Most self-funded ERISA medical plans provide that participants who have been injured by other people (think car accidents) must reimburse the plan if the participant recovers from the other person for those injuries. In order to obtain that reimbursement, a plan document must contain appropriate reimbursement/subrogation language and the plan must pay attention to the
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ERISA and Other Benefits Litigation
What Does the Trust Requirement of ERISA Mean?
By Stinson LLP on
ERISA requires that plan assets be held in trust so that they are protected from claims of the employer. With pension plans, it is generally easy to determine when assets become plan assets and when they should be held in trust. For welfare benefit plans, such as health plans, the situation is more complicated. Employers …
Not all Plans can Establish a Shortened Limitations Period for Filing Lawsuit
By Stinson LLP on
I recently blogged about a case in which a plan had established a shorter period of time (one year deadline) for filing a lawsuit, rather than relying on the state statute of limitation (six years) which would otherwise have applied. As I said in that blog, although courts have generally upheld reasonable plan deadlines, those …
Participants in Top Hat Plans Must Exhaust Administrative Remedies
By Stinson LLP on
So-called “Top Hat” plans are nonqualified deferred compensation plans for a select group of management or highly compensated employees. These executive compensation arrangements are exempt from many ERISA provisions, but are not exempt from ERISA’s claims procedure requirements. Therefore, top hat plans must provide a reasonable claims procedure.
ERISA compliant claims procedures can be written…
Don’t Play Hide the Ball with Your Claims Procedure
By Stinson LLP on
ERISA does not have a statute of limitations for lawsuits brought by participants to check claim benefits under the plan. Instead, courts borrow from similar state statutes of limitations. In a decision two years ago, the US Supreme Court upheld a disability plan’s one year limitations period, allowing the plan to impose that limitation rather…
Business As Usual: Supreme Court Upholds ACA Subsidies
By Tom Dowling on
The United States Supreme Court recently held in King v. Burwell that the Affordable Care Act (ACA) permits individuals to receive health insurance premium subsidies through federally-facilitated exchanges (in addition to state-based exchanges). Because this decision is consistent with existing agency interpretation, the decision has little direct effect on employer-sponsored group insurance plans.
In the…
Same Sex Marriage: Effect on Benefits
By Stinson LLP on
The United States Supreme Court recently held in Obergefell v. Hodges http://www.supremecourt.gov/opinions/14pdf/14-556_3204.pdf that all states must recognize and allow marriages between same sex partners. Depending on an employer’s current employee benefits plan, certain provisions may need to be changed in light of this ruling.
For those employers who already provide spousal benefits to same sex…
Internet Posting of SPD is Insufficient
By Stinson LLP on
Employers know that they must prepare and distribute a summary plan description (SPD) for their ERISA benefit plans, including retirement benefits, health insurance, life insurance and disability insurance. Because of the length of such documents, employers may prefer to distribute the documents electronically. Some would like simply to post the SPDs to a company intranet.…
A Bad Deed is Not Entirely Unpunished
By Stinson LLP on
Richard Thomas embezzled nearly $20,000,000 from his employer. The employer then kept Thomas’s profit sharing account of about $21,000 as an offset against the embezzled amount. Of course, this violated ERISA’s anti-alienation provisions. Thomas sued his former employer for the money and won.
To add to the employer’s misery, Thomas then sued to recover his…
Be Careful What You Promise Employees Who Leave Your Employment
By Stinson LLP on
Clients sometimes like to ease the transition for employees who are retiring or whom the client would like to encourage to leave. One strategy is to continue the employee “on payroll” for a period of time with the expectation that all benefits will remain in place. However, the practice makes benefits lawyers nervous because the…