Employee Benefits

A Major League Baseball Players (MLB) Benefit Plan participant recently filed an ERISA lawsuit against Aetna Health and Life Insurance Co. (Aetna) and the MLB Benefits Plan. The suit challenges the denial of inpatient mental health treatment claims for the participant’s daughter.
MLB offers mental health benefits to employees and their beneficiaries, including inpatient and outpatient treatment of mental health

Committees in both houses of Congress recently voted to advance legislation reforming pharmacy benefit managers (PBMs). In recent months, PBMs, which manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, and large employers, have come under fire for allegedly anticompetitive practices and inflated consumer drug prices.
The Senate Finance Committee, which handles matters related to

The Federal Trade Commission (FTC) recently unanimously voted to withdraw its previously issued policy statement that opposed state legislation increasing transparency over pharmacy benefit managers (PBMs). Consistent with heightened scrutiny of PBMs by federal agencies, the FTC issued a statement cautioning against reliance on prior advocacy statements regarding PBMs that no longer may be valid.
The FTC stated that although

Three federal agencies – the Department of Labor (DOL), the Department of Treasury (Treasury), and the Department of Health & Human Services (HHS) – released joint proposed rules designed to amend existing rules under the Mental Health Parity and Addiction Equity Act (MHPAEA). The proposed rules also fulfill the mandate of the Consolidated Appropriations Act, 2021 (CAA, 2021) to implement

The U.S. Department of Labor (DOL), U.S. Department of the Treasury (Treasury), and the U.S. Department of Health and Human Services (HHS) recently issued 395 pages of proposed rules designed to guide group health plans on compliance with mental health parity laws. These rules clarify that the Biden administration intends to restrict plans’ use of nonquantitative limits on mental health

The U.S. Department of Labor (DOL) has announced the settlement of a class action Employee Retirement Income Security Act (ERISA) lawsuit for more than $124.6 million on behalf of the more than 9,000 participants in the DST Systems Inc. 401(k) plan. The DOL and private plaintiffs alleged that DST and other defendants, including New York City investment management firm Ruane,

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury recently issued joint FAQs (Part 60) concerning the implementation of specific provisions of the Affordable Care Act (ACA) and Title I of Division BB of the Consolidated Appropriations Act, 2021 (the No Surprises Act). The purpose of these FAQs is to address overlap in some areas

Kraft Heinz Co. has filed an ERISA lawsuit against Aetna Inc. in a Texas federal court. Aetna provides claims processing and adjudication services for Kraft Heinz, which self-funds its employees’ and retirees’ medical expenses. Under ERISA, Aetna has a fiduciary duty to properly identify, deny, and prevent the payment of any provider claims that are false or improperly submitted.

By Kellie Mejdrich
Law360 (September 1, 2023, 7:22 PM EDT) —
In September, federal appeals courts have set oral arguments on several important employee benefits disputes from workers claiming violations of the Employee Retirement Income Security Act, and a D.C. Circuit panel will be asked to determine whether Rite Aid violated labor law when changing union retirees’ health benefits.