News & Analysis as of

Employer Group Health Plans Plan Administrators

Alston & Bird

New Year Brings New Tri-Agency FAQs About Gag Clause Prohibitions and Attestations, No Surprises Act

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Our Employee Benefits & Executive Compensation Group discusses new guidance for group health plans and insurers on complying with federal gag clause prohibitions and No Surprises Act requirements....more

Williams Mullen

Annual Employee Benefits Compliance Checklists - Plan Administrators

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Plan administrators should review the following actions to be taken before the end of 2024 and focus on what to expect for 2025. The following checklist addresses plan amendments, notices, and other considerations for...more

Alston & Bird

When Disaster Strikes: Issues and Relief for Health Benefit Plans

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In the wake of a federally declared disaster, employees may face issues with their benefit plans. Our Employee Benefits & Executive Compensation Group discusses what plan administrators should know and the agency guidance...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - September 2024

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This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more

Epstein Becker & Green

Three Things That Employer Health Plan Sponsors Should Do When the New MHPAEA Rules Are Published

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The U.S. Departments of Labor (DOL), Health and Human Services, and the Treasury (collectively, the “Tri-Departments”) published a Notice of Proposed Rulemaking (NPRM) on August 3, 2023, to propose new regulations for the...more

Robinson+Cole ERISA Claim Defense Blog

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more

Hall Benefits Law

United Behavioral Health Files Cert Petition Over Mental Health Coverage Loss

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United Behavioral Health (UBH) and the Alcatel-Lucent Medical Expense Plan, an employee health plan now owned by Nokia, have filed a petition for a writ of certiorari before the U.S. Supreme Court. They are seeking to...more

Williams Mullen

2023 Annual Employee Benefits Compliance Checklist for Plan Administrators

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Plan administrators should review actions to be taken before the end of 2023 and focus on what to expect for 2024. This checklist addresses plan amendments, notices and other considerations for qualified retirement plans,...more

Woodruff Sawyer

How to Choose an Employee Benefits Broker

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The most valuable feedback is something you can act on. A broker who takes a consultative approach doesn’t just give you options but uses their expertise to provide actionable insights. Let’s face it—not all Human Resources...more

Morgan Lewis - ML Benefits

Plan Sponsors and Administrators: Prepare for the End of the COVID-19 Emergency

The Biden administration intends to end the national emergency and public health emergency declarations (Emergency Declarations) attributable to the COVID-19 pandemic on May 11, 2023. The COVID-19 pandemic brought multiple...more

Williams Mullen

2022 Annual Employee Benefits Compliance Checklist for Plan Administrators

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Plan administrators should review actions to be taken before the end of 2022 and focus on what to expect for 2023. This checklist addresses plan amendments, notices and other considerations for qualified retirement plans,...more

Saul Ewing LLP

Guidance Issued on Implementation of ARPA COBRA Premium Subsidy

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Group health continuation coverage under the Consolidated Omnibus Reconciliation Act of 1985 (“COBRA”) permits certain group health coverage to be continued by participants and beneficiaries (“qualified beneficiaries”) when...more

Nelson Mullins Riley & Scarborough LLP

COBRA Subsidies are Revived — Update

The American Rescue Plan Act of 2021, signed by President Biden on March 11, 2021, (“ARPA”) includes generous provisions granting eligible individuals who have lost their jobs or had a reduction in hours (and their family...more

Proskauer - Employee Benefits & Executive...

DOL Releases COBRA Premium Subsidy Model Notices – With a Few Surprises

Immediate Action Required - As discussed in our prior posts, the American Rescue Plan Act of 2021 (“ARP”) requires that plan administrators distribute new COBRA notices advising individuals of their possible rights to a...more

Saul Ewing LLP

No Surprises Act Promises New Regime for Health Plans, Health Care Providers and Insurers

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The Consolidated Appropriations Act of 2021, enacted at the end of 2020 includes the No Surprises Act (“Act”), amending the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and the Public...more

Poyner Spruill LLP

Plan Administrators: (Re)Start Your Timers: Deadlines Extended by COVID Have One-Year Limit

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Notice 2021-01 recently issued by the Employee Benefits Security Administration, provides helpful clarification on relief from certain participant deadlines issued last year.  However, it also provides “suggestions” that plan...more

Williams Mullen

PODCAST: Williams Mullen's Benefits Companion - Plan Administrators’ 2020 Year-End Checklist

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On the latest episode of Williams Mullen's Benefits Companion, host Brydon DeWitt is joined by colleague Nona Massengill to discuss important steps that plan administrators need to take before the end of 2020. They will...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020

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As we enter the final months of 2020, this is a time to reflect on a year of unprecedented challenges. Although Covid-19 changed our lives in many ways, it did not halt new legal developments in the life, health and...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Utah Court Rules ERISA Plan Was Wrong to Deny Coverage for Mental Health Care Received at...

Hinshaw & Culbertson LLP on

In Raymond M. v. Beacon Health Options, Inc., 2020 U.S. Dist. LEXIS 94615 (D. Utah, May 29, 2020), a Utah district court held that an ERISA plan improperly applied acute-level criteria when denying benefits for a...more

Perkins Coie

COVID-19: Employee Health Plan Administration Considerations

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As federal and state governments respond to COVID-19, employers and plan fiduciaries must also address the evolving issues arising under employer-sponsored health plans. The specific considerations covered in this update are...more

Holland & Hart - The Benefits Dial

I Want to Know, Have You Ever Seen…your plan documents?

Owners and employees of smaller organizations often find themselves stretched in many directions. With all of the demands on one’s time associated with operating a business, it is not uncommon to see attention to the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: First Circuit Clarifies ERISA's Timing Requirements for Appealing Adverse Benefits Determination

In Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 (1st Cir. 2019) the U.S. Court of Appeals for the First Circuit clarified ERISA's timing requirements with respect to appealing an adverse benefits determination...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Courts Say Abuse of Discretion Standard is "Highly Deferential" to Plan Administrator's Denial of Benefits

In Rittinger v. Healthy Alliance Life Ins. Co., 914 F.3d 952 (5th Cir. Jan. 31, 2019), and Roebuck v. USAble Life, 380 F. Supp. 3d 852 (E.D. Ark. Mar. 30, 2019), the courts found no abuse of discretion where the ERISA plan...more

Dorsey & Whitney LLP

Don’t Get Bitten by Your COBRA Notices

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In a growing wave of class action lawsuits, plaintiffs are targeting employers who have allegedly failed to provide proper notice of health care coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985...more

Proskauer - Employee Benefits & Executive...

Best Practices in Administering Benefit Claims #10 – The Three C’s

We conclude our blog series on best practices in administering benefit claims with the three C’s: be clear, be consistent, and communicate. The key to effective benefit claim administration ultimately boils down to drafting...more

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