Self-Insurance

News & Analysis as of

ERISA Preemption: Don't Tread on my Uniform System of Plan Administration

On March 1 the U.S. Supreme Court again reinforced the broad preemptive scope of the Employee Retirement Income Security Act of 1974, 29 U.S.C.A. §1001. In Gobeille v. Liberty Mutual Insurance Co., 136 S. Ct. 936, the court...more

Supreme Court Protects Health Insurers From Onerous State Claims Reporting

On Tuesday, March 1, 2016, the Supreme Court issued a ruling in Gobeille v. Liberty Mutual, finding that states do not have the authority to require self-insured plans (like Liberty Mutual Insurance Co.) to collect and report...more

Providers Beware: In ERISA Land, a Right May Not Have a Remedy

A recent U.S. Supreme Court decision reminds us that straying into the land of the Employee Retirement Income Security Act of 1974 (“ERISA”) can be hazardous for an unwary state or health care provider. When ERISA preempts a...more

Employee Benefits & Executive Compensation Advisory: Supreme Court Strikes Down Vermont Health Data Reporting Law as Applied to...

On March 1, 2016, the Supreme Court held that a Vermont law requiring detailed reporting of health data could not be applied to self-funded plans subject to ERISA. In Gobeille v. Liberty Mutual Insurance Company, the Court,...more

Wisconsin Supreme Court Reminds That Duty to Defend is Broader Than Duty to Indemnify

A liability insurance policy generally imposes two duties on the insurer: (1) a duty to indemnify the insured against claims that are covered by the policy, up to the policy limits; and (2) a duty to defend the insured...more

U.S. Supreme Court Reaffirms ERISA’s Preemption Provisions as Applied to State Health Law Reporting Requirements

Recently, the U.S. Supreme Court, in Gobeille v. Liberty Mutual Insurance Co., 2016 U.S. LEXIS 1612, underscored the broad extent to which the preemption language of the Employee Retirement Income Security Act of 1974...more

Cybersecurity and Data Privacy: Big Win for Self-Insured ERISA Plans at Supreme Court (3/16)

On March 1, the Supreme Court issued a decision in Gobeille v. Liberty Mutual Insurance Company that delivered a big win for self-insured group health plans. The case involved a challenge to a Vermont law that required...more

Are Self-Insurers Subject to State Insurance Claim Handling Statutes?

According to the court in Bingham v. Supervalu, Inc., No. 15-1437 (1st Cir. November 13, 2015), the answer is “no.” As the Bingham decision illustrates, however, the answer to this question depends on the self-insurer’s risk...more

Hospitals Accused of Violating the False Claims Act Through Ownership of the PPO For Their Self-Funded Employee Health Plans

On August 27, 2015, following notification by the government that it had decided not to intervene, the United States District Court for the Middle District of North Carolina, ordered that a qui tam complaint charging...more

Zurich Insurance Decision Underscores Need for Caution in Regulatory Compliance

A recent trial court decision in the Federal District Court demonstrates the importance of taking a conservative approach to regulatory compliance. Zurich Insurance v. Country Villa Service Corp involved esoteric questions...more

Of Mice and Manpower: Companies That Lease Employees Cannot Be Self-Insured

In the recent California case of Kimco Staffing Services v. The State of California, the Court of Appeals for the 2nd Appellate District agreed with the lower court that staffing services that provide temporary service...more

Tennessee Legislation Wrap Up: What You Need to Know Before July 1st

We have previously updated you on Tennessee's new "non-retaliation for the lawful possession of a firearm" law which will go into effect on July 1, 2015. However, now that the State Legislature has wrapped up its 2015...more

United States District Court In Texas Holds AXIS Excess D&O Policy Cannot Be Triggered Where Insured Settled With Primary Insurer...

In a May 12, 2014 ruling, one week before the scheduled start of trial, United States Magistrate Judge K. Nicole Mitchell granted Summary Judgment to AXIS Insurance Company finding that the insured's settlement with its...more

Insurance Guaranty Association Must Pay Workers’ Compensation Claims Of A Former, Non-Member Group Self-Insurer

The North Carolina Court of Appeals has held that the state’s Insurance Guaranty Association is obligated to pay for workers’ compensation claims made or incurred against CompTrust, a former group self-insurer that issued...more

Illinois Supreme Court Agrees to Decide Limits on Self-Insured Car Rental Company's Liability for Customers' Accidents

In the closing days of its November term, the Illinois Supreme Court agreed to decide an issue of considerable importance for Illinois’ car rental industry: can a self-insured car rental company be held liable without...more

United States Tax Court Rules On Captive Insurance Arrangement

In 2003 and 2004, the Internal Revenue Service disallowed deductions taken by SHI Group, a subsidiary of the Swedish company Securitas AB, for insurance expenses related to a captive insurance arrangement established by...more

Self-Insured Group Health Plans: Two Deadlines to Note

As 2014 winds down, plan sponsors are likely thinking ahead to some of the significant changes that will take effect in 2015, most notably, the employer "pay or play" mandate under the ACA. However, there are two deadlines...more

New York Supreme Court Pro Rata Allocation for MGP Sites on Long Island Clarifies Self-Insured Periods

A New York State trial court judge applied a pro rata time on the risk allocation for pollution from manufactured gas plants on Long Island. Keyspan Gas East Corp. v. Munich Reinsurance America, Inc.,Index No. 604715/1997,...more

Workers' Compensation: Advantages of Self-Insurance

Employers in Pennsylvania can often benefit from self-insuring their workers' compensation plan, rather than simply opting for carrier based coverage year after year. The advantages of self-insurance include the following...more

Comcare licensees: Push to lower barriers to entry to the federal WHS system

The Federal Government is proposing to make it easier for businesses to opt out of State and Territory specific work health and safety (WHS) laws and to join the Federal WHS system. The case for self-insurance...more

Two Important Deadlines Approaching for Self-Insured Group Health Plans

If you sponsor a self-insured group health plan, then November includes two important deadlines: (1) you must obtain a health plan identifier for your plan, and (2) you must report the number of participants for whom a...more

Florida High Court Liberally Construes Self-Insured Retention Endorsement

On February 6, 2014, the Florida Supreme Court took a liberal view of self-insured retentions (SIRs) and held that an insured can apply indemnification payments from a third party to satisfy its SIR under a general liability...more

Weekly Law Resume - November 2013: Insurance Coverage-SIR Requirements

American Safety Indemnity Company v. Admiral Insurance Company - California Court of Appeal, Fourth Appellate District (September 27, 2013) - Many insurance policies contain a Self-Insured Retention (“SIR”) that...more

Ninth Circuit Affirms Dismissal of Negligent Misrepresentation Claim

In its recent decision in MultiCare Health System v. Lexington Ins. Co., 2013 U.S. App. LEXIS 17981 (9th Cir. Aug. 28, 2013), the United States Court of Appeals for the Ninth Circuit, applying Washington law, had occasion to...more

Connecticut Supreme Court: “Make Whole” Doctrine Is Default Rule, But Does Not Apply to Policy Deductibles

In Fireman’s Fund Ins., Co. v. TD Banknorth Insurance Agency, Inc., SC 18796 (Conn. 07/30/2013), the Connecticut Supreme Court answered two certified questions of first impression under Connecticut insurance law: - Is...more

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