Labor & Employment Insurance

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HRAs Under the Affordable Care Act

Analysis: HRAs are employer-funded accounts designed to reimburse employees for out-of-pocket medical expenses. Employees are not permitted to contribute their own funds, so they are unlike flexible spending accounts or...more

Affordable Care Act in Mergers and Acquisitions: New Guidance from Internal Revenue Service

In Notice 2014-49, the Internal Revenue Service (“Service”) issued guidance on how to avoid potential penalties under the Affordable Care Act (“ACA”) in connection with mergers and acquisitions (“M&A”). The notice provides a...more

How Does Arizona Same Sex Marriage Impact HR?

On Friday October 17, 2014, same sex marriages became legal in Arizona. What are the changes that Arizona employers and their HR professionals need to be aware of? 1. The definition of spouse in employee manuals and...more

The ERISA Litigation Newsletter - October 2014

Editor's Overview - The first article in this month's newsletter focuses on whether specific language in ERISA employer-provided disability insurance plans confer discretionary authority to plan administrators to...more

Life Insurer Prevails in First Circuit Appeal in ERISA Class Action Challenging Retained Asset Accounts

In a unanimous panel decision, the U.S. Court of Appeals for the First Circuit reversed a trial court’s ruling that the defendant, Unum Life Insurance Company of America (Unum), had breached fiduciary duties under the...more

Business Interruption Insurance for Ebola – Managing Risk for Hospitals and Healthcare Providers

William Gallagher Associates, a Boston-based insurance broker, has announced the rollout of a new policy to cover Ebola-related losses at hospitals and other healthcare providers involved in primary care emergency treatment. ...more

Absent an Initial Showing That It Is a Fiduciary, Employer Is Immune from Breach of Fiduciary Liability Claim under ERISA in the...

In Moon v. BWX Technologies, Inc., 2014 U.S. App. LEXIS 12525 (4th Cir. July 2, 2014), the Fourth Circuit rejected fiduciary breach and equitable estoppel claims, determining that an employer’s failure to alert an employee...more

Arrival of Ebola Virus Prompts Policyholders to Assess Insurance Coverage

With news of the Ebola virus arriving in the United States, many companies are moving quickly to protect the health and safety of their employees and customers. At the same time, some insurance providers have already...more

Eighth Circuit Says That Considerations Of Health Care Cost Savings Could Be Proxy For Age In ADEA Suits

The Eighth Circuit recently concluded that an employer may violate the ADEA by terminating an older employee in order to reduce its health care premiums. Tramp v. Associated Underwriters, Inc., 2014 WL 4977396 (8th Cir....more

Concurrent Causation from "A Medley of Interesting Disability Cases"

Facts and holding: Rita Kruk (“Kruk”), a Human Resources Specialist, was a participant in an ERISA plan provided through her employment that provided disability benefits. Kruk’s Plan stated that if a disability was due to a...more

When a Parent Retires, a Child with Disabilities Could Qualify for SSDI

When the parent of an adult with disabilities retires, the child may qualify for federal disability benefits, even if the child has never worked. This benefit, known as the Disabled Adult Child program, allows the...more

Health Plan ID Requirements and Other End-of-Year Considerations

Employers and other health plan sponsors may be focused on preparing for the commencement of the employer mandate under the Affordable Care Act on January 1, 2015, but a number of other deadlines and developments are emerging...more

Reinsurance Program Requires Self-Insured Health Plans to File Enrollment Data by November 15 and Pay Fee Later

The Transitional Reinsurance Program - The Health Care Reform Act established a transitional reinsurance program in an attempt to stabilize premium prices for health insurance plans in the individual market. Because...more

Provider Competition Matters—Even for “Reference Pricing”

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to imply that such pricing “will increase competition between providers.” In the...more

Decumulation – Increasing DC Plan Value and Ensuring Compliance with Best Practices (Part II)

In Part I of this series, we considered ways in which the “traditional” accumulation driven defined contribution (DC) plan design fails to maximize value. In this post, we discuss variable pensions as well as the role of...more

A Court’s Review of a Disability Benefit Claim May Hinge on the Meaning “Satisfactory to Us”

Twenty-five years ago, the U.S. Supreme Court ruled that courts should review an ERISA participant’s claim for benefits under a de novo standard of review unless the plan gives the plan fiduciary discretionary authority to...more

Is That Covered? "Additional Insured" Coverage for Claims Brought by Employees of Named Insured

Consider this common scenario: Big Shopping Mall owns the local shopping development and leases stores to multiple tenants, including the Popular Chain Restaurant. An employee of the Popular Chain Restaurant, Bob Suzealot, ...more

California Insurance-Related Bills Signed into Law

September 30, 2014, was the deadline for Governor Jerry Brown to take action on bills passed by the California Legislature during the 2014 regular legislative session. Here are summaries of noteworthy insurance-related bills...more

401(k) Plans and the Free Market: Is Your Vendor Ever a Fiduciary?

The Department of Labor and plaintiffs class action lawyers have been urging the courts to find that 401(k) vendors are fiduciaries when they design investment platforms or have contract provisions permitting them to adjust...more

ERISA: 11th Circuit Says “Show Me The Money” In Equitable Recovery Of Medical Expenses Even After Disbursement Or Commingling Of...

Can the Plan get reimbursed even when the beneficiary’s settlement funds have been disbursed or commingled? Yes in the 11th Circuit. But watch out in the 9th Circuit....more

Missing Participants in Your Terminated Defined Contribution Retirement Plan? The DOL Has Issued Guidance to Help You

Background - The U.S. Department of Labor ("DOL") recently issued Field Assistance Bulletin 2014-01 (the "FAB"), which provides guidance about how fiduciaries of terminated defined contribution retirement plans can...more

You’re Not on the List: Failure to Name Names Knocks Lloyd’s Out of Federal Court

It is impossible today to imagine a world without insurance. Individuals can’t buy houses or cars without insuring them against loss. Businesses cannot operate without any number of coverages—against damage to their...more

Are you Covered When an Employee Breaks Bad?

Legal Requirements - Of course, since a bank must protect depositor funds, the law requires all banks to have appropriate insurance coverage for fidelity losses. Oklahoma banking law, 6 Okla. Stat. § 713(A), mandates...more

First Circuit Rules for Insurers in Two Retained Asset Account Cases; An Insurer Does not Need “to Don the Commercial Equivalent...

The First Circuit recently decided two ERISA cases challenging the use of retained asset accounts in favor of the insurer-defendants. The decisions are Merrimon v. Unum Life Ins. Co. of Am., 758 F.3d 46, 50 (1st Cir. 2014)...more

District Court Certifies Class Challenging ERISA Plan Amendment

The Eastern District of Michigan has certified a class of ERISA plan participants challenging an amendment which, in attempt to address the plan’s underfunded status, reduced their monthly disability payments. The Court...more

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