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Ninth Circuit Faults Retiree Plan's Disclosure of Lifetime Maximum
HR Daily Advisor Link to more items from this source
Oct. 3, 2017
"The ACA's detailed amendments to the Public Health Service Act (PHSA) included a prohibition on group health plans or their insurers setting lifetime limits on benefits for any participant or beneficiary.... [A] blanket provision [stated] that the amended PHSA provisions would apply to ERISA group health plans 'as if included in this subpart.' This part of ERISA (Part 7) includes an exception for certain plans with fewer than two active employees. However, King argued that the ACA superseded this provision, especially since it eliminated a similar PHSA provision for certain retiree-only plans. The court ruled that the ACA ban did not apply to retiree plans ... Any inconsistency that was created between PHSA and ERISA is not so drastic that plans cannot comply with both, [the judge wrote]." [King v. Blue Cross and Blue Shield of Ill., No. 15-55880 (9th Cir. Sept. 8, 2017)]

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