Announcement

Collapse
No announcement yet.

Regulation by States to prohibit "discretionary clauses" .

Collapse
This is a sticky topic.
X
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Regulation by States to prohibit "discretionary clauses" .

    I understand that 8 states have already issued regulations prohibiting discretionary clauses in ERISA policies. California on top. They did a study of the cost implications of changes to the regulations. I'm trying to get our Florida Insurance Department to act. They seem to feel it is up to the state legislature.
    Is anyone else out there working to get their state on board to level the playing field in erisa cases? Can we assist each other?
    Are there any other movements afoot to improve ERISA by members of the group? I'm new.

  • #2
    Yes, I am involved in a white paper project on this issue which I will post here when completed. The AHIP is the insurance trade group that is most active in defending the use of discretionary clauses. This forum is an excellent place to post information on this topic. If you have links or documents developed on this issue, we would be delighted to make them available. If you need any assistance uploading files, you can e-mail me, or just post a reply.

    Here is a link to an AHIP amicus brief that providers their reasoning:

    http://www.ahip.org/content/default.aspx?docid=9209

    (See Brian King's comment in the Recent Decisions forum yesterday on the efficacy of the law and economics approach taken by the 7th Circuit and relied upon in the AHIP brief.)
    Harmon & Major, P.A.
    Greenville, SC
    Health Plan Law

    Comment


    • #3
      MiamiLaw,

      By chance, do you know the seven states other than California that have prohibited discretionary clauses? I've tried to get information out of the West Virginia Insurance Commissioner on this issue, but didn't have any luck. I'll make another run at it, though.
      www.wvbusinesslitigationblog.com

      Comment


      • #4
        New York, California, Montana, Michigan, Indiana, New Jersey, Oregon and Utah are what I have on my list.

        I have uploaded the AHIP position paper in this post (see below). This is the letter they send insurance departments considering prohibition of such clauses. You will quickly see that the issue is misstated and that the letter is actually misleading on several points, especially as it touches on the topic of ERISA preemption.

        By the way, Utah has a bit of an odd prohibition but Brian King says it is effective.

        Again, I am interested in any information on this topic anyone may have or come by in your state, as it will aid the position paper we are preparing. This paper will serve as a resource for those opposing the AHIP position and will include a point by point response.

        If you are new to this issue, read the overview here:

        http://healthplanlaw.com/?p=565

        P.S. New York is drafting regulations to back up their stated opposition to the clauses as explained in Circular Letter 14 -

        http://www.ins.state.ny.us/circltr/2006/cl06_14.htm

        Due to legal challenge potential they are going through the regulatory process instead of the circular letter - so now things are in flux.
        Harmon & Major, P.A.
        Greenville, SC
        Health Plan Law

        Comment


        • #5
          Here is an article from St Louis discussing potential state legislature action. I "stole it" from the Google news feed above. Here is the link http://www.stltoday.com/stltoday/bus...A?OpenDocument

          Comment

          Working...
          X