Tag: benefits

Indemnity Plan’s Recovery Provision Does Not Bind Providers, So Lawsuit to Force Pay-back Is Dismissed

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, […]

IRS Further Explains Reform Rules on Health FSAs

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, […]

Federal DOMA Unconstitutional, First Circuit Says, But Doesn’t Disturb State Laws

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 […]

Pay less for FLSA liability coverage by updating policies and monitoring workers

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 […]

What’s the Appropriate Sales Level for Commission to Kick In?

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 […]

Plan’s Network Policy Was Clear Enough to Ward Off ERISA Claims (in spite of poor call center performance)

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 […]

Rhode Island Recognizes Other States’ Same-sex Marriages

Same-sex marriage is not legal in Rhode Island, but employers there must make provision for employees’ same-sex spouses nonetheless. Gov. Lincoln Chafee (I) on May 14 signed an executive order announcing that Rhode Island will recognize the validity of same-sex marriages entered into in states where it is legal. The executive order went into effect […]

EBSA Loosens Health Reform Rules for SBC Delivery, Stays Enforcement

A set of safe harbors related to the enforcement of summaries of benefits and coverage (SBCs), which insurers and plan sponsors must distribute as part of health care reform, was issued May 11 by the U.S. Department of Labor and the Employee Benefits Security Administration. The DOL/EBSA guidance creates regulatory exceptions for situations where insurers […]