Anthem (Elevance) Sued for Alleged ERISA Violations A class action lawsuit has been filed against Anthem (now known as Elevance) claiming that ERISA was violated when Anthem “denied plan claims access due to mismanagement of funds.” The plaintiff claims that Anthem breached ERISA when it denied them access to their plan claim data, which Anthem […]

First Facilities Fined for Non-compliance with Hospital Transparency Rule The Centers for Medicare and Medicaid Services (CMS) has issued fines to two hospitals in the Northside health system in Atlanta for not following the hospital transparency rule. Northside Hospital Atlanta, and Northside Hospital Cherokee were fined a combined $1.1 million dollars for failing to release […]

Court Rules ERISA Plans Can’t Exclude Autism A California court ruled that a company with an ERISA plan covering autism, cannot limit coverage for the therapies that applied to that condition. The court determined that an employer who had an ERISA plan that covered autism but limited treatments was in breach of the Parity Act […]

New Disclosure Requirements for TPAs that Contract with ERISA Group Health Plans New transparency laws included in the latest Covid-19 relief act in December affect third-party administrators and other providers who work with ERISA group health plans. Included in these new regulations is the requirement for “covered service providers” to disclose their direct or indirect […]