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Plan Administrators Employee Retirement Income Security Act (ERISA) Health Insurance

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

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The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

Robinson+Cole ERISA Claim Defense Blog

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more

Troutman Pepper

Case Update: Tenth Circuit Denies Petitions for Rehearing in Decision Requiring Substantial Changes to Health Plan Denial Letters

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As discussed here, D.K. et al. v. United Behavioral Health et al. is a case that has been carefully watched in the health benefits space for its impact on what health plan administrators must include in adverse benefit...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - October 2022

The October Monthly Minute highlights a class action that hinges on deficient COBRA notices, the new 2023 benefit plan limits, and a case that held the benefit plan provisions in effect at the time of a claim denial control....more

Polsinelli

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

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The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more

K&L Gates LLP

Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA...

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On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA...more

Rivkin Radler LLP

Employee Relations Law Journal – From the Courts

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North Carolina District Court Permits Plan’s Lawsuit Against Third Party Administrator to Continue A federal district court in North Carolina has ruled that a plan subject to the Employee Retirement Income Security Act of...more

Seyfarth Shaw LLP

Does My Health FSA Cover My Surgical Mask Bulk-Purchase? (and other pressing questions about the intersection of coronavirus,...

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Seyfarth Synopsis: Because everything has a coronavirus angle now….this blog post covers various issues and considerations plan sponsors and administrators should keep in mind as the coronavirus outbreak continues to...more

K&L Gates LLP

K&L Gates Triage: Important Takeaways from Omega Hospital, LLC v. United Healthcare Services, Inc.

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In this episode, Gary Qualls discusses a recent development in payer litigation which implicates a number of recurring issues often raised in Employee Retirement Income Security Act (ERISA) cases. Specifically, a federal...more

Proskauer Rose LLP

ERISA Newsletter - Fourth Quarter 2018

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As we closed the door on 2018, we were met by two surprising decisions—one from a panel of the Second Circuit addressing employer stock drop litigation, and one from a federal district court in Texas declaring the entire...more

King & Spalding

November and December 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

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Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2015

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Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - September 2015

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Editor's Overview - It has been a little more than one year since the U.S. Supreme Court altered the legal landscape for litigating ERISA breach of fiduciary duty claims relating to the investment in employer stock...more

Baker Donelson

Court of Appeals to Plan Administrators: Inform Claimants of Time Limits on Front End of Discussions

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Recently, in Mirza v. Insurance Administrator of Am., Inc., __ F.3d__ (3d. Cir. 2015), the United States Court of Appeals for the Third Circuit was asked to determine whether plan administrators are required to include a...more

Williams Mullen

Plaintiffs’ Misdirected Demand for Documents Fails, and Their Claim for ERISA Civil Penalties Is Dismissed: Boyd v. Sysco...

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A federal court dismissed the plaintiffs’ claim to recover civil penalties for failure to provide plan documents requested by the plaintiffs. Boyd v. Sysco Corporation, No. 4:13-cv-00599 (D. S. C. September 3, 2015), provides...more

Foley & Lardner LLP

Second Circuit Reinstates Mental Health Parity Case Against UnitedHealth

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In late August the U.S. Court of Appeals for the Second Circuit reinstated a lawsuit by a physician association against a third-party plan administrator. The case against UnitedHealth Group and related entities (United) had...more

McDermott Will & Emery

Seventh Circuit Finds that State Insurance Law Applies, Resulting in De Novo Review of Benefit Claim

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On September 4, 2015, the U.S. Court of Appeals for the Seventh Circuit ruled in Fontaine v. Metropolitan Life Insurance Company that the Employee Retirement Income Security Act of 1974, as amended (ERISA), does not preempt...more

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