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Summary Judgment Against Participants?ÇÖ Claims Regarding Inaccurate Benefit Calculation in SPD Affirmed

The U.S. Court of Appeals for the Ninth Circuit affirmed a summary judgment against claims of participants who received summary plan description materials which incorrectly described the calculation of benefits based on the plan terms. Citing the U.S. Supreme Court?ÇÖs decision in Cigna v. Amara, the court stated that the discrepancy between the summary plan description and the plan document did not create a triable issue, because the summary plan description did not constitute the terms of the plan. The court found that reformation of the plan document was improper because there was no evidence that the plan document contained a mistake or that its terms were induced by fraud. Although Amara suggested that reformation might be appropriate if the employer intentionally misled employees, in this case there was no evidence that the employer materially misled employees, and even if it had misled employees, appellants conceded that they did not… Continue Reading

Sixth Circuit Holds that a Union?ÇÖs Indemnification of an Employer?ÇÖs Withdrawal Liability Does Not Violate Public Policy

In a case of first impression, the U.S. Court of Appeals for the Sixth Circuit held that a union?ÇÖs agreement in a collective bargaining agreement to indemnify an employer for its withdrawal liability under a multiemployer plan does not violate public policy and is therefore enforceable. In this case, the General Drivers, Warehousemen and Helpers Local Union No. 89 specifically agreed in its collective bargaining agreement with Shelter Distribution, Inc. that the union ?Ç£shall indemnify [Shelter] for any contingent liability which may be imposed under the Multiemployer Pension Plan Amendment Acts of 1980.?Ç¥ The court reasoned that (i) the indemnity was analogous to obtaining a policy from an insurance company to cover any potential liability for fiduciary breaches as described in Section 1110(b) of the Multiemployer Pension Plan Amendments Act; (ii) the indemnity is not a violation of any ?Ç£well defined and dominant?Ç¥ public policy; and (iii) the goals of… Continue Reading

Agencies Request Comments on Proposed Exemption for Certain Religious Employers from providing Contraception Coverage

The U.S. Departments of Labor, Health and Human Services, and the Treasury issued an advance notice of proposed rulemaking soliciting comments for proposed amendments to a recently-issued rule exempting certain religious employers from having to provide contraception coverage. Other non-exempt religious-affiliated employers?Çösuch as religious schools and hospitals?Çöthat provide health coverage to their employees have been given an additional year to comply with the requirement that their plans include contraception coverage. The proposed rule for which the agencies seek input will outline potential accommodations for non-exempt religious organizations while also ?Ç£ensuring contraceptive coverage for plan participants and beneficiaries covered under their plans (or, in the case of student health insurance plans, student enrollees and their dependents) without cost sharing.?Ç¥ A copy of the notice is available here.

Departments Release FAQs on Summary of Benefits Coverage Requirement

On March 19, 2012, the U.S. Departments of Labor, Health and Human Services and the Treasury issued Part VIII in the set of FAQs addressing implementation of the Affordable Care Act. The FAQs answer questions that were raised in connection with the Final Rules regarding the Summary of Benefits and Coverage (?Ç£SBC?Ç¥) that were published on February 14, 2012. For group health plan coverage, the Final Rules provide that, for disclosures concerning participants who enroll or re-enroll through an open enrollment period (including late enrollees and re-enrollees), the SBC must be provided beginning on the first day of the first open enrollment period that begins on or after September 23, 2012. For disclosures with respect to participants who enroll in coverage other than through an open enrollment period (including individuals who are newly eligible for coverage and special enrollees), the SBC must be provided beginning on the first day of… Continue Reading

March 2012
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