Are you in compliance with the new ERISA regulations?
Disability insurers and administrators of disability plans operate in a highly regulated environment, and the Department of Labor has issued regulations controlling adjudication of disability claims by administrators that significantly deviate from past practices in the industry. The regulations impose specific requirements for communicating with claimants, as well as additional substantive rules affecting the adjudication of such claims by administrators. This live webinar will help those charged with administering disability claims learn to comply with the regulations. It will explain what practices to follow, how to change past practices to become compliant with the regulations, and the risks of non-compliance. This workshop is critical for administrators, disability insurers and employers who want to ensure they are compliant with the applicable regulations.
Learning Objectives
- You will be able to describe the claims administration regulations imposed by the Department of Labor.
- You will be able to discuss how adjudication of disability benefit claims is impacted by compliance with the regulations.
- You will be able to explain how to adjudicate disability claims and communicate determinations to claimants in a manner that satisfies the Department of Labor regulations.
- You will be able to identify communications to claimants that comply with or instead violate Department of Labor regulations governing disability claims.
Agenda
Introduction
- Department of Labor Regulations Governing the Handling of Disability Claims Effective April 1, 2018
- What Types of Claims Do They Apply to?
- Overview of Additional Responsibilities Imposed on Administrators in Comparison to Other Types of Claims
- Why the Change?
The Disability Claim Regulations
- What Are They and What Do They Require?
- Impact on the Claim Adjudication Process
- Effect on Claim Communications
Key Issues
- Conflict of Interest
- Effect on a Claim of Failing to Fully Comply With the Regulations
- Shifting of Grounds of Denial
- Disclosure of Internal Rules, Guidelines and Protocols
- Effect on Contractual Limitation Periods - Requirement of Notice in Appeal Decisions
- Relation to Exhaustion of Administrative Remedies
- Substantial Compliance
- Prejudice From Violation of Regulations and Impact on Litigation
- Lessons From Judicial Rulings Relating to Disability Claim Communications and Adjudications
Speakers
Stephen Rosenberg, Esq.,
The Wagner Law Group- Partner in the Boston office of The Wagner Law Group, and Chair of the ERISA Litigation Practice
- Practice emphasizes all aspects of ERISA litigation, including disability and other benefit claims
- Conducts regular seminars and workshops on ERISA litigation issues
- Author of several publications related to ERISA and benefit litigation
- Massachusetts Super Lawyer
- Sole author of the award winning Boston ERISA & Insurance Litigation Blog
Who Should Attend
This live webinar is designed for benefits and human resource managers, presidents, vice presidents, CFOs, controllers, accountants, insurance professionals, payroll professionals, and attorneys.
