News & Analysis as of

Self-Insurance

Jackson Lewis P.C.

Open Issue: Employer-Sponsored Health Plans and Coverage of Gender-Affirming Care

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Transgender protections and rights in the workplace are currently the subject of much confusion. This issue extends to employer-sponsored health plans. Whether an employer-sponsored health plan must cover gender-affirming...more

Frantz Ward LLP

Can Self-Insured Employers Unilaterally Terminate Payment for Ongoing Prescription Medication in Workers' Compensation Claims? It...

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Prescription medications are a necessary, albeit expensive component of any self-insured workers’ compensation program. Unfortunately, injured workers are often prescribed unnecessary prescription drugs which can lead to...more

Rivkin Radler LLP

Insurance Update - March 16, 2023

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We bring you our March Insurance Update. As college basketball programs embark on the road to the final four, we select our top four insurance cases from the past month. In a dispute over the priority of coverage, the...more

Lowenstein Sandler LLP

The Ultimate Finger-Pointing Game: Other Insurance Provisions and How They Intersect With Self-Insured Programs

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Insurers like to make their coverage obligations someone else’s problem. One of the ways they do this is by saying that another insurer has to go first. In other words, insurers will sometimes take the position that another...more

Marshall Dennehey

The Supreme Court of New Jersey Holds that “Self-Insurance” Is NOT “Other Insurance”

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On February 16, 2023, the Supreme Court of New Jersey handed down its unanimous decision in Statewide Insurance Fund v. Star Insurance Company and held that, for purposes of determining the priority of overlapping insurance...more

Manatt, Phelps & Phillips, LLP

Realizing the Promise of All Payer Claims Databases

In 2020, health care spending in the United States increased by nearly 10 percent to reach $4.1 trillion, or 20 percent of the U.S. economy. Although the health care industry is foundational to the health and well-being of...more

Wiley Rein LLP

Kentucky Supreme Court Holds Prior Notice Exclusion Does Not Bar Coverage for Claims Related to Investigation Noticed and Accepted...

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Applying Kentucky law, the Kentucky Supreme Court has held that a prior notice exclusion did not bar coverage for a claim related to a government investigation noticed and accepted by a prior insurer because the insurers were...more

Husch Blackwell LLP

Final Rules Issued on Private Plans Under Colorado's Paid Family and Medical Leave Insurance Act

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On November 1, 2022, the Family and Medical Leave Insurance Division (the Division) of the Colorado Department of Labor and Employment adopted final rules that employers must follow to offer private plans under Colorado’s...more

Lowenstein Sandler LLP

Employer-Paid Travel Assistance for Interstate Abortion Access

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Last week, the U.S. Supreme Court officially overturned Roe v. Wade in its consequential decision, Dobbs v. Jackson Women’s Health Organization. With federal protection for abortion now dissolved, many employers are...more

White and Williams LLP

Montana Supreme Court Tackles Decade-Old Coverage Dispute Concerning Asbestos Mineworker Claims

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On November 23, 2021, the Montana Supreme Court issued an almost unanimous decision in National Indemnity Company v. State of Montana, a ten-year-old coverage dispute arising from claims against the State of Montana alleging...more

Farrell Fritz, P.C.

How Dealings Between Related Parties Doomed A Captive Insurer

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Insurance: What is it? How does it work? Assume that Acme Co is paying premiums for commercial insurance coverage to protect itself from economic losses that may arise out of various events. These premiums are deductible...more

Rivkin Radler LLP

Eleventh Circuit Affirms “Exceptional Case” Ruling: Insurer Had No Duty to Defend Construction Debris Claim Where Amended...

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Eleventh Circuit Affirms “Exceptional Case” Ruling: Insurer Had No Duty to Defend Construction Debris Claim Where Amended Complaint Omitted Crucial Fact Implicating Pollution Exclusion The Eleventh Circuit, affirming the...more

Clark Hill PLC

Stop Loss Carriers Need to Consent to any Material Changes to Self-Insured Employers' Healthcare Plans

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In response to COVID-19, Massachusetts, Illinois, Pennsylvania and a growing list of states have directed health insurance carriers to, among other things, relax cost-sharing and enhance telemedicine services. These...more

King & Spalding

A New Game In Town: Concepts and Opportunities in Direct-to-Provider Contracts

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As employers look for new ways to control healthcare costs and provide innovative healthcare offerings to their employees, employers are starting to consider the “direct-to-provider” contracting model as a way to achieve...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Massachusetts Paid Family and Medical Leave Update: Private Plan Exemptions and Reminders on Notice Compliance

The Department of Paid Family and Medical Leave (DFML) continues to issue updates concerning compliance with the Massachusetts Paid Family and Medical Leave Law (PFML). The DFML’s most recent updates address private plan...more

Seyfarth Shaw LLP

Massachusetts Releases Updated Guidance On PFML Private Plan Exemption Process And New Bond Coverage Formulae

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Seyfarth Synopsis: As the Massachusetts Paid Family and Medical Leave (“PFML”) law enters the first quarter of PFML contributions, the Department of Paid Family and Medical Leave (“DFML”) has released additional guidance on...more

Downs Rachlin Martin PLLC

Captive Insurance Update | Fall Edition | 2019 - A summary of the most recent state and federal developments in the captive...

There were no significant changes in Vermont’s leadership team during the last election cycle.  Governor Phil Scott, a Republican, was re-elected in November 2018 for another two-year term. Michael Pieciak, the Commissioner...more

Farrell Fritz, P.C.

Insured To Captive: “More, Charge Me More, Charge Me More . . .” Premiums?*

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It’s Not All About 2017- A casual review of the recent tax literature may leave a “lay person” with the impression that, prior to the passage of the 2017 tax legislation, tax advisers had nothing else to write about....more

Lowndes

Self-Insurance Means No Insurance

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It is not unusual for Tenants, especially larger ones, to negotiate for so-called “self-insurance” in their Leases. This concept can be applied to any form of insurance that a Landlord may require from a Tenant, except for...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Self-Insurance for Companies with Multiple Cleanup Liabilities Presents Financial and Environmental Risks for EPA and the Public:...

The United States Environmental Protection Agency (“EPA”) Office of Inspector General (“OIG”) issued a December 22nd report titled: Self-Insurance for Companies with Multiple Cleanup Liabilities Presents Financial and...more

Littler

New York Paid Family Leave Benefits Law Deadline for Employers to Apply for Approval as a Self-Insured Employer Rapidly...

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The New York Paid Family Leave Benefits Law requires all employers covered by the New York Workers’ Compensation Law to provide coverage for paid family leave (PFL) benefits for their employees on or before January 1, 2018....more

BCLP

Stop-Loss Policies, How Low Can You Go?

BCLP on

On April 5, the “Self-Insurance Protection Act” passed the House and moved to the Senate. This bill, if enacted, would amend ERISA, the Public Health Service Act and the Internal Revenue Code (the “Big 3” statutes containing...more

Womble Bond Dickinson

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

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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

Buchalter

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

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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

Alston & Bird

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

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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

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