Well Drafted Plan Document Saves Self-Insured Medical Plan Over $350,000

“A self-insured medical plan included an anti-assignment provision that prohibited a health care provider from suing on behalf of a participant. The court found the anti-assignment clause to be valid and enforceable. This case highlights the value of a well drafted plan document. Employers sponsoring self-insured plans are encouraged to review their plan documents to […]

By | 2017-08-31T12:11:10+00:00 September 19th, 2017|2017 News, News|

How Qualified and Nonqualified Plan Sponsors Should Respond to the Latest Guidance on ERISA Disability Claims Procedures

“While the fiduciary rule has received most of the attention in the world of ERISA as of late, a lesser known regulation that was finalized late last year also may require action by plan sponsors. This regulation, issued by the Department of Labor (DOL) in December 2016, requires applicable plans to satisfy additional procedural and […]

By | 2017-08-31T12:09:10+00:00 September 12th, 2017|2017 News, News|

COBRA and Severance Agreements: A Gift or a Curse?

COBRA“If the individual is left enrolled as an active employee, fully-insured employers may risk violating the medical plan eligibility requirements in their insurance contract. Similarly, self-funded employers may violate the coverage provisions of their stop-loss agreement. Consequently, failure to offer COBRA can expose an employer to significant […]

By | 2017-08-31T12:01:36+00:00 September 2nd, 2017|2017 News, News|

Updated SBC Templates Apply for 2018 Open Enrollment

“Given the current House and Senate ‘repeal and replace’ ACA legislation, many employers are wondering if they need to take the time to revise their SBCs to comply with the new template and requirements. The short answer is use of the new SBC templates is still required. Both the House-passed legislation and the current legislation […]

By | 2017-08-14T07:08:10+00:00 August 14th, 2017|2017 News, News|

Premiums the Big Factor in Health Plan Enrollment

“After eliminating employee premiums for all coverage tiers, HSA-eligible health plan enrollment increased from 4 percent to 25 percent among individuals with employee-only coverage and from 2 percent to 31 percent among individuals with family coverage…. Offering coverage with no payroll deduction attracted individual enrollees who were marginally healthier than those who would have enrolled […]

By | 2017-08-14T07:04:57+00:00 August 8th, 2017|2017 News, News|

Economy Needs Workers, but Drug Tests Take a Toll

“Just a few miles from where President Trump addressed his blue-collar base last Tuesday night, exactly the kind of middle-class factory jobs he has vowed to bring back from overseas are going begging.

It’s not that local workers lack the skills for these positions, many of which do not even require a high school diploma but […]

By | 2017-08-14T07:03:04+00:00 August 2nd, 2017|2017 News, News|

Two HHS Settlements for HIPAA Violations Include Penalties Totaling over $5 Million

“HHS has announced two major settlements it has reached with covered entities to resolve alleged violations of the HIPAA Privacy and Security Rules.  The terms of each settlement agreement require the covered entity to pay a multimillion dollar penalty to HHS and implement a corrective action plan.”  Read the details: [The […]

By | 2017-07-03T07:32:20+00:00 July 6th, 2017|2017 News, News|

SPD Was Enforceable Despite Referencing a Nonexistent Plan Document

In litigation involving a health plan reimbursement claim, the Fifth Circuit ruled that a plan’s summary plan description (SPD) could serve as the plan’s “written instrument” under the Employee Retirement Income Security Act of 1974 (ERISA) (that is, the plan document) in the absence of a separate written instrument. The court concluded that the plan […]

By | 2017-07-03T07:29:11+00:00 July 3rd, 2017|2017 News, News|