By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits) If you are a long time reader of mine, I would first like to say thank you for being the only person other than my mother to read what I write. It is
By Adam V. Russo, Esq. Self-Insuring Health Benefits – Thompson Information Services Adam Russo, Esq. is the co-founder and CEO of The Phia Group, LLC, a cost containment adviser and health plan consulting firm. In addition, Russo is the founder and managing partner of The Law Offices
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
Beer brewing and health plan implementations rarely are considered in the same sentence. But why not? Both have a series of steps to follow, pitfalls to avoid and significant effects on the economy and employment. In 2012, 60% of covered workers were in a self-funded plan. The brewing
Recently brought to our attention is the case of Express Oil Change, LLC v. ANB Ins. Serv., Inc., 2013 WL 1245748 (N.D. Ala. 2013). In this case, a benefit plan sponsor is suing its broker for failing to preemptively advise the plan regarding differences between the plan’s document la
This is the “Silent PPO” bill in its fourth iteration; TABA has successfully quashed this legislation in the past three legislative sessions. This year, hoping to neuter our opposition, the bill omits the requirement that TPAs or their employer-clients register as PPOs ba
ERISA requires that plans contain a reasonable claims procedure. Courts have generally required claimants to exhaust that claims procedure before filing a lawsuit. In addition, if the plan gives the plan administrator discretion to interpret the plan and decide claims, a court will of
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..