Tag: benefits

Judge Supports Employee Request for Benefit Details

By Jane Meacham Employers and plan administrators may want to err on the side of providing more information, not less. That is one of the messages behind a recent decision by the U.S. District Court for the Northern District of Ohio, Western Division. In Arp v. Whirlpool Corp.,  Case No. 3:12 CV 770 (July 10, […]

Groups Plead to Preserve Plans’ ERISA Discretionary Authority

Four groups — the ERISA Industry Committee, the American Benefits Council, the U.S. Chamber of Commerce and the Business Roundtable — filed an amicus brief July 26 to urge 2nd Circuit judges to support the principle of deference to plan administrators’ decisions over benefit plans. When plans reserve discretionary authority in plan documents, courts must […]

Flawed COBRA/Leave Policy Still Leaves Employer With Unpaid Stop-loss Claims

An employer whose COBRA/leave policy did not align with a stop-loss policy’s terms continues to be on the hook for a COBRA qualified beneficiary’s medical claims that were rejected by the stop-loss insurer. The employer unsuccessfully appealed a lower court ruling that the claims were ineligible under the policy terms because they did not include […]

Office Olympics

With the Olympics in full swing this summer, reruns of The Office have been replaced with reruns of the Olympics (OK, tape-delayed events, but you get the idea). I can only assume this means that every workplace in the entire world is now hosting its very own office-themed Olympics with events ranging from office-chair races to Flonkerton. (In Season 2, […]

Employers, There’s a Right Way to Distribute MLR Rebates

Today was the final day for insurers to issue rebates for 2011 premiums (as required by health reform), so employers should know by now whether they got one. The next step employers face is passing the proper amount of the rebate on to employees. When rebates go to employers, the incentives favor applying the rebates to […]

Nonreligious Firm Wins Enforcement Stay of Reform’s Contraceptive Mandate

A Colorado-based company that is not a religious organization got a temporary reprieve in complying with the Obama administration’s mandate that health plans cover contraceptives without patient cost sharing, under a new ruling from the U.S. District Court in Colorado. The reform requirement takes effect for non-grandfathered and non-religious employer health plans on Aug. 1. […]

HHS Auditions Benchmark Plans to Define Essential Health Benefits

How the U.S. Department of Health and Human Services will identify benchmark plans that would set the standard for essential health benefits under health reform was described in a final rule issued July 23. This is important because policies sold on health insurance exchanges — for individuals and for small groups — must cover the […]

Shift of Accounts to QDIA From Stable Value Fund Allowed by Courts

By Jane Meacham A plan sponsor’s immunity from financial losses that resulted from its shift of retirement plan participants’ investments into qualified default investment alternatives was upheld by the 6th U.S. Circuit Court of Appeals in its decision in Bidwell v. University Medical Center Inc., Case No. 11-5493 (June 29, 2012). Facts of the Case […]

Experts Describe Steps Needed to Begin Controlling Health Costs

Health costs have been growing much faster than the rate of inflation, and most observers agree that while health reform addresses the issue of access to insurance, it inadequately addresses the underlying problem: the cost of care itself. Unanswered questions surround reversing the unsustainable cost of health services. For example, would replacing the fee-for-service system […]

Getting a handle on summer absenteeism

With summer in full swing, employers may find more than a few empty desks around the office. That’s not too much of a burden when employees plan in advance and schedule time for their vacations, but sometimes the beach beckons on short notice and employees may extend a weekend with a sick day or two. […]