Most self-funded ERISA medical plans provide that participants who have been injured by other people (think car accidents) must reimburse the plan if the participant recovers from the other person for those injuries. In order...more
Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan is the fourth decision by the U.S. Supreme Court addressing the subrogation rights of self-insured ERISA-covered health plans. Three...more
It’s a common scenario when dealing with a benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA): an employee participating in the plan is injured by a third-party, the plan pays covered medical...more
Over the years, the U.S. Supreme Court from time to time has explored the scope of equitable relief available under the Employee Retirement Income Security Act of 1974 (“ERISA”) in circumstances where an employee benefit plan...more
The U.S. Supreme Court has ruled that an ERISA plan has no right to recover benefits paid on behalf of a participant where the participant has already dissipated settlement funds received from a third party. In...more
“A” gets hit by a drunk driver and incurs $121,044 in medical expenses. The ERISA Plan agrees to pay the expenses if “A” contractually agrees to reimburse the Plan for any recovery obtained as the result of any legal action...more
On January 20, 2016, the Supreme Court handed down yet another case addressing health plan subrogation. From the Supreme Court’s earlier decision in Sereboff v. Mid Atlantic Medical Services, Inc. (547 U.S. 356) (2006),...more