Guilty plea entered in union health care fund embezzlement scheme

A member of the Indiana/Kentucky/Ohio Regional Council of Carpenters (IKORCC) has pleaded guilty to embezzlement from the union’s health care fund. He is the 28th member of the IKORCC charged in federal court for submitting false claims to the union’s health care fund. The charges and guilty plea follow an investigation by the Department of […]

Class claims that Marriott’s COBRA notice was deficient certified

Claims by a fired Marriott housekeeper that the COBRA notice she received, which Marriott admittedly sent to about 15,000 other terminated employees over a four-year period, was deficient were certified as a Rule 23 class by a federal district court in Florida. Although Marriott tried to defeat class certification by arguing, in essence, that the […]

Employer didn’t violate FMLA by not reducing employee’s absences while on leave

An employee who was fired for excessive absences could not claim FMLA interference because his employer did not reduce his accumulated absences under its absence reduction policy while the employee was on FMLA leave, a federal district court in Ohio ruled. In granting the employer’s motion for summary judgment, the court found that the employer’s […]

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 […]