cmonfils | September 28, 2011
www.towerswatson.com
September 2011
On procedural and jurisdictional grounds, the U.S. Court of Appeals for the Fourth Circuit dismissed two cases challenging the individual mandate provision in the Patient Protection and Affordable Care Act (PPACA). First, in Virginia ex rel. Cuccinelli v. Sebelius, the Fourth Circuit Court held that Virginia lacked “standing” to bring the lawsuit that the individual mandate was unconstitutional and instructed the district court to dismiss the case. Additionally, in Liberty University Inc. v. Geithner, which challenged not only the individual mandate but also the employer play-or-pay mandate penalty, the Fourth Circuit found a lack of jurisdiction. The appellate court vacated the district court’s decision that had upheld the constitutionality of the individual mandate. The court did not address the constitutional merits of either case. (more…)
Category: 4th, Health Care Legislation |
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cmonfils | September 27, 2011
www.nydailynews.com
By Betsy Mccaughey Wednesday, September 14th 2011
Contrary to the headlines, the 4th Circuit Federal Court of Appeals did not “uphold” the constitutionality of the Obama health law’s mandatory insurance provision last week. The court dismissed the Virginia challenge for technical reasons but made a point of saying that the health law raises important constitutional questions that should be decided by the court on another day. (more…)
Category: 11th, Health Care Legislation, Virginia |
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cmonfils | September 19, 2011
Coordination of Benefits
Employee Benefits Series THOMPSON July 2011 | VOL. 19, No.3
Legal Brief
A recent decision by a U.S. appeals court upheld a recovery in which a plan dealt directly with the auto liability insurer to achieve a recovery. The case is Shaffer v. Rawlings Co., 2011 WL 1977252 (6th Cir., May 18, 2011). (more…)
Category: 6th, Reimbursement |
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cmonfils | September 16, 2011
The Self-Insurer August 2011
From the Bench Michael Friedman and John Eggertsen
The U.S. Supreme Court, in GIGNA Corp v. Amara, et al., 563 U.S., 2011 WL 1936077 (May 16, 2011), revisited, and likely expanded, the scope of equitable remedies available under ERISA § 502 (a)(3). The Court also rejected Plaintiff’s effort to sue under the terms of the SPD as opposed to the terms of the actual ERISA plan document. (more…)
Category: 2nd, 9th, ERISA, Summary Plan Description, Supreme Court |
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cmonfils | September 11, 2011
www.kaiserhealthnews.com Sep 08, 2011
The Virginia case, brought by state Attorney General Ken Cuccinelli, was considered one of the highest profile health law challenges to the health law. In its opinion, issued today, the appellate court ruled that the state does not have standing to challenge the law’s individual mandate because it lacks “a personal stake.” It also concluded that Liberty University’s challenge should be dismissed. (more…)
Category: 4th, Virginia |
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cmonfils | September 9, 2011
Sep 08, 2011
The Virginia case, brought by state Attorney General Ken Cuccinelli, was considered one of the highest profile health law challenges to the health law. In its opinion, issued today, the appellate court ruled that the state does not have standing to challenge the law’s individual mandate because it lacks “a personal stake.” It also concluded that Liberty University’s challenge should be dismissed. (more…)
Category: 11th, 4th, 6th, Health Care Legislation, Virginia |
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cmonfils | August 31, 2011
www.erisalawyerblog.com
August 24, 2011 By Stanley D. Baum
In Kough v. Teamsters’ Local 301 Pension Plan, No. 10-2128 (7th Cir. 2011) (Nonprecedential Opinion), the plaintiff had suffered a disability, and then returned to work in 2005. He soon (in that year) suffered a heart attack and abandoned his attempt to work. He filed a claim for disability benefits under a union pension plan subject to ERISA (the “Plan”), but the claim was denied by the Plan. The plaintiff then filed this suit. (more…)
Category: 7th, ERISA |
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cmonfils | August 31, 2011
www.ebia.com
From the August 18, 2011 EBIA Weekly
[State of Florida ex rel. Atty. Gen. v. HHS, 2011 WL 3519178 (11th Cir. 2011)]
Available at http://www.uscourts.gov/uscourts/courts/ca11/201111021.pdf
