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Health & Welfare Plans Newsletter

June 17, 2021

3 New Job Opportunities


Exceptional Usefulness and Quality icon Supreme Court Rejects Challenge to Constitutionality of ACA (PDF)

57 pages. "[The two individual plaintiffs] do not have standing to challenge Section 5000A(a)'s minimum essential coverage provision because they have not shown a past or future injury fairly traceable to defendants' conduct enforcing the specific statutory provision they attack as unconstitutional.... The States, like the individual plaintiffs, have failed to show how that alleged harm is traceable to the Government's actual or possible action in enforcing Section 5000A(a), so they lack Article III standing as a matter of law. But the States have also not shown that the challenged minimum essential coverage provision, without any prospect of penalty, will injure them by leading more individuals to enroll in these programs." [Excerpt from the syllabus provided by the court.] [California v. Texas, No. 19-840 (S. Ct. Jun. 17, 2021)]  MORE >>

Supreme Court of the United States

Supreme Court Declines to Overturn ACA -- Again

"The Supreme Court on Thursday turned back its third chance to upend the [ACA], rejecting a lawsuit filed by a group of Republican state attorneys general claiming that a change made by Congress in 2017 had rendered the entire law unconstitutional. By a vote of 7-2, however, the justices did not even reach the merits of the case, ruling instead that the suing states and their individual plaintiffs, two self-employed Texans, lacked 'standing' to bring the case to court." [California v. Texas, No. 19-840 (S. Ct. Jun. 17, 2021)]  MORE >>

Kaiser Health News

Marin County, California Requires Small Employers to Provide Supplemental Paid Sick Leave

"[E]mployers in the County's unincorporated areas with 25 or fewer employees [must] provide supplemental paid sick leave (SPSL) for certain COVID-19-related reasons through September 30, 2021. The ordinance was enacted on June 8, 2021, and took effect immediately.... The ordinance applies to employees who worked for an employer for more than two hours in the County's unincorporated boundaries."  MORE >>


Tenth Circuit: Onset of Disability After Notice of Termination Did Not Preclude LTD Benefits

"[T]he Tenth Circuit ... construed the ambiguous term ... to mean a 'current employee' rather than endorsing Reliance's proposed definition of an employee 'actually working' 'full time.' Because there was no dispute that Carlile was currently employed as of the date of his disability, which was prior to the effective date of his termination, the court affirmed the judgment of LTD benefits in Carlile's favor." [Carlile v. Reliance Standard Life Ins. Co., Nos. 19-4123, 20-4005 (10th Cir. Feb. 22, 2021)]  MORE >>

Hinshaw & Culbertson LLP

Pandemic Drives Increased Interest in Benefits

"Last year, 3 in 10 full-time employees made a change to their benefits selections -- the majority (8 in 10) adding or increasing coverages. For those employees who made changes to their benefits selections, 2 in 10 indicated the pandemic was one of several reasons behind the changes they made; only 2% stated that COVID-19 alone drove their benefit decisions. The top three benefits that were added/increased were life insurance, medical insurance, and dental insurance."  MORE >>


CVS Health Leak Left Log of 1 Billion Searches Exposed Online

"The database belonging to the healthcare and retail giant, which was not password protected, was discovered at the end of March by [an] independent cybersecurity researcher ... The data, collected from both CVS Health and, represents website visitors logs that shows everything visitors searched for[.] ... 'We immediately investigated and determined that the database, which was hosted by a third party vendor, did not contain any personally identifiable information of our customers, members, or patients,' [a CVS] spokesperson said."  MORE >>


Colorado Becomes Second State to Create Public Insurance Option

"The legislation ... would create individual and small group health plans starting in 2023.... The standardized plan must offer healthcare coverage on the bronze, silver and gold levels and offer all pediatric and other essential benefits."  MORE >>


Pending New York Drug Prices Law Would Test Supreme Court Decision Allowing State Regulation of PBMs Despite ERISA

