ATLANTA — A district court did not err in granting a disability insurer’s motion for judgment on the pleadings because the disability claimant did not exhaust all administrative remedies under the long-term disability (LTD) plan and the disability claimant was not entitled to short-term disability (STD) benefits as he already was receiving workers’ compensation benefits, the 11th Circuit U.S. Court of Appeals said June 24 (Lionel Garcon v. United Mutual of Omaha Insurance Co., No. 18-12220, 11th Cir., 2019 U.S. App. LEXIS 18713).
SEATTLE — A Ninth Circuit U.S. Court of Appeals panel on June 12 affirmed a district court’s summary judgment ruling in favor of the plaintiffs in an Employee Retirement Income Security Act class action after determining that an amendment to the pension plan violates the plain terms of the plan regarding employer contributions received on behalf of electricians who travel within the electrical construction industry (Richard Lehman, et al., v. Warner Nelson, et al., No. 18-35321, 9th Cir., 2019 U.S. App. LEXIS 17570).
NEW YORK — A Second Circuit U.S. Court of Appeals panel on June 19 denied a petition for permission to appeal class certification filed by Cornell University and others in a breach of fiduciary duty lawsuit (Cornell University, et al. v. Casey Cunningham, et al., No. 19-324, 2nd Cir.).
BOSTON — Plaintiffs in a class action suit filed in Massachusetts federal court and alleging that a retirement plan was mismanaged urge the court in a June 14 motion to preliminarily approve a proposed $6.8 million settlement between the parties (Melissa Velazquez, et al. v. Massachusetts Financial Services Co., d/b/a MFS Investment Management, et al., No. 17-11249, D. Mass.).
HARRISBURG, Pa. — The Pennsylvania Supreme Court on June 18 found that the Employee Retirement Income Security Act does not preempt the terms of a property settlement agreement (PSA) filed as part of divorce proceedings that occurred before the man died in which the parties agreed to retain their respective pension benefits, explaining that PSAs are contracts under Pennsylvania law (In re: Estate of Michael J. Easterday, Nos. 15 MAP 2018, 16 MAP 2018, Pa. Sup., 2019 Pa. LEXIS 3305).
BOSTON — An insured alleges in a June 14 complaint filed in a Massachusetts federal court that two insurers who are parties to an administration agreement and a reinsurance agreement engaged in a financial conflict of interest with regard to the denial of his long-term disability benefits under the Employee Retirement Income Security Act (Gary D. Powers v. Northwestern Mutual Life Insurance Co., et al., No. 19-11335, D. Mass.).
NEW YORK — In a June 13 memorandum of law in support of their motion to dismiss, the Metropolitan Life Insurance Company Employee Benefits Committee and its individual members (defendants, collectively) assert that an amended complaint by two retirees fails to state a claim for relief because the use of an older mortality assumption “actually works to the benefit of many participants” (William Masten, et al. v. Metropolitan Life Insurance Company, et al., No. 18-11229, S.D. N.Y.).
SALT LAKE CITY — Allegations that a health insurer covers subacute care in surgical settings but denies coverage in mental health settings provides a basis for a couple’s Parity Act claim under the Employee Retirement Income Security Act, a federal judge in Utah said June 14 (Timothy D., et al. v. Aetna Health and Life Insurance Co., et al., No. 18-753, D. Utah, 2019 U.S. Dist. LEXIS 100388).
WASHINGTON, D.C. — The U.S. Supreme Court on June 17 denied review of a District of Columbia Circuit U.S. Court of Appeals’ ruling that 29 U.S. Code Section 1344(c) precludes pension plan participants from recovering from the Pension Benefit Guaranty Corp. (PBGC) any post-termination increase in the value of plan assets as a remedy for alleged breach of fiduciary duty (K. Wendell Lewis, et al. v. Pension Benefit Guaranty Corp., No. 18-1279, U.S. Sup.).
CHICAGO — The Seventh Circuit U.S. Court of Appeals on June 12 reversed a district court’s ruling in favor of a disability insurer after determining that the court and the insurer failed to properly address the disability claimant’s mental limitations and failed to properly classify her occupation under the Dictionary of Occupational Titles (DOT) (Shirley Lacko v. United of Omaha Life Insurance Co., No. 18-2155, 7th Cir., 2019 U.S. App. LEXIS 17518).
