Passion for Subro

ERISA Preemption of Michigan Pail Claims Assessment ACT

cmonfils — Wed, 08 Feb 2012 12:57:22 +0000

We previously posted regarding Michigan’s Paid Claims Assessment Act (the “Act”) which assesses carriers a 1% surcharge on paid health claims. The Act defines carriers to include group health plan sponsors, along with insurance companies and also assesses third party administrators. Thus, it is likely that group health plan sponsors will end up either paying [...]

A Look at Case Law for Important Plan Documentation Reminders

cmonfils — Wed, 08 Feb 2012 12:56:33 +0000

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. http://icemiller.com/publications/Employee_Benefits/2012/01-24_Case_Summaries.htm

Kaiser Health Tracking Poll — January 2012

cmonfils — Wed, 08 Feb 2012 12:55:43 +0000

As the Supreme Court prepares to hear legal challenges to the health reform law in March, most Americans expect the Justices to base their ruling on their own ideological views rather than their interpretation of the law, according to the January Health Tracking Poll. Other key findings include: http://www.kff.org/kaiserpolls/8274.cfm

Obamacare mandate in bad faith

cmonfils — Wed, 08 Feb 2012 12:54:54 +0000

Last August, under authority granted by Obama- care, Secretary of Health and Human Services Kathleen Sebelius published an “interim final rule” for comment that would require private health-insurance plans to cover, as “preventive services,” all FDA-approved “sterilization procedures” and “contraceptive methods” — and without deductibles or co-pays. We and other critics raised numerous objections, none [...]

Wellness Program Approved for Oregon State Employees

cmonfils — Wed, 08 Feb 2012 12:54:05 +0000

January 24, 2012 (PLANSPONSOR.com) – Oregon’s Public Employees’ Benefit Board (PEBB) voted to give $155,000 to the Oregon Public Health Division to help fund its Wellness@Work program. http://www.plansponsor.com/Wellness_Program_Approved_for_Oregon_State_Employees.aspx

WSJ 1-26-12 Comment on ACO article

cmonfils — Wed, 08 Feb 2012 12:45:28 +0000

Chuck Weller, Cleveland–As a health care old timer who lived with the HMO Act of 1973 and a lawyer, ACOs seem much like HMOs under another name and will not succeed as much as the country needs for many of the same reasons. Eg, state regulation of insurance cripples interstate innovation and competition (the US [...]

Can Accountable-Care Organizations Improve Health Care While Reducing Costs? .

cmonfils — Wed, 08 Feb 2012 12:43:16 +0000

It’s often said that the main method of paying health-care providers—with a fee for each service—results in increased and wasteful spending. Such a system, its critics say, rewards providers just for doing more procedures, rather than for providing efficient and high-quality care. http://online.wsj.com/article/SB10001424052970204720204577128901714576054.html?KEYWORDS=ANNA+WILDE+MATHEWS

Legal considerations when implementing on-site clinics

cmonfils — Tue, 07 Feb 2012 01:54:21 +0000

On-site clinics utilized in conjunction with a group health plan are becoming an increasingly common method to help employers address the rising cost of health care. The issues in implementing an on-site clinic may seem obvious: Finding a service provider; installing an appropriate facility; and addressing employee access during work hours. However, there are less [...]

Labor: Checking in with recent and upcoming FMLA decisions

cmonfils — Tue, 07 Feb 2012 01:52:14 +0000

Three years after the effective date of the latest revision to regulations under the Family and Medical Leave Act (FMLA), issues concerning the FMLA continue to be a focus of the U.S. Department of Labor (DOL) and the courts. http://www.insidecounsel.com/2012/01/23/labor-checking-in-with-recent-and-upcoming-fmla-de

Workers Not Yet Eligible for FMLA are Protected from Interference and Retaliation, Federal Court Rules

cmonfils — Tue, 07 Feb 2012 01:50:40 +0000

The federal Family and Medical Leave Act protects an employee’s pre-eligibility request for post-eligibility leave, the federal appeals court in Atlanta has held. Pereda v. Brookdale Senior Living Communities, Inc., 2012 U.S. App. LEXIS 492 (11th Cir. Jan. 10, 2012). The Eleventh Circuit has jurisdiction over Alabama, Florida, and Georgia. Accordingly, the Court found that [...]