By Noah G. Lipschultz Most ERISA welfare benefit plans have provisions that allow the plan to recoup amounts of medical expenses it paid to participants or beneficiaries for injuries or illnesses caused by third parties (such as those sustained in automobile accidents), where the participant obtains a recovery from the third party. Often, an ERISA… Continue Reading
Monthly Archives: February 2012
HHS Issues New Set of FAQs on Determining Essential Health Benefits
By Ilyse Schuman The Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight (CCIIO) has issued additional guidance (pdf) on the approach the agency plans to take in defining the essential health benefits (EHB) that non-grandfathered insured health plans in the individual and small group markets must cover under the Affordable… Continue Reading
HHS Releases Model Notices Related to Medical Loss Ratio Requirement
By Ilyse Schuman The U.S. Department of Health and Human Services (HHS) has issued proposed notices that health insurance companies may use for compliance with the new Medical Loss Ratio (MLR) requirements under the Affordable Care Act. The new health care law mandates that health insurers, depending on the size of the insurance market, spend… Continue Reading
Agencies Issue Final Rule on Contraceptive Coverage
By Ilyse Schuman The Departments of Labor, Health and Human Services, and the Internal Revenue Service have issued a final rule that adopts without change interim final regulations that exempt group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the… Continue Reading
Second Circuit Holds that Dukes Prohibits Certification of ERISA Claim Under Rule 23(b)(2)
By Darren E. Nadel In Nationwide Life Insurance Co. v. Haddock, No. 10-4237 (2d Cir. February 6, 2012) [pdf], the Second Circuit reversed a district court order granting class certification. The plaintiffs in Haddock assert that Nationwide breached its fiduciary duty under ERISA by allegedly collecting “revenue sharing payments” from mutual funds that Nationwide selected… Continue Reading
DOL Issues New Guidance Related to Affordable Care Act Provisions
By Ilyse Schuman The Department of Labor has issued a new technical release document that provides responses to frequently asked questions (FAQs) about the Affordable Care Act’s automatic enrollment, employer shared responsibility, and the 90-day limitation on waiting periods provisions. In addition to providing guidance on these topics, the document discusses possible approaches under consideration… Continue Reading
Agencies Issue Final Rule Regarding Summary of Benefits and Coverage
By Ilyse Schuman The Departments of Health and Human Services, Labor, and the Treasury have issued final regulations (pdf) under the Affordable Care Act to implement the requirement that group health plans and health insurance issuers provide consumers with a summary of benefits and coverage (SBC) that “accurately describes the benefits and coverage under the… Continue Reading
IRS Publishes Interim Report on Section 401(k) Compliance Check Questionnaire
By Melissa B. Kurtzman On February 3, 2012, the Internal Revenue Service (IRS), published its Interim Report on Section 401(k) Compliance Check Questionnaire (“Interim Report”). The Interim Report is significant because, according to the IRS, 401(k) plans have become the most prevalent form of retirement plans in the United States – with more than 500,000… Continue Reading
IRS Proposes to Bless Longevity Insurance
By Susan Katz Hoffman On February 3, 2012, the U.S. Department of Treasury (“Treasury”) and the Internal Revenue Service (“IRS”) issued proposed regulations that would exempt the purchase of a “Qualified Longevity Annuity Contract” (“QLAC”) from the account balance that would have to be distributed under the minimum distribution rules of Internal Revenue Code Section… Continue Reading
The Department of Labor Publishes Final Regulations Regarding 408(b)(2) Fee Disclosures
By Joni L. Andrioff and Lisa A. Taggart On February 3, 2012, the Department of Labor (“DOL”) published final regulations setting out the fee disclosure rules for persons or entities providing services to retirement plans governed by ERISA. See Treas. Reg. §2550.408-2; 77 Fed. Reg. 023 (Feb. 3, 2012) pgs. 5632-5659. These regulations detail the… Continue Reading
House Votes to Repeal Affordable Care Act’s Long-Term Care Program
By Ilyse Schuman The House of Representatives on Wednesday voted to rescind another portion of the Affordable Care Act. The chamber approved by a 267-159 margin the Fiscal Responsibility and Retirement Security Act of 2011 (H.R. 1173), a measure that would repeal the Community Living Assistance Services and Supports (CLASS) Act, (pdf) the Affordable Care… Continue Reading
Connecticut Federal District Court Holds that Jury Trial May Be Available Under ERISA
By Daniel W. Srsic In Healthcare Strategies, Inc. v. ING Life Insurance & Annuity Co., [pdf.] the United States District Court for the District of Connecticut refused to strike a demand for jury trial with respect to a claim for relief it categorized as “legal” rather than “equitable.” In this case, a plan administrator contracted with… Continue Reading