One federal court decision could affect the way that health insurance benefits treat employee mental health claims in Washington, D.C., and across the country. In the case of Wit v. United Behavioral Health (UBH), a managed health care company was found responsible for denying tens of thousands of workers' insurance claims for mental health or substance abuse treatments. UBH oversees behavioral health services for a number of health insurance companies, including UnitedHealthcare.
A federal court in California has sided with plaintiffs in a class action suit concerning payment for behavioral health costs. The court ruling and rationale for the decision should make ERISA plan trustees and administrators in Washington, D.C., a little more mindful of accepted methods for treatment.
A recent ruling in the Eighth Circuit might be interesting to employees and employers in the Washington, D.C. area as well as the rest of the country. While the ruling is only binding on courts in the Eighth Circuit, it might indicate how other circuits might likewise rule.
When ERISA claims are filed in Washington, D.C., the plan fiduciaries commonly claim that the statute of limitations bars the claims. ERISA claims have a three-year statute of limitations, which means that claims must be filed within that period of time, or they will be time-barred.
In April 2018, new procedures for processing disability claims went into place for ERISA benefits plans. These changes, developed by the federal Department of Labor, are designed to provide additional protections for workers dealing with insurers or plan fiduciaries who deny disability benefits claims. The reforms mandate that employee benefit plans must provide a reason for a denied claim as quickly as possible. This reason must be provided in enough time before the appeal deadline to allow the plan member to respond adequately.
Employees in Washington, D.C., may be interested in the outcome of an ongoing case in which a group of ERISA plan participants are pursuing claims for a breach of fiduciary duty. The Court of Appeals for the Ninth Circuit upheld a ruling that the participants were not required to go to arbitration despite the existence of employment agreements requiring arbitration of disputes. The court said that the claimants were not representing their own interests but those of the ERISA plan itself.
There are many laws that protect workers' rights with regard to pensions and healthcare benefit plans. However, workers in Washington, D.C., should be aware of the Employee Retirement Security Act of 1974 and how the ERISA preemption can affect certain protections provided by local and state laws.
If you work in Washington, D.C., you may be concerned about how to handle improper actions taken by your employer when they affect your benefits. There is a law, the Employee Retirement Income Security Act, or ERISA, that is designed to protect the interests of workers in their retirement accounts as well as other key benefits provided on the job. While ERISA is best known as protective legislation to prevent unethical behavior with employee pensions, it also applies to medical insurance, health reimbursement accounts, additional health plans, disability insurance and severance agreements.
New rules are scheduled to take effect for short- and long-term disability claims and how they are investigated by plan fiduciaries. These changes will affect workers who have short- or long-term disability benefits through their jobs in Washington, D.C. and in the rest of the U.S.
News from Washington, D.C. indicates that although the Department of Labor is conducting fewer audits of employee retirement plans, it is recovering greater sums of money from missing employee contributions. The Labor Department's Employee Benefit Security Administration is responsible for enforcing policies to protect employee retirement funds. While American employers do not have to offer retirement programs and benefits to their employees, once those programs exist, they must follow certain guidelines and procedures in government regulations.