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Mealey's ERISA

  • May 30, 2019

    Judge Approves Settlement In Behavioral Health Care Reimbursement Case

    BOULDER, Colo. — A federal judge on May 24 granted a motion for fees, costs and final approval to a settlement resolving claims that an insurer reimbursed out-of-network providers of behavioral health care differently than in-network providers (Laural O’Dowd, et al. v. Anthem Inc., et al., No. 14-2787, D. Colo., 2019 U.S. Dist. LEXIS 88292).

  • May 29, 2019

    Parties Square Off In Dispute Over Expert Witness In ERISA Case

    LOS ANGELES — Northrop Grumman Corp. on May 17 told a California federal judge that “there is no basis in law” for the disqualification of its rebuttal witness in an upcoming trial on allegations that it violated the Employee Retirement Income Security Act (Clifton Marshall, et al. v. Northrop Grumman Corp., et al., No. 16-6794, C.D. Calif.).

  • May 29, 2019

    9th Circuit Reverses Common Control Holding In ERISA Suit

    SAN FRANCISCO — In a May 24 unpublished holding, the Ninth Circuit U.S. Court of Appeals found that a federal judge in California erred in granting a summary judgment that an individual exercised common control over a business that incurred $1.4 million in liability when it withdrew from an employee benefit pension plan (Kevin Liebeck v. Trustees of the Southern California IBEW-NECA Pension Plan, No. 17-56188, 9th Cir., 2019 U.S. App. LEXIS 15592).

  • May 28, 2019

    U.S. Supreme Court Won’t Hear Appeal Over Fiduciary Breach Pleading Standard

    WASHINGTON, D.C. — The U.S. Supreme Court on May 28 denied a petition for a writ of certiorari filed by participants in the Chevron Employee Savings Investment Plan seeking a ruling on the proper pleading standard to apply in Employee Retirement Income Security Act fiduciary breach actions (Charles E. White, Jr., et al. v. Chevron Corporation, et al., No. 18-1271, U.S. Sup.).

  • May 28, 2019

    Retiree Plaintiffs’ Petition 8th Circuit To Stay Mandate On Vesting Decision

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals should stay its mandate that the health benefits of a class of retirees were not vested as a matter of law to allow the retirees to file a petition for writ of certiorari to the U.S. Supreme Court because the retirees’ petition to the high court will present a substantial question, the retirees claim in their May 22 petition to stay (Augustine Pacheco, et al. v. Honeywell International Inc., Nos. 18-1006 and 18-1294, 8th Cir.).

  • May 28, 2019

    High Court Denies Petition, Allows Ruling In Disability Insurer’s Favor To Stand

    WASHINGTON, D.C. — The U.S. Supreme Court on May 28 denied a disability claimant’s petition for writ of certiorari, refusing to review the Sixth Circuit U.S. Court of Appeals’ decision that the disability claimant was not disabled from his own occupation as an anesthesiologist because the medical evidence supported the insurer’s finding that the claimant could perform the duties of his own occupation with appropriate accommodations (Timothy O’Neill D.O. v. Unum Life Insurance Company of America, No. 18-1305, U.S. Sup.).

  • May 28, 2019

    Panel: ERISA Claims Stemming From Plane Crash Properly Dismissed

    CINCINNATI — A Michigan federal judge did not err in denying a mother equitable relief under the Employee Retirement Income Security Act in her efforts to recover benefits under her son’s accidental death and dismemberment policy (AD&D policy), the Sixth Circuit U.S. Court of Appeals ruled May 23 (Karen Briggs v. National Union Fire Insurance Company, et al., No. 18-1828, 6th Cir., 2019 U.S. App. LEXIS 15302).

  • May 24, 2019

    Disability Insurer Did Not Have To Consider Each Of Claimant’s Unique Job Duties

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on May 23 reversed and remanded a district court’s ruling in favor of a disability claimant after determining that the insurer’s denial of benefits was not an abuse of discretion because, according to Fifth Circuit precedent, the insurer properly considered the general duties of the claimant’s regular occupation and did not have to account for each of the claimant’s unique job duties (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 18-60499, 5th Cir., 2019 U.S. App. LEXIS 15396).

  • May 24, 2019

    9th Circuit Grants Petition For En Banc Rehearing On Preemption Of Nevada Law

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 22 granted a petition for en banc rehearing filed by a number of trusts that administer multiemployer plans, agreeing to reconsider its decision that a repealed Nevada law that limits the damages that may be collected from general contractors who are vicariously liable for the debts of Employee Retirement Income Security Act plan members is not preempted by ERISA and does not conflict with ERISA’s objectives or impermissibly “relate” to ERISA plans (The Board of Trustees of the Glazing Health and Welfare Trust, et al. v. Shannon Chambers, No. 16-15588, 9th Cir.).

  • May 23, 2019

    Disability Benefits Properly Calculated According To Plan Terms, Panel Says

    SEATTLE — The Ninth Circuit U.S. Court of Appeals on May 21 determined that a district court did not err in finding that a disability insurer properly calculated a claimant’s long-term disability (LTD) benefits because the claimant’s benefits were calculated in accordance with the plan’s terms (Deborah A. Johnson v. General Electric Co. et al., No. 18-35581, 9th Cir., 2019 U.S. App. LEXIS 15019).

