Be Smart When Self-Funding

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits)   Introduction While we are seeing record growth across the country, self-funding is a topic that few are familiar with, even though many participate i
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The Power of Dicta—Make-Whole Relief Under ERISA Comes to the Fourth Circuit

On July 5, 2012, the United States Court of Appeals for the Fourth Circuit Court issued a significant opinion concerning the liability of insurers (and, potentially, employers) that are alleged to have provided misleading or faulty summary plan descriptions (SPDs) to employees.  The c
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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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Use of Electronic Distribution of SPDs Continues to Grow

There’s no doubt – electronic distribution of benefit communication materials is on the rise. Employers are realizing that not only does electronic distribution of Summary Plan Descriptions (SPDs) save money; it results in faster distribution of SPDs that better reflect current plan p
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Employers To Be Required to Provide Employees Duplicative New Description of Health Care Benefits by September 23, 2012

This week, DOL issued final PPACA regulations requiring all health plans, including large employers’ self-insured plans, to issue to participants a Summary of Benefits and Coverage (SBCs), and though the rules incorporate some minor improvements over the earlier proposal, the Departme
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