Insights

On September 25, 2024, in Knudsen v. MetLife Group Inc., the Third Circuit Court of Appeals (Third Circuit) affirmed the dismissal of a putative class action lawsuit claiming ERISA violations by defendant MetLife for its retention of prescription drug plan rebates. The Third Circuit found that the plaintiffs, who were former MetLife employees, had failed to allege the necessary financial harm to establish standing as required under Article III of the US Constitution. In Knudsen, MetLife was the

Certain pre-tax wellness arrangements that promise large tax savings for employers and employees with little employer investment (sometimes referred to as “wellness indemnity plans” or “FICA savings programs”) frequently lack a legitimate basis in tax law (the Internal Revenue Code (IRC)) and consequently are typically too good to be true. Unfortunately, marketing and other promotional materials regarding these cafeteria plan wellness arrangements can be vague and misleading, making it difficul

On September 27, 2024, California Gov. Gavin Newsom signed into law AB 2258, which prohibits any group or individual non-grandfathered healthcare service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2025, from imposing cost-sharing requirements for specified preventive care services and screenings such as reproductive healthcare (including contraceptives such as intrauterine device (IUDs)), HIV prevention medications like pre-exposure prophylaxis (

On September 19, 2024, in Dwyer v. United Healthcare Ins. Co., the United States Court of Appeals for the Fifth Circuit (the court) found that defendant United Healthcare (UHC) improperly denied benefits for the continuing treatment of a participant’s anorexia nervosa, disregarding both the plan’s own coverage terms and its claims and appeals procedures. In this case, ED, the preteen dependent of plaintiff Kelly Dwyer, received inpatient care at a residential treatment facility that specializes

On October 1, 2024, the IRS announced disaster tax relief for all individuals and businesses affected by Hurricane Helene, including the entire states of Alabama, Georgia, North Carolina, and South Carolina and parts of Florida, Tennessee, and Virginia. The relief includes the postponement of filing until May 1, 2025, for any Form 5500 series returns that were or are required to be filed by “affected taxpayers” on or after September 24, 2024, and before May 1, 2025, and applies to both retireme

On September 29, 2024, Gov. Gavin Newsom signed in to law SB 729, which requires fully insured large group health plans, state-regulated health plans, and disability insurance policies to provide coverage for infertility and fertility services, including in vitro fertilization (IVF), with a maximum of three completed oocyte retrievals and unlimited embryo transfers for the diagnosis of infertility and fertility treatment. As enacted, the legislation applies to policies issued, amended, or renew

The Massachusetts Department of Family and Medical Leave announced the premium rates and maximum weekly benefit amount for the Massachusetts Paid Family and Medical Leave (MA PFML) program beginning January 1, 2025. The total 2025 MA PFML premium contribution for employers with 25 or more employees who work in Massachusetts is 0.88% of eligible wages. For employers with fewer than 25 employees who work in Massachusetts, the 2025 MA PFML premium contribution is 0.46% of eligible wages. The emplo

FAQ: What is a spousal incentive HRA? A spousal incentive HRA (sometimes informally called a “SIHRA” for short) is an HRA that provides funds for an employee or spouse (or both, plus covered dependents if desired) who waives the employer’s plan and enrolls in the spouse’s coverage instead. The result is similar to a spousal surcharge or carve-out, as it is a different way for an employer to impose a strategy to encourage spouses to enroll in their own coverage. A SIHRA may be seen as more emplo

Going through a divorce can feel overwhelming, and many people say they struggle to keep track of everything. One way to regain control is by planning your insurance program for after the divorce.