Understanding Employee Benefits

The U.S. Supreme Court Upholds Plan Sponsor’s Recovery of Participant Damages Award

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On April 16, 2013, the U.S. Supreme Court issued its opinion in U.S. Airways, Inc. v. McCutchen http://www.supremecourt.gov/opinions/12pdf/11-1285_i4dk.pdf finding in favor of U.S. Airways in its quest to recover $66,866 in medical expenses incurred by its employee as a result of a traffic accident. McCutchen was a participant in the... Read More

Topics: ERISA and Other Benefits Litigation, Fiduciary Guidance, Health Plan, Welfare Plans

It Pays to Add a Statute of Limitations to Your Plan’s Claims Procedure

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ERISA requires that plans contain a reasonable claims procedure. Courts have generally required claimants to exhaust that claims procedure before filing a lawsuit. In addition, if the plan gives the plan administrator discretion to interpret the plan and decide claims, a court will often give deference to the plan administrator’s... Read More

Topics: ERISA and Other Benefits Litigation, Welfare Plans

A Wrap Plan Can Be Helpful

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Many employers know that one benefit to an ERISA plan is the standard of review available when the participant brings a lawsuit for benefits under the plan. If the plan documents give the plan administrator discretion to decide claims, then the court will review the exercise of the plan administrator’s... Read More

Topics: Welfare Plans

Key Provisions of the Affordable Care Act Upheld by U.S. Supreme Court

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            Last Thursday, June 28, in a 5-4 decision, the U.S. Supreme Court found that the Patient Protection and Affordable Care Act of 2010 (the “Affordable Care Act” or “Act”) is constitutional paving the way for final implementation of its provisions. http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf While the Administration argued that the Act was... Read More

Topics: ERISA and Other Benefits Litigation, Health Care Reform, Health Plan, Welfare Plans

Bad Things Can Happen to Employers Who Do Not Follow the Terms of Their Group Health Insurance Policies

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Blue Cross of Northeastern Pennsylvania (“Blue Cross”) insured New Life Homecare, Inc. (“New Life”) under a group health insurance contract. The insurance contract required New Life to enroll at least 75% of its eligible participants in the plan and provided that no more than 15% of the eligible employees could... Read More

Topics: Health Plan, Welfare Plans

408(b) (2) Disclosures – That Wasn’t So Bad Was It?

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Last week I received copies of the first new fiduciary fee disclosures required by final Department of Labor Regulations under ERISA Section 408(b) (2).  Fee disclosures were received from Fidelity Investments and Prudential Financial, providers to two client retirement plans.  The details of the required disclosures are described in my... Read More

Topics: Fiduciary Guidance, Health Plan, Welfare Plans