Claims & Appeals

Updates

Don’t Tax Working Families to Bail Out Troubled Health Exchanges

ERIC today submitted comments to the Centers for Medicare and Medicaid Services (CMS) supporting the legally required end of the Transitional Reinsurance Program, and calling for the flawed process under which employers can challenge individuals’ premium tax subsidies to be suspended immediately… More

protected content New Claims and Appeals Procedures for Disability Benefits and Final ACA Consumer Protection Rules

The Department of Labor (DOL) published a proposed regulation that would amend the claims and appeal rules currently applicable to employees who file for disability benefits… More

protected content Ninth Circuit Considers All Relevant Factors When Reviewing Fiduciary Decisions

The Ninth Circuit Court of Appeals recently examined the standard that applies when courts review a fiduciary’s benefit denial. The Court held that courts should consider “all of the relevant circumstances,” rather than upholding an administrator’s decision as long as it was reasonable.… More

protected content Final Regulations on the ACA Individual Mandate and the Exchange Appeals Process

Last week Treasury and the IRS finalized a regulation that was proposed last February regarding an individual’s “shared responsibility” for maintaining Minimum Essential (health) Coverage (MEC). HHS also published a final regulation on, among other things, the process for appealing decisions made by the Exchanges on an employee’s eligibility for subsidized coverage in the Exchanges.… More

ERIC Cautions Regulators to Avoid Burdensome Claims and Appeals Requirements

Washington, D.C. -- The ERISA Industry Committee (ERIC) today submitted comments on the amendment to the interim final regulations… More

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Court Rulings

protected content Ninth Circuit Considers All Relevant Factors When Reviewing Fiduciary Decisions

The Ninth Circuit Court of Appeals recently examined the standard that applies when courts review a fiduciary’s benefit denial. The Court held that courts should consider “all of the relevant circumstances,” rather than upholding an administrator’s decision as long as it was reasonable.… More

More Court Rulings

Judicial Documents

protected content Ninth Circuit Considers All Relevant Factors When Reviewing Fiduciary Decisions

The Ninth Circuit Court of Appeals recently examined the standard that applies when courts review a fiduciary’s benefit denial. The Court held that courts should consider “all of the relevant circumstances,” rather than upholding an administrator’s decision as long as it was reasonable.… More

More Judicial Documents

Legislative Documents

Key Health Care Reform Legislative Documents (H.R. 3590 and H.R. 4872)

The House and Senate on March 25, 2010, approved the Health Care and Education Reconciliation Act (H.R. 4872), the "sidecar" reconciliation… More

More Legislative Documents

Letters to Agencies

ERIC Cautions Regulators to Avoid Burdensome Claims and Appeals Requirements

Washington, D.C. -- The ERISA Industry Committee (ERIC) today submitted comments on the amendment to the interim final regulations… More

More Letters to Agencies

Press Releases

Don’t Tax Working Families to Bail Out Troubled Health Exchanges

ERIC today submitted comments to the Centers for Medicare and Medicaid Services (CMS) supporting the legally required end of the Transitional Reinsurance Program, and calling for the flawed process under which employers can challenge individuals’ premium tax subsidies to be suspended immediately… More

ERIC Cautions Regulators to Avoid Burdensome Claims and Appeals Requirements

ERIC News Release For Immediate Release: July 25, 2011 Washington, D.C. -- The ERISA Industry Committee (ERIC) today submitted comments on… More

More Press Releases