Explore "erisa" with insightful episodes like "What the J&J Case Means for Plan Administrators", "Recent Trends and common insurance coverage problems In Personal Injury", "Employee Benefits and Executive Compensation: Getting Ready for 2024 – Top-Hat Plans", "Demystifying ERISA, the Employee Retirement Income Security Act" and "016 - ERISA Does Your Benefit Plans Pass The Test?" from podcasts like ""Williams Mullen's Benefits Companion", "The Insurance Lawyer", "Troutman Pepper Podcasts", "AzDA's Audio Amalgam podcast" and "Everyday HR Podcast"" and more!
On this episode of Williams Mullen's Benefits Companion, host Brydon DeWitt discusses a recent ERISA class action case, Lewandowski v. Johnson & Johnson et al., that is a wake-up call for plan fiduciaries managing health and welfare benefit plans. He will discuss the case allegations and possible best practices that plan fiduciaries should consider as we enter a new era of increased litigation.
In the latest episode of The Insurance Lawyer, Evan Schwartz sat down with Richard A. Dubi, a CPA and the esteemed founder of the Law Offices of Richard A. Dubi, PC.
Specializing in personal injury, Richard has helped countless clients navigate cases ranging from motor vehicle accidents to professional malpractice claims and construction site incidents. During their conversation, Richard shared his insights into evolving trends in personal injury law, such as the growing influence of social media in investigations and the rise in claims related to emotional damage.
He also discussed the challenges involved in securing coverage in personal injury cases and recounted a particularly complex case involving an Uber driver. As an experienced litigator with personal attention to his clients, Richard embodies the benefits of choosing a boutique firm for representation.
Takeway:
Lower verdicts in personal injury cases are leading to greater use of mediations and arbitrations as alternatives to court trials. The shift underscores the importance of choosing an experienced personal injury lawyer, skilled in trial proceedings and adept at navigating coverage issues to ensure justice for their clients.
The Insurance Lawyer is available on all major podcast platforms. Subscribe today to never miss an episode! If you need help with an insurance recovery matter, contact us today for a free consultation.
In the final installment of our three-part Employee Benefits and Executive Compensation podcast miniseries, hosts Jim Earle and Josh Gelfand discuss the basics of top-hat plans — what they are and the necessary steps to ensure ERISA compliance.
We are excited to announce that we will be hosting our annual webinar in September 2024, which will provide a comprehensive look at the future landscape of employee benefits and executive compensation.
In this podcast, AzDA Executive Director Dr. Regina Cobb and AzDA member dentist Dr. Anthony Dicello cover:
ERISA is the Employee Retirement Income Security Act, which was designed to set minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. It provides fiduciary responsibilities for those who manage and control plan assets, requires plans to establish a grievance and appeals process for participants to get benefits from their plans, and gives participants the right to sue for benefits and breaches of fiduciary duty.
Dan and Roshni set down with Troy Burden and talk about what is ERISA and how it applies to health and welfare plans. Troy explains what employers are exempt and what ERISA processes need to be completed to satisfy the requirements of the law.
Host Contact information:
Disclaimer:
The purpose of this podcast is to provide news and information on human resources matters affecting employers. All content presented is for informational purposes only and should not be considered legal advice. Some of the information on the podcast relates to legal topics. The transmission of information on this podcast is not intended to establish, and receipt of such information does not establish or constitute, an attorney-client relationship or a consultant-client relationship. Anyone who receives information from the podcast should not act on the information without first consulting legal counsel or other expert on the specific topic. Human resources law and guidance changes on a regular basis. The information presented on the podcast may not reflect the most current legal developments. The opinions expressed at or through the podcast are the opinions of the individual speaker and may not reflect the opinions of all presenters. Likewise, the information presented is not intended to reflect the opinion of the presenter’s employer or firm.
Join our resident Business Ninja, Andy, and Glenn Kantor, Founding Partner of Kantor & Kantor, as they reveal the secrets to winning medical insurance claims.
With a proven track record and unmatched expertise, Kantor & Kantor stands as the champion for clients from start to finish. Discover why they are renowned in the fields of insurance, ERISA, and pension law, and learn how they navigate the complexities of insurance companies. These warrior attorneys, once defenders, now fight fiercely on the plaintiff's side, armed with invaluable insights into the tactics employed to deny rightful claims.
