Health & Welfare

Insurer's Payment of Reduced Benefit Not a Fiduciary Breach

The Fourth Circuit Court of Appeals, in Gordon v. CIGNA Corp., has affirmed a lower court's determination that an insurance company did not breach its fiduciary duty under ERISA when it paid an insured's widow only half of the amount of life insurance coverage for which the decedent had paid premiums. In particular, the Fourth Circuit held that the insurer had no fiduciary duty to notify the ...

Sixth Circuit Decision Highlights Importance of Firestone Language for Plan Interpretation

The Sixth Circuit Court of Appeals, in Clemons v. Norton Healthcare Retirement Plan, held that certain doctrines of contract interpretation did not apply to resolve ambiguities in an ERISA plan once a court has determined that the plan document grants the administrator broad discretion to interpret its terms.

ERISA Plan's Anti-Assignment Provision Bars Healthcare Provider's Benefit Claim

The Ninth Circuit Court of Appeals, in Eden Surgical Center v. Cognizant Technology Solutions Corp., dismissed a healthcare provider's lawsuit against a group health plan in which the provider sought benefits as the assignee of a plan participant.

Severance Plan Not Covered by ERISA

The Third Circuit Court of Appeals has ruled, in Girardot v. The Chemours Company, that an employer's severance plan is not a welfare benefit plan as defined under ERISA and, therefore, plan participants are not entitled to the protections provided by ERISA.

IRS Announces 2019 HSA Limits

The IRS has announced the 2019 calendar year dollar limits for health savings account ("HSA") contributions, and the minimum deductible amounts and maximum out-of-pocket expenses for high deductible health plans ("HDHPs"). By law, these limits are indexed annually to adjust for inflation.

Post-FMLA Leave Not Required Under ADA

The U.S. Supreme Court has declined to review Severson v. Heartland Woodcraft, Inc., which leaves standing a Seventh Circuit Court of Appeals decision concerning the availability of extended leave as a reasonable accommodation under the Americans with Disabilities Act ("ADA").

IRS FAQs Provide Guidance About the Paid Family and Medical Leave Tax Credit

The IRS has issued FAQs that provide guidance to employers on the Paid Family and Medical Leave Tax Credit which was created by the Tax Cuts and Jobs Act of 2017. 

Agencies Issue Proposed FAQs on Mental Health Parity Implementation

HHS, DOL and IRS (the "Agencies") have jointly issued proposed FAQs to provide guidance on the implementation of the requirements of the Mental Health Parity and Addiction Equity Act of 2008 (the "MHPAEA"). 

Employee Awarded Benefits Due to Employer's Flawed Administrative Procedures

In Frye v. Metropolitan Life Insurance Co., a federal district court in Arkansas has held that an employee is entitled to proceeds from dependent life and accidental death and dismemberment (AD&D) insurance policies, despite the fact that her son was ineligible for such coverage due to his age at the time of his death.

Employee's ADA and FMLA Claims Dismissed Due to Attendance Issues

In Wolf v. Lowe's Companies, Inc., a federal district court in Texas dismissed a former employee's Americans with Disabilities Act ("ADA") Family and Medical Leave Act ("FMLA") discrimination claims due to the employee's chronic, excessive attendance issues and poor performance.