BOSTON — While the exact amount of Massachusetts’ alleged injury from rules granting expanded employers expanded exemptions to the Patient Protection and Affordable Care Act (ACT) may not be known, it stands to reason that it is not zero and provides injury and standing, a First Circuit U.S. Court of Appeal panel held May 2 (Massachusetts v. United States Department of Health and Human Services, et al., No. 18-1514, 1st Cir., 2019 U.S. App. LEXIS 13293).
SAN FRANCISCO — A judge’s conclusion that an insurer violated the standards of care in denying coverage for intensive residential health care and substance abuse treatments requires changes to its business practices and court instruction on the processing of claims, plaintiffs in two Employee Retirement Income Security Act class actions told a federal judge in California on May 3. But in a motion seeking decertification of the class filed the same day, the insurer says the plaintiffs have not shown that common issues dominate the case (David and Natasha Wit, et al. v. United Behavioral Health, No. 14-02346, Gary Alexander, et al. v. United Behavioral Health, No. 14-5337, N.D. Calif.).
WASHINGTON, D.C. — The Department of Labor on May 1 appealed to the District of Columbia Circuit U.S. Court of Appeals a ruling invalidating a Patient Protection and Affordable Care Act (ACA) rule expanding the availability of association health plans that the court found did “violence” to the Employee Retirement Income Security (ERISA) definition of an employer (New York, et al. v. U.S. Department of Labor, et al., No. 19-5125, D.C. Cir.).
OCALA, Fla. — A Florida federal judge on May 1 adopted a magistrate’s report that recommended denying Aon Hewitt Investment Consulting Inc.’s and Alight Solutions LLC’s motion to dismiss a not-for-profit corporation’s lawsuit alleging breach of fiduciary duty under the Employee Retirement Income Security Act (Foundation Resolution Corp. v. Aon Hewitt Investment Consulting, Inc.,, et al., No: 18-458, M.D. Fla., 2019 U.S. Dist. LEXIS 73143).
WASHINGTON, D.C. — The U.S. Supreme Court should deny a disability claimant’s petition for writ of certiorari because the questions presented by the claimant were not litigated in the lower courts and, therefore, are not suitable for the high court’s review, the insurer argues in a May 2 response brief (Timothy P. O’Leary v. Aetna Life Insurance Co., No. 18-1266, U.S. Sup.).
NEW YORK — The Second Circuit U.S. Court of Appeals on April 25 affirmed a district court’s ruling that a former employer is entitled to only a pro-rated share of his retirement benefits according to the terms of a deferred compensation agreement between the employee and employer (Daniel Verdier v. Thalle Construction Co. Inc., No. 18-868, 2nd Cir., 2019 U.S. App. LEXIS 13150).
PHILADELPHIA — A divided Third Circuit U.S. Court of Appeals panel on May 2 reversed a Pennsylvania federal judge’s dismissal of allegations that the University of Pennsylvania breached its fiduciary duty when it charged excessive investment fees to 403(b) plan participants but agreed that allegations that the university engaged in prohibited transactions are inadequately pleaded (Jennifer Sweda, et al. v. University of Pennsylvania, et al., No. 17-3244, 3rd Cir., 2019 U.S. App. LEXIS 13284).
WASHINGTON, D.C. — The U.S. Supreme Court should grant a pension plan participant’s petition for writ of certiorari because the issue of whether private employee benefit plans can override the statutory venue choices that Congress made available to plan participants under the Employee Retirement Income Security Act is one of national importance and one that has arisen numerous times in lower federal courts, the plan participant argues in an April 23 petition to the high court (Jeffrey A. Robertson v. U.S. District Court for the Eastern District of Pennsylvania, et al., No. 18-1341, U.S. Sup.).
PROVIDENCE, R.I. — A Rhode Island federal judge on April 15 granted plaintiffs’ unopposed motion for preliminarily approval of a $3.5 million settlement in their class action alleging that Brown University breached its fiduciary duty in violation of the Employee Retirement Income Security Act in its management of its retirement plans (Diane G. Short, et al. v. Brown University, No. 17-318, D. R.I.).
MIAMI — A third federal judge in Florida on April 30 recused himself from a class action accusing United Health Care Insurance Co. (UHC) of violating the Employee Retirement Income Security Act when refusing to reimburse patients for proton beam radiation therapy (PBRT) after another judge said in an April 29 order that it is “immoral and barbaric” to not reimburse prostate cancer patients for the treatment because it is not experimental and causes less collateral damage (Richard Cole, et al. v. United Health Care Insurance Co., No. 19-cv-21258, S.D. Fla.).
