuits in holding that “healthcare providers are not ‘beneficiaries’ of an ERISA welfare plan by virtue...more

DOL Issues Proposed Revisions to Disability Plan Claims Regulations

The Department of Labor published proposed changes to its regulations governing disability claims and appeals in the Federal Register on November 18, 2015, and invited comments. The stated purpose of the proposed changes is...more

Group Life Insurance Claims by a Teacher’s Beneficiary Are Subject to ERISA Preemption: Woods v. American United Life Insurance...

On ERISA preemption grounds, a federal court has ruled against state law claims asserted by the beneficiary of a former school teacher who sought benefits from a group life insurance policy. Woods v. American United Life...more

Fiduciary Liability Insurance is Worth It

The warranty in the electronics business is gravy for the retailers who sell it. You’ll be surprised how many people pay $20 to get a warranty on a $100 Blu-Ray player. When Best Buy was going national, they advertised how...more

Supreme Court Agrees to Review Additional ACA Birth Control Mandate Cases

Last week, the U.S. Supreme Court agreed to hear the consolidated appeals of seven cases involving employer provision of birth control under the Affordable Care Act. In its 2013 Hobby Lobby case, the Court concluded that the...more

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

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 17 of 24): Reporting for Offers of Coverage and...

The recently enacted Bipartisan Budget Act of 2015 repealed Section 1511 of the Affordable Care Act (ACA), which generally would have required employers with more than 200 full-time employees to automatically enroll new...more

Issue 95: Health Care Reform Reporting Is Coming: Is Your Company Prepared?

This is the ninety-fifth issue in our series of alerts for employers on selected topics in health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of certain aspects...more

It’s health insurance open enrollment — research, choose carefully

November has become more than the month devoted to families and feasting: It’s now the start of the season when Americans try like heck to avoid becoming health insurance turkeys. Open enrollment periods are under way — for...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

ACA Reporting 101

One of the new Affordable Care Act (ACA) requirements imposed on employers is the obligation to report employee group health plan coverage information to the IRS and employees on Forms 1094-C and 1095-C. The first required...more

FCA and PRA Rules On Whistleblowing

The UK Financial Conduct Authority (FCA) and the Prudential Regulation Authority (PRA) published new whistleblowing rules in October 2015 (click here for FCA policy and here for PRA) aiming to ‘encourage a culture in which...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

November and December 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...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

New Affordable Care Act FAQs Provide Guidance on Preventive Services, Wellness Programs and Mental Health Parity

On October 23, 2015, the Departments of Labor, Health and Human Services and Treasury (the “Agencies”) jointly released their twenty-ninth (XXIX) set of Frequently Asked Questions (FAQs) about Affordable Care Act (ACA)...more

Recent Government-Issued FAQs Cause Plan Sponsors to Clarify Preventive Care and Wellness in Health Plan Communications

On October 23, 2015, the U.S. Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued frequently asked questions (FAQs) on the implementation of preventive care and wellness provisions of the...more

ACA Automatic Enrollment Mandate Repealed by Bipartisan Budget Act

On Monday, November 2nd, the President signed the Bipartisan Budget Act of 2015 (BBA). Some legislators had hoped that a budget deal would at least include a repeal of the controversial 40% excise tax on high-cost health...more

Benefits Fast Facts

PACE Act: Some Positive News For Employers With 51 To 99 Employees - For insurance market reform purposes, the Affordable Care Act (ACA) initially defined “small employers” as those with fewer than 50 employees. This...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

Automatic Enrollment for Health Plans Has Been Repealed

Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of...more

New Texas Medical Stop-Loss Rules Drafted by Texas Department of Insurance

Within an environment of increased federal and state regulatory emphasis on health insurance related issues arising due to the passage by the U.S. Congress of the Patient Protection and Affordable Care Act of 2010, the Texas...more

New UK Regulations to Govern Whistleblowing in Financial Institutions

This month, the FCA and PRA announced a new regime for whistleblowing that will start to be phased in from March 2016. This is part of the broader desire on the part of the UK regulators to encourage individuals to raise...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

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