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The claims administrator of an employer-sponsored health plan abused its discretion when it rejected a health benefits claim because it: (1) denied it without an explanation or plausible support; (2) had a structural conflict of interest because it was also the insurer; and (3) violated ERISA regulations by merely reciting its policy without refuting the […]
Employers may not feel much of an administrative burden from the new “starter” retirement savings accounts announced Jan. 28 in President Barack Obama’s State of the Union address, but those opting to participate should be prepared for employees’ questions about the My Retirement Account or “myRA” program ahead of its launch late this year. While […]
Pre-authorization procedures, plan disclosures and geographical restrictions are just a few features group health plans will need to re-examine by the time the recently finalized mental health parity rules take effect. For calendar-year plans, this means Jan. 1, 2015 — less than a year away. The interaction of the Mental Health Parity and Addiction Equity […]
Due to an administrative error, an employer clearly did not provide a qualified beneficiary with a COBRA election notice. However, the qualified beneficiary also benefited from that mistake by receiving 11 months of free health coverage. For that reason, a federal district court in Iowa rejected claims that the employer should be subject to COBRA […]
A third-party administrator that poorly communicated a COBRA premium rate increase — which in any case was likely prohibited under COBRA’s rules — is being sued for ERISA benefits denial and state-law promissory estoppel claims. The TPA instituted the premium change but did not provide clear written notice of it as required under plan terms. […]
A Texas man who reported he sustained a job-related injury while driving a truck and received income benefits from an insurance company was found driving a truck while collecting. Not a huge surprise. What was surprising was that he was also found to be climbing trees as part of a side business! Texas Mutual Insurance […]
A new type of “starter” retirement savings account for smaller balances that’s backed by the federal government but administered by employers was promised by President Barack Obama in his 2014 State of the Union address on Jan. 28. The president said he would use an Executive Order to direct the U.S. Treasury Department on Jan. […]
In proposed rules issued Jan. 27, the IRS clarifies how participants in employer-sponsored plans are to count employer contributions to HRAs and wellness program incentives when calculating their contributions to employer-sponsored coverage. In those rules, the IRS also allows temporary exceptions to health care reform’s definition of minimum essential coverage for government-sponsored limited-benefit plans, giving […]
Robots and androids will replace the majority of human jobs in the next few decades, according to the new book, Jobocalypse: The End of Human Jobs and How Robots Will Replace Them, by British author and futurologist Ben Way. Where will that leave “human” resources? Even jobs that were considered “safe” from outsourcing may be […]
Registered investment advisers and broker-dealers that may be misrepresenting their credentials or the benefits and features of individual retirement accounts will be targeted by the Office of Compliance Inspections and Examinations of the Securities and Exchange Commission, based on the initiatives listed in a Jan. 9 release of the agency’s 2014 examinatfion priorities. The so-called […]