WASHINGTON, D.C. — IBM employees on April 18 said there is no basis for the U.S. Supreme Court to grant certiorari review of the Second Circuit U.S. Court of Appeals’ decision that they plausibly asserted a duty-of-prudence claim against the fiduciaries of an IBM employee stock option plan (ESOP) under the Employee Retirement Income Security Act (Retirement Plans Committee of IBM, et al. v. Larry W. Jander, et al., No. 18-1165, U.S. Sup.).
WASHINGTON, D.C. — In an April 29 opposition brief, a respondent told the U.S. Supreme Court it should deny a petition for certiorari that poses the question of whether the “actual knowledge” exception to the “generally applicable” six-year statute of limitations under the Employee Retirement Income Security Act requires both knowledge that imprudent investment occurred and knowledge, at the time, that the investment was imprudent (Intel Corporation Investment Policy Committee, et al., v. Christopher Sulyma, et al., No. 18-1116, U.S. Sup.).
CHICAGO — A reasonable person would interpret a man’s cause of death of autoerotic asphyxiation to be an “intentionally self-inflicted injury” under life insurance policies governed by the Employee Retirement Income Security Act, a majority of the Seventh Circuit U.S. Court of Appeals held April 29, reversing a lower court (LeTran Tran v. Minnesota Life Insurance Co., No. 18-1723, 7th Cir., 2019 U.S. App. LEXIS 12895).
BAY CITY, Mich. — A federal judge in Michigan on April 26 turned down an insurer’s request to dismiss on remand an Indian tribe’s claims that the insurer violated the Employee Retirement Income Security Act by failing to pay Medicare-like rates for hospital services under two health care plans, saying more factual development is needed at this stage of the litigation (Saginaw Chippewa Indian Tribe of Michigan, et al. v. Blue Cross Blue Shield of Michigan, No. 1:16-cv-10317, E.D. Mich., 2019 U.S. Dist. LEXIS 70688).
CINCINNATI — In an April 25 holding, the Sixth Circuit U.S. Court of Appeals found that a plaintiff who failed to diligently pursue her claim for surviving-spouse benefits under the Employee Retirement Income Security Act is barred by the six-year statute of limitations in Tennessee for pursuing a contract claim (Joyce Ensley v. Charles Whobrey, et al., No. 18-5459, 6th Cir., 2019 U.S. App. LEXIS 12626).
WHITE PLAINS, N.Y. — A disability and life insurance plan provided to employees of a public library is not exempt under the governmental agency exception in the Employee Retirement Income Security Act because the library does not qualify as an agency of the government of New York City or the borough of Brooklyn, a New York federal judge said April 18 in denying the disability claimant’s motion to remand (Brian J. Skornick v. Principal Financial Group, et al., No. 18-4324, S.D. N.Y., 2019 U.S. Dist. LEXIS 66124).
PHILADELPHIA — A federal judge in Pennsylvania on April 5 entered final approval of a $9 million settlement to resolve allegations that Prudential Insurance Company of America breached its fiduciary duty under the Employee Retirement Income Security Act when failing to make lump sum payments to beneficiaries (Clark R. Huffman, et al. v. Prudential Insurance Company of America, No. 10cv5135, E.D. Pa., 2019 U.S. Dist. LEXIS 58667).
CHICAGO — Participants in the Boeing Voluntary Investment Plan on March 31 filed a class action in a federal district court alleging that Boeing and its plan fiduciaries’ failure to publicly disclose the truth about the company’s 737 Max aircraft’s safety problems left the public unaware and led to inflation of the company’s stock price (Diane Burke, et al. v. The Boeing Company, et al., No. 19-02203, N.D. Ill.).
NEW ORLEANS — A district court did not err in granting a disability insurer’s motion for summary judgment because the insurer properly denied a claim for long-term disability benefits under the policy, the Fifth Circuit U.S. Court of Appeals said April 26 in noting that the claimant is not disabled from his regular occupation (Deo G. Shanker v. United of Omaha Life Insurance Co., No. 18-20616, 5th Cir., 2019 U.S. App. LEXIS 12555).
BROOKLYN, N.Y. — Home health aides filed a first amended class action complaint on April 24 in a New York federal court, alleging that their employers’ captive insurance and reinsurance scheme cheated them out of lost wages and benefits (Ynes M. Gonzalez de Fuente, et al. v. Preferred Home Care of New York LLC, et al., No. 18-6749, E.D. N.Y.).