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Healthcare Litigation and Employee Benefits

This is a complex and evolving area in employment law, in which the risk of litigation has increased substantially in light of the Affordable Care Act and the Federal Health Mental Parity Act.  Some of these issues were discussed recently in Mental Health Parity Ruling Called “Watershed Case,” in Class Action Litigation Report (Bloomberg BNA August 24, 2015) & Pension & Benefits Daily (Bloomberg BNA August 25, 2015), which also quoted Holifield Janich Rachal Ferrera, PLLC’s (“HJRF”) Robert Rachal on these issues. Al Holifield also recently spoke at the ABA Labor Section’s 2016 annual meeting on cutting edge issues regarding ERISA class action exposure from allegedly reducing employee hours to avoid providing benefits mandated by the Affordable Care Act.

These cases also often raise complex questions regarding ERISA remedies and preemption, and how these new benefit mandates fit within ERISA.  In addition to defending companies and plans in litigation, HJRF’s attorneys also routinely advise employers on these issues, including how to limit litigation, tax and penalty exposures.

Our attorneys have extensive experience in defending complex claims seeking health benefits, including member Robert Rachal’s prior work at the premier ERISA litigation practice at Proskauer.  Representative cases include:

  • Litigation on retiree health benefits – Smith v. Regional Transit Authority, 827 F.3d 412 (5th 2016) (successfully defended retiree health claim on whether plan was a governmental or ERISA plan).
  • Litigation on retiree health benefits – Raetsch v. Lucent, 2006 WL 3068648 (D.N.J. Oct. 27, 2006) (defended company against claim tax code imposed retiree healthcare requirements) (worked with healthcare actuaries to develop defenses and offsets that eventually led to an amicable settlement).
  • Fiduciary breach claim –Gearlds v. Entergy Services, 709 F.3d 448 (5th 2013) (defended company against claim misled on entitlement to retiree health benefits) (appeal reversed on remedy issue).
  • Litigation on sex discrimination and health benefits: EEOC v UPS, 141 F. Supp. 2d 1216 (D. Minn. 2001) (defended company on class action claim benefit plan discriminated against females in the provision of contraceptive benefits) (after preliminary proceedings and investigation, amicably settled).

 

Publications and Presentations

Attorneys at HJRF also speak and write extensively on these issues.  Representative examples include:    

Publications:

Robert Rachal, co-author article, “View From Proskauer:  Developing Issues and Litigation Under the Federal Mental Health Parity Act and the Affordable Care Act,” in Bloomberg BNA, Pension & Benefits Daily (July 9, 2014).

Robert Rachal, chapter co-author, ERISA Litigation Chpt. 24 “The Affordable Care Act and ERISA Litigation.” (BNA 5th ed 2014).

Robert Rachal, co-author article, “How ACA Modifies ERISA’s Benefit Claims Procedures,” in Law 360’s Employment, Health, Insurance and Public Policy Newsletters (October 2012).

Robert Rachal, co-author article, “The Affordable Care Act and Its Coverage Mandates for Employers: A Potent Recipe for ERISA Class Actions,” in Bloomberg BNA, Pension & Benefits Daily (August 7, 2012).

Robert Rachal, co-author article, “Pay-or-Play State Health Insurance Laws and ERISA Preemption,” in HR Advisor (May/June 2008).

Presentations:

Al Holifield, panel presenter at ABA Labor Section 2016 Annual Conference on “Protection of Rights Under ERISA and ACA:  Claims of Interference, Discrimination and Retaliation (Chicago, IL).

Robert Rachal, speaker at Employee Benefits Update Seminar on “ACA Litigation” (August 2014, Knoxville, TN & November 2014, Bristol VA).

Al Holifield, co-chair of ABA JCEB National Institute program on ERISA Basics, presenter on “HIPAA,” (May 2014, 2015 and 2016).

Robert Rachal, co-chair of ABA JCEB National Institute program on ERISA Litigation, and panel presenter on “Healthcare Claims and Related Litigation Under the Affordable Care Act” (May 2013, Chicago IL).

Al Holifield, presenter, ASPPA National Conference, “HIPAA and HITECH,” (October 2011, Washington, D.C.).

Robert Rachal, panel presenter ABA Employee Benefits Committee mid-winter meeting on “ERISA Preemption” (January 2006 Key Biscayne, FL).

Robert Rachal, presenter at ABA Employee Benefits Mid-Winter Meeting on “The Davila and Calad Cases and ERISA Preemption for HMOs” (February 2004, New Orleans, LA).

Robert Rachal, panel presentation at ABA Employee Benefits Mid-Winter meeting on “Moran v Rush Prudential and Scope of ERISA Preemption” (February 2002, San Juan, P.R.).