News & Analysis as of

Health Insurance Fiduciary Duty

Maynard Nexsen

JPMorgan Sued Over Management of Prescription Drug Benefits

Maynard Nexsen on

On March 13, 2025, several current and former participants in the JPMorgan Chase Health Care and Insurance Program for Active Employees, as well as its component Medical Plan (collectively referred to as the “Plan”) filed a...more

Holland & Knight LLP

Excessive Fee Cases: Not Just for Retirement Plans Anymore

Holland & Knight LLP on

A recent wave of cases has attempted to apply the theory of liability for retirement plan excessive fee cases to health plans – specifically, arrangements with pharmacy benefit managers. Though the cases thus far have...more

Groom Law Group, Chartered

Plaintiffs Double Down on Challenges to PBM Arrangements in Class Action Lawsuits Involving Johnson & Johnson and JPMorganChase

On March 10, 2024, the plaintiffs filed an amended complaint in a much-followed putative class action lawsuit against Johnson & Johnson (“J&J”) alleging that the plan fiduciaries for J&J’s group health plan violated ERISA by...more

Ary Rosenbaum - The Rosenbaum Law Firm P.C.

DOL announces VFCP changes

The Department of Labor announced that its Employee Benefits Security Administration has updated its Voluntary Fiduciary Compliance Program, allowing employers more efficient ways to voluntarily correct compliance issues in...more

Morgan Lewis - ML Benefits

Tobacco Surcharge Lawsuits: Considerations for Plan Sponsors

A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more

Saul Ewing LLP

Organizing Your Company’s Health and Welfare Plans Part 2: Creating a Committee Checklist

Saul Ewing LLP on

In the prior article we discussed the reasoning behind creation of a health and welfare committee to oversee administration of the health and welfare plans. In creating a charter, a plan sponsor will need to decide whether to...more

Saul Ewing LLP

Organizing Your Company’s Health and Welfare Plans Part 1: Creating a Framework

Saul Ewing LLP on

Following the flurry of regulatory guidance and informal comments from officials at the Employee Benefits Security Administration, and other agencies of the Federal government, health and welfare plans should be a primary...more

Fisher Phillips

Rising ERISA Class-Action Lawsuits Over Tobacco Surcharges in Health Plans: What Employers Need to Know + 6 Steps to Stay...

Fisher Phillips on

A wave of ERISA class-action lawsuits is challenging tobacco surcharge programs in employer-sponsored health plans across the U.S. These cases center on potential fiduciary breaches, with plaintiffs arguing that surcharges...more

Jackson Lewis P.C.

Conjuring Health Plan Hygiene: The Final Chapter

Jackson Lewis P.C. on

As we conclude our “Health Plan Hygiene” blog series, we reflect on the important insights shared about fiduciary responsibilities under the Employee Retirement Income Security Act of 1974 (ERISA) and highlight the risk posed...more

Verrill

Final Mental Health Parity Rule Spells Compliance Changes

Verrill on

The long-anticipated final rule under the Mental Health Parity and Addiction Equity Act (MHPAEA) was published on September 9, 2024. The MHPAEA prohibits group health plans that provide mental health and substance use...more

Jackson Lewis P.C.

Health Plan Hygiene Part 4 – Show Me the Money

Jackson Lewis P.C. on

Our “health plan hygiene” series has focused on steps that fiduciaries of employer-sponsored group health plans can take to ensure they meet their fiduciary responsibilities. This issue has been brought to the forefront...more

Groom Law Group, Chartered

Recent Lawsuits Target Health Plan Premium Surcharges Based on Tobacco Use

There is a new series of putative class action lawsuits in which the plaintiffs allege that employers that sponsor self-funded health plans with health plan premium surcharges related to tobacco use or vaccination status...more

Pillsbury Winthrop Shaw Pittman LLP

Developments in Association Law 2022 – 2024

The following is a review of notable cases and regulatory developments for nonprofit organizations at the federal and state levels during the last two years....more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - June 2024

Saul Ewing LLP on

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

Dorsey & Whitney LLP

Healthcare Fraud: A World Beyond the Anti-Kickback Statute

Dorsey & Whitney LLP on

Americans spend more than $3 trillion per-year on healthcare-related expenses. Of that, the National Health Care Anti-Fraud Association estimates that between $60-250 billion is lost to fraud every year....more

Arnall Golden Gregory LLP

Appeals Court Revives AGG Class Action Against UnitedHealth Group for Federal Mental Health Parity Law Violations

The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more

Jones Day

Fiduciaries Beware: Employer Health Plan Under Fire for Alleged Prescription Drug Mismanagement

Jones Day on

An employer health plan is the latest target of class action litigation seeking redress for the alleged conduct of the plan's pharmacy benefit manager ("PBM")....more

The Wagner Law Group

Merger and Acquisition Considerations for Employee Benefit Plans

The Wagner Law Group on

In the context of mergers and acquisitions, an acquisition target’s qualified retirement plans, health plans, executive compensation arrangements, and benefit programs (referred to collectively as “benefit programs”) can all...more

Seyfarth Shaw LLP

Drugmaker Sued for…Overpaying for Drugs? Lawsuit Ushers in Expected Wave of Welfare Fiduciary Litigation

Seyfarth Shaw LLP on

The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more

Polsinelli

Department of Labor Settles with TPA to End Cross-Plan Offsetting Practice

Polsinelli on

The U.S. Department of Labor (“DOL”) recently entered into a settlement agreement with a New York-based insurer and third-party administrator (“Company”) of employer group health plans governed by the Employee Retirement...more

McDermott Will & Emery

Special Report - Funding Employer-Sponsored Group Health Coverage: The Group Captive Solution - November 2023

McDermott Will & Emery on

Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...more

Littler

Fourth Circuit Establishes New Standards for Plaintiffs Seeking Unjust Enrichment as an Equitable Remedy under ERISA

Littler on

The United States Court of Appeals recently shed light on when—and under what conditions—a plaintiff may seek a monetary recovery under § 502(a)(3) of the Employee Retirement Income Security Act (ERISA). Section 502(a)(3)...more

McDermott Will & Emery

Takeaways from a Recent COBRA Notice Class Action Settlement

Recent years have seen a barrage of class action lawsuits alleging that group health plan continuation coverage election notices, required under the Consolidated Omnibus Budget Reconciliation Act (COBRA), are deficient in one...more

Morgan Lewis

Plan Sponsors and Fiduciaries: Some Clarity on Mental Health Parity Compliance

Morgan Lewis on

A recently issued White House Fact Sheet, along with a regulatory package from the US Departments of the Treasury, Labor, and Health and Human Services (the Departments), provides some welcome clarity for plan sponsors and...more

Seyfarth Shaw LLP

Who Do I Need to Sue to Get a Decent Cup of Coffee? Jittery Fiduciaries Consider Options as Health Plan Litigation Froths Up

Seyfarth Shaw LLP on

Seyfarth Synopsis: In light of a recent focus on price transparency, claims data, and hidden fees in the health plan world, employer-sponsored health plans have been bringing their fight to the courtroom in an effort to lower...more

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