"New York's pending bill will provide an early signal of how willing states are to take on PBMs and other health-care businesses since the Supreme Court ruling. Widening states' power to regulate medical costs or incentives could embolden lawmakers to test new approaches that ERISA might have blocked before."  MORE >>

Bloomberg; subscription may be required

Pandemic-Fueled Trauma Is Hijacking Workers' Focus

"Key Mental Health Index Findings: [1] Risk of PTSD has increased 36% since February, and is now 55% higher than pre-pandemic. [2] Sustained attention has decreased 24% since April and is now 59% lower than pre-pandemic. [3] Ages 60+: 125% worse when compared to April 2021; Ages 20-39: 37% worse than one month ago. [4] Planning is trending down 8% in the past month Ages 60+: 30% worse when compared to April 2021."  MORE >>

National Alliance of Healthcare Purchaser Coalitions

Benefits in General

[Guidance Overview]

DOL: Plans May Need to Disclose Claims-Related Audio Recordings

"[EBSA Information Letter 06-14-2021 addresses] when it may be necessary for benefit plans and plan decisionmakers (including insurers in the benefit claims context) to disclose claims-related audio recordings to claimants on request. The DOL's letter rejects the notion that a recording is exempt from disclosure because it was generated for quality assurance purposes."  MORE >>

Thomson Reuters Practical Law

Ninth Circuit: Equitable Estoppel Cannot Be Used to Contradict Express Terms of ERISA Plan

"If the appraiser had overvalued the shares during his appraisal, applying equitable estoppel would require the payment of greater than the fair market value of the shares -- which is forbidden by the plan. Thus, whether a plaintiff or defendant, the court held a party cannot use equitable estoppel to contradict the express terms of an ERISA plan in litigation with the plan." [Wong v. Flynn-Kerper, No. 19-56289 (9th Cir. Jun. 7, 2021)]  MORE >>

Kantor & Kantor

Justice Department Sues to Block Aon's Acquisition of Willis Towers Watson

"The merger between Aon and Willis Towers Watson would combine two of the 'Big Three' insurance brokers who, as alleged in the complaint, can offer global service, sophisticated data and analytics, and a breadth and depth of knowledge and expertise that other brokers do not offer. As alleged in the complaint, Aon and Wills Towers Watson operate 'in an oligopoly' and 'will have even more [leverage] when [the] Willis deal is closed.' If permitted to merge, Aon and Willis Towers Watson could use their increased leverage to raise prices and reduce the quality of products relied on by thousands of American businesses -- and their customers, employees, and retirees." [U.S. v. Aon and Willis Towers Watson, No. 21-1633 (D.D.C. complaint filed Jun. 16, 2021)]  MORE >>

Antitrust Division, U.S. Department of Justice

Using Mandatory Arbitration to Avoid ERISA Class Actions, Part 1 (PDF)

"Provisions mandating arbitration have the potential to curb the ability of participants to pursue class action litigation and, by requiring plaintiffs' counsel to pursue claims on a participant-by-participant basis, may alter the economics that have made it so profitable for law firms to pursue ERISA fiduciary breach litigation. However, there are legal uncertainties regarding whether and how arbitration may be required of ERISA plan participants."  MORE >>

Cohen & Buckmann P.C.

Employee Benefits Jobs

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Press Releases

Vanguard and Infosys Announce Strategic Partnership


Northern Trust Surpasses $1 Trillion in Defined Contribution Assets Under Custody and Administration

Northern Trust

Last Issue's Most Popular Items

DOL Has Made CAA's Mental Health Parity Documentation a Top Enforcement Priority

Foley & Lardner LLP

The Importance of Plan Documentation

Berry, Dunn, McNeil & Parker, LLC

Colorado Supreme Court Bans 'Use-It or Lose-It' Vacation Policies

Husch Blackwell

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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.

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