“Tie Goes to the Plan Administrator: Sixth Circuit Clarifies Importance of Firestone Language for ERISA Plan Interpretation
[P]lan sponsors should take the following steps as a result of this litigation.
- Inventory all plans, including qualified, nonqualified, health and welfare, and severance plans that are subject to ERISA.
- Review these plans to make sure that they have language that provides the plan administrator with authority to interpret the […]
“[T]he DOL has been known to send notices to plan sponsors who have filed a 5500 for their large retirement plan but have not filed a 5500 for their health and welfare plan…. [C]ompanies with large retirement plan are also likely to cover enough people for their welfare plan to […]
“The IRS has issued FAQs that provide guidance to employers on the Paid Family and Medical Leave Tax Credit which was created by the Tax Cuts and Jobs Act of 2017.
Background: The FMLA Tax Credit, as provided under Internal Revenue Code Section 45S, enables eligible employers to claim a general […]
“In Frye v. Metropolitan Life Insurance Co., a federal district court in Arkansas has held that an employee is entitled to proceeds from dependent life and accidental death and dismemberment (AD&D) insurance policies, despite the fact that her son was ineligible for such coverage due to his age at the […]
“[M]edian cumulative out-of-pocket medical expenses [from age 70 until death] for the long-lived elderly is quite modest at $27,000. At the same time, it is true that some long-lived elderly report very high cumulative out-of-pocket medical expenses: 10 percent of this older cohort say they racked up more than $172,000 […]
“This is a case study in how not to administer benefits — a vague SPD, inconsistent explanations, cryptic claim records filled with acronyms and jargon, and poor coordination among the plan sponsor, TPA, and insurer resulted not only in an award of benefits but potential liability for the wife’s attorney […]
“The practice of charging a copay that is higher than the full cost of a drug is called a ‘clawback’ … After taking your insurance card, your pharmacist says you owe a $10 copay, which you pay, assuming that the drug costs more than $10 and your insurance is covering […]
“As President Donald Trump and congressional Republicans tirelessly try to dismantle the Affordable Care Act, a number of states are scrambling to enact laws that safeguard its central provisions….Maryland is on the cutting edge with legislation moving through both chambers of the Statehouse…. Proposals have been discussed or advanced in at […]
Thanks for Noticing: Disability Claims Procedure Regulations Change Notice Requirement Next Month, Impose Strict Compliance Standard
“The DOL’s revised ERISA disability claims procedures regulations will be taking effect [this] month, and plan sponsors should take a hard look at plan processes over the next few weeks to ensure compliance. The new requirements apply to disability benefit claims filed after April 1, 2018, after a 90-day delay […]
“Plans should have ERISA fidelity bond coverage from an approved provider as of the beginning of the plan reporting period with a coverage amount in accordance with the regulations…. Who needs to be covered? … What type of coverage do I need? … Which coverage is required to be disclosed […]