Cornelius B. FAISON, Plaintiff–Appellee v. DONALSONVILLE HOSPITAL INC., Defendant–Appellant.

United States Court of Appeals, Eleventh Circuit. Cornelius B. FAISON, Plaintiff–Appellee, v. DONALSONVILLE HOSPITAL INC., Defendant–Appellant. No. 12–15400. Aug. 22, 2013. Appeal from the United States District Court For the Middle District of Georgia. D.C. Docket No. 1:11–cv–00010–W
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Kentucky Court of Appeals Decides Several Significant Arbitrability Issues in a Stop Loss Context

Article Written By:  Thomas A Croft, Esq.   Taken From:  MyHealthGuide  Mr. Croft’s Preface: A Kentucky Court of Appeals was faced with a host of complex issues arising out of an arbitration clause in a “Trust Agreement” it held was stop loss insurance, ultimately co
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My HealthGuide Newsletter

News for the Self-Funded Community 2/10/2014 Article Taken From:  MyHealthGuide  Written by: Roy F. Harmon III, Esq. Having reviewed the Plan documents, the Court and both parties now agree that the SPD is incorporated within the Plan. The Supreme Court’s scrutiny of the plan do
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Bullock Cannot Save ERISA Fiduciary, a Sole Corporate Shareholder Whose Company Failed To Make Multiemployer Fund Contributions, From Being Unable To Discharge His Liability Through Personal Bankruptcy.

Article Found On: Benefits Link   Written By: Ron Kramer & Chris Busey Fiduciaries who breach their duties may pay the consequences far longer than they may think, for they may not even be able to escape liability through personal bankruptcy.  In Raso v. Fahey (In re Fahey), No. 1
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Self-Insured Plan Allowed to Recover Medical Benefits Paid to Employee Post-McCutchen

Article Written By: Anthondy Cacace Taken From: MyHealthGuide  Case: Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., 6/19/2013), Court’s Ruling In the above Quest  case, the court granted Quest Diagnostic’s motion for summary judgment, ruling that Quest, as the fiduc
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Arkansas Certifies Class of Insureds Claiming They Were Not Made Whole

Taken From:  The National Association of Subrogation Professionals AMICUS Updates June 19, 2013  Arkansas is becoming an extremely difficult state for a carrier to pursue subrogation rights or a right to reimbursement of any kind.  Recently, a federal court in Arkansas granted class a
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Administrator Deemed To Be Fiduciary and Breached Fiduciary Duty on Self-Insured Plan

Case: Hi-Lex Controls Incorporated, et al, v. Blue Cross and Blue Shield of Michigan Case No: 11-12557.  Hon. Victoria A. Roberts presiding. This is an action for alleged violations of the Employee Retirement Income Security Act of 1974 (“ERISA”). Plaintiffs filed suit on
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Claims Administrator Required To Enforce Plan Exclusionary Language

The U.S. District Court for the Central District of California recently held in Dubaich v. Connecticut General Life Insurance Co., C.D. Cal., No. 2L11-cv-10670-DMG-AJW (April 25, 2013), that a health plan participant could not obtain coverage for treatment of her degenerative disc dis
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Employer Will Pay $50,000 to Settle EEOC’s First GINA Lawsuit

An Oklahoma employer will pay $50,000 to settle the first lawsuit the federal government filed to enforce the Genetic Information Nondiscrimination Act. The case, Civil Case No.: 13-CV-248-CVE-PJC, was filed in the U.S. District Court for the Northern District of Oklahoma. The U.S. Eq
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Trial Moves Ahead for Broker That Failed to Explain Coordination of Stop-Loss Policy and Self-Insured PD

This controversy arises from Plaintiff Express Oil’s attempt to create a self-funded health benefits plan for its employees while eliminating any uninsured risk for itself by procuring stop-loss insurance. Express Oil employed and relied on Defendants ANB Insurance and Alan Wood to he
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