Mealey's ERISA

  • February 23, 2017

    Judge Remands Implied Insurance Contract Claims As Outside ERISA

    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).

  • February 22, 2017

    6th Circuit Finds Disability Coverage Claims Preempted By ERISA

    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).

  • February 22, 2017

    High Court Denies Cert In Stock-Drop Case Arising Under ERISA

    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.).

  • February 22, 2017

    Respondents To High Court: ERISA Requires Church Plan Be Established By A Church

    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).

  • February 22, 2017

    High Court Won’t Review Ruling Tossing Claims Against Third-Party Administrator

    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.).

  • February 22, 2017

    High Court Denies Cert In Case Over Termination Of Long-Term Benefits

    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.).

  • February 17, 2017

    2nd Circuit Rejects Bid For Rehearing Of Ponzi Scheme Case

    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.).

  • February 17, 2017

    Washington Appeals Panel: Garnishment Of Plan Assets Proper Under ERISA, State Law

    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).

  • February 16, 2017

    Texas Federal Judge Denies Parties’ Motions To Reconsider ERISA Preemption Ruling

    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).

  • February 16, 2017

    Connecticut Federal Judge Rules In Favor Of Retirees In Medical Coverage Dispute

    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).

  • February 14, 2017

    Federal Judge: ERISA Stock Ownership Plan Cannot Seek Recovery Under Crime Policy

    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).

  • February 14, 2017

    Judge: ERISA Preempts Provider’s Contract Claim Against Insurer

    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).

  • February 14, 2017

    2nd Circuit Panel Says Pension Plan Participant Has Standing To File Suit

    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).

  • February 14, 2017

    New York Federal Magistrate Advises $4.5 Million Fee For Pension Plan Withdrawal

    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).

  • February 14, 2017

    Data Breach Class Claims Against Premera Mostly Survive Dismissal Motion

    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).

  • February 10, 2017

    Texas Federal Judge Denies Groups’ Motions Challenging DOL’s Fiduciary Duty Rule

    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).

  • February 8, 2017

    United States Tells High Court Church Plan Exemption Applies To Church Agencies

    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.).

  • February 8, 2017

    Final Approval Granted To United Healthcare’s Settlement Of Harvoni Drug Coverage

    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.).

  • February 8, 2017

    Judge: Bank Did Not Breach Fiduciary Duty In Its Response To Directions

    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).

  • February 8, 2017

    J.C. Penney To Settle Plan Losses Class Suit For $4.5 Million

    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).