Legal Insurance

We are a participating attorney for ARAG, LegalShield, and MetLife Legal Plans. If you have coverage through one of these providers, you can use it with our firm.

Those three cover the large majority of workplace legal benefits in this market, but they are not the only plans in existence. Employers and unions sometimes offer coverage through smaller administrators, and some credit unions, professional associations, and homeowner or auto policies carry a limited legal benefit as a rider. If you have a plan we are not already in network with, tell us the carrier name. Many plans permit an out-of-network attorney at a reimbursement rate, and some will add a firm on request when a member asks for it.

What matters practically is the certificate of coverage or summary plan description, not the brand on the card. Two employers can buy very different products from the same carrier. We read the document rather than assuming.

It depends on your plan and your matter. Many covered services are fully paid by your plan, and members generally receive reduced rates on services that fall outside coverage. We will help you understand your costs before we begin.

In practice there are three outcomes. First, the matter is a fully covered service — a will-based estate plan, a document review, a residential closing — and the plan pays the network attorney directly, leaving you nothing to pay beyond your premium. Second, the matter is partially covered, typically with a capped number of hours or a defined scope, and you pay member rates for anything beyond the cap. Third, the matter falls outside the plan entirely and you are quoted at the member rate, which is generally lower than the standard rate.

Third-party costs are separate in all three cases. Court filing fees, recording fees, certified copies, service of process, deposition transcripts, and expert fees are almost never a plan benefit. Those are disclosed to you in writing before they are incurred.

Whatever the structure, Missouri Rule 4-1.5 requires that the basis of the fee be communicated to you, preferably in writing, before or within a reasonable time after beginning the representation. We do it before. See the parallel ABA Model Rule 1.5.

Contact your plan provider to confirm, or call us and we will help you check. If a matter isn’t covered, we will explain your options and any reduced-rate pricing available to plan members.

Coverage questions usually turn on three things. Matter type — is this category listed as a covered service in your certificate? Timing — many plans cover only matters that arose after your enrollment date, so a dispute that began before you enrolled may be excluded even though the category is covered. Adversity — most plans exclude matters against your employer, against the plan itself, or against another member of the same plan, because those create conflicts the carrier will not fund.

Bring the plan document, your member number, and any case reference the carrier has already assigned. We would rather spend twenty minutes confirming coverage than have you discover a gap after work has started.

Most plans let you maximize your benefit by choosing an in-network attorney. Because we participate in all three networks, you can select Haake Law Group and get the most from your coverage.

Out-of-network use is usually permitted but reimbursed on a schedule — you pay the attorney and the plan pays you back up to a fixed amount per service, which frequently falls short of the actual fee. In-network, the carrier pays the firm directly and the covered service costs you nothing further. The difference is often several hundred dollars on a single matter.

There is also an administrative difference. In-network engagements come with an authorization or case number that the carrier issues before work begins, which is what closes the loop on payment. Out-of-network, you carry the paperwork burden yourself.

If the plan comes through your employer, very likely yes. ERISA defines an “employee welfare benefit plan” to include a plan established or maintained by an employer to provide participants with, among other things, “prepaid legal services.” See 29 U.S.C. § 1002(1). A legal plan you buy individually, outside of employment or a union, generally is not an ERISA plan.

Being an ERISA plan matters for practical reasons. The plan must furnish you a summary plan description written so the average participant can understand it (29 U.S.C. § 1022), and you are entitled to plan documents on written request. The plan must maintain reasonable claims procedures under 29 C.F.R. § 2560.503-1. And if a benefit is wrongly denied after you exhaust the plan’s internal process, 29 U.S.C. § 1132(a)(1)(B) gives a participant a civil action to recover benefits due under the terms of the plan.

The U.S. Department of Labor’s Employee Benefits Security Administration publishes participant guidance and takes participant inquiries.

Appeal it, and appeal it in writing. For a non-disability welfare benefit claim, the ERISA claims regulation gives the plan up to 90 days to decide the initial claim, with one 90-day extension available if the plan notifies you in writing before the first period runs out, and gives you at least 60 days after an adverse determination to appeal. 29 C.F.R. § 2560.503-1.

