When Do State Laws Determine ERISA Plan Benefit Rights? PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download When Do State Laws Determine ERISA Plan Benefit Rights? PDF full book. Access full book title When Do State Laws Determine ERISA Plan Benefit Rights? by Albert Feuer. Download full books in PDF and EPUB format.
Author: Albert Feuer
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
The article supplements the two classic legislative histories of ERISA: (1) James A. Wooten, the Employee Retirement Income Security Act of 1974 -- A Political History (2004) and (2) Staff of S. Comm. on Labor and Public Welfare, Leg. History of the Employee Retirement Income Security Act of 1974 (1976). The article, however, also focuses on the development and evolution of the ERISA preemption principles in interpretations of the Supreme Court, and the major amendments to ERISA, particularly the Retirement Equity Act of 1984. The article seeks to give the reader the tools to reaches his or her own conclusions about the issues discussed, particularly the significance of the ERISA General Preemption Rule (the "Rule" that ERISA preempts all state laws that relate to any ERISA plan, and the explicit and implicit exclusions from the Rule. Thus, the reader may answer the essential question that arises about any federal preemption provision for ERISA preemption. What undue interference with the ERISA regulatory regime does ERISA preemption seek to prevent, and which interference is, in fact, prevented? The article proposes that three principles may be used to decide when state benefit laws determine ERISA benefit rights. First, ERISA permits state laws that do not diminish or enhance (a) ERISA benefit entitlements; (b) ERISA enforcement mechanisms; or (c) ERISA mandates. Second, ERISA preempts any state law that diminishes or enhances any of these ERISA protections unless the diminution or enhancement was needed to implement a state law that is not otherwise preempted, in which case the law is not preempted if the diminution or enhancement is limited to the extent needed for the effective administration of such state law. Third, a law is not otherwise preempted if the law (1) is described in an implicit or explicit exclusion from the ERISA General Preemption Rule, or (2) does not diminish or enhance any of the three above benefit protections other than with a reporting or disclosure mandate that is used to implement the law. Neither the courts nor other commentators have thoroughly explored these principles. The article applies these three principles to five kinds of state laws: (1) generally applicable criminal laws, which are explicitly excluded from the Rule;(2) tax laws, which are explicitly included in the Rule, but to a large extent are implicitly excluded from the Rule;(3) creditor laws, which are explicitly and implicitly preempted by specific provisions of ERISA, unless plan terms provide for their inclusion, as may be done, to some extent, for certain plans;(4) domestic relations laws, some of which are explicitly excluded from the ERISA General Preemption Rule, and some of which are implicitly included in the Rule; and(5) transfer on death laws, all of which ERISA preempts, unless plan terms provide for their inclusion, as may be done, to some extent, for certain plans. The article also discusses (1) the definition of a plan for purposes of determining whether an arrangement is an ERISA plan; and (2) the extent to which ERISA, the Employee Retirement Income Security Act of 1974, as amended, whose dominating purpose is the protection of ERISA plan participants and beneficiaries rather than the protection of ERISA plans and their sponsors, protects the benefit entitlements of a plan participant or beneficiary from state-law claims after the participant or beneficiary has received a distribution of their benefit entitlements.
