News & Analysis as of

Third Party Administrators Employee Retirement Income Security Act (ERISA) Patient Protection and Affordable Care Act (PPACA)

McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers,...more

Polsinelli

Department of Labor Sues UnitedHealth TPA Over Claim Denials

Polsinelli on

The U.S. Department of Labor (“DOL”) recently filed a lawsuit against UMR, Inc., a third-party administrator and UnitedHealth Group, Inc. subsidiary. The lawsuit alleges that UMR denied thousands of claims based on diagnosis...more

Littler

“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined

Littler on

A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan....more

Snell & Wilmer

2019 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare

Snell & Wilmer on

As 2019 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health...more

Ary Rosenbaum - The Rosenbaum Law Firm P.C.

How a Plan Sponsor Can Avoid Being a Deer Caught in the Headlights

The term “deer in the headlights” explains the mental state of a person who shows behavioral signs that remind us of a deer subjected to a car’s headlights where the deer is in such panic that they show no motor reaction to...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Religious Freedom, Contraceptive Services, and The ACA: The Dilemma of the Self-Certification Provision

On February 21, 2014, the Seventh Circuit Court of Appeals, in a 2-to-1 decision, denied a preliminary injunction enjoining the federal government from enforcing the self-certification provisions of the Affordable Care Act...more

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