GAINESVILLE, Ga. — Metropolitan Life Insurance Co. has agreed to pay $80 million to settle a class action suit alleging that the life insurer violated the Employee Retirement Income Security Act by profiting from a practice of converting life insurance benefits and by failing to pay life insurance proceeds in one lump sum to beneficiaries, according to two settlement agreements filed July 25 in Georgia federal court (Laura A. Owens et al., v. Metropolitan Life Insurance Co., No. 14-74, N.D. Ga.).
SCRANTON, Pa. — A Pennsylvania federal judge on July 29 partially denied a disability insurer’s motion for a protective order regarding information sought in depositions after determining that the fiduciary exception to the attorney-client privilege does not apply to communications regarding the administration of the disability plan concerning subrogation shared among the plan, its fiduciaries and any attorney assisting in the administration of the plan prior to the filing of the disability claimant’s lawsuit (Eric Yost, et al. v. Anthem Life Insurance Co., No. 3:16-cv-00079, M.D. Pa., 2019 U.S. Dist. LEXIS 125967).
WASHINGTON, D.C. — The Montana small employers that were granted the right to proceed with state law claims against two health insurance companies after the Ninth Circuit U.S. Court of Appeals found that the claims were not preempted by the Employee Retirement Income Security Act on July 22 waived their right to respond to a petition for a writ of certiorari filed by the insurers in the U.S. Supreme Court (Caring for Montanans, Inc., et al. v. The Depot, Inc., et al., No. 19-77, U.S. Sup.).
PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Aug. 1 affirmed a district court’s ruling that the operator of four casinos is not liable for partial withdrawal from a multiemployer pension fund following the closure of one of its casinos because the casino operator continued to contribute to its pension plan for engineering work at the remaining three casinos (Caesars Entertainment Corp. v. International Union of Operating Engineers Local 68 CappPension Fund, No. 18-2465, 3rd Cir., 2019 U.S. App. LEXIS 22991).
WASHINGTON, D.C. — The U.S Department of Labor (DOL) on July 31 released a final rule under the Employee Retirement Income Security Act that will expand access to retirement savings options for those working in small and mid-sized businesses by allowing employers of the same geographic areas to join association retirement plans (ARPs).
WASHINGTON, D.C. — Parties in a lawsuit concerning the federal common-law doctrine of successor liability as it applies to pension plan terminations that is currently on appeal before the U.S. Supreme Court filed a stipulation to dismiss the petition for a writ of certiorari on July 31, stating that they have reached an agreement to settle (September Ends Co., et al. v. Pension Benefit Guaranty Corp., No. 18-1265, U.S. Sup.).
PHILADELPHIA — A pension plan’s board of trustees did not act arbitrarily or capriciously when it determined that a plan participant’s vacation pay does not count as benefit hours, the Third Circuit U.S. Court of Appeals said July 24 in affirming a district court’s ruling that the plan participant is not entitled to disability benefits under the pension plan because the participant did not meet the required hours of service necessary to collect disability benefits (Norman Hansen v. International Union of Painters & Allied Trades Industry Pension Plan, et al., No. 18-2921, 3rd Cir., 2019 U.S. App. LEXIS 22066).
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on July 25 affirmed a district court’s dismissal of a disability claimant’s suit because the claimant clearly failed to file suit within three years of the accrual of his claim as required by the plan (Michael Faciane v. Sun Life Assurance Company of Canada, No. 18-30918, 5th Cir., 2019 U.S. App. LEXIS 222320).
COVINGTON, Ky. — In a July 25 summary judgment holding, a federal judge in Kentucky agreed with St. Elizabeth Medical Center Inc. that its defined-benefit pension plan is a “church plan” exempt from Employee Retirement Income Security Act scrutiny (Dolores Jane Boden, et al. v. St. Elizabeth Medical Center, Inc, et al., No. 16-49, E.D. Ky., 2019 U.S. Dist. LEXIS 124184).
RICHMOND, Va. — A widow sufficiently alleged that her husband’s employer was serving in a fiduciary capacity when it took various actions before and after his death in 2016 to withstand a request for dismissal, the Fourth Circuit U.S. Court of Appeals ruled July 24 (Rema Dawson-Murdock v. National Counseling Group Inc., No. 18-1989, 4th Cir., 2019 U.S. App. LEXIS 22080).