Author: Albert Feuer
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
The article supplements the two classic legislative histories of ERISA: (1) James A. Wooten, the Employee Retirement Income Security Act of 1974 -- A Political History (2004) and (2) Staff of S. Comm. on Labor and Public Welfare, Leg. History of the Employee Retirement Income Security Act of 1974 (1976). The article, however, also focuses on the development and evolution of the ERISA preemption principles in interpretations of the Supreme Court, and the major amendments to ERISA, particularly the Retirement Equity Act of 1984. The article seeks to give the reader the tools to reaches his or her own conclusions about the issues discussed, particularly the significance of the ERISA General Preemption Rule (the "Rule" that ERISA preempts all state laws that relate to any ERISA plan, and the explicit and implicit exclusions from the Rule. Thus, the reader may answer the essential question that arises about any federal preemption provision for ERISA preemption. What undue interference with the ERISA regulatory regime does ERISA preemption seek to prevent, and which interference is, in fact, prevented? The article proposes that three principles may be used to decide when state benefit laws determine ERISA benefit rights. First, ERISA permits state laws that do not diminish or enhance (a) ERISA benefit entitlements; (b) ERISA enforcement mechanisms; or (c) ERISA mandates. Second, ERISA preempts any state law that diminishes or enhances any of these ERISA protections unless the diminution or enhancement was needed to implement a state law that is not otherwise preempted, in which case the law is not preempted if the diminution or enhancement is limited to the extent needed for the effective administration of such state law. Third, a law is not otherwise preempted if the law (1) is described in an implicit or explicit exclusion from the ERISA General Preemption Rule, or (2) does not diminish or enhance any of the three above benefit protections other than with a reporting or disclosure mandate that is used to implement the law. Neither the courts nor other commentators have thoroughly explored these principles. The article applies these three principles to five kinds of state laws: (1) generally applicable criminal laws, which are explicitly excluded from the Rule;(2) tax laws, which are explicitly included in the Rule, but to a large extent are implicitly excluded from the Rule;(3) creditor laws, which are explicitly and implicitly preempted by specific provisions of ERISA, unless plan terms provide for their inclusion, as may be done, to some extent, for certain plans;(4) domestic relations laws, some of which are explicitly excluded from the ERISA General Preemption Rule, and some of which are implicitly included in the Rule; and(5) transfer on death laws, all of which ERISA preempts, unless plan terms provide for their inclusion, as may be done, to some extent, for certain plans. The article also discusses (1) the definition of a plan for purposes of determining whether an arrangement is an ERISA plan; and (2) the extent to which ERISA, the Employee Retirement Income Security Act of 1974, as amended, whose dominating purpose is the protection of ERISA plan participants and beneficiaries rather than the protection of ERISA plans and their sponsors, protects the benefit entitlements of a plan participant or beneficiary from state-law claims after the participant or beneficiary has received a distribution of their benefit entitlements.
Author: United States
Publisher: CCH Incorporated
ISBN: 9780808010579
Category : Employee fringe benefits
Languages : en
Pages : 2224
Get Book Here
Book Description
Author: Gary L. Wickert
Publisher: Juris Publishing, Inc.
ISBN: 1578233291
Category : Law
Languages : en
Pages : 1300
Get Book Here
Book Description
ERISA and Health Insurance Subrogation In All 50 States is the most complete and thorough treatise covering the complex subject of ERISA and health insurance subrogation ever published. NEW TO THE FIFTH EDITION! • Updated To Include All The Newest Case Law! • Updated To Include Medicaid Subrogation and Preemption of FEHBA ! • New Plan Language Recommendations! • Complete Health Insurance Subrogation Laws In All 50 States • Covers The Application of ERISA In Every Federal Circuit The Fifth Edition of ERISA and Health Insurance Subrogation In All 50 States has been completely revised, edited, and reorganized. This was partly to reflect the new direction recent case decisions have taken regarding health insurance subrogation as well as the crystallization of formerly uncertain and nebulous areas of the law which have now received some clarity. An entirely new chapter entitled, “What Constitutes Other Appropriate Equitable Relief?” has been added and replaces the old Chapter 9, which merely dealt with Knudson and Sereboff. The new edition introduces new state court decisions addressing the issue of causation and whether and when a subrogated Plan seeking reimbursement must prove that the medical benefits it seeks to recover were causally related to the original negligence of the tortfeasor. An entirely new section was added concerning the subrogation and reimbursement rights of Medicare Advantage Plans, a statutorily-authorized Plan which provides the same benefits an individual is entitled to recover under Medicare. This includes recent case law which detrimentally affects the rights of such Plans to subrogate. Also added to the new edition is additional law and explanation regarding Medicaid subrogation, including the differentiation between “cost avoidance” and “pay and chase” when it comes to procedures for paying Medicaid claims. Significant improvements have been made to suggested Plan language which maximizes a Plan’s subrogation and reimbursement rights. The suggested language stems from recent decisions and developments in ERISA and health insurance subrogation from around the country since the last edition. The new edition has been completely reworked both in substance and organization. Recent case law has necessitated consolidation of several portions of the book and elimination or editing of others. A new section entitled “Liability of Plaintiff’s Counsel” has been added, which provides a clearer exposition on the laws applicable and remedies available when plaintiff’s attorneys and Plan beneficiaries settle their third-party cases and fail to reimburse the Plan. Also new to the book are recently-passed anti-subrogation measures such as Louisiana’s Senate Bill 169, § 1881, which states that no health insurer shall seek reimbursement from automobile Med Pay coverage without first obtaining the written consent of the insured. The new edition also goes into much greater detail on the procedures for and law underlying the practice of removal of cases from state court to federal court, and the possibility of remand back to state court. This includes the Federal Courts Jurisdiction and Venue Clarification Act of 2011, effective Jan. 6, 2012, which amended federal removal, venue, and citizenship determination statutes in very significant ways. The new edition also delves into, for the first time, the role which the federal Anti-Injunction Act plays when beneficiaries sue in state court to enforce the terms of an ERISA Plan, while the Plan files suit in federal court seeking an injunction against the state court action. New case law and discussion on preemption of FEHBA subrogation and reimbursement claims have been added to Chapter 10 in the wake of new decisions regarding same.
