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Expert Analysis

• Mental Health Parity Act: A Compliance Wake-Up Call

  

  Recent developments, including the U.S. Department of Labor’s settlement with UnitedHealth, suggest that the DOL is taking a renewed and more aggressive approach to enforcing the Mental Health Parity and Addiction Equity Act, say Tim Kennedy and Anne Hall at Hall Benefits Law.

• Insurance Commissioner's Agenda

  

  State insurance commissioners discuss their enforcement and regulation priorities in this Expert Analysis series.

• Takeaways From DC Circ. Medicare Overpayment Ruling

  

  The D.C. Circuit's recent decision in UnitedHealth v. Becerra, reinstating a rule that requires Medicare Advantage organizations to refund certain overpayments, is a near-complete victory for the Centers for Medicare & Medicaid Services, but arguably abandons the rule's negligence standard, say attorneys at Ropes & Gray.

• Why The Future Of Telehealth Parity Remains Murky

  

  Though the federal government, states and private insurers have united during the pandemic in recognizing the value of expanding telehealth access, there is no consensus on the merits of long-term telehealth parity, say Adriana Riviere-Badell and Alexandria Swette at Kobre & Kim.

• A Primer On DOL Probes For ERISA Plan Service Providers

  

  As the U.S. Department of Labor shifts its enforcement resources from Employee Retirement Income Security Act plan sponsors to financial institutions that service such plans, nonfiduciary providers should know what to expect and how to respond to agency investigations, say attorneys at Groom Law Group.

• 5th Circ. Opinion Is Right To Question ERISA Review Norms

  

  A concurrence in the Fifth Circuit’s recent J. P. v. Blue Cross and Blue Shield of Texas decision rightly criticizes the standard of review in Employee Retirement Income Security Act cases as misplaced, nearly impossible for claimants to meet, and at odds with the holistic assessment required by the U.S. Supreme Court, says Mark DeBofsky at DeBofsky Sherman.

• Benefits Ruling Raises Jury Trial Question For ERISA Cases

  

  An Ohio federal court's recent ruling in Phillips v. Sun Life Assurance has reopened the debate over the utility of jury trials in Employee Retirement Income Security Act benefit denial cases, highlighting how the law’s silence on the issue leads courts to make up rules that lack statutory support, says Mark DeBofsky at DeBofsky Sherman.

• Bankruptcy Eligibility Is Expanding For Small Biz Debtors

  

  A Florida bankruptcy court's recent decision in Vertical Mac Construction expands the scope of "just enough" commercial or business activity for Subchapter V eligibility, and potential debtors should consider this evolving boundary, says Nicholas Koffroth at Fox Rothschild.

• Imposing Insurance Surcharges On Unvaccinated Workers

  

  Employers that are not covered by President Joe Biden’s new COVID-19 action plan or that want to further encourage vaccination may consider imposing a health insurance premium surcharge on unvaccinated workers, but compliance with myriad federal, state and local laws must be addressed before raising rates, say attorneys at Reed Smith.

• ERISA Ruling Reveals Big-Picture Health Benefit Issues

  

  While a California federal court’s recent ruling in Asner v. SAG-AFTRA Health Fund concerned fiduciary duty claims under the Employee Retirement Income Security Act, a closer look at the details raises broad questions about retirees’ rights to lifetime health benefits and the staying power of employer-sponsored health care, says Mark DeBofsky at DeBofsky Sherman.

• What's At Stake In High Court's CVS Disability Bias Case

  

  In its upcoming review of CVS Pharmacy Inc. v. Doe, the U.S. Supreme Court will likely address at least one circuit split concerning the availability of disparate-impact claims under the Rehabilitation Act and Affordable Care Act, say attorneys at Weil.

• Vehicle Service Contracts Present Opportunities For EV Cos.

  

  As the electric vehicle market grows faster than ever, manufacturers, dealers and even aftermarket participants can use vehicle service contracts to open up new revenue streams and maintain a touchpoint with customers — but contract providers must be aware of applicable laws and regulations, says Matthew R. Wagner at Frost Brown.

• SEC Cyber Disclosure Actions Point To Merciless Scrutiny

  

  Recent U.S. Securities and Exchange Commission actions over cyber-related disclosure failures show what to expect from a newly invigorated SEC and offer fresh insights on how to counter potentially unmerciful post-breach scrutiny from the agency, even in immaterial, nonfraudulent matters, says cybersecurity consultant John Reed Stark.