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.
Category: ERISA, Missouri |
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cmonfils | August 25, 2011
www.subrogation.org
Federal Employee Health Benefit Plan Recoveries Under Attack
Recently, four putative class action lawsuits, challenging a Federal Employee Health Benefits plans’ right to recover or subrogate, have been filed. The suits, one filed in New York and the others filed in Missouri, allege that the Federal Employee Health Benefit Act (FEHBA) does not preempt state anti-subrogation laws and that the health plans’ recoveries, on behalf of Federal Employee Health Benefit (FEHB) plans, are not allowed. The suits also seek the refund of past FEHB plan subrogation recoveries. (more…)
Category: Health Insurance, Missouri, New York, Subrogation |
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cmonfils | June 3, 2011
www.modernhealthcare.com John Bluford May 30, 2011
As healthcare providers, we are committed to helping people realize their full potential for health. The best place to start is with our own employees. At Truman Medical Centers in Kansas City, Mo., we put employees first in a host of wellness initiatives because we view each of them as a critical health ambassador who, in leading by example, can greatly improve the health of our entire community. (more…)
Category: Missouri, Wellness |
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cmonfils | May 31, 2011
www.hr.cch.com
CCH® BENEFITS — 05/25/11
Missouri. The Missouri Rx Plan will expire on August 28, unless lawmakers renew it. For the past 12 years, the plan has helped pay the medicine costs of 212,000 low-income seniors and disabled residents. A state senate budget plan is banking on the program’s demise, redirecting millions of dollars that normally would fund the prescription program to other government purposes. For more information, visit http://www.morx.mo.gov/.
Category: Health Care Legislation, Missouri |
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Adam V. Russo | September 7, 2010
Summary
State appeals court in Missouri affirms trial court ruling — Scroggins was injured in a trip-and-fall at a R.Lobster. Her employer’s (St. John’s Hospital, a subsidiary of Sisters of Mercy) self-funded plan covered her health expenses. Also, she sued the restaurant and extracted a settlement. The plan had subro clause up to the full amount it paid in expenses. The trial court refused to enforce the lien (it was a veiled partial assignment of her personal injury claim, and contrary to Missouri public policy). The plan was not subject to ERISA, because of its religious non-profit affiliation made it a church plan. Accordingly, the appeals court upholds state public policy, noting (a) that tort settlement is for pain and suffering, which is not to be a marketable commodity; (2) the plan had no separate claim against the tortfeasor; cases where liens were allowed in personal injury claims involved payers that claims against tortfeasor.
Click here to see the entire case
Category: 8th, Missouri, Subrogation, Welfare Benefit Plans |
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Adam V. Russo | June 28, 2010
Missouri. Gov. Jay Nixon recently signed a bill that requires health insurance companies in the state to speed up claims payments to doctors, hospitals, and other health care providers. The legislation was prompted by a 2009 report from the Missouri Department of Insurance that showed health care providers across the state were dealing with significant payment delays in the claims filed with insurance companies for treatment of patients. The report showed more than 26% of claims at Missouri hospitals are past due by 90 days or more. In addition, the state legislature has sent the governor a bill requiring Missouri health insurers to cover therapies and treatments for autism. When Mr. Nixon signs the bill, the autism provisions will go into effect on January 1. For more information, visit http://insurance.mo.gov/.
Category: Health Care Legislation, Missouri |
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Adam V. Russo | January 29, 2010
The Boeing Company v. Thurmon, No. 4:09-cv-1456, in the United States District Court for the Eastern District of Missouri, December 7, 2009. This is a subrogation case, significant for its fresh and express reiteration of the bedrock proposition that purchase of stop loss insurance by the sponsor of a self-insured employee benefit plan does not affect pre-emption analysis. In other words, a self-insured plan is still a self-insured plan, despite the existence of excess loss coverage. (more…)
Category: Missouri, Preemption, Stop Loss |
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