Mealey's ERISA

  • January 06, 2022

    1st Circuit Upholds AD&D Denial Under Transferee Court’s Decisional Law

    BOSTON — A First Circuit U.S. Court of Appeals panel on Jan. 3 affirmed a Massachusetts federal court’s ruling upholding the denial of accidental death and dismemberment (AD&D) benefits on the grounds that the insured had committed suicide, rejecting arguments that the transferor court’s decisional law should have applied and that the insurer’s determination was arbitrary, capricious or an abuse of discretion.

  • January 06, 2022

    Insurer Waives Right To Respond To Petition Seeking Review Of Disability Ruling

    WASHINGTON, D.C. — A disability insurer on Jan. 5 waived its right to respond to a disability claimant’s petition for writ of certiorari filed in the U.S. Supreme Court seeking a “uniform rule enforcing an ERISA plan’s choice of law and applying the chosen law to all plan participants” and a ruling that the Employee Retirement Income Security Act does not preempt state law prescribing de novo judicial review for challenged benefit determinations.

  • January 04, 2022

    11th Circuit Rules ERISA Plan Terms Unambiguous, Upholds Life Insurance Termination

    ATLANTA — An 11th Circuit U.S. Court of Appeals panel on Dec. 28 affirmed an Alabama federal court’s grant of summary judgment for employer Allstate Insurance Co. in retirees’ consolidated cases challenging termination of a life insurance benefit under the Employee Retirement Income Security Act, ruling that the plan language unambiguously permitted termination and that fiduciary breach claims were time-barred.

  • December 30, 2021

    Medicare-Based Dialysis Rates Don’t Violate MSPA, Government Tells High Court

    WASHINGTON, D.C. — In three amicus curiae briefs filed Dec. 22 and 23, entities including the U.S. government join health plan defendants in urging the U.S. Supreme Court to reverse a split Sixth Circuit U.S. Court of Appeals panel’s ruling that a complaint over linking dialysis reimbursement rates to Medicare rates plausibly alleged violation of the Medicare Secondary Payor Act (MSPA) under a discrimination-by-proxy or a disparate-impact theory.

  • December 28, 2021

    Putative Class Suit Against McDonald’s Alleges Deficient COBRA Notices

    MIAMI — McDonald’s Corp. violated the Employee Retirement Income Security Act by providing a deficient Consolidated Omnibus Budget Reconciliation Act (COBRA) notice that “confused and misled” her, a former employee alleges in a putative class action filed Dec. 15 in a Florida federal court.

  • December 22, 2021

    High Court Review Sought In Disability Benefits Case Over Discretionary Authority

    WASHINGTON, D.C. — In a Dec. 9 petition to the U.S. Supreme Court for a writ of certiorari regarding judgment in favor of a disability insurer, a beneficiary seeks a “uniform rule enforcing an ERISA plan’s choice of law and applying the chosen law to all plan participants” and a ruling that the Employee Retirement Income Security Act does not preempt state law prescribing de novo judicial review for challenged benefit determinations.

  • December 22, 2021

    ERISA Plan Says Medicare-Based Dialysis Rates Don’t Violate MSPA

    WASHINGTON, D.C. — Linking dialysis reimbursement rates to Medicare rates does not violate the Medicare Secondary Payor Act’s prohibition on taking into account program eligibility, and a ruling to the contrary would be an “affront” to Employee Retirement Income Security Act regulations, health plan defendants tell the U.S. Supreme Court in a Dec. 20 brief.

  • December 22, 2021

    Arguing Preemption, PCMA Seeks 8th Circuit Rehearing On Part Of North Dakota PBM Law

    ST. LOUIS — Narrowing its arguments to two provisions of a North Dakota law regulating pharmaceutical benefit manager (PBM) practices, the Pharmaceutical Care Management Association (PCMA) on Dec. 15 petitioned the Eighth Circuit U.S. Court of Appeals for panel rehearing or rehearing en banc, challenging the court’s ruling on remand that the Employee Retirement Income Security Act and Medicare Part D do not preempt the provisions.

  • December 22, 2021

    Allegations Of ‘Misprocessing’ Of Claims Under ERISA Fail, 9th Circuit Panel Affirms

    SAN FRANCISCO — A California federal court correctly granted judgment in favor of a benefit plan’s administrator and claims administrator on a beneficiary’s allegations of “systemic misprocessing of claims” under the Employee Retirement Income Security Act, a Ninth Circuit U.S. Court of Appeals panel ruled in a five-paragraph unpublished memorandum disposition issued Dec. 3.

