Practical HR Tips, News & Advice. Updated Daily.
While ERISA self-insured plans themselves are not subject to state regulation, states are clamping down on stop-loss coverage as a way to discourage self-funding, say attorney Ron Peck and legal administrator Chris Aguiar at the Phia Group, Braintree, Mass. The Texas Supreme Court ruling in TDI v American National Ins. Co. and the passage by […]
Employees can qualify for multiple exemptions under the Fair Labor Standards Act, so employers should remember that if they document an employee’s specific exemption, they should note any and all applicable exemptions, so that they are able to argue multiple exemptions in any FLSA litigation. This principle is illustrated in Schaefer La-Rose v. Eli Lilly […]
Because an employer health plan gave a full and fair review resulting in a reasonable benefits decision, a federal court upheld the plan’s lifetime limit on obesity services and its prohibition on payments to treat complications from earlier gastric bypass surgeries. The plan also weathered an allegation that it was not properly segregating plan funds. […]
Employers and plan administrators that find the over-the-counter drug rules put in place by the health care reform law to be onerous may have relief, if the Ways and Means Committee has its way. The committee on May 31 in a 24-9 vote ordered H.R. 5842, the Restoring Access to Medication Act, reported to the […]
ERISA can be the key to upholding benefit decisions based on plan language before money is paid, but it may be far less helpful once overpaid money goes out the door, particularly when the plan is indemnity-based with no provider contracts. This situation became evident in Int’l Longshore & Warehouse Union v. Sharp Surgery Center, […]
Employers and plan administrators that offer health flexible spending accounts have been bracing themselves for Jan. 1, 2013. That’s when the $2,500 limit on health FSA salary reduction contributions provided for in the Patient Protection and Affordable Care Act kicks in. The IRS on May 30 issued Notice 2012-40, which provides guidance on the limit, […]
Employers and plan administrators hoping clarity will soon dispel the confusing tangle of divergent laws governing same-sex marriage and how they must address it in their benefit plans and HR policies have longer to wait. The 1st U.S. Circuit Court of Appeals on May 31 issued a ruling in Commonwealth of Massachusetts v. U.S. Department […]
A relatively new form of insurance, employment practices liability insurance (EPLI) became popular in the 1990s after the 1991 Civil Rights Act amendments increased the frequency of discrimination claims in the workplace. EPLI typically covers defense costs, judgments and settlements of employment issues ranging from sexual harassment to wrongful termination. While many employers do not […]
Schum, a Senior Consultant at Compensation Resources, Inc. in Upper Saddle River, NJ offered his tips for sales compensation design at a recent webinar sponsored by BLR/HRhero. Sales Compensation Model Schum offers an example of the true cost of a salesperson and then charts out how that might translate into a bonus program. Cost of […]
Rejecting a plan participant’s claims that plan documents should specifically list in-network providers, the 7th U.S. Circuit Court of Appeals held that a plan clearly providing information on how to check for provider status was sufficient to escape benefits-denial and fiduciary-breach claims. In affirming a lower court decision, the court also rejected an argument that […]