Posts Categorized: Retiree Benefits

Clear Win for ERISA Health Plans

in Court Cases, Health Benefits, Retiree Benefits

Early this week the United States Supreme Court issued an important decision for health plans seeking to enforce their rights to reimbursement with respect to third party recoveries. The case, US Airways v. McCutchen, 569 U.S. ___ (2013), deals with the common situation where a health plan participant receives a settlement on account of a third party injury and the plan seeks reimbursement of the medical expenses it paid on the participant’s behalf with respect to the injury. In a clear win for plan sponsors, the Supreme Court held unanimously that an express provision in the plan document authorizing the… Continue Reading

CMS Closes ERRP Program

in Retiree Benefits

This afternoon CMS announced that it will not accept claims for ERRP reimbursement, if the claim is incurred on January 1, 2012 or later. However, claims incurred before January 1, 2012 and paid on or after January 1, 2012 may be submitted after the claim is paid based on current ERRP guidelines. A portion of the CMS announcement is appended as follows: CMS is exercising our authority under 45 CFR 149.45(a) to deny certain reimbursement requests based on the available amount remaining of the $5 billion in appropriated program funding, and the rate at which it is being disbursed. We… Continue Reading