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A third-party claims administrator may not be sued for violating the Mental Health Parity and Addiction Equity Act because the law by its terms applies only to group health plans and their insurers, a federal district court ruled. Related ERISA claims against the TPA were also dismissed because the company was not the “plan administrator” […]
The U.S. Supreme Court on Nov. 26 accepted an appeal of health care reform’s contraception coverage mandate. The cases that will be heard are Sebelius v. Hobby Lobby Stores, Inc. and Conestoga Wood Specialties v. Sebelius. (Kathleen Sebelius is named as a litigant in her capacity as U.S. Health and Human Services Secretary.) The cases […]
Earlier this month, health insurance exchanges (also known as marketplaces) under the Affordable Care Act were launched, giving consumers — including COBRA qualified beneficiaries — new coverage options. Because qualified beneficiaries may come to employers with questions about enrolling in COBRA versus exchange coverage, here are some key issues to keep in mind. The key […]
COBRA’s premium payment rules took center stage Aug. 12, when the “Bamboozled” column in the New Jersey Star-Ledger reported that a qualified beneficiary with leukemia had his coverage terminated early because his premium payment was 26 cents short. The story had a happy ending, but employers and their service providers can avoid being the villains […]
What Is Considered ‘Part-Time’ Employment? There is no state or federal employment law that defines the term “part-time” or specifies the number of hours an employee must work per week to be considered part-time as opposed to full-time. Many employers classify part-time employees as those who regularly work fewer than 30 hours per week.
by Maria Reed On June 26, the U.S. Supreme Court overturned Section 3 of the federal Defense of Marriage Act (DOMA), which had mandated that “in determining the meaning of any Act of Congress, or of any ruling, regulation, or interpretation of the various administrative bureaus and agencies of the United States, the word ‘marriage’ […]
A large employer was socked with $1.85 million in COBRA notice penalties, plus still-to-be determined attorney’s fees, for neglecting its duty as plan administrator to ensure that COBRA election notices were sent on a timely basis. The company’s negligence occurred over several years, affecting hundreds of former employees who participated in a class action lawsuit. […]
On April 23, a federal district court in Alabama gave final approval to a settlement agreement under which an employer and plan administrator will pay $1.3 million to a group of former employees who alleged they never received COBRA election or premium subsidy information after their involuntary termination of employment. The case is Hornsby v. […]
Group health plan terms clearly explained that the plan administrator had to be notified of a disability determination within 60 days in order to trigger an 11-month COBRA extension; therefore, the plan administrator was justified in denying the extension when notice was received five months after the determination was issued, a federal district court in […]
In rejecting a qualified beneficiary’s attempt to increase a nearly $3,000 COBRA notice penalty, the 3rd U.S. Circuit Court of Appeals noted that the employer/plan administrator’s efforts to remedy the violation did not warrant any higher award. The court also rejected the individual’s request for the reimbursement of medical expenses and attorney’s fees. But in […]