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United Behavioral Health (UBH) and the Alcatel-Lucent Medical Expense Plan, an employee health plan now owned by Nokia, have filed a petition for a writ of certiorari before the U.S.. ....
As discussed here, D.K. et al. v. United Behavioral Health et al. is a case that has been carefully watched in the health benefits space for its impact on what health plan. ....
Advertisement Third Circuit Clarifies Sufficiency Of Discussions Of Social Security Disability Insurance Awards In Adverse Disability Benefit Determinations Under Pre-2018 ERISA Claims Procedure Regulation Friday, January 22, 2021 Plaintiffs seeking recovery of group disability benefits under ERISA-governed plans routinely argue that claim fiduciaries failed to adequately consider and/or account for decisions by the Social Security Administration (“SSA”) to award Social Security Disability Insurance (“SSDI”) benefits. As a result, federal courts are regularly tasked with evaluating the substance and sufficiency of discussions of SSDI awards (that are made a part of the administrative record) in adverse benefit determination letters. Of course, “an ERISA plan fiduciary is not bound by an SSA disability determination when reviewing a claim for benefits under an ERISA plan.” ....