The 11th Circuit Court of Appeals has held that Congress exceeded its power to regulate interstate commerce when it enacted health care reform’s individual mandate, which beginning in 2014 will require individuals to maintain health coverage or pay a penalty. Conceding that the individual mandate cannot be neatly classified as either economic or noneconomic activity, the 11th Circuit examined the unprecedented nature and far-reaching implications of the mandate, as well as numerous limits on Congress’s commerce authority, and concluded that the federal government cannot mandate that individuals purchase and maintain health insurance from a private company. (more…)
Category: 11th, Health Care Legislation |
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cmonfils | August 22, 2011
Coordination of Benefits Employee Benefits Series THOMPSON July 2011 | VOL. 19, No.3
Legal Brief
A recent decision by a U.S. appeals court upheld a recovery in which a plan dealt directly with the auto liability insurer to achieve a recovery. The case is Shaffer v. Rawlings Co., 2011 WL 1977252 (6th Cir., May 18, 2011). (more…)
Category: 6th, ERISA, Reimbursement |
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cmonfils | August 22, 2011
The Self-Insurer August 2011
From the Bench Michael Friedman and John Eggertsen
The U.S. Supreme Court, in GIGNA Corp v. Amara, et al., 563 U.S., 2011 WL 1936077 (May 16, 2011), revisited, and likely expanded, the scope of equitable remedies available under ERISA § 502 (a)(3). The Court also rejected Plaintiff’s effort to sue under the terms of the SPD as opposed to the terms of the actual ERISA plan document. (more…)
Category: 9th, ERISA, Summary Plan Description, Supreme Court |
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cmonfils | August 22, 2011
www.eforerisa.com August 14, 2011
On August 12, 2011, a three-justice panel of the 11th Circuit Court of Appeals in Atlanta ruled that the PPACA’s individual mandate violated the Commerce Clause of the Constitution, which protects state commerce from federal regulation. In deeming the mandate to be unconstitutional, the 11th Circuit contradicted an earlier ruling in June by the 6th Circuit court in Cincinnati that upheld the measure. Now that two federal appeals courts have reached differing conclusions on the mandate, the issue may proceed to the Supreme Court, which begins a new term in October 2011. (more…)
Category: 11th, PPACA |
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cmonfils | August 22, 2011
www.nytimes.com
By MICHAEL COOPER August 12, 2011
The provision in President Obama’s health care law requiring Americans to buy health insurance or face tax penalties was ruled unconstitutional on Friday by the United States Court of Appeals for the 11th Circuit, in Atlanta.
It was the first appellate review to find the provision unconstitutional — a previous federal appeals court upheld the law — and some lawyers said that the decision made it more likely that the fate of the health care law would ultimately be decided by the Supreme Court. (more…)
Category: 11th, Georgia, Health Care Legislation, Health Insurance |
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cmonfils | August 22, 2011
www.myhealthguide.com
MyHealthGuide Source: Thomas Croft, Esq., King & Croft LLP, 8/17/2011, www.StopLossLaw.com
Case: Bekaert Corp. v. Standard Security Life Ins. Co of New York., No.5:09CV2903, in the United States District Court for the Northern District of Ohio, 8/15/2011. Court’s Opinion.
Mr. Croft’s Comment: This is the second federal decision rejecting a group’s unreasonable interpretation of its own Plan language in just over a month. Clarcor, Inc. v. Madison National Life Ins. Co. was the first. One can be hopeful that a trend is emerging, and that decisions like Diversatek, Inc. v. QBE Ins. Corp. will be shown to be the outliers that they are. (more…)
Category: 6th, Stop Loss |
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cmonfils | August 15, 2011
www.erisalawyerblog.com By Stanley D. Baum August 4, 2011
In Malkani v. Clark Consulting, Incorporated, No. 10-2008 (4th Cir. 2011) (Unpublished Opinion), the Fourth Circuit Court of Appeals reminds us about who can sue under ERISA. (more…)
Category: 4th, ERISA |
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cmonfils | August 15, 2011
www.myhealthguide.com
MyHealthGuide Source:
“The 11th U.S. Circuit Court of Appeals issued a ruling that forcing Americans to purchase health insurance, a key element of the 2010 health reform law, is unconstitutional. The court however allowed the rest of the law stand (including preventive care, dependent care and preexisting condition mandates), overturning the lower court on that,” writes Todd Leeuwenburgh, Thompson Blog on HR and Benefits. (more…)
Category: 11th, Health Insurance, PPACA |
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