Health Plan Law

ERISA, with particular focus on group health plans and other employee welfare benefit plans.

Author: Roy F. Harmon is a principal at Harmon & Major in Greenville, S.C. He also serves as vice president and general counsel of Greenville-based Cost Recovery Systems Inc.

Blawg Related Categories: Benefits/ERISA • In-house Lawyer • Solo / Small Firm

Recent Posts from Health Plan Law

:: Fact Check #4: “Endorsements” Of Health Care Legislation Are Deceiving
It’s an open secret in Washington that only about 15-20 percent of doctors are members of the AMA. Sermo, a 110,000-member, non-partisan online community of doctors — 25 percent of whom say they are members…
:: Defensive ERISA Preemption Inadequate To Sustain Removal Of Subrogation Dispute
Following an automobile accident, Plaintiffs Richard and Pamela Cottrill filed suit in the Court of Common Pleas of Perry County against Allstate Insurance Company (”Allstate”) and Blue Cross Blue Shield of Michigan (”Blue Cross”). In…
:: A Primer On Venue Choice In ERISA Claim Disputes
Plaintiffs originally filed their complaint in the Court of Common Pleas of Philadelphia County, Pennsylvania. Defendants then removed the action to federal court. The plaintiffs’ choice of venue is generally accorded great weight, but other…
:: Seventh Circuit Holds Disability Benefits Claim Incompatible With ADA Claims
Claiming disability benefits and asserting ADA claims are not always mutually exclusive, but a “plaintiff’s sworn assertion in an application for disability benefits that she is, for example, ‘unable to work’ will appear to negate…
:: Plan Language Sufficient To Authorize Settlement Of ERISA Benefit Claims With TCA’s
Thus, the fact that the Kodak and GM Plans provided for distribution of death benefits through the establishment of a TCA, and that MetLife complied with those provisions, does not in itself immunize MetLife from…
:: First Circuit Finds Plan Language Adequate For Delegation Of ERISA Fiduciary’s Authority
In this case, the Plan gives its named fiduciary- the Pension Committee–express power to “exercise its discretion” to decide on benefits, construe the Plan and render binding decisions. Unquestionably, the Pension Committee purported to delegate…
:: Joint Venture Liability For Medical Stop Loss Claims
Majestic has included RMTS as a defendant in Count I (declaratory relief), Count II (breach of contract), and Count IV (bad faith). RMTS argues that it should be “dismissed” from this action because it was not…
:: Missed COBRA Qualifying Events Cause Forfeiture Of Stop Loss Coverage
In Fenner, this court held that if the same medical coverage continues automatically after termination, no qualifying event occurs. 25 F. Supp. 2d at 873 (citing Mansfield v. Chicago Park Dist. Group Plan, 997 F.…
:: ERISA Plan’s Subrogation Rights Enforceable Against Workers’ Compensation Award
In Local 705 Int’l Bhd. of Teamsters Health & Welfare Fund v. Bilal, 2009 U.S. Dist. LEXIS 87090 (N.D. Ill. Sept. 22, 2009) the employee suffered two head injuries, one in January 2003 and the…
:: Health Care Economics - Why Prices ≠ Costs & Why That Matters
Prices are not costs. Prices are what pay for costs. Where the costs ar not covered by the prices that are allowed to be charged, the supply of the goods or services simply tends to…