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Employee Retirement Income Security Act (ERISA) Medical Reimbursement

Holland & Knight LLP

Health Reimbursement Arrangements: An Option for Small Employers

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Though the employer shared responsibility provisions of the Patient Protection and Affordable Care Act (PPACA) do not apply to small employers (generally, employers with fewer than 50 full-time equivalent employees), many...more

Maynard Nexsen

A Primer on Health Reimbursement Arrangements

Maynard Nexsen on

During a time when recruiting and retaining qualified employees is becoming more and more difficult, it is crucial for employers to consider (or even reconsider) their benefits offerings and determine if there are any...more

Schwabe, Williamson & Wyatt PC

Employer Provided Travel Benefits in Response to Dobbs and State Prohibitions on Abortion

The implications of the United States Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade’s constitutional right to abortion have had sweeping implications that affect...more

Foley & Lardner LLP

Key Considerations When Offering Abortion Coverage Under a Group Health Plan

Foley & Lardner LLP on

Not surprisingly, leading up to and in the wake of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, our employee benefits team has been spending a lot of time helping our clients wade through...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Medical Travel Reimbursement Benefits Under the Supreme Court’s New Dobbs Decision

On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more

Snell & Wilmer

Group Health Plans Must Provide Free Over-the-Counter COVID-19 Tests Effective January 15, 2022 – Six *Updated* Takeaways

Snell & Wilmer on

On January 10, 2022, the Departments of Labor, Health and Human Services, and Treasury (collectively the “Departments”) issued Affordable Care Act FAQs Part 51 which addresses, in relevant part, payment for over-the-counter...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - January 2022

The January Monthly Minute highlights the new OTC COVID-19 test coverage mandate (eff. January 15, 2022), group health plan provider compensation disclosure rules, and updated standards for ERISA plan financial statement...more

Manatt, Phelps & Phillips, LLP

Mental Health Parity Update: DOL and NY AG Actions Highlight Ongoing Scrutiny of NQTLs

On August 11, 2021, United Healthcare and its affiliates were served with separate enforcement lawsuits by the Department of Labor (DOL) and the New York Attorney General (NY AG) involving mental health parity, among other...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: ERISA Plaintiff Has Statutory Standing to Bring Action to Recover Spousal Healthcare...

Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more

Morgan Lewis - ML Benefits

DOL’s ERISA Enforcement Activities Focus on Health Plan Compliance

In recent years, reports have indicated robust, and in some respects increasing, enforcement activities by the US Department of Labor (DOL) related to ERISA. The DOL recently issued its enforcement statistics for fiscal year...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Sixth Circuit Rejects MSPA and ERISA Discrimination Claims

Seeking to control healthcare costs, many group health plans have adopted amendments that lower reimbursement rates for the treatment of end-stage renal disease ("ESRD"), which requires long-term dialysis treatment or a...more

Seyfarth Shaw LLP

New Surprise Billing Legislation and Rules Go Into Effect on January 1

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New legislation passed in the 2019 session of the Texas Legislature, SB 1264, went into effect on January 1, 2020. The statute protects Texas residents from so-called surprise billing, where patients receive costly medical...more

Seyfarth Shaw LLP

ERISA Preemption — The Courts of Appeal Continue to Rule As They Await Further Supreme Court Attempts To Define, Once and for All,...

Seyfarth Shaw LLP on

Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Enforces Hawaii Anti-Reimbursement Statutes Against Insured Plan

ERISA health care plans typically include reimbursement and subrogation clauses, which give plans a right to reimbursement of medical expenses paid on behalf of a beneficiary where the injury is caused by a third party. While...more

Mintz - Employment Viewpoints

Avoiding Unexpected Liability for Former Employees’ Medical Expenses

Adherence to the COBRA health care continuation rules is not always high on an employer’s list of priorities. Compliance is often “outsourced,” and even when handled “in-house,” it rarely consumes much attention. A recent...more

Seyfarth Shaw LLP

Vindication! Fifth Circuit Reverses Notorious District Court Health Care Fraud Decision

Seyfarth Shaw LLP on

Seyfarth Synopsis: In a major victory for ERISA plans and other payors, the Fifth Circuit recently overturned a district court’s notorious decision in favor of a healthcare provider and reinstated a plan administrator’s...more

Mintz - Employment Viewpoints

Expanding Association Health Plans—Which Agencies Need to do What

On October 13th, President Trump signed an Executive Order directing various federal agencies to consider how to achieve three administration health reform objectives: (1) expand access to Association Health Plans (AHPs); (2)...more

K&L Gates LLP

Supreme Court Holds That ERISA Preempts State Health Care Services Disclosure Law

K&L Gates LLP on

Preemption is not a foreign concept when dealing with the Employment Retirement Income Security Act of 1974 (ERISA). Preemption arguments frequently and increasingly arise, for example, in the context of claims by health care...more

K&L Gates LLP

Do Your Assignment of Benefits Clauses Need a Check-up? Recent Southern District of Florida Decision Highlights the Importance of...

K&L Gates LLP on

A frequently litigated issue in reimbursement cases brought by in- and out-of-network healthcare providers against insurers under the Employee Retirement Income Security Act of 1974 (“ERISA”) is provider standing. Because...more

K&L Gates LLP

ERISA’s Exhausting and Exasperating Exhaustion Requirement and the Exceptions Medical Providers Seeking Full Reimbursement From...

K&L Gates LLP on

The first Alert in this two-part series discussed three common issues facing out-of-network medical providers in asserting reimbursement claims against employee benefits plan administrators (whether an insurance company or...more

Franczek P.C.

Supreme Court to Hear Arguments Involving a Health Plan’s Right to Recover Plan Overpayments

Franczek P.C. on

While public attention is currently focused on the upcoming high profile Supreme Court decision in King v. Burwell (which involves subsidies for exchange-based coverage under the ACA), the Supreme Court recently decided to...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - December 2012

Proskauer Rose LLP on

In This Issue: - Editors' Overview - Supreme Court Revisits Meaning of 'Appropriate Equitable Relief' in US Airways v. McCutchen - Rulings, Filings, and Settlements of Interest ...more

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