Author: David A. Pratt
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
One of the most important and controversial provisions of ERISA is its wide-ranging preemption of state laws "relating" to covered employee benefit plans. The U.S. Supreme Court has grappled, largely unsuccessfully, with the scope of ERISA preemption; and the state of the law, particularly with respect to health and welfare plans, is not satisfactory. Despite ERISA preemption, plans cannot ignore state laws. First, there are gaps in ERISA that are sometimes resolved by resort to state law. Second, the ERISA rules often require the application of state law: for instance, who is a "spouse"? This article discusses some state law issues that arise in connection with retirement plans covered by ERISA.
Author: William Pierron
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 14
Get Book Here
Book Description
Author: John D. Temple
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 320
Get Book Here
Book Description
Author: William J. Kilberg
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 64
Get Book Here
Book Description
Author: Albert Feuer
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
This article discusses when a pension or welfare plan governed by ERISA must comply with state law reporting, record-keeping and disclosure mandates. Any such mandate directed at an ERISA plan, a plan participant or beneficiary, a plan sponsor or contributing employer, or a third party's interaction with an ERISA plan, would seem prima facie to relate to an ERISA plan. Thus, at first blush, any such mandate would appear to be preempted. However, this approach is obviously incorrect. It would preclude a state from compelling a pension plan or its participants from filing tax reports about benefit distributions. On the other hand, such plan mandates do not affect plan benefit structures or the administration of those structures other than requiring such reports, record-keeping, or disclosure, and imposing cost burdens on the plan. Thus, at second blush, all such mandates seem permissible. However, this approach is obviously incorrect. It would permit a state to compel plans to provide reports so that the state could regulate plan fiduciary conduct or to make large expenditures to generate and keep records with little utility. This article argues for a common sense approach. ERISA permits a state-law reporting or disclosure mandate directed at an ERISA plan, a plan participant or beneficiary, a plan sponsor or contributing employer, or a third party interacting with an ERISA plan, such as a service provider, that implements a state law that ERISA does not otherwise preempt, but only to the extent the mandate is needed for the effective administration of such state law. If ERISA preempted a mandate needed to implement a state law not otherwise preempted, the state law would in practice be preempted. The effective administration requirement prevents undue interference with ERISA's benefit protections other than the reporting, record-keeping and disclosure mandate. If the state mandate is generally applicable, rather than principally applicable to ERISA plans, there would be a rebuttable presumption that the mandate is so limited. ERISA preempts all other reporting and disclosure mandates directed at an ERISA plan, a plan participant or beneficiary, a plan sponsor or contributing employer, or a third party interacting with an ERISA plan, such as a third party administrator, even if the compliance burdens are slight. Preemption is unaffected by whether the mandate arises from a law that explicitly refers to ERISA. Plan sponsors must comply with all state-law mandates that ERISA does not preempt regardless of plan terms. On the other hand, plan administrators must comply with all state-law mandates with which plan terms require compliance. This approach recognizes that the preemption of a state-law reporting and disclosing mandates is determined by whether it unduly interferes with the other ERISA benefit protections. Thus, states may require employers to report their contributions to ERISA plans needed to show compliance with those prevailing wage laws that ERISA permits. Thus, state courts considering contract claims by a supplier to an ERISA plan may require the plan to respond to discovery requests with respect to the claim. Thus, states may require those plans subject to the QDRO rules to disclose, to an individual eligible to use a QDRO, the information that may be needed to have a state court prepare and issue a QDRO granting the individual plan benefit rights, but not other information that is not so needed. Thus, states may require ERISA plans to file reports and respond to audit request with respect to the healthcare, if any, they provide that the states may regulate. Thus, states may require ERISA health reimbursement plans, their insurers, or their third party administrators to report claims experience, including price data, if ERISA permits the states to assemble, maintain, and perhaps publicize, such a data base, but only to the extent the mandate is needed for the effective administration of the permitted activities.
