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Life Health > Health Insurance

New Health Insurance Suit Could Affect DOL Fiduciary Rule Litigation

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What You Need to Know

  • The Labor Department has imposed new notice rules on fixed indemnity health insurance issuers.
  • The department recently set new sales standards for retirement investment advice givers.
  • Suits challenging both actions have showed up in the same federal court in Texas.

Health insurance market players have started a lawsuit that could collide with annuity market players’ litigation over the U.S. Labor Department’s retirement investment advice fiduciary regulations.

ManhattanLife Insurance and Annuity Co., a supplemental health insurance issuer, filed the complaint Tuesday in the U.S. District Court for the Eastern District of Texas along with Paschall and Associates, a health insurance agency, and the agency’s owner, William Paschall.

The plaintiffs accused the U.S. Department of Health and Human Services, the U.S. Treasury Department and the U.S. Labor Department of using an arbitrary and capricious process to adopt a regulation requiring sellers of fixed indemnity health insurance to include a notice declaring that the product is “NOT health insurance” if they want the product to be exempted from the Affordable Care Act major medical insurance requirements.

The plaintiffs are asking the court to vacate the notice rule.

Representatives from HHS, the Treasury Department and the Labor Department did not respond to emails seeking their comments.

What it means: The plaintiffs in the ManhattanLife case filed their complaint in the same federal court in Texas where the Federation of Americans for Consumer Choice and several independent insurance agents filed a suit objecting to the Labor Department’s new effort to impose a fiduciary standard of care on efforts to help retirement savers roll assets out of 401(k) accounts, IRAs and similar accounts.

The new Labor department investment advice fiduciary requirements could have the biggest effect on sellers of non-variable indexed annuities.

Like the plaintiffs in the annuity regulation case, the plaintiffs in the ManhattanLife case have accused federal officials of violating the federal Administrative Procedures Act.

District Judge J. Barker Campbell is handling the ManhattanLife case, and District Judge Jeremy Kernodle is handling the annuity case.

How Campbell or other judges apply APA requirements in the ManhattanLife case could subtly influence, or be influenced by, how judges apply APA requirements in the annuity case.

Federal judges in Texas have issued a number of rulings blocking regulations adopted by the administration of former President Barack Obama, and appeals of decisions by the district’s judges go to the U.S. Court of Appeals for the 5th Circuit, which has issued rulings blocking several Obama administration regulation efforts, including the Labor Department fiduciary rule effort.

The background: Fixed indemnity health insurance can pay a fixed amount of benefits when an insured person suffers from a specified condition or needs a specified kind of health care.

Supporters of tight regulation of health insurance have been clashing for years with supporters of a looser approach.

The supporters of a looser approach succeeded at persuading Congress to exempt fixed indemnity health insurance, along with other “excepted benefits,” from the ACA benefits package, underwriting and pricing standards when they drafted the two statutes that created the ACA.

Critics of the current ACA excepted benefits rules, including many regulators and some large major medical insurance issuers, have argued that marketers are confusing consumers.

The critics say many buyers think they are getting low-priced major medical insurance, when, in reality, they are getting products like fixed indemnity health insurance with tight benefit limits and many coverage exclusions.

The Biden administration responded in April by publishing a final rule that sets new consumer notice requirements for fixed indemnity health insurance issuers.

The plaintiffs’ perspective: The plaintiffs in the ManhattanLife case asserted that regulators presented no evidence that widespread deceptive marketing problems exist.

Originally, the plaintiffs said, regulators suggested the warning notice would simply state the fixed indemnity health insurance was “not comprehensive health insurance,” not that it was “NOT health insurance.”

“The lack of legally required notice independently renders the notice rule unlawful,” the plaintiffs said.

Credit: vacharapong/Adobe Stock


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