cmonfils | December 29, 2011
The individual mandate is the Affordable Care Act’s least popular provision and lies at the heart of the legal challenge to the law before the U.S. Supreme Court. But a new poll finds that public opinion can be swayed by how the mandate’s implications are described.
cmonfils | December 29, 2011
DUBLIN (Reuters)—Ireland’s Quinn Healthcare has been sold to management in a deal that will see its 500,000 policies underwritten by reinsurer Swiss Re Ltd.
Quinn Healthcare, Ireland’s second-largest health insurer after state-owned VHI, was under the control of the state-owned Irish Bank Resolution Corporation following the collapse of the business empire of its former owner, Sean Quinn.
cmonfils | December 29, 2011
San Francisco Mayor Edwin Lee in November signed legislation that imposes new rules on the use of health reimbursement arrangements to satisfy the city’s health care spending law. Among other things, employees will have more time to use their account balances and have a new right to tap account balances after they terminate employment, while employers have new requirements to provide to employees a summary of contributions and reimbursement amounts. The City and Country of San Francisco Labor Standards Enforcement department has published the full law, highlighting the most recent changes, as well as sample contribution and separation of employment forms.
cmonfils | December 29, 2011
In Mitchell, et. al. v. Marcus Tyrone Robinson, Sr., et. al. the Plaintiffs are the grandparents of some minor children of Marcus Tyrone Robinson and his deceased wife. The allegation is that Mr. Robinson killed his wife. The wife had $121,000.00 in life insurance through her employer, Unilever, and insurer MetLife. Mr. Robinson made a claim for benefits under the policy which was paid. Thereafter, the grandparents filed suit alleging that Mr. Robinson was not entitled to recover under the Missouri Slayer Statute, and claimed that the benefits were wrongfully paid as a result thereof. Plaintiffs asserted several state law claims to recover the money and named Unilever and MetLife as Defendants. In the attached order the court is deciding Unilever’s motion to dismiss the state law claims based upon ERISA preemption. The court holds that the Missouri Slayer Statute is preempted.
cmonfils | December 29, 2011
Beginning Jan. 1, 2012, Forms 5500 and 5500-SF must have electronic signatures. The consequences of filing without them are serious: it will result in a form not being processed at all, and could result in penalties being imposed on the plan.
Forms 5500 and 5500-SF that have no electronic signature will be given a filing status of “unprocessable”; forms that have an invalid electronic signature will be given the status “processing stopped.”
cmonfils | December 29, 2011
NEW YORK (CNNMoney) — This has been a volatile year for the stock market. But one sector has been consistently earning a windfall for investors: health insurers that provide private Medicare plans to seniors
cmonfils | December 29, 2011
To view a PDF version of this article, please click here.
Medicare expands resolution options to include a new Medicare repayment program for small settlements or judgments. This program will be available starting in February 2012 and applies to cases settling for $25,000 or less. Under this program, Medicare will provide final conditional payment amounts before settlement under certain circumstances. This program has the potential to revolutionize the settlement process for many Medicare beneficiaries, their counsel, and settling parties. The foundation of that process is to start the verification process early.
cmonfils | December 27, 2011
In response to the federal health reform law, now known as the Affordable Care Act (ACA), and separate state reform initiatives, some members of at least 45 state legislatures have proposed legislation to limit, alter or oppose selected state or federal actions. In general many of the opposing measures, in 2010 and 2011:
cmonfils | December 27, 2011
The Department of Health and Human Services (“HHS”) has begun a pilot program of HIPAA privacy and security audits for health care providers and health plans, and the audits will have some very short turnaround times.
cmonfils | December 27, 2011
The Supreme Court announced on Monday that it would devote three days in late March to hearing arguments in challenges to the 2010 health care overhaul law. A decision in the case is expected by the end of June.
The court agreed to hear the case on Nov. 14, saying it would put aside five and half hours for arguments and specifying how much time it would devote to each of four issues. Monday’s announcement assigned those issues to particular days, giving a sense of the logical sequence in which the justices will approach them.
cmonfils | December 27, 2011
Health insurance is a critical factor in making health care accessible to women. Women with coverage are more likely to obtain preventive, primary, and specialty care services, and have better access to many of the new advances in women’s health. Most of the 96 million women ages 18 to 64 have some form of coverage. However, the patchwork of different private sector and publicly-funded programs in the U.S. leaves one in five uninsured. The new health reform law includes several measures that will change the profile of women’s coverage between now and 2014 when the new law will be implemented.
cmonfils | December 27, 2011
On December 16, 2011, the Department of Health and Human Services (HHS) issued a bulletin addressing the agency’s approach to defining essential health benefits, which small group and individual health plans will be required to provide under health care reform. HHS proposes that essential health benefits be defined using a benchmark approach.
cmonfils | December 27, 2011
On November 16, 2011, a panel of the Third Circuit Court of Appeals decided US Airways v. McCutchen, No. 10-3836, 2011 U.S. App. LEXIS 22883 (3d Cir. Nov. 16, 2011). The Court claims to respond to the Sereboff court’s argument left open by footnote two in the Supreme Court’s decision in Sereboff v. Mid-Atlantic, which the Court declined to address because it was not raised in the district court or the Fourth Circuit: “…even if the relief Mid Atlantic sought was ‘equitable’ under § 502(a)(3), it was not ‘appropriate’ under that provision in that it contravened principles like the make-whole doctrine.”
cmonfils | December 27, 2011
In a surprising move, the Department of Health and Human Services will not impose a uniform definition of “essential health benefits” (EHB) that individual and small group health insurance plans must provide in order to be offered on state exchanges starting in 2014.
cmonfils | December 27, 2011
Riding the Toronto subways in the early ’80s, nothing pleased me more than finding religious pamphlets – comic books, really – on the trains. Even though their content was predictable they were wildly entertaining, and best of all: They foretold the future.
Or someone’s idea of the future, anyway: one in which those who did not find salvation in Jesus Christ suffered eternal damnation. Being Jewish, I didn’t see how the text spoke to me. The illustrations, however, remain etched in my mind 30 years later, such was their power.
