Key Facts You Need to Know: Minimum Essential Coverage and the Individual Mandate Penalty

“The ACA requires most individuals to have minimum essential coverage (MEC) or pay a penalty… Questions and answers in this article describe the individual mandate, the types of coverage that are considered MEC, and the penalty for not maintaining MEC.” A reference chart on MEC is also provided. (Center on Budget and Policy […]

By |2017-01-23T08:27:06+00:00July 17th, 2016|2016 News, News|

Fiduciary Liable Under ERISA for Denied Life Insurance Coverage

“This case illustrates how an employer can end up paying a high price for assuming that an insurance company will take responsibility for providing necessary information to its employees. In this instance, the group life carrier denied coverage for additional benefits due to failure to supply an ‘evidence of insurability’ form for the increased coverage. […]

By |2017-01-23T08:28:52+00:00July 10th, 2016|2016 News, News|

Cigna Administered Self-insured ERISA Health Plans Sued for Embezzlement

“Just eight days after a federal court slammed Cigna with a $13M judgment, 113 of Cigna’s self-insured clients, along with their Plan Administrators, have been named as defendants in a massive fraud lawsuit, alleging the plans ‘participated in a conspiracy and pattern of unlawful, reckless, and deceptive conduct to conceal an embezzlement and/or skimming scheme’.” […]

By |2017-01-23T08:31:05+00:00July 3rd, 2016|2016 News, News|

Life Insurance Pricing Structure Upheld in ERISA Class Action

“An employee benefit plan that includes an alleged subsidization component for its basic and supplemental options is neither prohibited by ERISA nor a violation of the plan sponsor or service provider’s fiduciary duties. … Plaintiffs had alleged that the Insurer and the Company engaged in a ‘cross-subsidization scheme’ to overcharge plaintiffs for supplemental life insurance […]

By |2017-01-24T09:50:15+00:00June 22nd, 2016|2016 News, News|

EEOC Issues Final Rules Under ADA and GINA on Wellness Plans

“The U.S. Equal Employment Opportunity Commission issued two final rules May 16, 2016 that guide employers on the manner with which their wellness programs that ask health-related questions and/or require participants to undergo medical examinations can incentivize employee participation, while remaining in compliance with Title I of the Americans with Disabilities Act (ADA) and Title […]

By |2017-01-24T09:54:42+00:00June 8th, 2016|2016 News, News|

DOL Fiduciary Rule: Employers Should Not Overlook Impact on HSAs

“Employers having group health plans supplemented by health savings accounts should be aware that health savings accounts are specifically covered by the new fiduciary rule…. Employers should examine their role with any health savings account arrangements to assess how the health savings accounts are being made available to employees, how the providers offering those services […]

By |2017-01-24T09:56:12+00:00June 1st, 2016|2016 News, News|

Bad COBRA Notices Can Cost You

Health Plan/SunTrust Bank was sued in a class action challenging its COBRA notice. The plaintiffs who brought the lawsuit claimed that the COBRA notice was materially deficient in that it failed to provide the name and address of the party responsible under the plan for COBRA administration and that it failed to provide an adequate […]

By |2017-07-10T10:27:25+00:00May 9th, 2016|2016 News, News|

ERISA Plan’s Noncompliance with Claims-Procedure Rule Prompts De Novo Review Absent Harmless Mistake

“The DOL advises plans that certain inadvertent and harmless errors will not trigger de novo review. The Second Circuit saw no reason why courts should not also tolerate such minor deviations, but cautioned that the deviations should not be tolerated lightly. Accordingly, the court held that when denying a claim for benefits, a plan’s failure […]

By |2017-07-10T10:24:38+00:00May 1st, 2016|2016 News, News|