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Results:1-10 of 84

Proposed Mental Health Parity Guidance Focuses on Nonquantitative Treatment Limitations
  • Proskauer Rose LLP
  • USA
  • June 7 2018

On April 23, 2018, the Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (together, the “Agencies”) released proposed


Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA
  • Proskauer Rose LLP
  • USA
  • June 8 2017

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA


U.S. Supreme Court agrees to hear case on ERISA statute of limitations
  • Proskauer Rose LLP
  • USA
  • April 16 2013

The U.S. Supreme Court announced on April 15, 2013 that it will take up the question of when the statute of limitations period may begin to run for


The Affordable Care Act and its coverage mandates for employers: a potent recipe for ERISA class actions
  • Proskauer Rose LLP
  • USA
  • August 20 2012

Although the Patient Protection and Affordable Care Act (ACA) has engendered much controversy (pro and con) in the business community, one area that has received less discussion is whether ACA may increase employers’ exposure to high-stakes class action litigation.


Claims for benefits
  • Proskauer Rose LLP
  • USA
  • April 16 2012

In Schultz v. Aviall, Inc. Long Term Disability Plan, 670 F.3d 834 (7th Cir. 2012), the Seventh Circuit held that the plan admistrator of a disability plan acted properly by interpreting a Social Security offset provision that limited benefits by accounting for Social Security benefits paid to the participants and their dependent children.


Third Circuit limits relief available to ERISA welfare plans seeking reimbursement of medical expenses
  • Proskauer Rose LLP
  • USA
  • November 17 2011

In a case of significant importance for plan sponsors and fiduciaries, the U.S. Court of Appeals for the Third Circuit held in US Airways, Inc. v. McCutchen, No. 10-3836 (3d Cir. Nov. 16, 2011), that an employee benefit plan was not entitled to full reimbursement of medical expenses it paid to a participant even though the plan provided that the participant was required to reimburse the plan for all amounts paid "out of any monies recovered from a third party."


Exhaustion of benefit claims
  • Proskauer Rose LLP
  • USA
  • November 7 2011

In Laird v. Norton Healthcare, Inc., No. 10-5205, 2011 WL 4597539 (6th Cir. Oct. 6, 2011), the Sixth Circuit held that claims for short-term disability ("STD") benefits and long-term disability ("LTD") benefits were properly denied for failure to timely exhaust the respective plans' administrative remedies.


Preemption
  • Proskauer Rose LLP
  • USA
  • November 7 2011

In Fossen v. Blue Cross and Blue Shield of Montana, Inc., ---F.3d---, 2011 WL 4926006 (9th Cir. Oct. 18, 2011), the court held that ERISA and HIPAA preempted plaintiffs’ state law claims seeking restitution of health care coverage premiums they allegedly overpaid.


Retiree Benefits
  • Proskauer Rose LLP
  • USA
  • November 7 2011

In Evans v. Sterling Chemicals, Inc., --- F.3d ----, No. 10-20493, 2011 WL 4837847 (5th Cir. Oct. 13, 2011), the Fifth Circuit held that an employer violated ERISA by increasing the cost of certain retirees' health care benefits.


Standing
  • Proskauer Rose LLP
  • USA
  • November 7 2011

In Caples v. U.S. Foodservice, Inc., No. 11-30120, 2011 WL 4605375 (5th Cir. Oct. 6, 2011), the Fifth Circuit held that a deceased life insurance plan participant’s ex-wife lacked standing to sue for benefits because she was neither a surviving spouse nor a designated beneficiary under the most recent life insurance plan.