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Filed Rate Doctrine Addressed in Recent Second Circuit Decision

The filed rate doctrine can often provide a strong defense to an insurer in a class action claiming that insurance premiums were too high for some reason. A recent Second Circuit decision applied the doctrine broadly. This...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 4 of 24): Highlights from the Draft 2015...

The IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C (“2015 Instructions”). These are the forms that employers with 50 or more full-time employees (including full-time equivalent employees) in the...more

Will § 4980H Require Judicial Amendment Too?

Absent applicable transitional relief, most of which vanishes after 2015, an ACA Applicable Large Employer that fails to offer Minimum Essential Coverage to at least 70% of its 2015 full-time employees and their dependents...more

Hospitality Businesses Should Consider “Play and Pay” for the ACA

A hospitality industry professional recently asked me if I thought most hotels would stop offering group health insurance coverage to their employees and have them purchase their own policies from Covered California.  My...more

Health Care Update - July 2015

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Congressional Health Policy Hearings - June 2015 #2

A House Ways and Means Subcommittee on Oversight hearing recently reviewed the effects of the Affordable Care Act (ACA) on health insurance premiums. In addition, a House Energy and Commerce Health Subcommittee hearing...more

Stretched for Resources, the IRS Sets Its Sights on Small Captive Insurers

A "captive" insurance company is an insurer formed for the limited purpose of insuring the risks of its non-insurer owner or owners. A captive can be an effective risk-management tool, especially for costly or unconventional...more

Investors Should Be Aware of an Interesting Blue Cross Antitrust Case

It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more

Is Private/Non-Profit D&O Coverage Under Priced? [Video]

From the 2015 PLUS D&O Symposium session “Who Me? I Didn’t Do Anything…Wrong,” moderator Jeff Lattmann (Beecher Carlson) and panelists Liz Olsson, RPLU (Wells Fargo Insurance) and Shelley Norman (AIG) discuss the differences...more

Wholly foreign retrocession premiums not subject to US excise tax

The United States Court of Appeals for the District of Columbia has affirmed a lower court’s grant of summary judgment in Validus Reinsurance, Ltd. v. United States, in favor of the taxpayer, though on narrower grounds than...more

Locke Lord QuickStudy: Validus Court of Appeals Decision - Wholly-Foreign Retrocessions Not Subject to Federal Excise Tax

On May 26, 2015, the United States Court of Appeals for the District of Columbia upheld a District Court decision and ruled that the Internal Revenue Service could not impose excise tax on certain wholly-foreign retrocessions...more

Injured Workers – Will Claims Cost You Less?

WorkCover New South Wales (WorkCover NSW) has announced the most significant workers compensation premium changes for medium and large employers in New South Wales since the commencement of the current workers compensation...more

And the Defense Wins

In Banner Life Insurance Co. v. Jacqueline L. Noel, 2013 U.S. App. LEXIS 1539 (4th Cir. 2013), aff’g 861 F. Supp. 2d 701 (E.D. Va. 2012), the U.S. Court of Appeals for the Fourth Circuit recently affirmed the district court’s...more

Stripping the ACA of Both the Carrot and the Stick: Sticking it to Consumers On and Off the Federal Exchange

Even as we write and you read, the Supreme Court in King v. Burwell is considering whether qualifying (often low income) individuals and families who have an opportunity to purchase healthcare coverage through the Affordable...more

Premium Refund Theory in Insurance Class Action Rejected By Michigan Federal District Court

One theory that has been raised by plaintiffs’ lawyers in some insurance class actions is that policyholders should receive a partial refund of their premiums because they are not receiving the coverage they paid for, or...more

FHA Reduces Annual Insurance Premiums

On January 8, HUD announced that the Federal Housing Administration (FHA) will reduce the annual insurance premiums new borrowers pay by 50 basis points....more

Quirky Question #247, An Update on Wellness Programs

Question: Our company has been considering implementing financial incentives for employees to participate in biometric screening as part of an employee wellness program. Are there legal issues we should be...more

Manatt on Health Reform: Weekly Highlights: November 2014 #4

In this week’s highlights, new proposed guidance from the feds would allow default renewals to lower cost plans and bring enhanced transparency to Qualified Health Plan rate increases; open Enrollment hits its stride –...more

Employee Benefits Developments - November 2014

Health Care Cost Consideration May Support Age Discrimination Claim. Recently, the U.S. Court of Appeals for the Eighth Circuit overturned a lower court’s summary judgment ruling against a plaintiff’s age discrimination...more

Don't Forget! Preparing for the Affordable Care Act Employer Mandate

With 2015 just a few weeks away, employers with 100 or more full-time and full-time equivalent employees should be gearing up for the implementation of the Affordable Care Act (“ACA”) employer mandate, which subjects...more

Eighth Circuit Permits Employee to Maintain Age Bias Claim Based on Company's Age-Based Health Care Considerations

With the rising costs of health care benefits for both employers and employees alike, a recent case out of the Eighth Circuit provides an important reminder that even seemingly innocuous cost control measures can have a...more

Employer Reimbursement of Employee’s Individual Medical Insurance May Subject Employer to Penalty

IRS Notice 2013-54 provides that an employer’s reimbursement of healthcare insurance premiums paid by an employee on an individual health insurance contract of the employee on a pre-tax basis (an “employer payment plan”) may...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

Class Action Against State Auto Concerning Homeowners’ Policy Limits Is One Worth Watching

Insurers typically adjust (or propose to adjust) the policy limits on a homeowners’ policy every year to take into account changes in the cost of construction. This is intended to help insureds make sure that sufficient...more

U.S. Court of Appeals for the District of Columbia Circuit to Rehear ACA Subsidy Challenge

On September 4, 2014, the D.C. Circuit vacated a panel decision in Halbig v. Burwell (Civ. No. 14-5018) striking down the federal government’s provision of premium subsidies to individuals purchasing coverage through the...more

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