Concerning the employee benefits, on 22nd July 2021, ERIC (the ERISA Industry Committee) put in a request to the US Court of Appeals to ask the Ninth Circuit to permit it to make a response to the opposition to its petition to the City of Seattle to rehear the appeal by ERIC in its legal [...]
On June 14, 2021, the U.S. Department of Labor (DOL) issued an information letter stating that ERISA claims procedures require participants to be given any telephone conversation audio recordings which are deemed relevant to their claim for benefits. This statement followed the denial of a request from a participant to be given an audio recording [...]
In October of 2020, Blue Cross Blue Shield (BCBS) Association and member plans reached an agreement to settle a class action lawsuit brought by subscribers alleging antitrust violations. While the companies denied the allegations, they agreed to the settlement to avoid further litigation costs and risks. The Court's settlement terms will be reviewed on October [...]
As we informed you in our post last month, the American Rescue Plan Act of 2021 (ARPA) which was passed by Congress in early March included a 100% COBRA subsidy for individuals who experience(d) a loss of coverage due to an involuntary termination or reduction in hours between October 1, 2019 and September 30, 2021. [...]
Much has been written about the stimulus checks and vaccine aid that are major elements of the American Rescue Plan Act of 2021 (ARPA), which was enacted last week, but the Act also includes a number of other lesser-known elements designed to provide relief to struggling Americans, and employers need to take notice. Of particular [...]
While the most widely discussed elements of the Consolidated Appropriations Act of 2021 (CAA) relate to monetary relief for those affected by the COVID-19 pandemic, the act also includes new disclosure requirements for brokers and consultants providing services to ERISA health plans. Additionally, it effectively lays responsibility for policing compliance in the laps of plan [...]
Under the Employee Retirement Income Security Act of 1974 (ERISA), employee welfare benefit plans are subject to certain fiduciary rules, claims procedures and plan document requirements (including providing participants with a Summary Plan Description (SPD) and possibly also filing a Form 5500 annual return). The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) generally requires [...]
Over the past several months, there has been a spate of federal legislation and corresponding guidance related to COVID-19 that requires group health plan changes and allows voluntary changes aimed at removing barriers to care and minimizing the impact of the pandemic on employees’ pocketbooks. Mandatory changes include first-dollar coverage for COVID-19 diagnostic testing and [...]
Last week, the U.S. Department of Health and Human Services released the HHS Secretary’s Report on Addressing Surprise Billing which was required under President Trump’s Executive Order 13877. The Report calls for steps, including Congressional action, to combat surprise billing and promote pricing transparency, with the following principles in mind: Patients receiving emergency care should [...]
A constellation of recent developments related to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) should prompt employers to take action to ensure there are no errors or omissions in their communications and procedures that could invite legal or regulatory penalties. COBRA is the government mandate that allows employees and their “qualified beneficiaries” to [...]