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Employer Group Health Plans › Denial of Insurance Coverage

Alston & Bird

Insurance Insights for the Dog Days of August

Alston & Bird on

Welcome to the inaugural issue of Insurance Insights, a gathering of notable legal developments and trends relevant to the insurance industry. In this issue, the California Supreme Court covers COVID-19 claims, Georgia...more

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

Fisher Phillips on

A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

McDermott Will & Emery

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

McDermott Will & Emery on

Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more

Husch Blackwell LLP

New York District Court: The Choice of Medical Necessity Criteria is a Fiduciary Act

Husch Blackwell LLP on

We continue to see an increase in fiduciary litigation involving employer-sponsored group health plans, particularly litigation involving mental health. A recent New York Federal District Court case, Collins et al. v....more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: Utah Court Rules ERISA Plan Was Wrong to Deny Coverage for Mental Health Care Received at...

Hinshaw & Culbertson - The LHD/ERISA Advisor on

In Raymond M. v. Beacon Health Options, Inc., 2020 U.S. Dist. LEXIS 94615 (D. Utah, May 29, 2020), a Utah district court held that an ERISA plan improperly applied acute-level criteria when denying benefits for a...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: ERISA Plaintiff Has Statutory Standing to Bring Action to Recover Spousal Healthcare...

Hinshaw & Culbertson - The LHD/ERISA Advisor on

Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more

Baker Donelson

Three Things Health Care Employers Should Know About Affordable Care Act Section 1557

Baker Donelson on

Health care providers are likely familiar with the Affordable Care Act's (ACA) prohibitions on discriminating against the recipients of their services, but providers also must be mindful that the ACA may also make them...more

Stinson - Benefits Notes Blog

What You Say in Your SPD About Claims Processing Makes a Difference

Stinson - Benefits Notes Blog on

Employers who self fund their medical plans often have contracts with their third party administrators about claims processing. Some of those contracts provide that the claims processor has discretion to decide claims; others...more

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