Headlines about "Disability plans"
Gathered from the web by the editors at BenefitsLink.com.
[Guidance Overview] Estoppel in ERISA: Simple Mistakes Can Lead to Costly Litigation
"Even if the participant ultimately fails in proving the elements of estoppel, defending against such claims is costly and time-consuming. Accordingly, employers and plan administrators should take the following steps to protect themselves from these types of claims: . . . ." (Employee Benefits Law Report)
Use of TPAs to Outsource Benefit Plan Administation Increased Substantially During Past Four Years (PDF)
"[R]oughly two in five plan sponsors (37%) say they are increasing the use of third party administrators (outsourcing benefits administration) to some extent in order to manage costs. Among those using this strategy, 65% indicate it has been successful in achieving desired cost savings." (Prudential)
[Guidance Overview] No Extended COBRA Coverage for Disabled Employee Terminated after Reduction of Hours
"As for the employee's argument that a disability extension could be based on an insurer's determination, other courts have held that a plain reading of the statute requires the determination to be made by the SSA. The statutory language requiring a qualified beneficiary to be determined to be disabled 'under title II or XVI of the Social Security Act' seems less than clear on that point, but DOL regulations specifically require a qualified beneficiary to notify the plan administrator that he or she has been determined by the SSA to be disabled." (Thomson Reuters/EBIA)
[Guidance Overview] ERISA 'Participant' Status Is Not a Jurisdictional Issue
"Whether a plaintiff is a 'participant' has posed one of the great metaphysical questions in ERISA benefits litigation. It is usually clear that the person was once a participant ? but following separation from employment, are they still? The question can present itself in the form of another ERISA imponderable ? that of standing . . . ." (Roy Harmon III, Health Plan Law)
The Shortcomings of Group LTD Plans
"Employers willingly providing any type of income protection plan to employees is of course worthy of applause. However, it's reasonable, make that imperative, that both employers and employees are informed of any shortcomings of their GLTD plan." (BenefitsPro)
[Guidance Overview] Court Sides with NFL Pension Board for Denial of Disability Benefits
"[The judge] noted the terms of the Bert Bell/Pete Rozelle NFL Player Retirement Plan say if the voting members of the board are deadlocked on whether a player meets the requirements for disability benefits, the plan provides that it may submit that medical questions to a medical advisory physician (MAP) for a final and binding determination." (PLANSPONSOR.COM)
How to Avoid Leave-Related Lawsuits
"Employers that grant generous leaves for disability or maternity can run afoul of insurance contracts for medical, disability or life coverage. Here are two tips for employers to avoid leave-related lawsuits . . . ." (Employee Benefit News)
[Guidance Overview] ERISA Regs, Conflict of Interest, and Assessing Mental Disabilities and Capabilities
"A New Jersey telecommunications worker became depressed and anxious and went out on medical leave late in 2004. His employer provided 26 weeks' short-term disability, and he then applied for long-term disability benefits. He received them for a year, but the plan then required reapplication, and he and the plan administrator have been wrangling ever since." (Business & Legal Reports, Inc.)
How to Avoid Leave-Related Lawsuits
"1. With self-funded health plans, make sure eligibility policies that are more generous than FMLA or other federal laws are approved by the reinsurance carrier. . . . 2. Clearly communicate conversion rights and termination of coverage to employees on leave." (Employee Benefit News)
[Guidance Overview] Failure to Disclose Time Limit for Filing Suit Resulted in Extended Deadline
"This case reinforces the importance of thorough disclosure and adherence to ERISA's claims procedure requirements. In particular, if a plan imposes a time limit for filing suit under ERISA, this limit should be set forth in the benefit denial notice, as well as in SPDs and other communications, if the plan hopes to enforce it." (Thomson Reuters/EBIA)
Legislation Introduced to Stem Abuse of Public Employee Disability Pensions in New Jersey
"The changes in the bill include: an increase from 4 to 10 years the service credit required before a member of state pension systems becomes available for an ordinary disability pension, and a restriction of disability awards to members who sustained injuries during regular and assigned duties. Disability awards for willful negligence would be eliminated." (newjerseynewsroom.com)
[Guidance Overview] Sedgwick's Denial Letter Complies with ERISA
"The plaintiff's primary argument is that Sedgwick's denial letter did not adequately advise her of what she needed to do to 'perfect' her claim and, therefore, that it was not in compliance with 29 C.F.R. ? 2560.503-1. The Second Circuit disagrees and affirms the District Court in ruling for the plan." (Jelsoft Enterprises Ltd.)
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