Thank you for sharing!

Your article was successfully shared with the contacts you provided.
The 8th Circuit panel held that a “cross-plan offsetting” effort is too far away from the language in the UnitedHealth health plan documents reviewed to be allowed through use of UnitedHealth’s discretionary clauses. (Photo: Thinkstock)

A three-judge panel at the 8th U.S. Circuit Court of Appeals says UnitedHealth Group Inc.‘s insurance carrier units must put clear warnings in the health plan documents if they want to combine different health plans when trying to recover overpayments from the providers.

The Employee Retirement Income Security Act of 1974 (ERISA) gives a health plan discretion to interpret plan provisions, the panel acknowledged in its ruling.

Complete your profile to continue reading and get FREE access to BenefitsPRO.com, part of your ALM digital membership.

Your access to unlimited BenefitsPRO.com content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events.
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com

Already have an account?



Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join BenefitsPRO.com now!

  • Unlimited access to BenefitsPRO.com - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
  • Exclusive discounts on BenefitsPRO.com and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2022 ALM Global, LLC. All Rights Reserved.