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10 Sep 2015, 5:03 am by David DePaolo
(By comparison, California will direct $34.95 million to districts attorneys for the fiscal year ending in 2016 to investigate and prosecute work comp fraud.)The contract, posted online by the Tribune and the American-Statesman, calls for the District Attorney's Office to investigate and prosecute alleged violations of the Texas Insurance Code "or other penal laws of the state relating to crimes committed against the company. [read post]
9 Sep 2015, 6:30 am by Michael B. Stack
You should consult with your insurance broker, attorney, or qualified professional. [read post]
2 Sep 2015, 6:30 am by Michael B. Stack
You should consult with your insurance broker, attorney, or qualified professional. [read post]
21 Aug 2015, 6:07 pm by Cynthia Marcotte Stamer
  Since ACA generally extends the duty to comply with its out-of-pocket and many other reforms directly to insurers, insurers that issue non-compliant group or individual health plans generally risk direct liability for violations. [read post]
21 Aug 2015, 11:24 am by Cynthia Marcotte Stamer
Under its provisions, federal law now limits the amount of the maximum deductible, co-payments or other cost sharing that most employer or union sponsored group health plans can impose on essential health benefits to the out-of-pocket limitation allowed by ACA § 1302(c)(1). [read post]
3 Aug 2015, 12:07 pm by Cynthia Marcotte Stamer
Employer and other sponsors of non-grandfathered group health plans, their insurers, administrators and fiduciaries should adjust the co-payment, deductible and out of pocket limits applicable for the 2015 plan year to reflect the recent adjustment in the out-of-pocket limits on essential benefits allowed by that the Patient Protection and Affordable Care Act (ACA) § 1302(c)(1). [read post]
29 Jul 2015, 8:00 am by Rania Combs
 In such a situation, consider a distribution to your spouse in trust with an independent trustee or co-trustee administering the trust assets. [read post]
27 Jul 2015, 11:56 am by Cynthia Marcotte Stamer
While most employers that sponsor group health plans historically have assumed that the insurers or other health plan vendors hired to administer their programs have designed and administer claims and appeals in compliance with these mandates, the processes and notices of many health plan insurers and self-insured plan claims and appeals vendors typically fall far short of meeting the requirements of even the pre-existing ERISA claims and appeals requirements as… [read post]
26 Jul 2015, 7:30 am by Robert Kreisman
Related blog posts: Illinois Appellate Court Affirms Cook County Summary Judgment Order that Insurer Must Defend Toxic-Tort Complaints Even When the Dates of Exposure or Injury Were Vague or Unknown Insurance Coverage Wins Out in Loading Car Claim at Menards Insurance Company’s Restrictive Endorsement Did Not Limit Coverage in Accident; Indiana Insurance Co. v. [read post]
7 Jul 2015, 2:23 pm by Goldfinger Personal Injury Law
One of the most common reasons we see that insurer deny claims, or refuse to believe a claimant’s disability may come down to “independent medical reviews” or “independent medical examinations”. [read post]
30 Jun 2015, 2:43 pm by Cynthia Marcotte Stamer
A Fellow in the American College of Employee Benefit Counsel, past Chair and current Welfare Benefit Committee Co-Chair of the American Bar Association (ABA) RPTE Section Employee Benefits Group, Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, former Chair of the ABA Health Law Section Managed Care & Insurance Interest Group,  an ABA Joint Committee on Employee Benefits Council… [read post]
30 Jun 2015, 4:13 am by Rebecca Tushnet
 I want to reiterate my call to think of consumers and not the consumer—the plurality/bell curve concept is logically independent of the idea of treating consumers differently in different contexts, but I think that conceiving of consumers in the plural more easily allows us to adjust to different contexts, such as the nuclear reactor not run by Homer Simpson. [read post]
22 Jun 2015, 6:30 am by Michael B. Stack
    Re-Insurer Reporting:   Due to the expense and length of medical treatment it is wise to report the loss to the re-insurer. [read post]
The Planning Landscape – Post ATRA Estate, business and succession planning changed dramatically with the enactment of the American Taxpayer Relief Act (ATRA) in early 2013. [read post]
27 May 2015, 1:45 pm by Michael B. Stack
You should consult with your insurance broker, attorney, or qualified professional. [read post]
19 May 2015, 6:45 am by Amy Howe
The Court granted one new case: Campbell-Ewald Co. v. [read post]
18 May 2015, 4:40 pm by Kevin LaCroix
This annual event features an all-star line-up of speakers and will be co-chaired by my friends, Diane Parker of AWAC and [read post]