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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

Ohio BWC Agrees to Settle Class Action Lawsuit for Overcharging Employers

Business owners who may be eligible to share in a $420 million class action settlement over inflated premiums charged by the Ohio Bureau of Workers’ Compensation have until Oct. 22 to submit a claim form....more

One Step Closer to the Supreme Court: The Fate of Obamacare Premium Tax Credits in the Face of the Circuit Split

Last month, two federal courts of appeals issued opposing decisions on whether the Patient Protection and Affordable Care Act (the “ACA”) permitted subsidies, in the form of premium tax credits, to health coverage bought...more

Can You Link Insurance Premiums To Smoking?

Rocked by soaring costs, including skyrocketing increases in health insurance premiums, employers are desperate to manage, and hopefully limit, whatever costs they can. Many employers have begun to look to the lifestyle...more

Still Reimbursing Employees For Health Insurance Premiums? You May Be Subject To Significant Penalties!

Until very recently, it was not uncommon for employers to reimburse employees for substantiated premiums paid for individual health insurance coverage. Many small employers saw this as a viable alternative to group...more

Connecticut Holds that When a Lapsed Policy is Reinstated, Coverage is Only Restored Prospectively

In a case of first impression in the Nutmeg State, an intermediate level court in Connecticut recently held that reinstatement of coverage after a lapse for non-payment of premiums does not operate to restore coverage...more

Connecticut Appellate Court Rules Reinstatement of Coverage After Lapse for Nonpayment Is Prospective Only

When a homeowner’s insurer reinstates coverage that was cancelled for nonpayment of premium, can it avoid coverage for a fire loss that happened while the policy was cancelled? Yes, said the Connecticut Appellate Court in the...more

Final Regulations Allow Retirement Plan Payments for Accident, Health and Disability Insurance

On May 9, 2014, the Internal Revenue Service finalized regulations that govern the tax treatment of payments made by retirement plans to pay accident or health insurance premiums. Under the final regulations, accident or...more

Appellate Court Notes

SC18961 - Robbins v. Physicians for Women's Health, LLC - The plaintiff filed this medical malpractice against a hospital, the doctor, the midwife, and the company (“PWH”) that bought the assets of the hospital after...more

Federal Banking Agencies Issue Guidance on Flood Insurance Requirements for Existing Loans Secured by Multi-Family Residential...

As we have previously advised, the maximum amount of flood insurance available under the National Flood Insurance Program (“NFIP”) for multi-family residential buildings with five or more units will increase from $250,000 to...more

Is It a Violation to Help?

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius confirmed HHS’s position that private, not-for-profit...more

San Allen Decision on Ohio BWC Group Rating Affirms Trial Court

The Ohio Bureau of Workers’ Compensation’s appeal of a Cuyahoga County judge’s decision awarding $860 Million in damages to a class of employers has been rejected by the Court of Appeals. “Reduced to its irreducible essence,...more

New Rule Allows Disability Insurance Premiums To Be Paid From Qualified Plan Accounts - Employers Will Be Able To Offer Employees...

HIGHLIGHTS - - The Treasury Department and the IRS released final regulations regarding amounts used by a qualified plan to pay for accident or health insurance premiums. Under the regulations, there is one notable...more

Is SLIMPACT Losing Steam? Tennessee Switches To NIMA

As part of the passage of the Dodd–Frank Wall Street Reform and Consumer Protection Act (“Dodd-Frank”) in July, 2010, Congress incorporated the Nonadmitted Insurance and Reinsurance Reform Act (“NRRA”), which provides that...more

Arizona Court of Appeals Reverses Course and Holds A Valid Offer of UIM Coverage Need Not Include Premium Prices

In Newman v. Cornerstone National Insurance Company, 2014 WL 1257129 (Ariz.App. Mar. 27, 2014), the Arizona Court of Appeals held that a valid offer of underinsured motorist (“UIM”) coverage need not include premium prices...more

Reminder: ACA’s Out-of-Pocket Limits Differ from HSA-Qualified HDHPs Starting in 2015

In April, the IRS released the 2015 inflation adjustments for Health Savings Accounts (HSA) and HSA-qualified high deductible health plans (HDHPs). A month earlier, HHS released details on the “premium adjustment percentage,”...more

Health Care Update

In This Issue: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health Care News - Upcoming Hearings and Markups -...more

Cost of Insurance Litigation -- District Court Says Stick to Enumerated Factors

In a class action challenging a cost of insurance (COI) rate increase, a New York federal district court has stated that an insurer may only consider factors specifically enumerated in the policy when raising COI rates on a...more

Health Care Reform Implementation Update - April 21, 2014

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously...more

CMS Now Requiring Qualified Health Plans To Accept Premium Payments From Certain Third Parties

As previously reported on November 13, 2013 and February 20, 2014, the Centers for Medicare and Medicaid Services ("CMS") has attempted to provide guidance as to when it is appropriate for issuers of "qualified health plans"...more

The Elevator Speech Overview

The House and Senate were both on recess this week. On Tuesday, the U.S. suspended the operations of Syria’s U.S. embassy and consulates as the Syrian civil war enters its fourth year. Also Tuesday, details of an NSA...more

Affordable Care Act Redux

Another delay in implementation of the Affordable Care Act (“ACA” or “Obamacare”) has prompted PK Law to update our material on the Act. Here are some points to bear in mind as March 31 approaches...more

Flood Insurance Reform Bill with Escrow Amendments Awaits President’s Signature

The U.S. House of Representatives and Senate recently passed, and the President is expected to sign into law, amendments to the Biggert-Waters Flood Insurance Reform Act of 2012 (the Act). The legislation seeks to address...more

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