New claims rules & collectively bargainned group(s)

[alexa]

We have 2 LTD plans that cover collectively bargainned unions.

As long as their is a claims review process in place spelled out in combination

of agreement/plan document, are these LTd plans exempr from the new claims

rules?

Any insight would be appreciated

[mroberts]

What new claims rules are you referring to?

[alexa]

The DOL claims rules that were finalized on 11/21/2000 , They changed the timeframes for processing of claims for both health & disability plans.

[mroberts]

Awww yes....sorry, I was thinking medical and saw your post regarding LTD and I was confused....hey, it was early in the morning.

If the bargaining agreement leaves the employees worse off than the law prescribes I would assume the agreement would have to be modified. Just because it's a union agreement doesn't make it exempt from any federal law. If the agreement you currently have is "better" than what is prescribed by law, you can definitely leave it alone since there's no rule that you can't be more than generous.

I would be interested in seeing a comparison between your union contract and the passed laws.

[Guest BenefitsLawyer]

Section (B)(6) of the new reg. addresses the question, and the answer depends on whether the collectively-bargained plan is a Taft-Hartley (i.e., multiemployer, jointly-trusteed) plan or not. Taft-Hartley plans don't get any special treatment under the new reg. Collectively-bargained, non-Taft-Hartley plans do get a break. If the collective bargaining agreement (CBA) "sets forth or incorporates by specific reference" provisions on filing and initial disposition, and a grievance and arbitration procedure for adverse benefit decisions, then the plan is deemed to comply with the claim provisions and the appeal provisions of the reg (i.e., sections © through (j)). If the CBA has a grievance and arbitration procedure for adverse benefit decisions, but no provisions on filing and initial disposition, then the plan is deemed to comply with the appeal provisions of the reg (i.e., sections (h) through (j), but not the claim provisions (i.e., sections © through (g)).

[mroberts]

Thanks for the input benefits lawyer!

[alexa]

Thanks benefits attorney

Yes I was referring to this cite when I read the claims regs

We do have such a procedure spelled out in the collectively bargained agreement (it is not Taft Hartley). Parts of the procedure reference our LTD plan document, specifically on timing matters

Currently our plan document has the old 60 day stuff

Is it ok to leave this alone or do we need to amend plan doc for the new 45 day rules?