"The spouse persuaded the Eleventh Circuit that the employer's failure to provide the forms to [the employee] was a breach of fiduciary duty and that he should be able to bring a claim under Section 502(a)(3) to recover the $350,000 in supplemental life insurance coverage.... Though the apparent harm in Gimeno occurred during the enrollment process, its reasoning could be applied to statements, actions, or inactions that occur at any point during the plan administration process." [Gimeno v. NCHMD, Inc., No. 21-11833 (11th Cir. Jun. 28, 2022)]  MORE >>

"While collective bargaining agreements (CBAs) typically do not include such a granular level of detail on health care to specifically provide for abortion-related coverage, there are still collective bargaining issues employers should consider.... [1] CBA language on changes in medical coverage ... [2] Illegality ... [3] Protected activity."  MORE >>

"The Bill's most important health care provisions include [1] establishing a new program for Medicare to directly negotiate prices with pharmaceutical manufacturers for certain high-spend Medicare drugs, with stiff penalties for companies that refuse; [2] requiring manufacturers to pay rebates on drugs reimbursed under Medicare Parts B or D for which average (i.e., net) prices increase faster than inflation; [3] revamping the Medicare Part D benefit, including establishing an annual out-of-pocket cap for beneficiary cost-sharing on prescription drugs and eliminating patient cost-sharing in the catastrophic phase; ... and [5] extending temporary expanded health insurance subsidies for ACA plans through 2025."  MORE >>

"The bill makes major changes to Medicare as well as extends the enhanced tax credits that enable Americans to buy health insurance through the [ACA] exchanges. Those enhanced tax credits were due to expire at the end of this year, leaving an estimated 3 million people without coverage."  MORE >>

"A draft plan for universal health care in Oregon would raise taxes on the state's businesses and residents by more than $20 billion per year.... The health plan would be funded by an employer payroll tax that would collect about $12 billion in 2026 and by a personal income tax that would collect about $10 billion.... Oregon's business tax burden is among the country's 20 highest, and the combined state and local income tax rate in the Portland area is the nation's fourth highest. Meanwhile, more than 95% of Oregonians already have access to health care."  MORE >>

"[The authors] found that state implementation of paid sick leave mandates was associated with a 5.6 percent reduction in the total ED visit rate relative to the baseline, equivalent to 23 fewer visits per 1,000 population per year. The reduction was concentrated in Medicaid patients. Some of the largest reductions were ED visits related to adult dental conditions, adult mental health or substance use disorders, and pediatric asthma."  MORE >>

"[I]nstead of plenary hearings, ERISA claims are mostly conducted as record review proceedings. That means courts generally disallow the introduction of any evidence not previously introduced during the claim process. On July 29, a federal appellate court ruled that a district court's preclusion of additional evidence proffered by the plaintiff in an ERISA benefits case was erroneous." [Harris v. The Lincoln National Life Ins. Co., No. 21-13186 (11th Cir. Jul. 29, 2022)]  MORE >>

"With so many people opting to strike out on their own, ... some professional groups are setting up systems ... offering group health insurance and, in some cases, retirement funds. Similarly, the Freelancer's Union has arranged health, dental, disability and liability insurances (among others) for members. And various popular workforce management services offer health insurance options as well."  MORE >>