After en banc review, unionized flight attendant free to pursue state-law claim for use of vacation time to cover medical leave

In an en banc decision, a divided Ninth Circuit held that the Railway Labor Act did not preempt an employee’s claim premised on a state-law right to reschedule vacation leave for family medical purposes when that right to vacation leave was covered by a collective bargaining agreement. Here, the appeals court found that the employee […]

CMS proposes rule to address risk adjustment program for the 2018 benefit year

The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would adopt the risk adjustment methodology that the Department of Health and Human Services (HHS) previously established for the 2018 benefit year which uses the statewide average premium in the payment transfer formula. The risk adjustment program, required under Sec. 1343 […]

Full-time presence may not be essential function, so fired HR rep whose postpartum depression delayed return to full time may take claims to jury

Emphasizing the harsh reality that “people with disabilities, as a group, occupy an inferior status in our society, and are severely disadvantaged … economically,” and that in passing the ADAAA, Congress reasserted its goal to provide “clear, strong, consistent, enforceable standards” to implement “a comprehensive national mandate for the elimination of discrimination against individuals with […]

Parity determination requires discovery to detail claim adjudication process, district court rules

The District of Massachusetts denied a motion to dismiss by Harvard Pilgrim Health Care Insurance Company (Harvard Pilgrim), finding that the process and factors by which a nonquantitative treatment limitation could be applied to both mental health benefits and medical/surgical benefits need to be evaluated after discovery to determine whether a violation of mental health […]

Providing health benefits nears $15,000 per employee

With the cost to provide health care benefits expected to approach $15,000 per employee next year, large U.S. employers are increasingly playing an activist role in changing the health care delivery system and reexamining existing models, according to recent research from the National Business Group on Health (NBGH). The survey also found a majority of […]

Majority of employers offer financial wellness programs

Nearly 60 percent of employers offer a financial wellness program, or plan to in 2018 and beyond, according to recent research from Strategic Benefit Services (SBS). The study, Assessing the Merits and Challenges of Financial Wellness, found that the remainder of survey respondents do not offer a financial wellness program and do not plan to […]

Increasing HSA limit would not necessarily influence individuals to contribute more

The House of Representatives has passed the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts of 2018. The bill would increase the annual limits on contributions to health savings accounts (HSAs) to match the out-of-pocket deductibles of high deductible health plans (HDHPs). However, the Employee Benefit Research Institute (EBRI) has found that […]

‘Top performer’ demoted week after requesting leave to care for sick husband advances FMLA claim

Demoted after a long and positive tenure with her town employer, and months after being rated a top performer and a “joy to work with,” but only one week after requesting intermittent FMLA leave to care for her cancer-ridden husband, the employee, who ultimately resigned in lieu of termination, can take her FMLA retaliation claim […]

Colorado Division of Insurance releases preliminary 2019 health insurance information

The Colorado Division of Insurance, part of the Department of Regulatory Agencies (DORA), has released preliminary information for proposed health plans and premiums for 2019 for individuals and small groups. Colorado consumers can file formal comments on these plans through August 3. 2018 companies return for 2019. The same seven companies that offered on-exchange, individual […]

Building data capacity for patient-centered outcome research, 2017 report issued

An annual report providing project descriptions for each of the HHS Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS-PCORTF) portfolio’s 21 projects that were active in calendar year 2017 has been issued by its administering entity, the Office of the Assistant Secretary for Planning and Evaluation (ASPE). Each project description in the report […]