On June 24, 2022, the United States Supreme Court released Dobbs v. Jackson Women’s Health Organization, overturning Roe v. Wade. The Dobbs decision has employers scrambling to understand the impact on group health plan coverage. Many employers are considering implementing travel reimbursement options to assist employees who wish to seek abortions that might be restricted …
High Deductible Health Plans Allowed to Provide Additional Preventive Care Benefits for Individuals with Chronic Conditions
A high deductible health plan (“HDHP”) is not permitted to pay for medical expenses until the plan’s deductible has been satisfied, with the exception of medical expenses incurred for preventive care. Preventive care did not generally include expenses for any service or benefit intended to treat an existing illness, injury or condition. In a welcome …
Sixth Circuit Court of Appeals Rules that Retiree Health Benefits May be Terminated Based on Ordinary Contract Principles
In its latest case addressing retiree health benefits, the Sixth Circuit Court of Appeals has held that a collective bargaining agreement’s general durational clause controls when retiree healthcare benefits end. Zino v. Whirlpool Corp., 2019 BL 50961, 6th Cir. (2019). This is a new data point indicating that the Sixth Circuit has moved away from …
SPD v. Plan Document: Who Wins?
Conflicts between a benefit plan Summary Plan Description and a plan document are an ever-present concern for plan sponsors. An aggrieved participant who relies on SPD language will often pursue a claim for benefits even though he/she is not entitled to the benefit under the plain terms of the plan document. This problem is illustrated …