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3 Matching News Items

1.  Reed Smith LLP via Lexology; registration required Link to more items from this source
Jan. 13, 2025
"New ERISA rulings hold that health plans breach their duties by sending denial letters that lack specific references to medical records, detailed explanations and particularized evaluations of the member's needs and by ignoring materials sent by providers during claims appeals By evaluating and addressing potential deficiencies now, health plans may be able to buttress their defenses to bad faith actions"
2.  Reed Smith LLP via Lexology; registration required Link to more items from this source
Jan. 10, 2025
"Loper Bright and Corner Post are already changing how courts handle challenges to ERISA regulations.... [A Texas District Court] applied Loper Bright to enjoin the effective date of a 2024 DOL rule that broadly redefines fiduciary under ERISA.... [Another District Court] agreed with the above analysis and enjoined the same rule.... However, Loper Bright is not without limitsĀ ... 2025 should see additional Loper Bright challenges."
3.  Reed Smith LLP via Lexology; registration required Link to more items from this source
Mar. 21, 2016
"Two recent decisions address a frequent strategy by participants denied benefits under such plans: claiming that the plan fails to meet the top hat exemption, thus making it subject to ERISA and all of its protections. Both ... decisions reject such claims, but are notable mainly for the courts' lack of interest in addressing informal guidance from the [DOL]."

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