Learn more about them at https://www.kantorlaw.net/
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If this were a video show, I would stare into the camera with steely eyeballs right now and say that I have a special message for employer CFOs. If you aren’t a CFO, pretend that you are so that you get the full effect here.
So, now that we’re all CFOs, let’s pull up the company P&L (Profit and Loss) statement. This is what keeps us all up at night, right? Making sure that the net profit line at the bottom looks good.
We could decide to lay off a few people. Reorg something or other. Beat up a vendor. Stop buying the gold paper clips. We also could go over and have a strident conversation with sales leadership about what they can do to jack up their sales revenue. Top line begets bottom line, after all.
Or, here’s another idea: In this healthcare podcast, I am speaking with Paul Holmes, who is an ERISA (Employee Retirement Income Security Act) attorney with a specialty in PBM (pharmacy benefit manager) contracts, especially the PBM contracts from the big PBMs that get jammed in employer plan sponsor faces by whomever and which they are told look fine and that the employer plan sponsor should just go ahead and sign.
Now, if we, meaning all of us CFOs, sign that paper, or someone on our benefits team signs the paper … fun fact, our company just spent 30% to 40% over market for our pharmacy benefits. That contract we just signed contains all kinds of expensive little buried treasures—treasures accruing to the PBM and other parties, to be clear, and coming at our expense. There’s 17-ish very common treasures in your typical PBM contract, and none of us will ever spot them unless we know what we are looking for.
But let’s dig into this for a sec, especially for all of us newly minted CFOs because the real ones already did this math.
Say our company spends whatever—we’re a bigger company, and we spend $100 million a year on our drugs. That’s a minimum of $30 million that we got taken for … $30 million a year. That’s a metric load of our cold hard cash that got dumped out back and burned.
Because of the huge dollars at stake (30% to 40% of drug spend), it’s certainly the advice of almost anybody that you talk to who’s an expert in PBM contracts to have a third party—not your EBC (employee benefit consultant), which we’ll get into in a sec, but somebody else (a third party)—review every PBM contract.
I mean, what’s the worst that can happen for anybody considering having an independent third party review their PBM contract? It costs a couple grand in lawyer fees, and they give it a stamp of approval. Knowledge is power, and now we know.
But let’s just say this third-party review doesn’t happen. We all go with a “devil may care” about this whole PBM overcharging us by 30% to 40% possibility. And let’s say the PBM contract is, in fact, a ride on the Hot Mess Express, but we don’t know it. Here’s two pretty bad downsides, especially now, this year, since the passage of the CAA (the Consolidated Appropriations Act) at the beginning of 2022.
Number one bad thing: Plan sponsors may get sued as per the CAA for ERISA violations. It’s not just the company paying that extra $30 million, or 30% to 40%, right? It’s also employees. This is risk exposure, bigly. Just like it was on the 401(k) side of the house, which Paul Holmes, my guest today, mentions later on in the interview. He talks about just how much those lawsuits cost and, yeah, exposure.
As I mentioned three times already, today I am speaking with Paul Holmes about PBM contracts in all their stealthy glory. The one thing I came to appreciate is that these things are works of art … if you’re into those paintings of pretty flowers where, if you look hard enough, you spot a skull tucked in the greenery (memento mori).
Paul is a longtime ERISA attorney. He has dedicated his career to helping plan sponsors in their negotiations with PBMs and trying to help them reduce drug spend, especially drug spend that isn’t actually paying for drugs.
Here’s a link to an article we discuss about how a school district in Florida is suing their longtime EBC for taking $2 million a year in alleged secret payments.
We also mention an episode with AJ Loiacono (EP379).
And along similar lines, Jeff Hogan mentioned on LinkedIn the other day, “It’s pretty amazing that just in the course of the [past few] weeks, I’m reading, seeing, and hearing about big new CAA breach of fiduciary duty cases.”
So, Paul Holmes says this more eloquently, but if you’re a plan sponsor, definitely get your PBM contract reviewed and maybe consider working with an EBC who’s happy to sign the disclosure statement that your lawyer has provided without disclaimers.
