D & O liability insurers lose argument that self-insured multiemployer health plan is an ERISA plan but win remand of case to district court to determine whether each individual employer's participation in the trust constitutes an ERISA plan

Article Abstract:

The US 3d Circuit Court of Appeals in Gruber v. Pennsylvania Insurance Guaranty Ass'n held against a directors' and officers' liability insurance carrier seeking to characterize a multiple employer self-insured health plan as an ERISA plan. Such characterization would allow the insurer to deny coverage for related claims involving directors and officers. The court allowed the insurer to argue on remand that individual employers' trust participation results in ERISA plan characterization.

Direct Property and Casualty Insurance Carriers, Pension, health, and welfare funds, Pension Funds & Benefit Plans, Pension Funds, Surety insurance, Directors & Officers Liability Insur, Usage, Directors' and officers' liability insurance

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Department of Labor holds that a health care program is a MEWA even though it is not an employer welfare benefit plan covered by ERISA

Article Abstract:

The US Labor Dept in Advisory Opinion 98-08A found that a multiple employer welfare arrangement (MEWA) existed under ERISA section 340(A) regardless of its not being a section 3(1) employer welfare benefit plan. Specific statutory language was cited to support the finding. The ruling will allow state insurance law to control to the extent applicable under section 514(b)(6)(A).

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Revising self-insured ERISA health plan documents to optimize plan reimbursement and subrogation rights to personal injury recoveries

Article Abstract:

The author surveys cases regarding personal injury recoveries from ERISA health plans and suggests employers and plan managers adopt reimbursement and subrogation rights provisions.

Remedies, Personal injuries, Subrogation

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