Mealey's ERISA

  • June 15, 2020

    Appeal Launched In Residential Treatment Center Coverage Case

    SAN FRANCISCO — A man on May 28 appealed an adverse ruling by a California federal judge to the Ninth Circuit U.S. Court of Appeals, asking it to weigh in on an Employee Retirement Income Security Act case challenging a denial of medical benefits for 14 months of care at a residential treatment center (Martin P., et al. v. Premera Blue Cross, et al., No. 20-16071, 9th Cir.)

  • June 10, 2020

    Insurer, Woman Battle Over Need For Bench Trial In ERISA Mental Health Case

    BOSTON — Appellees told a First Circuit U.S. Court of Appeals panel that having lost on summary judgment, an appellant cannot now seek a bench trial in an Employee Retirement Income Security Act case, but the woman fired back on June 8, saying that the insurer applied the wrong standard in denying care and that a bench trial is the lone way forward (Jane Doe v. Harvard Pilgrim Health Care Inc., et al., No. 19-1879, 1st Cir.).

  • June 10, 2020

    Application Of Retroactive Rate Assumption Defended In High Court Petition

    WASHINGTON, D.C. — On June 5, a respondent waived its right to weigh in on a petition for certiorari in which The National Retirement Fund asserts that the Employee Retirement Income Security Act does not bar multiemployer pension plan actuaries from applying an interest rate assumption retroactive from the measurement date when calculating withdrawal liability (The National Retirement Fund v. Metz Culinary Management Inc., No. 19-1336, U.S. Sup.).

  • June 09, 2020

    HIV-Positive Worker Alleges Firing Due To Seeking Pandemic Quarantine

    PHILADELPHIA — A New Jersey man filed a complaint on May 27 against his Pennsylvania employer in a Pennsylvania federal court alleging that he was fired for seeking to quarantine during the novel coronavirus pandemic in violation of the Family and Medical Leave Act (FMLA), the Employee Retirement Income Security Act and the Families First Coronavirus Response Act (John Doe v. Dee Packaging Solutions, Inc., et al., No. 20-2467, E.D. Pa.).

  • June 09, 2020

    Disability Claimant Alleges Insurer Used Pandemic To Delay Decision On Appeal

    DENVER — A disability claimant alleges in a June 8 complaint filed in Colorado federal court that a disability insurer used the COVID-19 pandemic to delay making a decision on her appeal of the insurer’s termination of her long-term disability (LTD) benefits (Windy Nesti v. Life Insurance Company of North America, No. 20-1642, D. Colo.).

  • June 09, 2020

    Cert Denied In Dispute Over Standard For Enforcing Retaliation Claims

    WASHINGTON, D.C. — The U.S. Supreme Court on June 8 revealed that it will not weigh in on claims by a long-term care facility that allegations of retaliation and interference under the Employee Retirement Income Security Act are within the exclusive jurisdiction of the federal courts (Jackson Ridge Rehabilitation and Care v. Rhonda Meadows, No. 19-1239, U.S. Sup.).

  • June 09, 2020

    Judge: No Class Certification For Challenge To American Airlines ERISA Plan

    FORT WORTH, Texas — A federal judge in Texas on May 22 denied class certification of a group of participants in American Airlines Inc. defined benefit retirement plans seeking to reform the mortality table American uses to calculate retirement benefits, finding that the representative plaintiffs failed to show that they are adequate class representatives and that the reformation being sought would harm some members of the proposed class (Olga Martinez Torres, et al. v. American Airlines, Inc., et al., No. 18-983, N.D. Texas).  

  • June 09, 2020

    9th Circuit OKs Sua Sponte Dismissal Of Suit Seeking $1.7 Million In Surgery Bills

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 19 affirmed the sua sponte dismissal of a surgical center’s Employee Retirement Income Security Act action alleging that United Healthcare Services Inc. owes approximately $1.7 million in surgery bills because the complaint was too general (Glendale Outpatient Surgery Center v. United Healthcare Services, Inc., et al., No 19-55142, 9th Cir.).

  • June 09, 2020

    Indiana High Court Revives Dialysis Center’s Row Over Reimbursement Rates

    INDIANAPOLIS — The Indiana Supreme Court ruled May 11 that an unresolved factual dispute over payments to a South Bend dialysis center should have barred a state trial court from ruling that the Employee Retirement Income Security Act preempted the provider’s lawsuit against two health insurance plans that allegedly failed to pay agreed reimbursement rates for covered services (FMS Nephrology Partners North Central Indiana Dialysis Centers, LLC, v, Meritain Health, Inc., et al., No. 20S-PL-302, Ind. Sup., 2020 Ind. LEXIS 384).

  • June 09, 2020

    5th Circuit: Insurer Did Not Abuse Discretion In Denying Life Insurance Benefits

    NEW ORLEANS — The Fifth U.S. Circuit Court of Appeals affirmed a lower court ruling that Metropolitan Life Insurance Co. did not abuse its discretion under an ERISA-governed plan when it denied benefits to the survivors of a Louisiana man who failed to convert his life insurance coverage after losing his job (Sharon Kim Beazley, et al. v. Metropolitan Life Insurance Co., et al., No. 19-30734, 5th Cir.; 2020 U.S. App. LEXIS 17131).

