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Category Archives: Employee Benefits/ERISA

U.S. AIRWAYS V. MCCUTCHEN: IS IT “FAIR” FOR YOUR HEALTH PLAN TO ENFORCE ITS REIMBURSEMENT RIGHTS?

Group health plans typically provide that when the plan pays benefits for treatment of injuries incurred as the result of a third party’s negligence, the plan is entitled to reimbursement for those payments from the proceeds of injured participant’s recovery (if any) from the third party.  In general, those kinds of provisions are enforceable under [...]
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LEAVING ONE HOSTILE WORK ENVIRONMENT FOR ANOTHER

Back in August, the United States Court of Appeals for the Fifth Circuit decided a case and ruled that the Uniformed Services Employment and Reemployment Rights Act (“USERRA”) did not recognize claims of hostile work environment based on an employee’s membership in the National Guard or Reserves.  Well, Congress was obviously not happy with that [...]
Also posted in General Employer Interest | Leave a comment

WOLFE V. ADKINS: WAGE PAYMENT AND COLLECTION ACT CLARIFIED IN FAVOR OF EMPLOYERS

Every employer and human resource professional with an interest in West Virginia needs to be aware of a recent decision from the West Virginia Supreme Court of Appeals concerning the Wage Payment and Collection Act, W. Va. § 21-5-1, et. seq.   In Wolfe, et al. v. Adkins, et. al., Number 101476 (Sept. 29, 2011), the [...]
Also posted in General Employer Interest, Wage and Hour | Leave a comment

HEALTH CARE REFORM – EXTERNAL REVIEW PROCEDURES

The Patient Protection and Affordable Care Act (“PPACA”) requires health insurance issuers and certain employer-sponsored group health plans to comply with “the applicable State external review process for such plans and issuers.”  States’ external review processes must provide for external review of denials of insurance claims (and claims for group health plan benefits) for medical [...]
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THE SUPREME COURT RELAXES THE STANDARD FOR AWARDS OF ATTORNEYS’ FEES IN ERISA CASES. BUT DOES IT REALLY MATTER?

As a general rule, under what is called “the American Rule” each party to a lawsuit pays his own attorney’s fees, win or lose, unless a statute or a contract provides otherwise.  The Employee Retirement Income Security Act (“ERISA”) authorizes courts to award attorneys’ fees and costs to either party.  Such “fee-shifting” is not automatic [...]
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