News & Analysis as of

Employee Retirement Income Security Act (ERISA) Healthcare Health Insurance

Troutman Pepper

9th Circ. Clarifies ERISA Preemption for Healthcare Industry

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On May 31, the U.S. Court of Appeals for the Ninth Circuit published an opinion in Bristol SL Holdings Inc. v. Cigna Health and Life Insurance Co., which has significant implications for the healthcare industry. Originally...more

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

Hall Benefits Law on

The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

Verrill

Can a Self-Funded Group Health Plan Exclude Coverage for Gender-Affirming Care?

Verrill on

We are sometimes asked whether a self-funded group health plan is required to cover gender-affirming medical services. As this post explains in detail, it is generally impracticable for a self-funded ERISA-covered plan to...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2024

The March Monthly Minute digs into an Ohio district court ruling that rejected application of a medical plan exclusion, missing participant guidance and related audit concerns, and responses to the Change Healthcare...more

Fenwick & West LLP

The Shifting Regulatory Landscape for Level-Funded Plans: An Alternative for Group Health Insurance

Fenwick & West LLP on

In the constantly changing health insurance landscape, level-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans—arguably offering...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

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Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

Seyfarth Shaw LLP

The Benefits of Flying into SFO; Employees Have Free Family Health Insurance – For Now

Seyfarth Shaw LLP on

Seyfarth Synopsis: In August, the Ninth Circuit Court of Appeals revived a challenge by Airlines for America (“A4A”), to San Francisco’s Healthy Airport Ordinance (the “Ordinance”), which requires airlines that use the San...more

Quarles & Brady LLP

Oklahoma Patient's Right to Pharmacy Choice Act Preempted by ERISA

Quarles & Brady LLP on

On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit issued an opinion in Pharmaceutical Care Management Association v. Glen Mulready, in his official capacity as Insurance Commissioner of Oklahoma, Oklahoma...more

McDermott Will & Emery

Key Takeaways | Putting Employee Wellness Programs to Work

McDermott Will & Emery on

During this session, panelists discussed the unique opportunities and challenges of digital-health wellness programs that partner with employers and health plans in considering, adopting and operationalizing wellness programs...more

Foley & Lardner LLP

Applying the ERISA Controlled Group and Affiliated Service Group Rules in the Health Care Industry

Foley & Lardner LLP on

Entities interested in entering into health care related industries must consider compliance with the corporate practice of medicine doctrine. In a number of states, the corporate practice of medicine doctrine prohibits...more

Akerman LLP - HR Defense

Your Employee Benefit Plans May Need a Check Up: Nearing the End of the COVID-19 Public Health Emergency

Where did the time go? Just a brief 1,199 days after it began, the COVID-19 Public Health Emergency (PHE) is coming to an end. The PHE formally ends on May 11, 2023, short of any unexpected developments. And that means the...more

Ballard Spahr LLP

Spring Cleaning: Preparing for the COVID Emergency’s End

Ballard Spahr LLP on

Summary - The almost three-year-old COVID-19 national emergency and public health emergency declarations (Declarations) are slated to expire May 11, 2023....more

Manatt, Phelps & Phillips, LLP

Wit Redux: Ninth Circuit Issues New Superseding Opinion in Landmark Mental Health Case

The Ninth Circuit has issued a new opinion in the long-running Wit v. United Behavioral Health litigation that changes the legal landscape for ERISA class actions. The Ninth Circuit’s opinion includes significant holdings on...more

Proskauer - Employee Benefits & Executive...

After Dobbs v. Jackson Women’s Health Organization: Impact on Employee Benefits

Employers and other group health plan sponsors are left with much to consider following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overruled the Supreme Court’s prior landmark...more

Proskauer - Employee Benefits & Executive...

Post-Dobbs: FAQs for Employers and Other Benefit Plan Sponsors

Can group health plans continue to provide coverage for abortion-related expenses? In short, yes. Dobbs does not prohibit group health plans from covering abortion-related expenses. Instead, Dobbs eliminates federal...more

Burr & Forman

What Employers Need To Know in a Post-Roe World

Burr & Forman on

On June 24, 2022, the Supreme Court issued its decision in Dobbs v. Jackson Women’s Health Organization, overturning Roe v. Wade, the 1973 ruling that protected a woman’s right to have an abortion. In Dobbs, the Supreme Court...more

Akerman LLP - Health Law Rx

Biden Administration Signals MHPAEA Enforcement a Priority with Fiscal 2023 Budget

The Biden Administration’s proposed budget for fiscal year 2023 serves as a warning to all plan issuers and administrators that enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) is a top priority for...more

Polsinelli

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

Polsinelli on

The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more

ArentFox Schiff

As It Mulls Whether To Grant Cert in ERISA Case on PBM Fiduciary Liability, Supreme Court Seeks Government's Input

ArentFox Schiff on

In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more

Robinson+Cole ERISA Claim Defense Blog

Second Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute...

In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more

Sheppard Mullin Richter & Hampton LLP

State, Federal, and Private Enforcement of Mental Health Parity Compliance

Six months ago, we cautioned health plans and plan sponsors that states, the federal government, and private litigants were laser focused on Mental Health Parity and Addiction Equity Act (“MHPAEA”) compliance. The United...more

Stoel Rives LLP

Outbreak Period to Be Applied on a One-Year Rolling Basis

Stoel Rives LLP on

In this legal update, our employee benefits attorneys cover three recent health and welfare plan developments....more

McCarter & English, LLP

Benefit Plan Deadlines Extended, Enforcement Standards Relaxed by DOL And IRS During Pandemic

The U.S. Department of Labor’s Employee Benefits Security Administration and the IRS recently issued the following coordinated guidance providing additional relief to employee benefit plan sponsors, fiduciaries, participants,...more

Troutman Pepper

COVID-19 Employee Benefits: FAQs for Employers Focus on Health and Welfare Benefit Plans

Troutman Pepper on

It is hard to find a sector of the American workforce that has not been affected by the COVID-19 emergency. Employees are being asked to work from home if they are able, businesses are being forced to close, and employers are...more

Proskauer - Employee Benefits & Executive...

Seventh Circuit: Agreement for Retiree Healthcare Benefits Survives Agreement’s Termination

The Seventh Circuit held that retirees and their families were entitled to lifetime healthcare benefits because, although the healthcare agreement that had been negotiated by their union had expired, it provided that covered...more

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