Legal Analysis
Employment Tip of the Month – April 2024
April 2024
Given the intricacies of life, health, disability & ERISA laws and regulations, there are no “one size fits all” solutions. Wilson Elser is committed to finding what works best for each client. Our breadth of experience, collaborative approach and extensive resources allow us to do so consistently, efficiently and effectively.
Drawing on 45 years of related experience, we represent the insurance industry and self-funded plans and also work closely with insurers, underwriters, claims personnel, insurance agents and contract drafters. We have a profound understanding of our clients’ legal challenges and a strong working knowledge of their respective businesses.
Recognizing that our clients want cost-effective solutions to complex cases, we proactively seek resolutions through early file analysis and risk assessment. Team members have extensive experience defending clients through all phases of litigation proceedings. When early resolutions are not possible, we do not hesitate to resolve cases in court. Wilson Elser is the preeminent litigation defense firm in the country. We represent insurers, plans, employers, fiduciaries and third-party administrators in almost every kind of litigation, including:
- First-party bad faith claims
- Agent misconduct and compensation disputes
- Trademark infringement
- 419(e) welfare benefit plans
- 412(i) defined benefit plans
- Employment issues
- ERISA
- Stranger-owned/investor-owned life insurance (STOLI/IOLI)
- Stop loss
- Health provider pricing
Practice members have defended cases involving claims for denial of severance and pension benefits, wrongful termination of disability benefits, denial of accidental death and dismemberment benefits, life insurance rescission and claims issues, wrongful discharge under ERISA, eligibility for ERISA medical benefits and medical provider insurance fraud. We also provide advice and guidance for ERISA fiduciary matters and help clients address such issues as preemption, breach of fiduciary duty, fraud and misrepresentation, reporting and disclosure, and potential financial exposure.
We apply many of these same disciplines in counseling employers, plan administrators, fiduciaries and plan insurers nationwide on the proper and efficient implementation, administration and maintenance of benefits plans.
Our attorneys conduct customized educational programs and workshops designed to guide the development and administration of plans that are truly valued by employees and less susceptible to the risk of litigation. Should claims nonetheless be brought, we confer with our clients to achieve swift, cost-effective and predictable resolutions conforming to well-defined and mutually agreed objectives.
Specific consultative services with respect to employee benefits plans, such as pension and retirement plans and health and welfare plans, include but are not limited to:
- Plan design, implementation, amendment
- Plan termination or withdrawal
- ERISA reporting and disclosure compliance
- Patient Protection and Affordable Care Act compliance
- HIPAA compliance
- Fiduciary duty compliance, e.g., reporting and disclosure, prohibited transactions, unauthorized disbursements, fee structure
- Claims consulting, e.g., eligibility, medical bills, disability payments, COBRA, conversion benefits, disability payments.
With more ERISA appearances than any other law firm in the country, our litigation experience is extensive and our track record unsurpassed. We have represented benefits plans and related entities in connection with most every conceivable type of claim.