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Category: Health Insurance

ERISA Watch – Court Rules That Medical Plan Improperly Asserted Subrogation Lien to Deny Benefits

This week’s notable decision is Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, No. 16 C 11014, __F.Supp.3d__, 2017 WL 6549759 (N.D. Ill. Dec. 20, 2017), a case in which the plaintiff was represented by Michelle Roberts of Kantor…

ERISA Watch – The ACA Does Not Prohibit Lifetime Benefit Maximum for Certain Retiree-only Health Plans

This week’s notable decision, King v. Blue Cross & Blue Shield of Illinois, No. 15-55880, __F.3d__, 2017 WL 3928339 (9th Cir. Sept. 8, 2017), involves a claim for unpaid medical benefits on the basis that the claim exceeds the welfare…

ERISA Watch – Self-funded Medical Plan Can Enforce Subrogation Interest in Wrongful-Death Settlement

This week’s notable decision, Mackey v. Johnson, No. 16-1886, __F.3d__, 2017 WL 3595504 (8th Cir. Aug. 22, 2017), is a coup for self-funded medical plans and terrible precedent for the wrongful-death trustees those plans’ participants.  In this case, the deceased,…

ERISA Watch – Parent Has Standing under the Affordable Care Act to Challenge Denial of Son’s Gender Reassignment Surgery

This week’s notable decision is Tovar v. Essentia Health, No. 16-3186, __F.3d__, 2017 WL 2259632 (8th Cir. May 24, 2017).  In Tovar, Plaintiff is an employee who filed suit against her employer and the administrator of the employer’s self-insured health…

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