Reimbursements

News & Analysis as of

Employer Cash Payments To Reimburse Employees For Health Insurance Costs – No!

Many employers offer or provide cash to employees to reimburse them for the cost of purchasing an individual health insurance policy. Others offer employees with high claims risk a choice between enrolling in the company’s...more

Second Circuit Rejects Plan’s Claim For Reimbursement From Another Plan

Where an ERISA plan specifically sets forth in the plan document its rights to reimbursement/subrogation vis-à-vis a plan participant then there is no requirement that recovery be conditioned on the plan being able to trace...more

California Employers Beware: Cell Phones Present Another Area for Class Action Potential

In August 2014, the California State Court of Appeals (2nd Circuit, Division 2) decided in Cochran v. Schawan's Home Service that employers were responsible for reimbursing employees for the business use of personal cell...more

California Supreme Court Denies Review of Cell Phone Reimbursement Case

The California Supreme Court has denied a petition to review Cochran v. Schwan’s Home Service, Inc., Court of Appeal of California, Second Appellate District, Division Two, No. B247160 (August 12, 2014). As a result of the...more

Eleventh Circuit Enforces Subrogation Clause

The Eleventh Circuit recently concluded that Robert Montanile, a welfare plan participant, could not avoid reimbursing the National Elevator Industry Health Benefit Plan for benefits it paid on his behalf after he recovered...more

Alert: Closing Affordable Care Act Loopholes

The U.S. Departments of Labor, the Internal Revenue Service and the Department of Health and Human Services recently issued guidance clearly stating that employers may not, without incurring penalties, reimburse employees who...more

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

Weekly Update Newsletter - November 2014 #2

GAO Bid Protest Annual Report to Congress for Fiscal Year 2014 - The Government Accountability Office (GAO) has issued its bid protest annual report to Congress for fiscal year 2014 reporting each instance in which a...more

Indemnification and Reimbursement Sought from Insurers Based on Allegedly Fraudulent Funding Program: Fifth Third Bancorp v. Ace...

Who: Plaintiffs: Fifth Third Bancorp and Fifth Third Bank Defendants: Ace Insurance Company, Axis Insurance Company, Certain Underwriters at Lloyd’s, Continental Insurance Company, Federal Insurance Company,...more

Massachusetts Supreme Judicial Court Strengthens Policyholders’ Ability to Pursue Consumer Protection Claims against Insurers for...

The Massachusetts Supreme Judicial Court (“SJC”) has made it clear that an insurer cannot avoid claims for failing to defend a policyholder merely by tendering payment to the policyholder at the last minute. The central issue...more

Will the Mid-Term Elections Help Telemedicine Reimbursement?

Our recent survey of senior-level health care executives reinforced that lack of reimbursement remains the primary barrier to providers in adopting telemedicine services. Of our respondents, 41 percent indicated that their...more

Is Provider-Based Reimbursement Going Away?

We get this question every year: will Medicare, Medicaid or other payors continue to recognize hospital-level facility fee reimbursement for hospital outpatient departments meeting the provider-based designation criteria at...more

New Agency FAQs Drive a Stake Further into the Heart of Premium Reimbursement Arrangements and Eliminate a Common Executive Perk

In clear and unambiguous terms, the U.S. Departments of Labor (“DOL”) and Health and Human Services and the Internal Revenue Service (“IRS”) (the “Agencies”) drove a stake into the heart of two suspect health insurance...more

Third Circuit Upholds Defense Cost Reimbursement Clause in Professional Liability Policy

On October 10, 2014, the 3rd Circuit Court of Appeals decided Camico Mutual Ins. Co. v. Heffler, Radetich & Saitta, LLP, where it enforced a policy clause providing for repayment to the insurer of defense costs, and confirmed...more

Who Pays for Employee Cell Phone Use?

For many employees, their cell phones are always close at hand, whether at work or in their personal life. But what if the employer requires employees to use their personal cell phones for work-related activities? Then we...more

California Federal Courts Tell Insurers Not to Jump the Gun in Suing Policyholders for Reimbursement

In a series of opinions issued over the past few months, federal judges in California have reiterated that insurers must wait until they are finished defending their policyholders before they sue those policyholders for...more

Third Circuit Holds That Insured Must Reimburse Insurer For Litigation Costs Paid In Excess Of Sub-limit

In CAMICO Mutual Insurance Co. v. Heffler, Radetich & Saitta, L.L.P., the United States Court of Appeals for the Third Circuit recently held that a $100,000 sub-limit for claims involving employee misappropriation, misuse,...more

Southeast State & Local Tax: Important Developments - September/October 2014

The Williams Mullen Southeast State and Local Tax (SESALT) team is pleased to provide you with a comprehensive recap of important tax developments around the Southeast. VIRGINIA - INDIVIDUAL INCOME TAX...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

It's Payback Time: Reimbursement Of Employee Expenses Is A Hot Issue In California

As class actions continue to plague employers in California, one area that is often overlooked is expense reimbursement. The California Labor Code makes clear that employers must indemnify employees for all necessary...more

Employment Law Commentary -- Volume 26, Issue 9, September 2014 -- California Court Warns Employers Trying To Pass The Buck...

California employers hoping to save money through a bring your-own device (BYOD) program should think twice about that objective, based on a recent California appellate decision. In Cochran v. Schwan’s Home Service, the...more

Why It’s Time Employers Revisit Their Cell Phone Reimbursement Policy

What happens when your employees use their personal smartphones to check or respond to work email? It may be a question that you hadn’t given much thought to. Presumably, if an employee makes a work-related call, email or...more

California Court of Appeal Rules Employers Must Reimburse Employees For Work Calls on Personal Cell Phones

The California Court of Appeal’s recent decision in Cochran v. Schwan’s Home Service, Inc. was simple. When employees must use their personal cell phones for work, California law requires employers to reimburse them,...more

Weekly Update Newsletter - September 2014 #3

8(A) Subcontracting Limitations: Continued Noncompliance with Monitoring Requirements Signals Need for Regulatory Change - The Government Accountability Office (GAO) has conducted a study to review how federal agencies...more

Employment Law: Sep 2014

California Enacts Paid Sick Leave - Why it matters: Employers in California must now provide three paid sick days per year for workers, pursuant to a new law going into effect on July 1, 2015. The controversial...more

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