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District Court Upholds Plan's Application of Out-of-Pocket Limit
Thomson Reuters Practical Law Oct. 9, 2020 "The court concluded that [the plan's claims administrator] did not fail to consider whether the [ACA's] cost-sharing provisions supported its earlier conclusion that the plan required a plan beneficiary to meet the family, rather than individual, out-of-pocket limit before the plan would fully cover her medical expenses. The court also awarded the beneficiary some, but not all, of her requested attorney's fees and costs." [Fisher v. Aetna Life Ins. Co., No. 16-0144 (S.D.N.Y. Oct. 5, 2020)] |
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