EBIA Weekly Archives - ERISA
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Results (1094 articles found)
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- MSP Rules Prohibit Terminating Group Health Plan Coverage Based Solely on ESRD Eligibility, Except as Permitted by COBRA
- From the August 20, 2009 EBIA Weekly
- This case addresses the application of the Medicare Secondary Payer (MSP) rules to Medicare entitlement based on end-stage renal disease (ESRD). A kidney dialysis center (Center), as assignee of a deceased participant’s retiree health care benefits, sued ...
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- Two Seventh Circuit Disability Cases Illustrate Glenn Conflict of Interest Analysis
- From the August 20, 2009 EBIA Weekly
- The Seventh Circuit has decided a pair of LTD benefit cases that consider the impact of the U.S. Supreme Court’s Glenn decision. That case held that if an ERISA plan document gives a plan decisionmaker “discretionary&#...
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- For purposes of the Form 5500 small plan filing exemption, how does our welfare benefit plan show that it is going above or dropping below the 100-participant threshold?
- From the August 13, 2009 EBIA Weekly
- QUESTION: Our welfare benefit plan had over 100 participants in the 2008 plan year and in the beginning of the 2009 plan year had under 100 participants (so it is now a small welfare benefit plan exempt from filing Form ...
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- Participant Who Voluntarily Cashed Out Has Statutory and Constitutional Standing to Sue for Fiduciary Breach
- From the August 13, 2009 EBIA Weekly
- In this case, the Ninth Circuit clarified its earlier holding that former employees who have cashed out of a defined contribution plan are still “participants” with standing to sue for a breach of fiduciary duty that allegedly reduced ...
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- SPD Disclaimer Does Not Cure Conflict in Plan Documents Regarding Grant of Discretionary Authority
- From the August 13, 2009 EBIA Weekly
- The employee in this case was denied disability benefits and sued his employer’s plan. In this decision affecting only the standard of review to be applied in later proceedings, the employee asked the court for the less deferential &#...
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- Employee Who Signed Up Ineligible Individual for Health Plan Must Repay Benefits
- From the August 06, 2009 EBIA Weekly
- The employee in this case listed an individual as his spouse for purposes of his employer’s health plan. But the individual was not his spouse, and was ineligible for plan coverage. The plan paid over $70,000 in ...
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- Court Finds That LTD Plan Is Subject to ERISA and Addresses Various Rules Regarding Disability Claim Decisionmaking
- From the July 30, 2009 EBIA Weekly
- The plan participant in this case had several chronic conditions, including morbid obesity and heart problems. After quadruple bypass surgery, he began receiving benefits under his employer’s insured long-term disability (LTD) plan. Some months later, the insurer ...
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- Appeals Court Confirms That CEO Was Not Required to Take Additional Action on Plan Losses
- From the July 30, 2009 EBIA Weekly
- In 2007, we twice reported on the Holdeman case, a class action involving employees who were left with unpaid medical claims when their financially troubled employer failed to adequately fund the company’s self-insured health plan. (See our ...
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- Court Enforces Plan-Imposed Limitations Period for Filing Benefit Lawsuit
- From the July 23, 2009 EBIA Weekly
- The ERISA disability plan participant in this case had received long-term disability benefits for five months when the insurer requested proof of her continued disability (“proof of loss”). After the participant failed to submit additional requested information, ...
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- Termination of Plan Coverage Was an Adverse Benefit Determination
- From the July 16, 2009 EBIA Weekly
- During the time the employee in this case received long-term disability benefits under his employer’s plan, he also paid for and received benefits under the employer’s various welfare benefit plans. After more than seven years, ...
