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ERISA Plan Cannot Recover Overpayments Resulting From The Plan's Own Mistake

Most employee benefit plans (e.g., employer-sponsored health or disability insurance) allow the plan to recover excess overpayments it provides the insured.  This typically occurs where the plan provides benefits that are duplicated by another source of funding.  324 more words

ERISA

You can terminate that employee who is off for a work injury…….but, based on this new 6th Circuit Court case, don’t forget that there are implications outside of workers’ compensation/FMLA/ADA issues

In Stein v. Atlas Industries, 2018 WL 1719097 (6th Cir. April 9, 2018) the 6th District considered an FMLA/ERISA action brought by an employee who was terminated after failing to show up for work after the physician treating him for a work-related injury released him to light-duty. 667 more words

Health Plans Can't Discriminate Against Mental Health Treatment Says Ninth Circuit

Among the challenges of a mental health condition is the difficulty persuading health insurers to cover treatment.  Mental health conditions can be difficult to objectively diagnose and can require lengthy and expensive treatment often with little prospect of a conventional “cure.”  Hence, health plans have a powerful incentive to minimize coverage for mental health conditions to reduce costs. 243 more words

McKean Evans

Employer Stock in Qualified Plans: Recent Developments Largely Good News for Fiduciaries

Contributed by William Scogland, June 13, 2018

Many employer sponsored defined contribution (DC) plans qualified under Section 401(a) of the Internal Revenue Code of 1986, as amended (the “Code”) maintain employer stock funds. 455 more words

ERISA

ERISA Appeal FAQs

ERISA, the federal law governing most employer-sponsored benefits (e.g., health, disability or life insurance, or pension or retirement benefits) gives participants the right to appeal the Plan or insurer’s denial of payment or benefits (in legalese, an “adverse benefit determination”).  454 more words

McKean Evans

Court of Appeals Clarifies Policy Causation Language In Favor Of The Insured

When language in one part of your ERISA policy says your claim is covered, can the company rely on language elsewhere in the policy to deny your claim?  334 more words

McKean Evans