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Anti-Assignment Clause in Health Plan Prevents Physician from Asserting ERISA Claim

In the case of Torpey v. Blue Cross Blue Shield of Texas, a medical doctor had obtained documents from his patient (?Ç£Participant?Ç¥), which provided that the doctor (1) was entitled to receive all of the benefits under Participant?ÇÖs employer-sponsored group health plan (the ?Ç£Plan?Ç¥), and (2) was authorized to represent Participant in any appeals to the employer or insurance company that provided benefits under the Plan. The doctor was not a participating provider in the Plan?ÇÖs network, and the Plan did not cover out-of-network services. When Participant?ÇÖs claim for Plan benefits was denied, the doctor exhausted the Plan?ÇÖs administrative appeals and then filed a claim in federal court for denial of benefits under the Employee Retirement Income Security Act of 1974, as amended (?Ç£ERISA?Ç¥). The Plan?ÇÖs insurance policy contained a provision which stated that rights and benefits under the Plan were not assignable, either before or after the services were… Continue Reading

IRS Releases 2015 Inflation-Adjusted Amounts for HSAs

The IRS recently issued Revenue Procedure 2014-30, which set the calendar year 2015 limits on annual contributions that can be made to a health savings account at $3,350 for an individual with self-only coverage under a high deductible health plan (?Ç£HDHP?Ç¥) and $6,650 for an individual with family coverage under a HDHP.?á A HDHP for calendar year 2015 is a plan which has an annual deductible of at least $1,300 for self-only coverage or $2,600 for family coverage and which limits annual out-of-pocket expenses to $6,450 for self-only coverage or $12,900 for family coverage.?á A copy of Revenue Procedure 2014-30 is available here.

May 2014
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