Author:
Publisher:
ISBN:
Category : Employer-sponsored health insurance
Languages : en
Pages : 108
Get Book Here
Book Description
Author: Albert Feuer
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
Administrators of employee benefit plans governed by the Employee Retirement Income Security Act of 1974, as amended ("ERISA"), often struggle to determine who is entitled to be paid survivor benefits. Trusts and estates attorneys often struggle to determine who, if anyone, may use state law to wrest benefits from the person entitled to receive survivor benefits from an ERISA plan. Two Supreme Court decisions appeared to have resolved these issues. Boggs v. Boggs, and Egelhoff v. Egelhoff held that the person entitled to the benefits under the designation terms of an ERISA is entitled to be paid the benefits by the plan, and no one may use state law to wrest the benefits from such designee. The Supreme Court questioned whether wresting of benefits is permitted in Kennedy v. Plan Administrator of the DuPont Sav. & Inv. Plan. That question seems to have been laid to rest by this year's Supreme Court decisions in Hillman v. Maretta, and U.S. v. Windsor. Although there are many court decisions to the contrary, ERISA preempts state orders requiring Top-Hat Plans and life insurance plans to defer to domestic relations orders that have QDRO characteristics, when such orders are inconsistent with plan terms. In contrast, state laws, including testamentary requirements, may govern accrued but unpaid compensation at an employee's death that are not ERISA benefits, such as wages, commissions, and bonuses. Although there are many court decisions to the contrary, ERISA preempts any state law order that directs (1) a participant to make beneficiary designations, or (2) a beneficiary to waive or consent to the waiver of benefit entitlements. Although there are many court decisions to the contrary, ERISA preempts state laws that compel duly designated beneficiaries to give up their ERISA survivor benefit or the value of the benefit, such as (1) revocation on divorce statutes inconsistent with plan terms; (2) waivers in domestic relations orders that are inconsistent with plan terms, such as the spousal survivor benefit terms certain pension plans called Spousal Survivor Benefit Plans; (3) prenuptial or post-nuptial agreements that are inconsistent with plan terms, such as the terms that Spousal Survivor Benefit Plans must contain; and (4) elective-share laws or community-property laws that are inconsistent with plan terms. The article suggests plan policies and provisions to minimize ambiguous beneficiary designations while fulfilling the participant's intentions, such as the use of plan beneficiary designation template that clearly describes the consequences of one or more beneficiaries predeceasing the participant and limit beneficiary choices. This article also discusses how Federal common-law rather than state common-law determines how the doctrines of fraud, undue influence, substantial compliance, and the capacity to make designations apply to determining the effectiveness of beneficiary designations. This article suggest that an ERISA plan confronted with conflicting benefit claims is required to decide simultaneously which claims, if any, to accept, and the claims, if any, to deny, and then if any of the denied claims are appealed to give the accepted claims a chance to respond, and decide simultaneously, which ones on appeal, if any, to accept, and which to deny. The DOL has suggested be given to have the plan inter-plead if there continues to be a conflict about the benefit entitlement at this point, so that the conflicting parties may resolve the issue at no further cost to the plan even if the plan is totally responsible for the dispute. This article suggests that inter-pleader is generally appropriate for QDRO disputes. However, this article suggests for other disputes ERISA plans are required to (1) pay the successful claimant his or her benefit, and (2) to defend its denial decision if challenged in the same manner as it would defend any other benefit denial.
