- Advancement of Loss Within the Retention. The policy will step in on covered claims when a company or plan refuses or fails to indemnify its directors and officers or employee fiduciaries for any reason.
- Disproven Allegations. The Insurer shall not seek recovery of amounts previously paid if an allegation that triggered coverage is later disproven, such as when an alleged fiduciary is found to have acted only in a business or “settlor” capacity, or when an insured establishes that it did not sponsor the subject plan at the time of the alleged wrongful act.
- Improper Selection of Third Party Service Providers. Explicit coverage for the alleged improper selection of third party service providers – including managed care service providers – with no sublimits and no exclusion for self-administered plans.
- Labor Management Relations Act (“LMRA”) Coverage. Protection when plaintiffs allege violations of LMRA along with ERISA breaches in connection with collectively bargained plans – an important enhancement for any company with union-represented employees.
- Flexible Reporting of Governmental Fact-Finding Investigations. The decision to report such fact-finding investigations when no wrongful acts are alleged<sup>1</sup> is left to the Insured – without the risk that failure to report might trigger a denial for late notice.
- Flexible Reporting of Internal Appeals of Benefit Denials. The conundrum of whether and when to report to the Insurer such internal matters prior to litigation<sup>2</sup> is now resolved. The Insureds are allowed, but not required, to report such appeals, and can make the choice that’s best for them – again, with no risk of losing coverage due to late notice.
- Health Care Reform Penalty Coverage. Generous coverage for penalties under recently enacted health care reform law.3
1Prior to incurring defense costs for which coverage is being sought or before the investigation becomes a litigated matter.
2 Prior to any allegation of investment loss within a plan or prior to incurring defense costs for which coverage is being sought
3 Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.