Let Our ERISA Experts Get You the Best Results for Your Cases
Our lien resolution specialists work with hundreds of health insurance liens every day. Our expert Team is conprised of Attorneys with government experience in Washington, D.C. working in ERISA health plans. We understand the burden of both private insurance and ERISA lien resolution.
Some of the most confusing laws have to do with health insurance and subrogation. ERISA may be the most complicated of them all. It is also why having an attorney who specializes in ERISA lien resolution is crucial.
When the Employee Retirement Income Security Act (ERISA) law was passed in 1974, it was intended to protect employees. Originally, the government passed this act to make sure that employee contributions for health care and pensions were safe. Unfortunately, the law has morphed into something completely different than what it was originally intended for.
Legal Actions Regarding ERISA Laws
The case that controls much of how ERISA liens work is US Airways, Inc. V McCutchen. This is an important case to understand.
In the McCutchen case, the Supreme Court stated that self-funded plans are entitled to full repayment under ERISA. They’re not subject to any state laws that limit the amount of reimbursement an insurance company can demand.
This means that if your health insurance is part of a self-funded plan, you’ll have to pay back 100% of the medical expenses. This is true even if repaying the plan means you are left with nothing.
The other important thing about a self-funded plan is that you can’t deduct your attorney fees from it. Normally, you can deduct the percentage of your lawyer’s contingency fee from the money paid back to health insurance. With self-funded plans, this isn’t the case. This means that the attorney fee portion will have to come out of your portion of settlement proceeds.