The Gap Trap

By: Jon Jablon, Esq. So how ‘bout those stop-loss carriers?! We work closely with some excellent carriers that look for reasons to pay claims and are a pleasure to interact with – but there are also carriers and MGUs out there that will do whatever they can to deny claims. Make sure y
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Attack on ERISA Preemption Continues…

By: Chris Aguiar, Esq. ERISA preemption seems like such a simple concept; further proof that reasonable minds can disagree.  In just the past 10 days we have received mixed messages from some of the highest courts in the country.  First it was the 8th Circuit’s unanimous pro-preemptio
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Stop-loss Insurance Policy Purchased by an Employer for its Self-insured Health Plan is not a Plan Asset Under Certain Conditions

MyHealthGuide Source: US Dept. Labor, 10/19/2015, DOL Letter A DOL’s Advisory Opinion says a stop-loss insurance policy purchased by an employer for its self-insured health plan would not be a plan asset under certain conditions. • “It is the view of the Department, based
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Another Voice: State legislators should undo new self-insurance limit

By Mike Ferguson New York lawmakers are making life harder for many of the state’s businesses and labor unions. This summer, Albany’s finest had the chance to preserve medium-sized firms’ and unions’ ability to “self-insure,” whereby they forego conventional health insurance and pay t
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Size Doesn’t Matter But the Regulators Do

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits)  What is the perfect size for a self-funded plan?  This is one of my favorite questions and I love to ask it at any conference at which I happen to hav
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Exclusive Reporting for the Week of June 29, 2015

June 29, 2015 — This is your weekly update of state legislative/regulatory developments affecting companies involved in the self-insurance/alternative risk transfer marketplace. Should you have any questions on information provided in these reports and/or would like to alert SII
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Federal Court Keeps TPA As Third-Party Defendant in Suit Between Stop Loss Carrier and Group: A Walk Through the Procedural Thicket

MyHealthGuide Source: Thomas A. Croft, Esq., 1/10/2015, StopLossLaw.com Article Case: Unimerica Insurance Company v. GA Food Services, Inc., et al., No. 8:14-cv-2419-T-33TBM, In the United States District Court for the Middle District of Florida, Tampa Division, December 10, 2014) Cou
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NAIC White Paper

WHITE PAPER STOP LOSS INSURANCE, SELF FUNDING AND THE ACA I. Introduction Since the passage of the Patient Protection and Affordable Care Act of 20101 (ACA), there has been a lot of speculation about its potential impact. The goal of the law is to make affordable, quality health insur
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SIIA State Legislative/Regulatory Update Report

Exclusive Reporting for the Week of September 10, 2014 September 10, 2014 — This is your weekly update of state legislative/regulatory developments affecting companies involved in the self-insurance/alternative risk transfer marketplace. Should you have any questions on informat
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State Legislative/Regulatory News

Self-Insurance Institute of America, Inc. Exclusive Reporting for the Week of September 4, 2014 September 4, 2014 — This is your weekly update of state legislative/regulatory developments affecting companies involved in the self-insurance/alternative risk transfer marketplace. S
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