A New Jersey federal district court has ruled in a case involving an employer's alleged failure to notify a former employee of her COBRA rights or promptly process her request for continued health coverage. The case is Davis v. World Ins. Assocs., LLC, 2023 WL 2665727 (D.N.J. 2023). Davis filed an employment discrimination lawsuit against her former employer. Her claims included allegations concerning the adequacy Read More

The U.S. Department of Labor (DOL) reportedly has abandoned its appeal in the case of American Securities Association [“ASA”] v. U.S. Department of Labor, No. 8:22-cv-00330 (M.D. Fla. Feb. 13, 2023). In ASA, a Florida federal district court, consistent with a similar ruling by a New York federal district court, rejected a critical DOL interpretation of its fiduciary rules under the Employee Retirement Income Security Read More

The U.S. Department of Labor (DOL) issued FAQs in March that looked toward the end of the national COVID-19 emergency, which was set to expire on May 11, 2023. However, the Biden administration opted to end the national emergency early, on April 10, 2023. Nonetheless, the DOL has indicated that it will not alter its March guidance regarding the outbreak period, which is 60 days following the end of the national Read More

UnitedHealthcare, Oxford Health Plans, LLC, and Oxford Health Insurance, Inc. are facing a lawsuit under ERISA and the Affordable Care Act (ACA) in a Connecticut federal district court concerning the alleged reversal of an approved claim. The plaintiffs allege that the companies denied coverage for midwife services after initially approving the care as in-network. Plaintiffs Jonathan A. Winter, Rebecca E. Moore, Read More

The U.S. Court of Appeals for the First Circuit has affirmed the decision of a trial court finding that the third-party administrator (TPA) of a self-insured multiemployer health plan was not an ERISA fiduciary. The case is Mass. Laborers’ Health and Welfare Fund v. Blue Cross Blue Shield of Mass., 2023 WL 3069637 (1st Cir. 2023). Based on its administrative activities, the plan argued that the TPA was an ERISA Read More

During the COVID-19 national emergency, the claims and appeals deadlines for various employee benefit plans were extended by disregarding the COVID-19 “outbreak period,” which ends 60 days after the national emergency ends unless federal agencies announce another end date. As of April 10, 2023, the COVID-19 national emergency has ended, putting the outbreak period end date on June 10, 2023. However, the U.S. Read More

A 2023 Urban Institutes research report concludes that the 2020 No Surprises Act (NSA) has achieved the goal Congress expressed in passing the legislation: price transparency in medical billing to protect consumers. Researchers creating the report interviewed 32 regulators and stakeholders representing hospitals, payors, billing companies, and consumers. They also analyzed relevant data to measure the effectiveness Read More

In a recent ALM Benefits Pro article, Lindsay Barnard and Duke Janssen, two Alegeus executives, discussed the disconnect between what employers and employees find most important regarding health savings accounts (HSAs) and lifestyle spending accounts (LSAs). Alegeus is a leading provider of SaaS-based benefit funding and payment solutions. Health Savings Accounts Barnard, who leads product management for HSAs Read More

Secure 2.0, which Congress passed last year, contains a wide range of retirement provisions that benefit various parties. For example, employees may benefit from this legislation if employers utilize its provisions to provide new financial wellness programs, such as emergency savings accounts and Starter K plans. Emergency Savings Accounts An emergency savings account is fundamental to any financial wellness Read More

The purpose of the Health Insurance Portability and Accountability Act (HIPAA) privacy rule was to protect the medical records and protected health information (PHI) of individuals. As a result, insurance companies provide extremely sparse data to employers with less than 250 employees, in the form of large claims data at the end of the year. Insurance companies provide this limited data to prevent HIPAA violations Read More