Plan Administrators

News & Analysis as of

When it’s time to go

Like George Costanza who always tried to leave on  a high note in an episode of  Seinfeld, I always try to leave at the right time. Most of the time, it’s the right time. Sometimes it’s like the last episode of Breaking Bad. ...more

Revenue Sharing Demolition Night

When I was a kid in the 1970’s, disco was the biggest thing. By 1980, disco was dead thanks to a backlash. People didn’t know it at the time, but disco died the night of July 12, 1979, thanks to the riot during a White Sox...more

More Clarity on Expatriate Health Plans and the ACA

Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more

Financial Services Quarterly Report - Second Quarter 2016: Does the Supreme Court’s Dudenhoeffer Decision under ERISA do “More...

Earlier this year, the U.S. Supreme Court decided the case of Amgen v. Harris, in which the Court revisited and clarified its 2014 holding in Dudenhoeffer v. Fifth Third Bancorp.2 Both cases concern the application of a...more

Third Party Administrator Update: TPA Regulatory and Legislative Developments

Polsinelli is pleased to share the June 2016 Third Party Administrator Newsletter. This newsletter covers topics throughout the year that impact TPAs. Information specific to Polsinelli's TPA practice is also included....more

I’m not interested in making $$$$ off referrals

Maybe I’m like Larry David, but I have a lot of pet peeves. I hate when people whistle or sing in public. I hate when people talk on the phone in line. I also don’t deal well with working with, working for, and being related...more

Harvey Berman, R.I.P.

People often ask me how I got into ERISA/retirement plan law and I tell them the truth: it’s because it’s the first job I got. The person that gave me that first job was an ERISA attorney named Harvey Berman. I’m sad to...more

What Does the Supreme Court’s Spokeo Decision Mean in the ERISA Litigation Context?

ERISA practitioners should be aware of the extent to which the United States Supreme Court’s decision in Spokeo, Inc. v. Robins may touch on ERISA claims and defenses. In Spokeo, decided 6 to 2 last month, the Supreme Court...more

The Rosenbaum Law Firm Review - July 2016

The Future Is Now For 401(k) Plan Sponsors. The future is here. When I was the head ERISA attorney at a New York based third party administrator (TPA), I left because I saw the future of the retirement plan...more

For ERISA Section 502(c) Penalties — Must Plaintiff Prove “Actual Injury”? A Recent U.S. Supreme Court Decision Creates the...

These Section 502(c) penalty claims seem to be added to most every ERISA lawsuit... Does a claimant have to prove “actual injury” to win ERISA Section 502(c) penalty claims? MAYBE. Here’s why...more

401(k) Providers and their Plans

I love Clint Eastwood movies and one favorite is “In The Line of Fire’. John Malkovich is playing a wannabe Presidential assassin named Leary and Clint is playing Frank Horrigan, the Secret Service agent who is trying to...more

Spokeo—New Hope for Defending Against ERISA Claims?

Last month, the Supreme Court of the United States issued its decision in Spokeo, Inc. v. Robins, No. 13–1339 (May 16, 2016). Spokeo involved a lawsuit brought under the Fair Credit Reporting Act of 1970 (FCRA). ...more

Plan Sponsors are Seeking ERISA Fiduciary Services

When I was in law school at American University and we moved into a new building (20 years later, they are now in another new building) a few blocks away from the main campus. The computer sync site at the new building had a...more

Court Orders Cigna to Pay Out-of-Network Surgical Claims

On June 1, 2016, the United States District Court for the Southern District of Texas ordered Cigna to pay nearly $13.7 million to Humble Surgical Hospital, LLC (“Humble”). Of the nearly $13.7 million, almost $11.4 million...more

ERISA: Reviewing What Needs to Be Proved to Establish the Suicide Exclusion

For many reasons, some of the toughest cases to litigate involve the application of the suicide exclusion. There is a growing body of evidence challenging suicide exclusion determinations....more

The Bottom Line On What Retirement Plan Sponsors Need To Do

I worked for a third party administrator (TPA) for almost 5 years and one of my favorite things about the boss there was that he just wanted to cut to the chase. We had an actuary who developed a speech im- pediment when he...more

Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

Department Of Labor Audits Are Focusing On Plan Procedures For Locating Missing Vested Participants

The U.S. Department of Labor (DOL) has increased its examinations of the procedures of defined benefit and defined contribution retirement plans for locating and paying out benefits to terminated vested participants whom the...more

Recent Lawsuit Demonstrates Continuing Need for Plan Fiduciaries to Document Decision-Making Process

Late last year, another lawsuit was brought on behalf of participants in a 401(k) plan alleging breaches of fiduciary duties resulting from allegedly high plan fees. This type of case is not novel; the law firm that brought...more

Seventh Circuit Does The Math and Sides with Plan Administrator in Pension Calculation Dispute

On Wednesday, March 16, the Seventh Circuit inspired a collective sigh of relief among actuaries and plan administrators everywhere. In Cocker v. Terminal Railroad Association of St. Louis Pension Plan for Nonschedule...more

Out with the Old, In with the New: What’s New with the Ontario Pension Regulator

FSCO reminds administrators about their roles and responsibilities On January 25, 2016, the Financial Services Commission of Ontario (“FSCO”) issued a new policy that describes the roles and responsibilities of administrators...more

Alert: Proposed Ontario Amendment Eliminating the 30-per-cent Rule for Pension Fund Investments

The Ontario government has announced a consultation? until April 29, 2016, relating to a proposed regulation change under the Pension Benefits Act (Ontario) that would permit a pension plan administrator to invest pension...more

Supreme Court Concludes That ERISA Preempts State Reporting Requirements

In a closely observed federalism battle over the scope of ERISA preemption, the Supreme Court came down on the side of Federal power. Specifically, in Gobeille v. Liberty Mutual Insurance Company, the Court, in a 6-2 ruling,...more

ERISA Preemption Made Easy? Supreme Court Sends Vermont All-Payer Database Back to the Drawing Board

On the first day of decisions since the unexpected passing of Justice Scalia, the Supreme Court of the United States ventured into the thorny area of preemption under the Employee Retirement Income Security Act (ERISA) and...more

HHS Fact Sheet on Your Employees’ and Clients’ Rights under HIPAA to Access their Health Information

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, contains extensive rules designed to limit access by non-health plan entities to certain individually identifiable health...more

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