NEWARK, N.J. — A neurosurgical specialist’s claim seeking payment for out-of-network care is based on an implied contract providing a separate and independent basis for recovery and thus is not preempted by ERISA, a federal judge in New Jersey held Feb. 17 in remanding the case (North Jersey Brain & Spine Center v. Aetna Life Insurance Co., et al., No. 16-1544, D. N.J., 2017 U.S. Dist. LEXIS 22710).
CINCINNATI — After finding that a former marketing director's claims for coverage against a medical review company were completely preempted by the Employee Retirement Income Security Act, the Sixth Circuit U.S. Court of Appeals on Feb. 17 affirmed dismissal of the claims and found that a previous lawsuit filed against a plan administrator was the proper recourse (James Hackney v. Allmed Healthcare Management Inc., No. 16-5651, 6th Cir., 2017 U.S. App. LEXIS 2877).
WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 21 denied a petition for writ of certiorari in a stock-drop case arising under the Employee Retirement Income Security Act (Alex E. Rinehart, et al. v. John F. Akers, et al., No. 16-562, U.S. Sup.).
WASHINGTON, D.C. — The church plan exemption in the Employee Retirement Income Security Act unambiguously requires that a church plan be established by a church, the appellee-respondents in three cases consolidated before the U.S. Supreme Court say in their initial brief filed Feb. 16 (Advocate Health Care Network, et al. v. Maria Stapleton, et al., No. 16-74, Saint Peter’s Healthcare System, et al. v. Laurence Kaplan, No. 16-86, Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 515).
WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 21 denied a petition for a writ of certiorari in a case in which an 11th Circuit U.S. Court of Appeals panel affirmed the dismissal of claims against a third-party administrator of an employee pension benefit plan because it was not a fiduciary of the plan and a self-dealing claim was time-barred (Carolinas Electrical Workers Retirement Plan, et al. v. Zenith American Solutions Inc., et al., No. 16-731, U.S. Sup.).
WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 21 denied a petition for a writ of certiorari in a case in which the 11th Circuit U.S. Court of Appeals said a district court did not err in determining that a disability plan did not wrongfully terminate a claimant’s long-term disability benefits (Elizabeth Jenkins v. Grant Thornton LLP, et al., No. 16-682, U.S. Sup.).
NEW YORK — In a two-sentence order, the Second Circuit U.S. Court of Appeals on Feb. 13 denied a motion to rehear an Employee Retirement Income Security Act lawsuit brought by pension fund trustees alleging that the fund’s investment manager and its principals knew that investing in a Ponzi scheme was imprudent (Trustees of the Upstate New York Engineers Pension Fund v. Ivy Asset Management, et al., No. 15-3124, 2nd Cir.).
SEATTLE — A Washington appellate panel on Feb. 13 affirmed that garnishment of a pension’s assets was proper under both the Employee Retirement Income Security Act and Washington state’s garnishment law, Revised Code of Washington (RCW) 6.15020, because Washington law does not “relate to” ERISA and, therefore, neither is preempted (Jack A. Johnson v. Clyde E. Carlson, et al., No. 7424001, Wash. App., Div. 1, 2017 Wash. App. LEXIS 342).
HOUSTON — A Texas federal judge on Feb. 6 denied motions to reconsider a Sept. 28 ruling that the breach of contract claims of an out-of-network hospital that Cigna Healthcare allegedly underpaid by using flawed data to calculate usual, customary and reasonable rates to reimburse out-of-network and emergent care services are preempted by the Employee Retirement Income Security Act (North Cypress Medical Center Operating Company, et al. v. Cigna Healthcare, et al., No. 4:09-cv-2556, S.D. Texas; 2017 U.S. Dist. LEXIS 16076).
HARTFORD, Conn. — A Connecticut federal judge on Feb. 8 granted summary judgment in favor of Honeywell International Inc. union employees who retired before the expiration of collective bargaining and related agreements that offered them lifetime medical coverage benefits but ordered a hearing on whether a subclass of plaintiffs who retired after the expiration of the agreements are contractually vested (David Kelly, et al. v. Honeywell International Inc., No. 3:16-cv-00543, D. Conn., 2017 U.S. Dist. LEXIS 17463).
HOUSTON — A federal judge in Texas on Feb. 9 held that a third-party holding corporate stock cannot seek coverage under an insurance policy’s plain language that limits coverage to “direct” losses when a corporate officer committed fraud that caused the devaluation of the corporation’s stock (HC4, Inc. Employee Stock Ownership Plan v. Travelers Casualty and Surety Company of America, No. 16-00090, S.D. Texas, 2017 U.S. Dist. LEXIS 19605).
