Call Us Today 617-357-5200
Sophisticated Legal Solutions Boutique-Style Service
HHS, DOL and IRS have issued final FAQs on the implementation of the requirements of the Mental Health Parity and Addiction Equity Act ("MHPAEA"). The MHPAEA requires that the financial requirements (e.g., coinsurance and copays) and treatment limitations ( e.g.,...
The Department of Labor ("DOL") has released a revised and updated model notice that employers can use to inform employees of the potential for state premium assistance subsidies for the purchase of group health coverage. The Children's Health Insurance Program...
Almost every ERISA employee benefit plan contains so-called "Firestone language," which grants discretionary authority to determine eligibility for benefits and construe the terms of a plan. If a plan contains such language, then a plan administrator's interpretation...
Earlier this year the EEOC announced it would reinstate the collection of EEO-1 Component 2 data, thus requiring employers to submit pay data broken own by job category, sex, race, and ethnicity. The deadline for employers to submit Component 2 data for 2017 and 2018...
The Eighth Circuit Court of Appeals, in MBI Energy Services v. Hoch, has held that a self-insured medical plan is entitled to reimbursement because its summary plan description ("SPD") was also the plan document. With this ruling, the Eighth Circuit has joined the...
The battle over what constitutes "actual knowledge" of an ERISA fiduciary breach or violation ratcheted up a notch with the filing of an amicus brief in Sulyma v. Intel Corporation Investment Policy Committee, on behalf of several of the largest trade associations in...
On October 22, 2018, the DOL issued a proposed regulation in response to the August 31, 2018, Executive Order by President Trump to remove regulatory burdens faced by defined contribution multiple employer pension plans ("MEPs"). On July 31, 2019, final DOL...
On September 4, 2019, the 5th Circuit Court of Appeals in Bangaru v. Shell U.S. Hosting Company et al, 4:17-cv-00629 (S.D. Tx.), shut the door on a former Shell executive who sought $1.5 million of severance based on his interpretation of the severance laws of his...
DOL, IRS and HHS (collectively, the "Agencies") have issued a FAQ to address whether drug manufacturers' coupons for name brand prescription drugs should be counted toward the annual cost-sharing limits under the Affordable Care Act ("ACA"), including situations where...
The United States District Court for the District of Nevada, in Speca v. Aetna Life Ins. Co., has ruled that a ERISA plan administrator did not provide a full and fair review when it denied a short term disability ("STD") claim in just 14 days and before receiving...