"As we fast approach the July 1, 2022 deadline to post these files it is important for plan sponsors to understand what their insurance carrier or TPA will be requiring them to do and the timeline that the carriers and TPAs will be making the files available for posting. Employers who do not host a public site may be required to work with their insurance carrier or TPA to determine if the insurance carrier or TPA will host a site in their name, or if the employer will be required to create a public site for the purpose of posting the files."  MORE >>

"The related Family and Medical Leave Insurance Program will be funded by employer and employee contributions. Contributions will begin on January 1, 2025. Employees will be able to utilize the job-protected paid leave beginning on January 1, 2026.... The maximum amount of leave benefits a covered individual may take is 12 weeks per year for parental leave and an aggregate of six weeks in any 24-month period for other qualifying reasons, for a cumulative total of up to 12 weeks of benefits per year."  MORE >>

"As noted in both opinions, at least two federal appellate courts have determined that pay during leave is a 'right and benefit' protected by USERRA. Employers providing paid leave for non-military reasons should consult with counsel before denying pay during short-term military leave.... [E]mployees on military leave generally have a right under USERRA to elect to continue employment-based group health plan coverage for themselves and their covered dependents. This is in addition to any continuation rights under COBRA." [Baker v. United Parcel Service Inc., No. 21-0114 (E.D. Wash. Mar. 31, 2022); Haley v. Delta Airlines, Inc., No. 21-1076 (N.D. Ga. Mar. 29, 2022)]  MORE >>

"In two nearly identical rulings, a federal trial court has concluded that plan-imposed deadlines for filing lawsuits did not apply because they were not set forth in final denial letters to the participants. While the cases involved separate ERISA plans (one fully insured and one self-insured) sponsored by different employers, both plans involved denials by the same entity (as insurer for the insured plan and claims administrator for the self-insured plan)." [E.F. v. United HealthCare Ins. Co., No. 21-190 (D. Utah Mar. 30, 2022); Anne A. v. United HealthCare Ins. Co., No. 20-814 (D. Utah Mar. 30, 2022)]  MORE >>

"A doctor's opinion relied on by the plan that was not based on a full review of the relevant evidence was viewed by the court as neither principled nor reasoned.... [T]he plan's imposition of an absolute requirement that all conservative treatments must be exhausted before approving surgery was also considered an abuse of discretion.... Finally, ... [an] abuse of discretion may exist when the benefit determination is inconsistent with the purpose of the plan." [Garner v. Cent. States, SE & SW Areas Health & Welfare Fund Active Plan, No. 21-1602 (4th Cir. Apr. 20, 2022)]  MORE >>

"The Court was satisfied that Sedgwick's determination was grounded in sufficient evidence and was adequately explained to Canter.... The Court rejected Canter's argument that the district court was wrong to reject evidence outside the administrative record concerning the reviewers' efforts to contact his doctors and the leave-of-absence accommodation that AT&T granted him." [Canter v. AT&T Umbrella Benefit Plan No. 3, No. 21-1514 (7th Cir. May 11, 2022)]  MORE >>

"ERISA-governed life insurance benefit plans are typically administered jointly by the employer and an insurance company.... It is common for one party to be uncertain as to what the other is supposed to be doing, and frequently neither party possesses full information as to which employees have signed up for what, and whether those employees have met all the requirements for eligibility or enrollment.... [T]his confusion, unfortunately, appears to be a feature of the system, not a bug. It gives both the employer and the insurer plausible deniability and leaves employees ... holding the bag. [This] case hopefully accelerates a trend toward ending such arrangements." [Skelton v. Radisson Hotel Bloomington, No. 21-2641 (8th Cir. May 6, 2022)]  MORE >>

"41 million Americans -- nearly 1 in 4 enrolled in employer-provided coverage -- received mental health support in 2020. 6 million children received mental health services and treatment through a parent or guardian's employer-provided coverage in 2020. There was a 100-fold increase in telehealth appointments for mental health in 2020. Patients spend less than $15 in out-of-pocket costs for most drugs prescribed to treat mental health conditions."  MORE >>

"In light of recent state-level trends, businesses have begun exploring avenues to assist employees in states with restrictive abortion laws with travel to nearby states to receive abortion services. In implementing these programs, employers should consider the various ERISA and tax code-related provisions that may impact design."  MORE >>