NEW ORLEANS — A disability insurer’s denial of long-term disability (LTD) benefits was arbitrary and capricious because the claimant’s treatment for a symptom that later turned out to be caused by ovarian cancer cannot be considered the condition that caused her disability, the Fifth Circuit U.S. Court of Appeals said June 11 in rejecting the insurer’s argument that the plan’s pre-existing condition exclusion barred the claim for LTD benefits (Marcia L. Smith v. United of Omaha Life Insurance Co., et al., No. 18-60753, 5th Cir., 2019 U.S. App. LEXIS 17367).
NEW YORK — The Fifth Circuit U.S. Court of Appeals on June 7 affirmed a lower federal court’s dismissal of a breach of fiduciary duty and loyalty lawsuit brought by SunEdison Inc.’s board of directors and investment by former employees who participated in the company’s defined contribution retirement plan (Eric O’Day, et al. v Ahmad Chatila, et al., Nos. 18-2621 and 18-2632, 2nd Cir., 2019 U.S. App. LEXIS 17199).
NEW YORK — An insurer’s contention that an out-of-network provider never alleges that a stroke sufferer inquired into the availability of in-network emergency surgery is “ludicrous and offensive,” and the procedure clearly falls within the policy’s surprise bill exception to the anti-assignment provision, a federal judge in New York held May 15 in denying a motion to dismiss (Jeffrey Farkas, M.D. LLC v. Group Health Inc., No. 18-8535, S.D. N.Y., 2019 U.S. Dist. LEXIS 83096).
OAKLAND, Calif. — A California federal judge on June 3 granted a motion for preliminary approval of an almost $14 million class action settlement in a suit alleging that an employer and its retirement plan investment committee violated the Employee Retirement Income Security Act by charging 401(k) plan participants excessive fees and engaging in prohibited transactions (Marlon H. Cryer, et al. v. Franklin Resources, Inc., et al., No. 16-4265, c/w No. 17-6409, N.D. Calif.).
NASHVILLE, Tenn. — A Tennessee federal judge on May 30 granted a motion for preliminary approval of a $14.5 million settlement of a plan participants’ lawsuit accusing Vanderbilt University, the oversight committee and members of the committee of mismanaging the employee retirement plan in violation of the Employee Income Retirement Security Act (Loren L. Cassell, et al. v. Vanderbilt University, et al., No. 16-2086, M.D. Tenn.).
ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on June 5 issued a mandate that the health benefits of a class of retirees were not vested as a matter of law; the mandate was filed one day after the appellate panel issued an order denying the class’s motion to stay to allow them to file a petition for writ of certiorari to the U.S. Supreme Court (Augustine Pacheco, et al. v. Honeywell International Inc., Nos. 18-1006 and 18-1294, 8th Cir.).
WASHINGTON, D.C. — The U.S. Supreme Court on June 10 denied a disability claimant’s petition for writ of certiorari, refusing to review the 11th Circuit Court of Appeals’ finding that a disability insurer had a reasonable basis for terminating the claimant’s disability benefits (Timothy P. O’Leary v. Aetna Life Insurance Co., No. 18-1266, U.S. Sup.).
ST. LOUIS — A Missouri federal judge on June 5 entered final judgment and approved a class settlement agreement in a dispute over whether three defined pension benefit plans qualify as exempt “church plans” under the Employee Retirement Income Security Act (Lisa Feather, et al. v. SSM Health, et al., No. 16-1669, E.D. Mo.).
WASHINGTON, D.C. — The U.S. Supreme Court on June 10 granted certiorari in a case that poses the question of whether the three-year statute of limitations under the Employee Retirement Income Security Act can be avoided by demonstrating an absence of “actual knowledge” that a breach of fiduciary duty has occurred (Intel Corporation Investment Policy Committee, et al. v. Christopher Sulyma, et al., No. 18-1116, U.S. Sup.).
CHICAGO — A district court did not err in finding that the Employee Retirement Income Security Act preempts a disability claimant’s state law claims and that the claimant’s complaint is barred by the disability plan’s three-year suit limitation, the Seventh Circuit U.S. Court of Appeals said June 7 (Teresa Di Joseph v. Standard Insurance Co., et al., No. 18-2178, 7th Cir., 2019 U.S. App. LEXIS 17127).