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Welcome to the Snell & Wilmer Benefits Blog. We will be posting about current employee benefits and executive compensation topics and issues. We invite you to contact the authors with your thoughts or questions.Blog Contributors
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Authorized Representatives – Fresh Look at an Old Rule
Earlier this year, the Department of Labor issued an information letter explaining ERISA’s authorized representative requirement. Below are some of the takeaways employers may want to consider.
1. The Authorized Representative Requirement Under ERISA
ERISA’s claims procedure regulations expressly give participants and beneficiaries the right to appoint authorized representatives to act on their behalf in connection with a claim for benefits and an appeal of an adverse benefit determination. Furthermore, when a claimant clearly designates an authorized representative to assist with a claim and/or appeal, the plan should direct the claimant’s information and notifications to the authorized representative to act on behalf of the claimant. Read More ›
Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform
| Tagged appeals, authorized representative, claims, DOL, ERISA, health plan
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The New Disability Claims Regulations: They Don’t Only Apply to Disability Plans
Introduction
The Department of Labor (“DOL”) issued regulations that revise the ERISA claims procedure regulations for employee benefit plans that provide disability benefits (the “New Disability Claims Regulations” or “New Regulations”). They are based on the Affordable Care Act’s (the “ACA”) enhanced claims and appeals regulations for group health plans (the “ACA Enhanced Regulations”). The scope of the New Regulations are broader than you may realize and apply to any plan, regardless of how it is characterized, that provides benefits or rights that are contingent on whether the plan determines an individual to be disabled. This can include ERISA governed short-term disability plans, long-term disability plans, qualified retirement plans (e.g., a 401(k) plan), nonqualified retirement plans, and health and welfare plans. Read More ›
Posted in Employee Benefits, Health & Welfare Plans, Qualified Retirement Plans
| Tagged appeals, claims, claims and appeals, denial, disability, indepent review, regulations, review, Social Security, SSA, treatment
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