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Employee Retirement Income Security Act (ERISA) › Self-Funded Health Plans › Fiduciary Duty

Holland & Knight LLP

Sixth Circuit Reverses Dismissal of ERISA Healthcare Fee Suit Against Third-Party Administrator

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There has been a recent rise in Employee Retirement Income Security Act of 1974 (ERISA) litigation against third-party administrators (TPAs) and other service providers challenging their management of self-funded health...more

Snell & Wilmer

Reminder for SBCs – Yes, Please!

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The Affordable Care Act’s requirement that group health plans provide summaries of benefits and coverage (“SBCs”) to applicants and enrollees at various times is not new. Nevertheless, because of the steep penalties for...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2016

Proskauer Rose LLP on

Editor's Overview - This month, we look at the implications of the two federal district court cases from California that applied the ban on discretionary clauses typically found in ERISA plans to self-insured plans. The...more

Snell & Wilmer

Dealing with Long-Winded Out-of-Network Provider Nuisance Letters

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Over the past couple years, more and more of my clients with self-funded plans have received letters from out-of-network providers appealing denied claims. The letters are usually 20 to 30 pages long, not very specific, and...more

Goodwin

Sixth Circuit Addresses Plan Assets and Limitations Issues in Holding Service Provider’s Fee Assessments Constituted Self-Dealing

Goodwin on

The Sixth Circuit held in Hi-Lex Controls, Inc. v. Blue Cross and Blue Shield of Michigan that a service provider was liable as a fiduciary under ERISA for unauthorized fees it assessed against a self-funded health plan. In...more

Goodwin

In Pipefitters, Sixth Circuit Holds Service Provider Is Fiduciary in Assessing Fee

Goodwin on

Speed Read - The Sixth Circuit, in a unanimous decision, affirmed a lower court ruling in Pipefitters Local 636 Insurance Fund v. Blue Cross and Blue Shield of Michigan, holding that an entity providing services to a...more

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