Aetna Life Insurance Company (Aetna) has settled an ERISA claim with a woman who claimed that it underpaid or failed to pay claims related to her mental health care and substance abuse disorder treatment. The parties reached a settlement agreement several months after a federal district court granted partial summary judgment in favor of the plan beneficiaries, finding that Aetna had violated the terms of the health Read More

  President Joe Biden issued executive orders in 2021 establishing a government-wide approach to climate-related financial risks. In response, the Employee Benefits Security Administration (EBSA), the employee benefits division of the U.S. Department of Labor (DOL), requested public comments in February 2022 on specific actions to protect workers' retirement savings from financial risks related to climate Read More

Attorneys for laborers who sued a general government contractor and master subcontractor, under the Fair Labor Standards Act (FLSA), following cleanup work they performed after Hurricane Michael, recently appeared before the U.S. Court of Appeals for the 11th Circuit. The workers argued that a district court judge improperly granted summary judgment in September 2020 to the two defendants, finding that they were not Read More

The federal government has begun cracking down and fining hospital systems that fail to publicize the rates they charge for medical procedures. With inflation increasing at record levels, hospitals are protesting that the data they have provided is outdated as all their costs are skyrocketing.  Insurers and plan providers may find that the valuable data they have been expecting from hospitals is already obsolete. Read More

The U.S. Department of Health and Human Services (HHS) has provided various resources concerning the No Surprises Act, which was enacted as part of the Consolidated Appropriations Act, 2021 (CAA). These resources include a “Chart for Determining the Applicability for the Federal Independent Dispute Resolution (IDR) Process.” This chart summarizes when a state or other IDR process applies instead of the federal IDR Read More

The U.S. Supreme Court’s leaked draft in Dobbs v. Jackson Women’s Health Organization now has become law with the Court’s recent issuance of its final opinion. A post-Roe America raises new and challenging issues for employers concerning employment law, medical plan coverage, and employee privacy.  Issues Related to Employment Law Allegations of Discrimination The Dobbs decision will likely bring about a Read More

The IRS has announced the implementation of a 90-Day Pre-Examination Compliance Pilot program in its Employee Plans newsletter dated June 5, 2022 ("the Pilot Program). When the IRS identifies a retirement plan for an audit, it will first send a letter to the plan sponsor of the retirement plan. The letter will inform the plan sponsor that the plan has been selected for audit and advise that it has 90 days to identify Read More

A three-panel judge of the U.S. Court of Appeals for the Seventh Circuit has affirmed the district court’s grant of summary judgment to AT&T amid claims of ERISA violations by a former employee. The case is In Craig Canter v. AT&T Umbrella Benefit Plan No. 3 et al., case number 21-1514.  Craig Canter worked as a premises technician for Illinois Bell Telephone Co., a subsidiary of AT&T. His job involved Read More

A federal district court in Utah has held in two similar cases that plan-imposed deadlines for filing lawsuits in ERISA cases are unenforceable. The court reasoned that the deadlines were inapplicable to the cases at issue because the entity’s final denial letters to the participants did not contain notice of the deadlines. The cases are E.F. v. United HealthCare Ins. Co., 2022 WL 957200 (D. Utah 2022) and Anne A. Read More

The IRS recently withdrew and replaced regulations that it had proposed in 2019 concerning sections 413(c) and 413(e) of the Internal Revenue Code (IRC), which offer an exception to section 413’s “unified-plan rule” (the Rule). The Rule is more commonly known as the “one-bad-apple rule” for multiple employer (MEP) and pooled employer (PEP) plans.  Under the Rule, a failure by one participating employer in a MEP or Read More