Two things make an appeal materially stronger. First, request the plan documents and the specific plan provision the denial relied on — the regulation requires the denial notice to identify it. Second, put your evidence in the administrative record now. Courts reviewing an ERISA benefit denial ordinarily consider what was in front of the administrator, not new material introduced later, so the appeal is generally your last chance to build the file.

Practically, many legal-plan denials are category disputes rather than merits disputes — the carrier read the matter as “business” when it is really consumer, or as “litigation” when the covered service is document review. Reframing the request accurately resolves a fair number of them without any dispute at all.

You. The plan pays the bill; it does not become the client. Missouri Rule 4-1.8(f) permits a lawyer to accept compensation from someone other than the client only if the client gives informed consent, there is no interference with the lawyer’s independence of professional judgment or with the client-lawyer relationship, and client confidences are protected. Missouri Rule 4-5.4(c) states the same principle from the other direction: a lawyer shall not permit a person who recommends, employs, or pays the lawyer to render legal services for another to direct or regulate the lawyer’s professional judgment.

Rule 4-2.1 adds that a lawyer shall exercise independent professional judgment and render candid advice. Taken together, these rules mean the advice you get on a plan-covered matter is the same advice you would get if you were paying the full standard rate out of your own pocket. If the carrier’s preferred outcome and your interests diverge, your interests govern.

See the parallel ABA provisions: Model Rule 1.8 and Model Rule 5.4. Missouri’s own versions are published by the courts as the Missouri Rules of Professional Conduct.

Your file is not open to the carrier. Missouri Rule 4-1.6 prohibits a lawyer from revealing information relating to the representation of a client without the client’s informed consent, subject to narrow exceptions. Rule 4-1.8(f) independently conditions third-party payment on protection of client confidences, so the fact that the plan is paying does not create a window into your matter.

Attorney-client privilege operates on top of confidentiality. Under RSMo § 491.060(3), an attorney is incompetent to testify “concerning any communication made to the attorney by such attorney’s client in that relation, or such attorney’s advice thereon, without the consent of such client.”

What the carrier does receive is administrative: confirmation that a covered service was authorized, that it was performed, and the billing detail needed to pay it. That is a category and a date, not the substance of your matter. Where a plan form asks for more than that, we push back or ask you to consent explicitly, rather than treating enrollment as blanket permission. See ABA Model Rule 1.6.

Generally the employer-paid premium is treated as taxable income to the employee, and employee-paid premiums are paid with after-tax dollars. There was a federal exclusion — Internal Revenue Code § 120, covering qualified group legal services plans, together with § 501(c)(20) — but it carried its own sunset: the statute provided that the section “shall not apply to taxable years beginning after June 30, 1992,” after Congress extended it several times, most recently by Pub. L. 102-227. It has not been revived.

The IRS’s historical explanation of how those plans worked is still published in its exempt-organizations materials at Prepaid Legal Plans Under IRC 120 and 501(c)(20).

Deductibility of the legal fees themselves is a separate question that turns on what the fees were for. Fees connected to producing or collecting taxable income, or to a trade or business, may be deductible; personal legal expenses generally are not, and the 2017 suspension of miscellaneous itemized deductions narrowed this further. This is general information and not tax advice — confirm your own treatment with your CPA.

Exclusions are more consistent across carriers than inclusions. The recurring ones are matters that arose before your enrollment date; matters adverse to your employer, the plan, the carrier, or another member of the same plan; business and commercial matters under a personal plan; criminal defense beyond limited traffic coverage; class actions and matters where the plan considers a contingency fee available; appeals; and matters already in progress with another attorney.

Fee caps are the other common limit. A plan may list “civil litigation” as covered but fund only a set number of attorney hours, or cover the trial court proceeding but not post-judgment work. Coverage of a category is not the same as coverage of the whole matter.

None of this makes the benefit less useful — it means the benefit is best used deliberately. Estate planning, document review, real estate, consumer disputes, and everyday contract questions are where these plans deliver the most real value.

