In a decision issued a couple of years ago, the United States Supreme Court held that a summary plan description that differed from the plan document could not be enforced as the plan document. The Court said that the summary plan description was supposed to describe the plan and it was the plan that should
Understanding Employee Benefits and key developments in the employee benefits field and items of interest to our clients. MORE
Welfare Plans
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…
Standard of Review is Important – Again
By Stinson LLP on
I recently blogged about the importance the standard of review can make when a court decides whether a claims decision made under an employer plan will be upheld. My recent blog post dealt with the standard of review under a top-hat plan, a plan for executives. Another recent case makes the same point in a…
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.…
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…
Employers Should Monitor Closely Group Term Life Insurance Enrollments
By Stinson LLP on
Many employers offer group term life insurance, including supplemental life. Often an employee who wants to buy coverage above a particular level after an initial open enrollment period must show evidence of insurability. This requirement is present to protect the plan from adverse selection so that employees do not wait until they develop a medical…
Welfare Benefit Plan Might not be Required to Cover Same Sex Spouses
By Stinson LLP on
Much has been written about the impact of the Supreme Court’s decision last term declaring unconstitutional the provision of the Defense of Marriage Act (DOMA) that required federal law not to recognize same sex marriages. Since then, more states have recognized same sex marriages either by court order or legislation. The IRS has also issued…
Health Plans Should Make Eligibility Determinations Quickly
By Sam Butler on
In an opinion released earlier this month, the United States Court of Appeals for the Seventh Circuit held that a self-insured health plan was not entitled to a refund of the nearly $1.7 million it paid to two Wisconsin hospitals for treatment administered to a participant’s newborn child, despite the plan’s ultimately concluding the newborn…
Are All Severance Plans Subject to ERISA?
By Stinson LLP on
I blogged recently about an ERISA case involving an executive severance plan where the executive sued claiming that his employment termination was effective before the first anniversary of a change in control, thereby entitling him to severance benefits under the plan. The court had concluded that the severance occurred after the first anniversary but allowed …