Oh, hey … one last thing and new topic. Here’s a cool goings-on: Right now, the March Healthcare Classic is in full swing. Each spring, Josh Berlin’s rule of three team collaborates with other experts to predict which major trend will find itself at the top of the healthcare agenda over the next 12 months.
This year, their selection committee includes Anisha Sood; Danny Brywczynski; David Carmouche, MD; Shaheed Koury, MD; and Stephanie Mercado.
Check it out and weigh in yourself should you choose to do so.
You can learn more by emailing Paul at pbh@williamsbarbermorel.com.
Paul B. Holmes, JD, is a seasoned ERISA lawyer with nearly 40 years of specialization in that field. Paul joined Williams Barber Morel recently, after 31 years with Nixon Peabody LLP and Ungaretti & Harris LLP. Paul has extensive and unique experience in representing large employers and Taft-Hartley welfare funds in their selection, contracting, auditing, and litigation with large pharmacy benefit managers (PBMs).
Paul has logged over 8000 hours during the past four to five years, advising large employers and Taft-Hartley welfare funds managing their prescription drug benefit plans. This work includes active oversight of the request for proposal (RFP) process for selecting a PBM, the negotiation of final PBM contracts (including pricing, rebates, and audit rights), and regular audits of PBM compliance with their contracts.
He was selected, through a peer-review survey, for inclusion in The Best Lawyers in America (2020 and 2021) in the field of Employee Benefits (ERISA) Law.
Paul received his bachelor’s degree from Bradley University and his Juris Doctor degree from the University of Illinois College of Law.
06:06 What are Paul’s usual observations when a PBM contract crosses his desk?
06:57 “If you just sign … one of their model contracts …, you’re probably gonna pay 30% to 40% above market on your drug spend.”
10:35 What is a PBM lawyer? And why is it important to find an ERISA PBM lawyer?
15:37 EP379 with AJ Loiacono.
16:05 Who is on the hook for the cost of the PBM contracts?
20:36 What’s the problem with most ERISA lawyers today?
22:28 Lawsuit about PBM contract.
27:15 What’s Paul’s advice for benefits consultants?
31:11 How much might a plan sponsor be paying their consultant versus what a consultant might be making from a PBM?
You can learn more by emailing Paul at pbh@williamsbarbermorel.com.
Paul Holmes discusses #PBMContracts on our #healthcarepodcast. #healthcare #podcast
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Anna Hyde, Dea Belazi (Encore! EP293), Brennan Bilberry, Dr Vikas Saini and Judith Garber, David Muhlestein, Nikhil Krishnan (Encore! EP355), Emily Kagan Trenchard, Dr Scott Conard, Gloria Sachdev and Chris Skisak, Mike Thompson
This week, we explain how New Jersey’s WARN Act (officially known as the “Millville Dallas Airmotive Plant Job Loss Notification Act”) is set to become the strictest and most punitive in the nation. Epstein Becker Green attorney Marc Mandelman tells us more.
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The EMPLOYMENT LAW THIS WEEK® and DIAGNOSING HEALTH CARE podcasts are presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.
Can retirement accounts hold cryptocurrency? Guidance on what’s allowed, the legal uncertainties, risks and benefits of cryptocurrency in IRA and 401k accounts.
The American College of Trust and Estate Counsel, ACTEC, is a professional society of peer-elected trust and estate lawyers in the United States and around the globe. This series offers professionals best practice advice, insights and commentary on subjects that affect the profession and clients. Learn more in this podcast.
Liens are an important part of your settlement process after an injury case. Justin Lovely and Amy Lawrence discuss this topic of liens. Governmental liens such as Medicare, Medicaid, and Tricare are discussed. Private Health insurance liens under ERISA or non Erisa plans. BCBS liens. Letters of protection. IS there a lien at all? How does The Lovely Law Firm Maximize your recovery by negotiating these liens and bills down for you? All of these topics are discussed in this weeks episode. Learn More here: Liens After a Personal Injury Case
Are you sufficiently saving for retirement? Do you have a 401k through your work, or are you an employer that offers a 401k to your employees?
