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Medical plan preauthorization language violates SPD standards

Hodgson Russ LLP
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USA
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August 29 2012

In Koehler v. AETNA Health Inc., the U.S. Court of Appeals for the Fifth Circuit held that Aetna’s benefits decision was not, as a matter of law, entitled to deference where the same document, Aetna’s certificate of coverage, served as both the plan document and summary plan description (SPD

Supreme Court considers constitutionality of individual mandate

Hodgson Russ LLP
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USA
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April 27 2012

At the end of March, the U.S. Supreme Court heard arguments on the constitutionality of a provision in the Patient Protection and Affordable Care Act (ACA) that requires most U.S. residents to maintain health care coverage for themselves and their dependents

Plan administrator not obligated to provide benefit accruals for unpaid hours

Hodgson Russ LLP
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USA
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July 29 2011

Nurse participants in a hospital retirement plan were upset that their unpaid meal breaks, during which they were required to work, and an unpaid 20-40 minute period of patient status review before the official start of their shifts were not counted for benefit purposes in the hospital's retirement plans

Legal challenges to health care reform continue to work through the courts

Hodgson Russ LLP
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USA
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April 15 2011

In late January, a district court in Florida ruled that the Patient Protection and Affordable Care Act (PPACA) is unconstitutional

Same-sex domestic partner policy does not discriminate against opposite-sex couples

Hodgson Russ LLP
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USA
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April 15 2011

Reversing a decision by the Westchester County Human Rights Commission, a New York appeals court recently held that a policy adopted by a local Board of Cooperative Educational Services (BOCES) to offer health care to same-sex domestic partners did not unlawfully discriminate against opposite-sex domestic partners

Full-time medical residents subject to FICA

Hodgson Russ LLP
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USA
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February 11 2011

The US Supreme Court recently affirmed a decision of the Court of Appeals for Eighth Circuit upholding the IRS's position that remuneration paid to medical residents working full-time is subject to FICA tax

Insurer not a fiduciary when negotiating rates

Hodgson Russ LLP
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USA
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February 11 2011

The Court of Appeals for the Sixth Circuit ruled that an insurer was not acting as a fiduciary when it negotiated rates with hospitals that favored its health maintenance organization clients over its self-funded plan clients

Search results

Medical plan preauthorization language violates SPD standards

Supreme Court considers constitutionality of individual mandate

Plan administrator not obligated to provide benefit accruals for unpaid hours

Legal challenges to health care reform continue to work through the courts

Same-sex domestic partner policy does not discriminate against opposite-sex couples

Full-time medical residents subject to FICA

Insurer not a fiduciary when negotiating rates

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