cmonfils | January 5, 2012

CHIP –AL, AK, CA, ID, IL, OA, KS, LA, MI, NJ, NM, OH, OR, WA, WI

Dec. 28 (Bloomberg) — Twenty-three states will share $296.5 million in U.S. payments for encouraging low-income families to enroll their children in public health programs.

Bonuses announced today reward states that streamline eligibility for Medicaid, the federal-state health program for the poor, or the Children’s Health Insurance Program. The effort is aimed at children younger than 19 from households with annual incomes of as much as $45,000 for a family of four, though some states have more generous criteria.

Category: Alabama, Alaska, California, CHIP, Idaho, Illinois, Iowa, Kansas, Louisiana, Michigan, New Jersey, New Mexico, Ohio, Oregon, Washington, Wisconsin | No Comments »
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cmonfils | December 16, 2011

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.

Category: California, Health Care Legislation, Indiana, Louisiana, Minnesota, New York | No Comments »
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cmonfils | July 12, 2011

www.subrogation.org

The Louisiana Bill we first reported on back in June of this year was recently signed by Governor Bobby Jindal and enacted into law.  The original bill has been modified, but still lacks clarity. (more…)

Category: Legal, Louisiana | No Comments »
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cmonfils | June 8, 2011

www.subrogation.org

Louisiana has introduced a bill that is problematic for both health and property and casualty carriers.  

As for health carriers, the bill seeks to only allow reimbursement from a med pay carrier with the written consent of the insured or legal representative.  Further amendments create a threshold and limit the written consent requirement to when the med pay carrier wishes to pay a third party the greater amount of five hundred dollars ($500.00) or twenty-five percent (25%) of available coverage.  (more…)

Category: Louisiana | No Comments »
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cmonfils | May 31, 2011

www.hr.cch.com 

CCH® BENEFITS — 05/25/11

Louisiana. Governor Bobby Jindal plans to sell the state health insurance plan to a private company. Critics of this approach said that it would result in higher premiums and lower benefits for state workers and retirees. However, Mr. Jindal’s budget advisor, Paul Rainwater, noted that Louisiana is currently the only state besides Utah that operates its own health insurance plan. For more information, visit http://new.dhh.louisiana.gov/.

Category: Health Care Legislation, Louisiana | No Comments »
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Adam V. Russo | August 12, 2010

CCH® BENEFITS, www.hr.cch.com

California

The California Public Employee’s Retirement System (CalPERS) has approved an average increase of more than 9% in health premiums next year for state and local government workers. CalPERS blamed the rate increase on rising costs for hospital care, doctor visits, and prescriptions. The increase will mean higher premiums for public agencies and their 1.3 million employees, dependents, and retirees. For more information, visit http://www.calpers.ca.gov/. (more…)

Category: California, Connecticut, Health Care Legislation, Kansas, Louisiana, Maine, Massachusetts, New York, Ohio, Utah, Washington D.C., Wisconsin | No Comments »
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Adam V. Russo | August 31, 2009

From The Bench – The Self-Insurer Volume 26* August 2009

By John H. Eggertsen, Esq. and Michael Friedman, Esq.

II. Fifth Circuit Rejects Benefit Decision For Procedural Defects; Can’t Even Assess If Determination was Arbitrary And Capricious

In Lafleur v. Louisiana Health Service Indemnity Company, d/b/a Blue Cross Blue Shield of La., 563 F.3d 148 (5th Cir. 2009), the Fifth Circuit found that Blue Cross Blue Shield of Louisiana (“BCBSL”) was so deficient in its substantive compliance with ERISA’s procedural regulations that it could not even express an opinion as to whether the determination was arbitrary and capricious. (more…)

Category: 5th, Louisiana, MetLife v. Glenn | No Comments »
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Adam V. Russo | October 28, 2008

You may have heard of the case Benefit Recovery, Inc. v. Donelon, et al., 521 F.3d 326 (5th Cir. 2008); F.3d 2008 WL 642972 (5th Cir. La.), 43 Employee Benefits Cas. 1417.  It was likely brought to your attention by someone claiming there is a made whole rule in Louisiana that binds even self-funded employee benefit plans, coming within the purview of ERISA.  This is simply not the case. (more…)

Category: ERISA, Louisiana, Made Whole Rule, Preemption | No Comments »
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Adam V. Russo | March 26, 2008

Benefit Recovery, Inc. sued Louisiana Commisioner of Insurance and lost its case.  See entire 5th Circuit Court of appeals decision.

Category: 5th, Louisiana | No Comments »
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Adam V. Russo | March 14, 2008

A Louisiana State Law requiring that insureds be made whole before an insurance carrier could seek reimbursement was upheld by the 5th Circuit, Benefit Recovery, Inc. v. Donelon, 2008 WL 642972 (March 11, 2008).  Note that the decision only applies to plans that are not self-funded, but will apply to plans that are fully insured, and governmental plans, even if ERISA otherwise applies.

Category: 5th, Louisiana, Made Whole Rule | No Comments »
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