  • June 08, 2020

    ERISA Diversification And Prudence Claims Properly Dismissed, 5th Circuit Says

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on May 22 affirmed a lower court’s ruling that a group of participants in an ERISA-governed plan failed to plausibly claim that the plan investment committee, which presented participants with a variety of investment options, had breached its fiduciary duties of prudence and diversification (Jeffery Schweitzer, et al. v. The Investment Committee of the Phillips 66 Savings Plan, et al., No. 18-20379, 5th Cir., 2020 U.S. App. LEXIS 16462).

  • June 08, 2020

    Class Allegations Struck From Proton Beam Treatment Case

    CHICAGO — An insured whose proton beam radiation therapy (PBRT) treatment for brain cancer was rejected by her Employee Retirement Income Security Act plan and the plan administrator may proceed with claims for benefits and attorney fees and costs against both defendants and a breach of fiduciary duty claim against the administrator only, a federal judge in Illinois ruled June 1, dismissing the breach claim against the plan and striking the complaint’s class claims partially based on the “fail-safe” definition (Brittany Day, et al. v. Humana Insurance Company, et al., No. 19-3141, N.D. Ill., 2020 U.S. Dist. LEXIS 95211).

  • June 08, 2020

    Anthem Wrongly Denied Coverage For Opioid Alternative, Class Action Says

    LOS ANGELES — Health benefits company Anthem Inc. violated the Employee Retirement Income Security Act in ruling out coverage for Food and Drug Administration-approved devices that use percutaneous neuromodulation therapy (PNT), a nondrug, electric stimulation treatment that manages pain, by labeling the therapy as “investigational,” an ERISA plan participant argues in a class action filed in a federal court in California on June 4 (Marie Fortier, et al. v. Anthem, Inc., et al., No. 2:20-cv-4952, C.D. Calif.).

  • June 08, 2020

    IBM, Feds, ERISA Plan Members Argue Inside Fraud Case To 2nd Circuit On Remand

    NEW YORK — In an insider information case on remand from the U.S. Supreme Court, the investment committee of an IBM employee stock option plan, plan participants, the U.S. Securities and Exchange Commission and the U.S. Department of Labor (DOL) each filed documents June 1 in the Second U.S. Circuit Court of Appeals to argue over the duties a fiduciary has to disclose alleged corporate fraud under the Employee Retirement Income Security Act (Larry W. Jander, et al. v. Retirement Plans Committee of IBM, et al., No. 17-3518, 2nd Cir.).

  • June 08, 2020

    MIT Retirement Plan Participants’ Counsel Awarded $5.25M In Fees

    BOSTON — Counsel for participants in the Massachusetts Institute of Technology (MIT) retirement plan were awarded $5,249,000 in attorney fees by a Massachusetts federal judge on May 29 as part of an $18.1 million settlement with the university (David B. Tracey, et al. v. Massachusetts Institute of Technology, et al., No. 16-11620, D. Mass.).

  • June 08, 2020

    Government Says Private Equity Investments Are Permissible Under ERISA

    WASHINGTON, D.C. — In an information letter published June 3, the U.S. Department Of Labor (DOL) said there is no bar under Employee Retirement Income Security Act to providing private equity investments as a designated investment alternative for individual defined contribution benefit plans covered by the statute.

  • June 05, 2020

    2nd Circuit Undoes Verizon ERISA Win, Citing ‘Gross Negligence’ On Death Benefit

    NEW YORK — In partly reversing a lower court ruling for Verizon Communications Inc., the Second U.S. Circuit Court of Appeals on June 1 found that the beneficiary of an ERISA-governed plan had plausibly argued for a variety of equitable remedies in alleging that the telecom giant repeatedly promised more than half a million dollars in death benefits, but ultimately paid out $11,400 (Kristine Sullivan-Mestecky v. Verizon Communications Inc., et al., No. 18-1591-cv, 2nd Cir., 2020 U.S. App. LEXIS 17230).

  • June 04, 2020

    Employees Accuse Plan Sponsor Of Engaging In Prohibited Transactions

    BOSTON — A purported plaintiff class asserts in a May 26 complaint filed in Massachusetts federal court that an employer breached its fiduciary duty and engaged in prohibited transactions while sponsoring a 401(k) employee pension benefit plan, resulting in millions of dollars in losses for plan participants (David Turner, et al., v. Schneider Electric Holdings Inc., et al., No. 20-11006, D. Mass.).

  • June 04, 2020

    Judge Gives Preliminary Approval Of $9M Settlement In JPMorgan 401(k) Fee Dispute

    NEW YORK — A federal judge in New York on May 26 granted preliminary approval of a proposed agreement to a settle a class action lawsuit over allegedly excessive fees charged to participants in JPMorgan Chase Bank N.A.’s 401(k) plan (Terre Beach, et al. v. JPMorgan Chase Bank, National Association, et al., No. 17-563, S.D. N.Y.).

  • June 03, 2020

    Lobbying Group Plans To Appeal Ruling That Seattle Benefit Law Dodges ERISA

    SEATTLE — An ERISA-focused lobbying group on May 29 filed a notice of appeal of a recent ruling from a Washington federal court that the Employee Retirement Income Security Act does not preempt a Seattle city ordinance that requires large hotels to spend certain amounts toward health coverage for their employees (The ERISA Industry Committee v. Seattle, No. 18-1188, W.D. Wash.).

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