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District Court Highlights Importance of Complying with ERISA's 'Other Instruments Rule' for Document Disclosures
The Wagner Law Group Sept. 15, 2021 "[T]he court found that the Defendants did not comply with ERISA's Other Instruments Rule when they provided the participant only the criteria related to mental health and substance use disorder benefits and also failed to provide the criteria related to medical/surgical benefits.... [T]he court observed the ASA was required to be disclosed to the participant because it evidenced the divided administration of the plan between the plan administrator and the TPA, and that organizational structure affected the participant's rights under the plan." [M. S. v. Premera Blue Cross, No. 19-0199 (D. Utah Aug. 10, 2021)] |
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