Seventh Circuit Sides With Fiduciaries On Question of Out-of-Network Disclosures

At the summary judgment stage of the case, the district court dismissed James’s denial-of-benefits and breach-of-fiduciary-duty claims, but awarded him minimal statutory damages against the health plan administrator. James has appealed.   Read More..
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Plan’s Network Policy Was Clear Enough to Ward Off ERISA Claims (in spite of poor call center performance)

Rejecting a plan participant’s claims that plan documents should specifically list in-network providers, the 7th U.S. Circuit Court of Appeals held that a plan clearly providing information on how to check for provider status was sufficient to escape benefits-denial and fiduciary-brea
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A LOOK AT CASE LAW FOR IMPORTANT PLAN DOCUMENTATION REMINDERS

Two important cases provide good reminders to plan fiduciaries about (1) the importance of documentation of fiduciary processes, and (2) accurate communication of plan design changes to participants and beneficiaries. Read More..
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Insurance For Fiduciaries: Know Your Options

Insurance coverage can be a confusing thing. Coverage for employee benefit plan fiduciaries sometimes adds a wrinkle to the process that can be overlooked. Depending on the type of claim asserted, there are a variety of “coverage” options that may apply. I think the new fe
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What Vanity Fair Teaches About Fiduciary Obligations

Not to be too flippant or cynical, but whenever, over the years, I have heard an economist base a nice, highly logical, elegantly structured analysis on the underlying base assumption that investors or business people or consumers are acting rationally – without accounting for the lik
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