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This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more
This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more
In Byerly v. Std. Ins. Co., 2021 U.S. App. LEXIS 2937 (5th Cir. Feb. 2, 2021), the Fifth Circuit determined that a claimant, whose leg was amputated after he stubbed his toe, did not suffer a qualifying loss under his group...more
As we enter the final months of 2020, this is a time to reflect on a year of unprecedented challenges. Although Covid-19 changed our lives in many ways, it did not halt new legal developments in the life, health and...more
Employers impacted by COVID-19 have a variety of questions regarding the situation’s effect on employee health and welfare plans - particularly on how to maintain compliance with state and federal regulations....more
The novel coronavirus (COVID-19) pandemic raises many employee benefit and compensation considerations for employers. In this alert, we examine key issues relating to COVID-19 and provide suggested strategies for employers to...more
Employee Benefit Questions - If I furlough or lay off employees, can I continue some or all of their benefits during the leave? There may be ways to continue some or all benefits during a furlough or layoff. Each plan...more
As employers prepare their workforces for issues related to COVID-19, they should also take steps to ensure that their benefit plans are prepared. The impact of the virus will put a financial and logistical strain on many...more
This week in our blog series on best practices in administering benefit claims, we discuss the importance of knowing and, importantly, understanding the laws governing benefit claim administration. Section 503 of ERISA...more
Late last year, the Internal Revenue Service (the “Service”) began enforcing penalties with respect to failures to comply with the employer shared responsibility provisions of Section 4980H of the Internal Revenue Code. In...more
In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more
After several rounds of additional review and a three-month delay in the effective date, the final regulations originally issued by the U.S. Department of Labor (the “DOL”) in December 2016, which established new requirements...more
In spite of certain sound bites you probably heard late last year, the Affordable Care Act (“ACA”) was not repealed for employers. The individual mandate penalty was reduced to zero for a few years, beginning after 2018, so...more
As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more
21st Century Cures Act Impacts Employers with 50 or More Employees - Employers with 50 or more employees need to watch developments under the 21st Century Cures Act (“Cures”) because in addition to the establishment of...more
On November 18, 2015, the Department of Labor (the “Department”) published a notice of Proposed Rulemaking at 80 Fed. Reg. 222 (the “Proposed Rule”) to amend ERISA’s claims procedures (29 C.F.R. 2560.503-1) as they apply to...more