Welfare Benefit Plan ERISA News
November 2013

 
Illinois' Legalization of Medical Marijuana
Affects Workplace Drug Policies
"Illinois Governor Pat Quinn recently signed into law the Compassionate Use of Medical Cannabis Pilot Program Act (the Act). The Act authorizes a four-year pilot program for dispensing and using medical marijuana in Illinois. Starting January 1, 2014, individuals may obtain access to medical marijuana if they are diagnosed with one of the debilitating medical conditions listed in the statute and they register with the Illinois Department of Public Health (registered qualifying patient)." (Full Article)
No More Pre-Tax Premiums for
Individual Health Insurance Policies?
Under an old IRS revenue ruling, employers could pay premiums for individual health insurance policies on a pre-tax basis so long as they either paid the insurance company directly or reimbursed the employee for the cost of the coverage. Some employers have been considering that approach for providing coverage to employees under the ACA. By providing funds to employees to purchase coverage on the individual market, employers were hoping to avoid the penalty for failure to offer coverage while limiting their cost. In recently issued guidance, the IRS and the Department of Labor have essentially said "no" to this alternative. (Full Articles: Here and Here)
ERISA Disclosure Rules have Real Teeth
John Butler filed an ERISA claim on his own behalf and on behalf of his former wife Janie Butler against United Healthcare of Tennessee (United), disputing its denial of benefits for his wife's residential substance abuse treatment. Butler requested copies of United's internal claim guidelines, which United did not provide until 900 days later.

The court found that the patient's history supported residential treatment under the internal guidelines and ordered United to pay the disputed benefits of $35,725, with interest, plus $99,000 in statutory penalties (the maximum penalty under ERISA of $110 per day) for failure to provide the internal guidelines when the participant requested them.

The $99,000 penalty was awarded less for reaching the wrong claim decision than for ignoring the participant's request for documents for over 2 years. Butler v. United Healthcare of Tenn., Inc., 2013 WL 5488644 (E.D. Tenn. 2013) For a list of other court cases, awards, and DOL fines related to employers not complying with ERISA laws pertaining to Welfare Benefit Plans, click here.

 

 

 

 

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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.

 

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