Ruling Shows Medicare Confusion Can Lead to Costly Results

Health insurance is a critically important benefit since illness and injury are unpredictable, and the high cost of medical care makes it unaffordable to most people absent insurance. Healthcare coverage is confounding, especially if one has health insurance through their employer and are eligible for Medicare due to the so-called Medicare as secondary payer rules […]

Update on ERISA-Governed Insurance Benefit Claims: NACLE

ERISA law is constantly changing; and with each new ruling, the scope and context of how issues relating to disability, life and health benefits are resolved by the courts is constantly evolving.  In June of 2021, Mark DeBofsky recorded a continuing legal education program for the National Academy of Continuing Legal Education (NACLE) providing an update on ERISA-governed insurance claims.

Is Your Retirement Plan Governed by ERISA?

The Employee Retirement Income Security Act (ERISA) of 1974 was passed by Congress primarily to protect employee retirement benefits by establishing requirements to assure that promised benefits are delivered. One of the principal reasons that Congress was spurred to pass the ERISA law was the bankruptcy of the Studebaker car company in the 1960s. When the car maker failed, its workers learned to their surprise and disappointment that their promised pensions were not going to be paid to them […]

High Court Social Security Ruling’s Implications for ERISA

It is a generally accepted tenet in litigation under the Employee Retirement Income Security Act that claimants challenging benefit denials must first exhaust prelitigation claim appeals as a condition precedent to filing suit. While an administrative exhaustion requirement applies to claim exhaustion, whether ERISA claimants are barred from raising new issues in court that were not previously asserted in their claim appeals remains open to question. […]