  • May 22, 2019

    8th Circuit Denies Retiree Plaintiffs’ Motion To Rehear Vesting Decision

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on May 16 denied a petition for rehearing en banc, refusing to reconsider its decision that a class of retirees’ health benefits were not vested as a matter of law (Augustine Pacheco, et al. v. Honeywell International Inc., Nos. 18-1006 and 18-1294, 8th Cir.).

  • May 22, 2019

    Government:  Participants In Overfunded Plans May Still Sue Under ERISA

    WASHINGTON, D.C. — In a May 21 brief filed with the U.S. Supreme Court, the U.S. solicitor general argues that the Eighth Circuit U.S. Court of Appeals erroneously found that a putative plaintiff class lacks statutory standing under the Employee Retirement Income Security Act to maintain an action against their pension plan because the plan was subsequently overfunded (James J. Thole, et al. v. U.S. Bank, N.A., et al., No. 17-1712, U.S. Sup.).

  • May 20, 2019

    Anti-Assignment Provision Bars Medical Provider’s Suit Against Health Insurer

    PHILADELPHIA — An anti-assignment provision in an insured’s medical benefits plan clearly bars an insured from assigning his rights under the plan to a medical provider, the Third Circuit U.S. Court of Appeals said May 16 in affirming a district court’s dismissal of the medical provider’s complaint against the medical insurer (University Spine Center, on assignment of John W. v. Aetna Inc., et al., No. 18-2842, 3rd Cir., 2019 U.S. App. LEXIS 14588).

  • May 20, 2019

    9th Circuit Rules Domestic Partner Owed Survivor-Spousal Benefits

    SAN FRANCISCO — A California federal judge erred in denying the surviving domestic partner of a benefit plan participant spousal benefits after the plan participant died, a Ninth Circuit U.S. Court of Appeals panel ruled May 14 (David R. Reed v. KRON/IBEW Local 45 Pension Plan, et al., No. 17-17176, 9th Cir., 2019 U.S. App. LEXIS 14581).

  • May 17, 2019

    11th Circuit: Procedure Errors Don’t Alter Standard; Insurers’ ERISA Ruling Stands

    ATLANTA — Insubstantial procedural errors do not require anything other than the capricious and arbitrary standard in an Employee Retirement Income Security Act case challenging an insurer’s denial of coverage for eating disorder treatments, an 11th Circuit U.S. Court of Appeals panel held May 15 (O.D. v. Jones Lang LaSalle Medical PPO Plus Plan, No. 17-13060, 11th Cir., 2019 U.S. App. LEXIS 14385).

  • May 15, 2019

    In Northwestern University ERISA Row, Parties Dispute Impact Of Sweda

    CHICAGO — In a May 13 notice of supplemental authority, appellees told the Seventh Circuit U.S. Court of Appeals that contrary to the position taken by a group of retirement plan participant appellants, a recent decision by the Third Circuit does not support reversal of an Illinois federal judge’s dismissal of allegations that Northwestern University breached its fiduciary duties (Laura L. Divane, et al. v. Northwestern University, et al., No. 18-2569, 7th Cir.).

  • May 14, 2019

    Panel Affirms: ERISA Claim For Denied Benefits Already Litigated

    NEW YORK — A New York federal judge’s rejection on res judicata grounds of allegations that a plaintiff was wrongfully denied retirement benefits was affirmed May 8 by the Second Circuit U.S. Court of Appeals (Kathleen Whelehan v. Bank of America Benefit Appeals Committee, et al., No. 18-2668, 2nd Cir., 2019 U.S. App. LEXIS 14052).

  • May 14, 2019

    Federal Judge Allows 401(k) Plan Participant To Add Breach Of Fiduciary Claim

    NEW YORK — A New York federal judge on May 9 granted a 401(k) plan participant’s motion to amend a complaint to add a breach of fiduciary claim after determining that the participant sufficiently alleged facts in support of the allegation that the plan defendants retained a plan fund despite the fund’s higher fees and lower performance (Arthur Bekker, et al. v. Neuberger Berman Group LLC, et al., No. 16-6123, S.D. N.Y., 2019 U.S. Dist. LEXIS 79149).

  • May 10, 2019

    High Court Should Deny Review Of Equitable Remedy Ruling, Plan Trustee Says

    WASHINGTON, D.C. — The U.S. Supreme Court should refuse to review the District of Columbia Circuit U.S. Court of Appeals’ decision on whether equitable remedies other than disgorgement are available on pension plan participants’ breach of fiduciary duty claim because there is no conflict with the decisions of other circuits and because review at this stage of the litigation would be premature, the plan trustee says in its May 8 respondent’s brief (K. Wendell Lewis, et al. v. Pension Benefit Guaranty Corp., No. 18-1279, U.S. Sup.).

  • May 10, 2019

    Court Should Have Allowed Widow To Submit Evidence Rebutting Benefits Denial

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 8 held that a lower federal court should have allowed a widow to submit evidence rebutting the denial of benefits under an accident plan, finding that the court’s failure to do so of necessity affected its finding that the life insurer had no more than a structural conflict of interest, vacating and remanding the lower court’s judgment in an Employee Retirement Income Security Act lawsuit (Marnie Masuda-Cleveland v. Life Insurance Company of North America, No. 17-17149, 9th Cir., 2019 U.S. App. LEXIS 13782).

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