Labor & Employment Insurance

Read need-to-know updates, commentary, and analysis on Labor & Employment issues written by leading professionals.
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Entities that are subject to the Affordable Care Act’s Nondiscrimination Rules must post notice by October 17, 2016 and implement...

In May, the Department of Health and Human Services (“HHS”) published a final rule implementing Section 1557 of the Affordable Care Act (“ACA”). The rule prohibits discrimination on the basis of race, color, national origin,...more

Washington Supreme Court: Corporate Attorney’s Communications with Former Employees Not Privileged

The Supreme Court of Washington recently held that the attorney-client privilege does not protect a corporation’s attorney’s communications with former employees of the corporation, even if the communications concern events...more

A Question of Timing – Social Security Disability Determinations and the Administrative Record

Seyfarth Synopsis: Court excludes evidence of Social Security disability award issued after the final decision issued on plaintiff’s claim for plan disability benefits. The decision accentuates the importance of fighting to...more

Dealing with Long-Winded Out-of-Network Provider Nuisance Letters

Over the past couple years, more and more of my clients with self-funded plans have received letters from out-of-network providers appealing denied claims. The letters are usually 20 to 30 pages long, not very specific, and...more

As Obamacare draws fire, millions more struggle with employer coverage

The Affordable Care Act aka Obamacare has been a vital path into health insurance coverage for millions of Americans. But the Houston Chronicle and other media deserve credit for reminding that most people in this country...more

HIPAA Compliance – Not Just an Issue for Health Care Providers

Many people believe that compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) is solely an issue for health care providers and their affiliates. However, nothing could be further from the...more

Financial Services - Preparing Your Global Workforce for the New UK Whistleblowing Regime

New rules on whistleblowing have come into effect which impact certain Financial Conduct Authority (FCA) and Prudential Regulatory Authority (PRA) regulated financial services firms. The aim of these rules is to promote a...more

NEW UPDATE: Is Your Workers’ Compensation Program Unlawful?

In two previous posts, on April 19, 2016 and June 21, 2016, we reported on the EquityComp workers’ compensation program offered by Berkshire Hathaway subsidiaries Applied Underwriters (Applied) and California Insurance...more

Upcoming CLE examines ways to avoid tax traps in life insurance

Beware that an employer-owned life insurance contract might not qualify for the usual exclusion from regular income tax. An “employer-owned life insurance contract” (a term that applied to much more than one would think) does...more

CT Supreme Court Permits a Workers' Compensation Insurer to Sue Third Parties for Reimbursement

In a decision to be officially released on September 27, 2016, the Connecticut Supreme Court holds that a workers’ compensation insurer can maintain an equitable subrogation claim against third-party tortfeasors to recover...more

Louisiana Supreme Court Adopts Pro Rata Allocation of Defense Costs Among Insurers and Insured

On September 7, 2016, the Louisiana Supreme Court applied, for the first time, a pro rata allocation method to defense costs where commercial general liability policies provided coverage during a portion of the time of...more

Maine WC Alert: WC Board Appellate Division Rules on Medical Marijuana Reimbursement

The Workers’ Compensation Board Appellate Division recently issued decisions in Bourgoin v. Twin Rivers Paper Company, WCB App. Div. No. 16-26 (August 23, 2016) and Noll v. Lepage Bakeries, Inc., WCB App. Div. No. 16-25...more

Louisiana Supreme Court Adopts Time on the Risk Allocation for Defense Costs

In its recent decision in Arceneaux v. Amstar Corp., 2016 La. LEXIS 1675 (La. Sept. 7, 2016), the Supreme Court of Louisiana had occasion to consider whether an insured must bear a pro rated share of defense costs for...more

Employers Who Self Administer Life Insurance Plans Had Better Do So Correctly

Many employers self-administer welfare benefit plans such as life insurance or disability insurance plans. This self administration requires the employer to determine eligibility for coverage, remit proper premiums and notify...more

Long Term Disability Payments: Standard for Abuse of Discretion

Insurance for long term disability – payments to an insured who is prevented from earning his or her income due to long term disability – is a fruitful field for litigation for many reasons. Though the insurance may be...more

California Court Finds That Discretionary Clauses in Health Insurance Policies Are Enforceable

In 2011, the California legislature passed Insurance Code Section 10110.6 which bans the use of discretionary clauses in any policy, contract, certificate, or agreement offered, issued, delivered, or renewed, whether or not...more

Federal District Court Enforces Forum Selection Clause Contained in ERISA Plan

A federal district court in the Eastern District of Pennsylvania transferred an ERISA lawsuit against Caterpillar Inc. to the Northern District of Illinois after finding the forum selection clause contained in the governing...more

United Behavioral Health v. MIHS

Medicare Part C, 42 U.S.C. §§ 1395w-21 et seq., permits enrollees to obtain Medicare-covered healthcare services from private healthcare organizations and their third-party contractors. The Employee Retirement Income Security...more

Check Your Neutral Policies: The EEOC Joins the ACLU’s Challenge to Dignity Health’s Exclusion of All Care Related to Sex...

The ACLU filed a complaint against Dignity Health, claiming that the total exclusion of care related to “sex transformation surgery” in Dignity’s employee health insurance plan is unlawful sex discrimination. Now the EEOC...more

What is Telemedicine? A Cool Benefit or a Hot Mess?

We’ve had numerous inquiries lately about telemedicine benefits. My clients most typically ask either “is this a group health plan?” or “is it just access to another provider?” Clearly, there is much confusion surrounding...more

Hospital and Fixed Indemnity Policies; Excepted Benefits; Supplemental Coverage under Recently Proposed Treasury Regulations; and...

We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more

Michigan Health Insurance Claims Assessment Act is Not Preempted by ERISA

The Sixth Circuit, has decided, on remand from the Supreme Court, that the Michigan Health Insurance Claims Assessment Act (Act) is not preempted by ERISA. The Act imposes a 1 percent tax on all paid claims by insurers or...more

ERISA Preempts State Law Requiring Insurer “Prompt Payment”

Alaska’s prompt pay statute—which requires insurers to pay benefit claims within 30 days of submission—is preempted by federal laws governing employer-provided benefits and benefits for government workers, a federal judge...more

Health Plan Case Managers Entitled to Overtime Pay

Managed care companies help insurers and government programs coordinate healthcare plans by making coverage determinations for participants. In many situations, case managers conduct utilization reviews to determine the...more

Where Does a Third Party “Stand” on Liens?

Dion v. William Robert Batten, Sr. (8/2/16) Facts and Procedural History: Plaintiff was employed by Neuwirth as a servicing agent. In the course and scope of his employment with Neuwirth, he was involved in a car...more

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