3 Takeaways From Cigna’s Win In 9th Circ. Rehab Claim Fight

Law360 (June 10, 2024, 5:46 PM EDT) -- The Ninth Circuit's recent decision finding Cigna is off the hook for $8.6million in out-of-network mental health and substance use disorder treatment claims against employee benefit plans administered by the insurer could discourage similar litigation, benefits attorneys say. The Ninth Circuit on May 31 upheld a California court's grant of summary judgment to Cigna on claims Read More

The DOL’s New “Economic Realities” Test to Determine Employee Status: ERISA Considerations for Benefit Plan Sponsors

By Bonita Hatchett-Bodle (April, 2024) The Department of Labor (DOL) Wage and Hour Division issued final regulations, effective March 11, 2024, which are intended to serve as a practical guide to employers on how the DOL determines whether a worker is an employee or independent contractor under the Fair Labor Standards Act (FLSA) [29 CFR part 795]. This new guidance may impact employee classification under the Read More

Group Health Plans Must Affirm Compliance with Price Transparency Rule

January 17, 2024 | Leah Shepherd Employers that sponsor group health plans need to ensure they are in line with a new annual requirement to vouch that they are complying with a federal price transparency rule. The reporting requirement was part of the No Surprises Act, which passed in 2021 as part of the Consolidated Appropriations Act. It prohibits group health plans from entering into any agreement that prevents Read More

4 Benefits Issues That May Trip Up Worker Reclassification

By Kellie Mejdrich Law360 (January 12, 2024, 6:02 PM EST) -- The U.S. Department of Labor's recently finalized rule toughening the test for determining whether someone qualifies as an independent contractor or an employee under federal wage and hour law may make businesses rethink deeming workers contractors. The DOL's final rule, published in the Federal Register on Wednesday, sets out a six-factor, nonexhaustive Read More

The Self-Funded Plan’s Guide To Gender-Affirming Coverage

By Tim Kennedy and Anne Tyler Hall (October 31, 2023) In recent years, the U.S. has seen an increase in the number of individuals identifying as transgender.[1] With this development, there also has been increased attention on transgender rights and protections, as well as an increase in the demand for employer-sponsored group health plans, or GHPs, to cover gender-affirmation benefits. Whether or how a GHP Read More

Secure an Employee Plan’s Future by Proactively Self-Correcting

By Grant Shuman and Anne Tyler Hall, Hall Benefits Law SECURE 2.0 provides retirement plan sponsors an avenue to control the narrative in resolving any compliance issues under EPCRS, say Grant Shuman and Anne Tyler Hall of Hall Benefits Law. Retirement plan sponsors can take advantage of new and expanded self-correction remedies under the Employee Plans Compliance Resolution System even before the IRS releases Read More

September Brings 5 Appellate Benefits Arguments To Watch

By Kellie Mejdrich Law360 (September 1, 2023, 7:22 PM EDT) -- In September, federal appeals courts have set oral arguments on several important employee benefits disputes from workers claiming violations of the Employee Retirement Income Security Act, and a D.C. Circuit panel will be asked to determine whether Rite Aid violated labor law when changing union retirees' health benefits. Here are five appellate Read More

HBL Certified by the Women’s Business Enterprise National Council

ATLANTA, July 18, 2023 /PRNewswire/ -- Boutique ERISA and employment law firm Hall Benefits Law (HBL), serving employer plan sponsors and benefit service provider clients in 40 states, is proud to announce its national certification as a Women's Business Enterprise by the Greater Women's Business Council, a regional certifying partner of the Women's Business Enterprise National Council (WBENC). WBENC Certification is Read More

4 Major Benefits Policy Developments In The First Half Of 2023

By Kellie Mejdrich Law360 (June 16, 2023, 2:52 PM EDT) -- Congress and the Biden Administration took several key actions that made an impact on employee benefits policy in the first six months of 2023, including advancing federal legislation cracking down on pharmacy benefit managers, ending emergency designations tied to the coronavirus pandemic, and proposing rules for group health plans on contraceptive Read More

Recent State and Federal Scrutiny Presents Unique Opportunity for Plan Sponsor PBM Agreement Negotiation

By Anne Tyler Hall, Grant Shuman, and Tim Kennedy* INTRODUCTION: THE PBM LEGISLATIVE AND REGULATORY FIRESTORM Pharmacy benefit managers (PBMs) and their fee generation methods have been controversial for some time. More recently, however, PBMs have begun receiving considerable scrutiny from all sides. Both the Federal Trade Commission and the U.S. Senate have opened parallel probes of ‘‘alleged anticompetitive Read More