The United States Supreme Court decision in Sereboff v. Mid Atlantic Med. Serv., Inc., 126 S.Ct. 1869 (2006) contributed to a flourishing of plan subrogation efforts and, as a consequence, a refinement of remaining issues in the health plan context. In the cases below, all decided in 2008, the health plans have by and large …
he U.S. Department of Labor today announced a proposed rule to provide greater protection for employee contributions deposited to pension and welfare benefit plans with fewer than 100 participants by proposing a safe harbor period of seven business days following receipt or withholding by employers. “Our proposal will protect workers by encouraging employers to deposit …
Additional employee benefits blogs for the Benefits Blawgs page: Benefits Biz Blog A forum for topical employee benefits issues. Featuring discussions of how benefit law developments affect plan sponsors and participants and how retirement plan vendors may also be impacted by the issue of the day. Written by the benefits and executive compensation group at …
K & L Gates Electronic Discovery Law Blog notes Finley v. Hartford Life and Acc. Ins. Co., 2008 WL 509084 (N.D. Cal. Feb. 22, 2008), an ERISA case, concerning penalties imposed for omissions in Rule 26(a)(1) initial disclosures. In that case, Hartford failed to disclose video footage taken of the plaintiff in her kitchen. Plaintiff …
:: Discovery Abuses Pose Risks To Counsel As Well As Litigants Read More »
Benefit contends that ERISA’s conflict preemption section, 29 U.S.C. § 1144(a) (“Section 514â€), preempts Directive 175. Section 514 “supersede[s] any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.†§ 1144(a). The preemption is not complete, however, because ERISA saves “any law of any State which regulates …
:: Fifth Circuit Upholds State Insurance Regulation Of Subrogation Rights Read More »
The Department has agreed with EBM that certain of its ventures are within ERISA and are regulated by the Department of Labor. Indeed, the appealed order provided: “Belch and EBM are not prohibited from doing business with employers in the form of single employer self insured health plans as those activities are outside the scope …
Like Magistrate Judge Shaffer in Jeffryes, 2006 WL 1186493, *2, I am not persuaded that a “blanket prohibition on discovery in ERISA cases is appropriate or required by the case law.†While it would not be appropriate to permit Plaintiff to conduct discovery directed to the factual merits of her claim, the Court will permit …
:: “Blanket Prohibition” On Discovery In ERISA Benefit Claims Dispute Inappropriate Read More »
Scott MacStravic, Ph.D, questions whether insurance industry payers have sufficient economic incentives to promote their members’ proactive health management. Scott writes: At first glance, health insurance plans ought to be major supporters of proactive health management (PHM) for their member populations, at least to the extent that this reduces members’ use of sickness care. Most …
:: Patient Health Management Incentives From The Payer’s Perspective Read More »
As noted in yesterday’s post, the lack of the plan administrator’s involvement in the benefits denial decision was cited as the reason for applying a de novo, as opposed to an abuse of discretion, standard of review. In the case discussed there, Shelby County Healthcare Corp. v. Majestic Star Casino, LLC, Slip Copy, 2008 WL …
:: A Closer Look At The Procedural Aspects Of Delegation Of Claims Review Read More »
The South Carolina Bar CLE Division will be presenting a unique seminar designed to comprehensively address the subrogation and reimbursement issues that arise in resolving claims for injured persons. As seminar planner and member of the faculty, I invite you to consider attending the seminar either in person or via webcast. My fellow South Carolinian, …
:: Subrogation & Reimbursement Issues – Seminar & Webcast Read More »