Usually not, and that is by design rather than an oversight. Most plans exclude matters where a contingency fee arrangement is available, because the plan is built to fund work you would otherwise pay for hourly. A personal injury claim is normally handled on contingency, so it falls outside the covered services.

That is not a problem for you here. We handle personal injury matters directly, on contingency, and no plan benefit is needed to get the claim moving. In Missouri, a contingent fee agreement must be in a writing signed by the client stating the method by which the fee is to be determined, under Rule 4-1.5(c) — so you will see the percentage, how expenses are handled, and whether expenses come off before or after the fee is calculated, in writing, at the start.

Some plans do cover an initial consultation or a document review even when they exclude the representation. If yours does, we will use it for that.

A personal legal plan generally excludes business and commercial work, including entity formation, operating agreements, commercial leases, employment matters on the employer side, and business disputes. Some carriers offer a separate small-business product, and some employer plans add a rider for sole proprietors and side businesses — check whether yours does before assuming it does not.

Where the personal plan will not reach, we handle the work directly. Formation and operating agreements matter more in Missouri than many owners realize: RSMo § 347.081 requires an LLC to adopt an operating agreement and directs that the statute be construed to give maximum effect to the principle of freedom of contract. What that agreement says will govern almost every dispute the company ever has.

One boundary worth knowing: if your plan comes through your employer, a matter adverse to that employer is excluded by essentially every carrier. That exclusion is the plan’s, not ours.

You get told before it happens, not after. When a covered service is about to hit its cap, or the matter develops into something outside the covered category, we stop and lay out the options: continue at member rates, narrow the scope to what the plan funds, or conclude the engagement.

Any continuation beyond the plan benefit is covered by its own written engagement agreement with its own fee terms. Missouri Rule 4-1.5(a) requires a lawyer’s fee to be reasonable and lists the factors that bear on it — the time and labor required, the novelty and difficulty of the questions, the skill required, the customary fee in the locality, the results obtained, and the nature and length of the professional relationship, among others.

What we do not do is let the meter run past the plan benefit and present the number afterward.

Tell us as soon as you know. Plans differ on what happens to a matter already in progress. Some continue funding a matter opened while you were covered through to its conclusion; some fund only services performed while the plan is in force; some allow you to continue coverage directly after employment ends, at your own cost. The certificate says which, and the answer is worth confirming before you make a decision about the job.

From our side, a lapse in your coverage does not end the representation on its own. Under Missouri Rule 4-1.16, a lawyer may withdraw where the client fails substantially to fulfill an obligation regarding the lawyer’s services after reasonable warning, but must take steps reasonably practicable to protect the client’s interests — giving notice, allowing time to retain other counsel, and returning papers and property. In practice we discuss the transition rather than surprise anyone with it.

If timing is flexible, completing a covered service before coverage ends is often the simplest answer.

If your employer offers it and you anticipate any of the covered matters in the next year — an estate plan, a home purchase, a contract review, a name change — the arithmetic usually favors enrolling. Annual premiums for workplace plans typically run well under the cost of a single drafted estate plan.

Two timing points decide most of the value. Employer plans are ordinarily elected during open enrollment and cannot be added mid-year without a qualifying life event, so the decision has a deadline. And because most plans cover only matters arising after enrollment, buying coverage in response to a dispute that has already started generally does not work.

If you do not have access to a plan and cannot get one, that does not shut the door. We quote flat fees for most estate planning and transactional work, so you know the number before we start — and the initial consultation is free either way.

Schedule the free consultation and mention which carrier you have. Before the call, if you can, locate your member or certificate number and your summary plan description or certificate of coverage. If the carrier has already issued you a case number or authorization, bring that too.

We confirm coverage with the carrier, obtain the authorization if one is needed, and send a written engagement agreement that states the scope, what the plan is paying for, and what — if anything — falls to you. Work begins after that, not before.

Contact: derek@haakelawgroup.com or (314) 732-1547. Offices in Wildwood, MO and St. Louis, MO, by appointment; most matters are handled by phone, video, and secure document exchange.