GREENSBORO, N.C. — A substance abuse provider’s claims that an insurer failed to pay for medically necessary treatments are preempted by ERISA or fail to state a claim, a federal judge in North Carolina held Feb. 9 (Bobby P. Kearney, M.D., PLLC, v. Blue Cross and Blue Shield of North Carolina, et al., No. 16-191, M.D. N.C., 2017 U.S. Dist. LEXIS 18428).
NEW YORK — A Second Circuit U.S. Court of Appeals panel on Feb. 10 issued a summary order vacating a New York federal judge’s ruling that a pension plan participant does not have standing to sue on behalf of himself, his pension plan and other similarly situated Employee Retirement Income Security Act plans over alleged improper fiduciary conduct (Landol Fletcher v. Convergex Group LLC, et al., No. 16-734, 2nd Cir., 2017 U.S. App. LEXIS 2459).
CENTRAL ISLIP, N.Y. — A New York federal magistrate judge on Feb. 7 recommended that a federal judge require a trucking company to pay more than $4.5 million in withdrawal liability for allegedly withholding payments from multiemployer pension plan funds pending an arbitrator’s determination of the reasonableness of the amount (Thomas Gesualdi, et al. v. Scara-Mix Inc., No. 2:14cv765, E.D. N.Y., 2017 U.S. Dist. LEXIS 18059).
PORTLAND, Ore. — Although an Oregon federal judge on Feb. 9 found that some fraud and contract-based claims related to a 2014 data breach experienced by Premera Blue Cross merited dismissal, he held that the plaintiffs cured some previous deficiencies and concluded that their claims are not preempted by the Employee Retirement Income Security Act of 1974 (ERISA) (In Re: Premera Blue Cross Customer Data Security Breach Litigation, No. 3:15-md-02633, D. Ore., 2017 U.S. Dist. LEXIS 18322).
DALLAS — A Texas federal judge on Feb. 8 denied motions for summary judgment in consolidated cases filed by the U.S. Chamber of Commerce (COC) and other groups opposed to the U.S. Department of Labor’s (DOL) new “fiduciary rule” set to take effect April 10, saying that the DOL has not exceeded its authority and that the new rule does not violate the Employee Retirement Income Security Act (Chamber of Commerce of the United States of America, et al. v. Edward Hugler, Acting Secretary of Labor, et al., No. 3:16-cv-1476, consolidated with 3:16-cv-1530, 3:16-cv-1537, N.D. Texas; 2017 U.S. Dist. LEXIS 17619).
WASHINGTON, D.C. — The United States on Jan. 24 in an amicus brief asked the U.S. Supreme Court to follow the Internal Revenue Service, the Department of Labor and the Pension Benefit Guaranty Corp.’s longstanding conclusion that a plan need only be “maintained” by a qualifying church-affiliated organization and not be “established” by a church to qualify for the church plan exemption to the Employee Retirement Income Security Act (Advocate Health Care Network, et al. v. Maria Stapleton, et al., No. 16-74, Saint Peter’s Healthcare System, et al. v. Laurence Kaplan, No. 16-86, Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.).
MIAMI — A federal judge in Florida on Feb. 2 granted final approval to a class action settlement in which United Healthcare Inc. agreed to remove certain restrictions on coverage for treatment of hepatitis C with the prescription drug Harvoni (Ilissa M. Jones, et al. v. United Healthcare Services, Inc., et al., No. 15-cv-6114-RLR, S.D. Fla.).
NEW YORK — The Bank of New York Mellon’s response to investment directions provided by representatives of a pension plan in investing a portion of the plan’s in cash equivalents instead of equities did not “fall below the floor” imposed by the Employee Retirement Income Security Act, a federal judge in New York ruled Jan. 9 (Richard Harley, et al. v. The Bank of New York Mellon, No. 15-8898, S.D. N.Y., 2017 U.S. Dist. LEXIS 3068).
TYLER, Texas — A Texas federal judge on Jan. 3 granted preliminary approval of a $4.5 million settlement to be paid by J.C. Penney Corp. Inc. to end a class suit accusing the retailer of violating the Employee Retirement Income Security Act by allowing the J.C. Penney Corporation Inc. Savings, Profit Sharing and Stock Ownership Plan (the plan) to remain invested in the J.C. Penney Common Stock Fund when it should have known the stock was being traded at an artificially inflated price due to misrepresentations by J.C. Penney senior officers (Roberto Ramirez, et al. v. J.C. Penney Corporation, Inc., et al., No. 14-601, E.D. Texas; 2017 U.S. Dist. LEXIS 389).