EEOC REVISES PUBLICATIONS ABOUT SPECIFIC DISABILITIES

The U.S. Equal Employment Opportunity Commission (EEOC) has updated a series of question-and-answer documents addressing particular disabilities in the workplace.  These documents explain how the Americans with Disabilities Act (ADA) applies to job applicants and employees who have or had cancer, diabetes, epilepsy and intellectual disabilities.

DOL RELEASES MODEL NOTICES REGARDING HEALTH MARKETPLACES

The Department of Labor (DOL) has issued guidance on the Affordable Care Act Exchange Notifications.  All employers are required to provide all of their employees copies of a notice beginning October 1, 2013.

2014 LIMITS FOR HEALTH SAVINGS ACCOUNTS AND OOP LIMITS UNDER ACA

The IRS has announced inflation adjustments for 2014 related to Health Savings Accounts (HSAs).

SPLIT DECISION BY 6th CIRCUIT UPHOLDS DISABILITY CLAIM DENIAL

The United States Court Of Appeals for the Sixth Circuit has ruled that a denial of benefits was not arbitrary and capricious.  While the insurer prevailed, there are lessons to be learned that could make other cases more clear cut in the future.

Q AND As RELATED TO HEALTH INSURANCE MARKET REFORMS

The Center for Consumer Information & Insurance Oversight (CCIIO) within the Centers for Medicare & Medicaid Services (CMS) has provided questions and answers for health insurance insurers and states related to health insurance market reforms.  Topics addressed include geographic rating areas, association coverage and premium adjustment when coverage becomes secondary to Medicare.

GUIDANCE ISSUED FOR 2014 SBCs

The Departments of Labor, Health and Human Services (HHS), and the Treasury have issued Frequently Asked Questions (FAQs) about the summary of benefits and coverage (SBC) requirements for 2014.  The documents authorized for the first year of applicability do not include language for the statement in the SBC regarding whether a plan or coverage provides minimum essential coverage (MEC) and whether the plan’s share of the total allowed costs of benefits provided under the plan or coverage meets applicable minimum value (MV) requirements.

SUPREME COURT HOLDS THAT PLAN TERMS MUST BE FOLLOWED

The U.S. Supreme Court, addressing an issue where the Circuit Courts have been split, has held that ERISA plans seeking reimbursement from a plan participant who obtains a recovery from a third party are entitled to follow the terms of the plan.  To the extent that a plan’s terms are not clearly expressed, general equitable principles will apply.