How do you, as an investor minimize the loss in value in your 401k when the market drops or corrects?
How do you, as an employer minimize your liability to provide investment advice to your employees through the 401k plan?
This week's guest on the Crushing Debt Podcast is Michael Watkins. Mike is a repeat guest and friend of the show, having appeared on episode 196.
Mike has just finished and released his new book The 401k Revival where he answers the question - how can you side step the next market crash.
You can get a copy of the book at www.The401kRevival.com.
You can also get copies of my two books at www.ShawnMYesner.com to discover ways to create more money in your budget so that you can invest for retirement!
Finally, please refer our sponsor, Sam Cohen of Attorneys First Insurance to a Florida or Texas attorney or title agent you know who is nearing renewal of their professional liability (malpractice) insurance. Sam@AttorneysFirst.com www.AttorneysFirst.com
In this week's episode - Nationwide ERISA Long Term Disability Attorney Nancy Cavey talks about "Why Those Living With Disability Should Consider Having A Will & What You Should Know About Estate Planning Featuring Estate Planning Attorney Autumn Hancock" and much more!
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
ATTORNEY AUTUMN HANCOCK INFORMATION:
Attorney Autumn Hancock focuses her practice on adoption, collaborative law, and family law. Attorney Hancock also handles certain probate and estate planning, real estate, foreclosure, and criminal law cases.
For more information about a specific legal issue, her contact information is:
Phone: 727-222-0529
website: www.hancocklawfl.com
She represents clients all over the Tampa bay area.
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
In this week's episode - Nationwide ERISA Long Term Disability Attorney Nancy Cavey talks about "What You Need To Know About Providing Your Disability Insurance Carrier With Adequate Proof of Loss" and much more!
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
In this week's episode - Nationwide ERISA Long Term Disability Attorney Nancy Cavey talks about "The Difference In The Standard Of Disability Between Social Security Disability Claims & Long-Term Disability Insurance Policies" and much more!
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
With the nation in the throes of a lame-duck congressional session and slow-motion presidential transition, the judiciary is the only branch of the federal government that is working smoothly at the moment, even in the wake of seismic change in the U.S. Supreme Court’s personnel. And, as it happens, employee benefits policy hangs in the balance.
On November 10, the high court heard oral arguments in California v. Texas, the latest lawsuit challenging the constitutionality of the Affordable Care Act. A number of other important benefits cases will also come before the court in the coming months.
In this episode, special guest host James Klein, American Benefits Council president, speaks with Meaghan VerGow, a partner and litigator with the law firm of O’Melveny and Myers and a former clerk for Supreme Court Justice David Souter and for D.C. Appeals Court Judge Merrick Garland. VerGow and Klein discuss the fate of the ACA, the nuances of ERISA litigation and where the “highest court in the land” really is.
Please rate and subscribe the American Benefits Podcast on iTunes. For more information on the Council or the American Benefits Podcast, please email us at info@abcstaff.org.
In this week's episode - Nationwide ERISA Long Term Disability Attorney Nancy Cavey talks about "The Evaluation Process Used In Every Long-Term Disability Benefits Claim For Diabetes" and much more!
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
In this weeks podcast - Nationwide Long Term Disability ERISA Attorney Nancy Cavey talks about Elimination Periods.
Show Title: Episode 9: Learn What An Elimination Period Is In A Long-Term Disability Insurance Policy & How It Can Destroy Your Claim.
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
Our debut episode explores the world of Long Term Disability and ERISA claims by Nationwide ERISA LTD Attorney Nancy L. Cavey. Nancy shares her personal story about her father and why she became a disability attorney in the first place. We also share the beginning facts about Long Term Disability claims.
Resources Mentioned In This Episode:
LINK TO ROBBED: https://caveylaw.com/get-free-reports/get-disability-book/
LINK TO PROFESSIONAL BOOK: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/
FREE CONSULT LINK: https://caveylaw.com/contact-us/
Need Help Today?
Need help with your Long Term Disability or ERISA claim? Have questions? Please feel free to reach out to use for a FREE consultation. Just mention you listened to our Podcast!
Review like and give us a thumbs up! We love to see your feedback about our Podcast!
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