It appears that the individual mandate under the PPACA may be headed for rough sailing. Here is an excerpt from an opinion today in which the Obama administration’s motion to dismiss was denied. The government …
The federal agencies regulating under the PPACA have determined that changing issuers should not result in a loss of a plan’s grandfathered status. The new guidance was anticipated inasmuch as a change in insurers is …
The Courts of Appeals disagree as to whether Varity prohibits a plaintiff from simultaneously pursuing equitable relief pursuant to Section 502(a)(3) and benefits due under the terms of the plan pursuant to Section 502(a)(1)(B). The …
Thus, in a nutshell, Blue Cross lowered rates for its own subsidiary by effectively raising them for Flagstar and other self-insured plans. The letter agreements between Blue Cross and the hospitals spell out these facts …
More on this later, but Judge Henry Hudson has ruled that the PPACA individual mandate is unconstitutional: Judge Henry E. Hudson ruled Monday for the state’s claim that the requirement for people to purchase health …
The new group health plan external review requirements require analysis on several levels. Some of the more obvious issues involve whether the external review requirements apply, and if so, whether state or federal external review …
rom the Employee Benefit Security Administration’s website: EBSA Unified Agenda Entries DOL Fall 2010 Semi-Annual Agenda 1210-AB33 — Lifetime Income Options for Participants and Beneficiaries in Retirement Plans — Prerule Stage 1210-AB46 — Automatic Enrollment …
The NAIRO released a white paper covering a number of points on the new external review requirements. A press release on the white paper appears here. Under the DOL’s point of view, the decision of …
ERISA provides federal courts with jurisdiction to review benefits determinations made by fiduciaries or plan administrators. 29 U.S.C. § 1132(a)(1)(B); see also Lopez ex rel. Gutierrez v. Premium Auto Acceptance Corp., 389 F.3d 504, 509 …
Alexander A. Reinert, Assistant Professor of Law, Benjamin N. Cardozo School of Law, has published a meticulously researched article that examines effects of the heightened pleading requirements under recent United States Supreme Court jurisprudence. Entitled …