The Ninth Circuit Court of Appeals, in Kay v. Hartford Life and Accident Insurance Company, has reversed a lower court’s decision upholding an insurer’s termination of long-term disability (“LTD”) benefits after concluding that the “district court abused its...
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Federal Court Finds Key Part of ACA’s Preventive Service Mandate Unconstitutional
A Texas federal district court, in Braidwood Management, Inc. v. Becerra, has held that the Affordable Care Act’s (“ACA’s”) requirement that most group health plans and health insurers cover certain recommended preventive services without cost-sharing violates the...
Department of Labor Updates Guidance on Independence of Qualified Plan Accountants
Plan sponsors of large employee benefit pension plans are familiar with the requirement of audited financial statements for annual reporting purposes. That requirement is discussed in the DOL’s 2018 guidebook “Selecting an Auditor for Your Employee Benefit Plan,” and...
“Probate Exception” Precludes Federal Jurisdiction over ERISA Lawsuit
The Sixth Circuit Court of Appeals, in American Electric Power Service Corporation v. John K. Fitch et al., has affirmed a district court’s dismissal of a group health plan’s ERISA action seeking settlement proceeds from a wrongful death lawsuit involving a...
Pay for Performance 2022: From Disclosure to Execution … to Retention
By Mark Poerio Tight labor markets tend to sharpen loyalty issues, as employers compete for an edge by which to retain — and motivate — their key employees. It does not take rocket science to defuse the temptation posed by greener pastures. But it takes action. Simple...
ERISA Lawsuit Time-Barred Due to Plan’s Limitations Period
The Eleventh Circuit Court of Appeals, in Bakos v. Unum Life Insurance Company of America, has upheld the dismissal of a lawsuit for wrongful denial of long-term disability (“LTD”) benefits because the lawsuit was time-barred by a provision in the LTD policy. In...
No Surprises in Agencies’ Reproposal of Independent Dispute Resolution Regulations on No Surprise Act Billing Arbitration
By Danae Delano, Roberta Watson and Barry Salkin Last November, we published a law alert regarding the first two rounds of regulatory guidance on the No Surprise Billing portion of the Consolidated Appropriations Act, 2021 (the “CAA”). Since that date, separate...
SEC Provides Further Guidance in its Staff Bulletin: Standards of Conduct for Broker-Dealers and Investment Advisers Conflict of Interest
By Stephen Wilkes and Seth Gaudreau The U.S. Securities and Exchange Commission (“SEC”) recently published a Staff Bulletin (the “Bulletin”) providing further fiduciary standards guidance for broker-dealers and investment advisers under Regulation Best Interest (“Reg...
Court Finds Employee-Paid LTD Policy Was Part of Employer’s ERISA Plan
A federal district court in the Middle District of Tennessee has held, in Insurance Company of America, that a long-term disability (“LTD”) policy offered under an employer’s group health plan was subject to ERISA despite the fact that the premiums for the LTD...
Inflation Reduction Act’s Impact on Group Health Plans
On August 16, 2022, President Biden signed into law the Inflation Reduction Act (“IRA”). The new legislation contains several provisions impacting group health plans. Below is a description of some of the key changes that will be implemented in the wake of the IRA’s...