  • December 21, 2021

    6th Circuit:  Forfeited ERISA Equitable Lien Argument Spoils ‘Jurisprudential Feast’

    CINCINNATI — A self-funded employee welfare benefit plan that sought an equitable lien against a law firm under the Employee Retirement Income Security Act forfeited its right to argue the lowest intermediate balance test in challenging a Tennessee federal court’s finding that commingled funds had been dissipated, a Sixth Circuit U.S. Court of Appeals panel ruled Dec. 17.

  • December 21, 2021

    Residential Treatment Denial Overturned On De Novo Review Following Remand

    SALT LAKE CITY — In a Nov. 30 decision on remand from the 10th Circuit U.S. Court of Appeals, a Utah federal judge granted summary judgment in favor of plaintiffs who challenged a denial of benefits for psychiatric residential treatment, ruling that the health plan administrator abandoned one stated rationale for the denial and its arguments on the other were “unpersuasive.”

  • December 17, 2021

    Counsel Gets 3rd Of $13M Fund In Settlement Of Suit Over UPenn Pension Plans

    PHILADELPHIA — A federal judge in Pennsylvania on Dec. 14 granted final approval to an agreement under which The University of Pennsylvania will establish a $13 million settlement fund in exchange for the release of class action claims by participants in the university’s 403(b) defined contribution pension benefits plans; the judge also approved awards from the fund of $4,333,333 for attorney fees and $25,000 each to six class representatives.

  • December 17, 2021

    Appellees To High Court: Estoppel Is Reason Not To Review ERISA Prudence Ruling

    WASHINGTON, D.C. — Arguing against U.S. Supreme Court review of a ruling that they stated a claim of imprudence against New York University (NYU) under the Employee Retirement Income Security Act, retirement plan participants in a Dec. 15 opposition say that “[p]rinciples of waiver and estoppel preclude the relief NYU seeks, which is wholly unnecessary in any event.”

  • December 16, 2021

    PBGC To High Court Over Pension Plan Termination: No Conflict, No Review Needed

    WASHINGTON, D.C. — Arguing in part that there is no circuit split, the Pension Benefit Guaranty Corp. (PBGC) tells the U.S. Supreme Court in a Dec. 15 filing that no review is needed of a ruling that it did not violate due process in terminating a pension plan with the plan administrator without court adjudication.

  • December 15, 2021

    Insurer To High Court: Resolve Circuit Split Over ERISA Contribution, Indemnity

    WASHINGTON, D.C. — Arguing that a ruling that it cannot seek contribution and indemnity from an employer that it alleges was a co-fiduciary of a life insurance policy offered through an employee welfare benefit plan is wrong and “entrenches a split” in which the Eighth and Ninth circuit courts of appeals conflict with the Second and Seventh circuits, an insurer on Dec. 7 petitioned the U.S. Supreme Court for a grant of certiorari.

  • December 14, 2021

    Respondents Tell High Court Beneficiary Determination Case Lacks Circuit Conflict

    WASHINGTON, D.C. — The U.S. Supreme Court should deny review, a life insurer and employer assert in Dec. 13 opposition to a petition for certiorari filed by an estate administrator who was denied life insurance benefits when an insured died without naming a beneficiary, arguing that the Second Circuit U.S. Court of Appeals’ ruling in their favor was correct and involves neither a circuit conflict nor an important question of federal law.

  • December 14, 2021

    Chamber Denied Leave To Participate In ERISA Class Fees, Funds Suit

    WASHINGTON, D.C. — A federal judge in the District of Columbia on Dec. 7 denied the Chamber of Commerce of the United States of America’s motion for leave to participate as amicus curiae in a suit challenging a defined contribution retirement plan’s fees and selection of funds under the Employee Retirement Income Security Act.

  • December 13, 2021

    ERISA Insurer: Reviewers’ Decisions Support Denial For Residential Treatments

    DENVER — The fact that three separate reviewers found residential treatment not medically necessary demonstrates that a denial of insurance coverage was not arbitrary or capricious and should end the analysis even if a separate reason for denying coverage was improper, an insurer tells the 10th Circuit U.S. Court of Appeals in a Dec. 8 opening brief.

  • December 13, 2021

    High Court Denies Certiorari For Fiduciary Duty Petition Conditioned On Gannett

    WASHINGTON, D.C. — The U.S. Supreme Court on Dec. 13 denied certiorari for a petition by retirement plan participants concerning whether dismissal on the pleadings is appropriate when a fiduciary is accused of imprudence based on maintaining a single-stock fund in a defined contribution plan where participants may sell their shares and reinvest in diversified funds.

  • December 13, 2021

    U.S. Supreme Court Won’t Review 4th Circuit 401(k) Diversification Ruling

    WASHINGTON, D.C. — The U.S. Supreme Court on Dec. 13 denied certiorari to a petition from Gannett Co. Inc. and The Gannett Benefit Plans Committee regarding a dispute over the Employee Retirement Income Security Act’s diversification requirement.

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