ST. LOUIS — A patient did not assign Employee Retirement Income Security Act equitable relief rights to an emergency air transport provider, and nothing in the allegations requires that the insurer pay the full bill, an Eighth Circuit U.S. Court of Appeals panel held July 23 (Air Evac EMS Inc. v. USAble Mutual Insurance Co., et al., No. 18-2264, 8th Cir., 2019 U.S. App. LEXIS 21938).
PHILADELPHIA — A divided May 2019 decision by the Third Circuit U.S. Court of Appeals that reinstated allegations that the University of Pennsylvania administered an employee pension benefit plan imprudently will stand, in view of a July 19 denial by the court of a request for rehearing (Jennifer Sweda, et al. v. University of Pennsylvania, et al., No. 17-3244, 3rd Cir.).
BOSTON — Whether a health plan covers an adolescent’s residential treatment requires a deeper dive into the facts, a federal judge in Massachusetts said July 19 in permitting an Employee Retirement Income Security Act benefit claim and saying dismissing the equitable relief at this stage of the litigation was premature (Brent S., et al. v. Blue Cross Blue Shield of Massachusetts Inc., No. 17-11569, D. Mass., 2019 U.S. Dist. LEXIS 120415).
WASHINGTON, D.C. — Two health insurance companies filed a petition for a writ of certiorari with the U.S. Supreme Court on July 15 seeking a decision on whether the Employee Retirement Income Security Act preempts state law claims accusing the companies of making misrepresentations about monthly premiums that induced an employer to create the plan (Caring for Montanans, Inc., et al. v. The Depot, Inc., et al., No. 19-77, U.S. Sup.).
DENVER — A district court did not err in applying an arbitrary and capricious standard of review to a health care plan’s denial of benefits for a plan beneficiary’s treatment at a residential center because the plan participant failed to identify any procedural irregularities under the Employee Retirement Income Security Act that would warrant the application of a de novo standard of review, the 10th Circuit U.S. Court of Appeal said July 15 (Mary D. v. Anthem Blue Cross Blue Shield, et al., No. 17-4195, 10th Cir., 2019 U.S. App. LEXIS 20842).
DES MOINES, Iowa — Two women received cost-free in-network lactation services in the hospital when they gave birth and incurred costs they claim should be covered under the Patient Protection and Affordable Care Act (ACA) only later when they independently sought out-of-network care, an insurer tells the Eighth Circuit U.S. Court of Appeals in a July 16 brief (Jillian York, et al. v. Wellmark Inc., et al., No. 19-1705, 8th Cir.).
WASHINGTON, D.C. — The association health plan rule relies on an unreasonable reading of the Employee Retirement Income Security Act and constitutes an end-run around Patient Protection and Affordable Care Act (ACA) protections, New York and its fellow plaintiffs told the District of Columbia Circuit U.S. Court of Appeals on July 15 (New York, et al. v. U.S. Department of Labor, et al., No. 19-5125, D.C. Cir.).
ATLANTA — The 11th Circuit U.S. Court of Appeals on July 15 affirmed a district court’s denial of attorney fees to a plaintiff seeking coverage for "partial hospitalization" at a specialized treatment facility for anorexia after determining that attorney fees were inappropriate because the health care benefits administrator litigated a question of first impression in good faith (Alexandra H. v. Oxford Health Insurance, Inc., No. 18-14846, 11th Cir., 2019 U.S. App. LEXIS 20811).
WASHINGTON, D.C. — George Washington University (GW) prevailed July 15 when a federal judge in the District of Columbia found that a general release signed by a plaintiff in 2016 precludes her from now asserting that the school breached its fiduciary duty by charging excessive fees and offering imprudent investments (Melissa Stanley v. George Washington University, et al., No. 18-878, D. D.C., 2019 U.S. Dist. LEXIS 116772).
SAN FRANCISCO — Whether a court properly certified a class of plaintiffs with various health care plans who were denied mental health treatments and the extent of remedies available under the Employee Retirement Income Security Act are all before a California federal judge after post-trial briefing July 10 (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.).