The Employee Retirement Income Security Act and Health Maintenance Organization Litigation

Author(s):  
Diane Trace Warlick
2003 ◽  
Vol 31 (4) ◽  
pp. 729-731 ◽  
Author(s):  
Valerie Gutmann

In Kentucky Association of Health Plans, Inc. v. Miller,, the Supreme Court unanimously held that states’ “any willing provider” laws are not preempted by the Employee Retirement Income Security Act of 1974 (ERISA). The Court ruled that states can regulate their health maintenance organizations (HMOs), and thus upheld a Kentucky law that requires insurers to reimburse services of any health care provider who is willing and able to meet established criteria. The Supreme Court has heard several cases related to ERISA in the last few years, and other such cases are working their way through the court system. Coupled with this most recent decision in Miller, the Supreme Court may significantly alter the shape of the insurance industry.


1997 ◽  
Vol 23 (2-3) ◽  
pp. 251-289
Author(s):  
Margaret G. Farrell

The result ERISA compels us to reach means that the Corcorans [who lost their unborn child allegedly as a result of United Healthcare’s negligent determination that hospitalization was not medically necessary] have no remedy, state or federal, for what may have been a serious mistake. This is troubling....In the words of its sponsor, Senator Jacob Javits, the Employee Retirement Income Security Act (ERISA) was enacted in 1974 “to maintain the voluntary growth of private [pension and employee benefit] plans while at the same time making needed structural reforms in such areas as vesting, funding, termination, etc. so as to safeguard workers against loss of their earned or anticipated benefits....” Ironically, one of ERISA’s provisions—its indeterminate provision for the preemption of state law—has probably created more uncertainty about the adequacy and security of health care benefits than any other piece of legislation. Neither ERISA nor any other federal statute comprehensively regulates the content of employer provided health care plans, including benefits provided through managed care organizations (MCOs).


2009 ◽  
Author(s):  
Michael Baker ◽  
Jonathan Gruber ◽  
Kevin Milligan

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 977-977
Author(s):  
J. Quinn ◽  
K. Cahill

2006 ◽  
Vol 18 (2) ◽  
pp. 11-30 ◽  
Author(s):  
Christian E. Weller ◽  
Jeffrey B. Wenger ◽  
Elise Gould

Author(s):  
Teresa Ghilarducci

The American retirement income security system fails in many ways: it does not cover every worker, provide adequate retirement income, operate efficiently, or distribute government subsidies effectively and fairly. Only about half of workers have a pension at work—one of the best and most practical ways to save for retirement. Many of those pensions are rather small. Workers who do save have limited access to the best quality investment managers, appropriate portfolio structures, low fees, economies of scale, and cost-effective annuities because of the growing use of 401(k) plans that favor the highest-income workers. Consequently, many American workers will face economic hardships when they retire.


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