Source: http://www.annalsofhealthlaw.com/annalsofhealthlaw/vol__24_issue_1?pg=15
Timestamp: 2019-04-25 08:24:39+00:00

Document:
pose of providing medical, surgical, or hospital care benefits to beneficiaries through the purchase of insurance. 29 U.S. C. A. § 1002(1) (West, WestlawNext current through P.L. 113- 180). Some 175 million workers and their families are covered through an ERISA-governed health plan. ROSENBAUM, supra note 29, at 259. As a result of ERISA, certain kinds of employee benefit plans, including those offering health benefits, do not have to comply with state insurance laws. Janet E. Kaminski, Self-Insured Benefit Plans and Insurance Mandates, OLR RESEARCH REPORT (2005). ERISA contains three important clauses that implement federalist principles and work together to remove most denial of benefit claims to federal court. The preemption clause states that ERISA provisions “shall supersede . . . State laws” to the extent that those laws “relate to any employee benefit plan.” 29 U.S. C. § 1144(a) (West, WestlawNext current through P.L. 113-180). The savings clause accepts from the preemption clause state laws that regulate insurance. Id. § 1144(b)(2)( A). The deemer clause makes clear that a state law that purports to regulate insurance cannot deem an employee benefit plan to be an insurance company. Id. § 1144(b)(2)( B). In interpreting these provisions, the Supreme Court has held that Congress intended ERISA to completely preempt any state law that expands the remedies available for a failure to provide plan benefits, even if that law regulates insurance. Pilot Life Insurance Co. v. Dedeaux, 481 U.S. 41, 44–45 (1987). ERISA does provide civil remedies for plan enrollees who have been denied health insurance benefits, although these remedies are typically less robust than those available under state law. See Aetna Health, Inc. v. Davila, 524 U.S. 200, 221 (2004) (finding that no remedy for a wrongful death resulting from the improper denial of health benefits exists under ERISA).
50. Nat’l Conf. of State Legs., Mandated Health Insurance Benefits and State Laws, http://www.ncsl.org/research/health/mandated-health-insurance-benefits-and-state-laws.aspx (last updated Jan. 2013).
52. ROSENBAUM, supra note 29, at 206–07.
53. State Health Insurance Mandates and the ACA Essential Benefit Provisions, supra note 24.
55. See Rose, supra note 26, at 1352–55.
56. Randall, supra note 47, at 626–28.

References: § 1002
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