NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Sept. 6 reversed and remanded a district court’s sua sponte dismissal of a plaintiff’s claim for reimbursement of medical expenses under the Consolidated Omnibus Budget Recovery Act (COBRA) after determining that the district court abused its discretion in ruling that the plaintiff was legally barred from obtaining a penalty award under the Employee Retirement Income Security Act for the employer’s failure to provide the required notice of coverage termination under COBRA (David L. Hager v. DBG Partners Inc., No. 17-11147, 5th Cir., 2018 U.S. App. LEXIS 25358).
BOSTON — The First Circuit U.S. Court of Appeals on Sept. 6 reversed a district court’s denial of a health plan participant’s motions to expand the scope of the administrative record after determining that the health plan should be held to its agreement with the plan participant to expand the scope of the administrative record (Jane Doe v. Harvard Pilgrim Health Care Inc., et al., No. 17-2078, 1st Cir., 2018 U.S. App. LEXIS 25347).
SAN FRANCISCO — The majority of the Ninth Circuit U.S. Court of Appeals on Sept. 4 vacated a district court’s ruling that a 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Retirement Income Security Act plan members is preempted by ERISA after determining that the law, which has since been repealed, does not conflict with ERISA’s objectives or impermissibly “relate” to ERISA plans (The Board of Trustees of the Glazing Health and Welfare Trust, et al.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., 2018 U.S. App. LEXIS 25030).
RICHMOND, Va. — An arbitrator did not err in finding that a business’ accrued rent, owed to the owner of the building — a trust owned by the business’ president — was a bona fide debt for the purposes of withdrawal liability under the Employee Retirement Income Security Act, a Fourth Circuit U.S. Court of Appeals panel ruled Sept. 4 (Board of Trustees, Sheet Metal Workers’ National Pension Fund v. Lane & Roderick, Inc., No. 17-2205, 4th Cir., 2018 U.S. App. LEXIS 25044).
NEW YORK — A former Morgan Stanley & Co. LLC employee’s second appeal of a district court’s ruling that his claims for pension and stock benefits were untimely is barred by the law of the case doctrine, a Second Circuit U.S. Court of Appeals panel ruled in a Sept. 6 summary order (Benjamin Reches v. Morgan Stanley & Co. LLC, No. 17-2874, 2nd Cir., 2018 U.S. App. LEXIS 25263).
RICHMOND, Va. — A Fourth Circuit U.S. Court of Appeals panel in an unpublished per curiam opinion issued Sept. 4 affirmed the denial of accidental death and dismemberment (AD&D) benefits under an Employee Retirement Income Security Act employee benefit plan, ruling that the death from a pulmonary embolism was not an accident (Linda Grabowski v. Hartford Life & Accident Insurance Company, No. 17-2108, 4th Cir., 2018 U.S. App. LEXIS 25039).
NEW ORLEANS — A Fifth Circuit U.S. Court of Appeals panel on Sept. 4 affirmed a federal judge in Texas’ decision to dismiss a former Whole Foods Market Inc. employee’s Employee Retirement Income Security Act lawsuit, finding that the plaintiff was unable to show that the company’s executives breached any fiduciary duties when allegedly artificially inflating the company’s stock price during a widespread overpricing scheme, finding that there was no alternative available to help the company’s 401(k) plan (Thomas Martone v. Walter E. Robb, et al., No. 17-50702, 5th Cir., 2018 U.S. App. LEXIS 25052).
CINCINNATI — The majority of the Sixth Circuit U.S. Court of Appeals on Sept. 4 reversed and remanded a district court’s ruling that a trust created by a company’s founder is not liable for the underfunding of the company’s pension plan after determining that the lower court applied the wrong test in determining whether the trust can be held liable as a “trade or business” for the more than $30 million in pension plan losses incurred after the company ceased operations (Pension Benefit Guaranty Corp. v. Findlay Industries Inc., et al., No. 17-3520, 6th Cir., 2018 U.S. App. LEXIS 25071).
SEATTLE — State law claims alleging that an insurer uses specially crafted guidelines to avoid providing third-party mental health coverage invokes a duty distinct from those imposed by ERISA and belongs in state court, the Ninth Circuit U.S. Court of Appeals held Sept. 4 (Karen Hansen, et al. v. Group Health Cooperative, No. 16-35684, 9th Cir.).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Aug. 31 denied the University of Southern California’s (USC) request for a rehearing en banc of a July 24 ruling affirming a federal judge’s decision to deny its motion to compel arbitration in a suit claiming that it charged excessive fees for its 403(b) retirement plan, as well as other breaches of fiduciary duties (Allen L. Munro, et al. v. University of Southern California, et al., No. 17-55550, 9th Cir.).
NEW YORK — Despite plaintiffs’ conclusory legal statements, there is no evidence that a pharmacy benefits administrator acted in an arbitrary or capricious way in limiting its coverage of fentanyl to cases of breakthrough cancer pain, nor that the plan was unclear or intentionally discriminated against a woman in violation of the ACA, a federal judge held Aug. 29 (Rebecca Weinreb, et al. v. Xerox Business Services, et al., No. 16-6823, S.D. N.Y., 2018 U.S. Dist. LEXIS 147706).
CINCINNATI — While a federal court got most of its decision correct in awarding a Michigan Indian tribe $8.4 million for Blue Cross Blue Shield’s charging of hidden administrative fees for the tribe’s employee benefits program, it erred in dismissing a claim by the tribe that it was illegally forced to pay more than Medicare rates for services, the Sixth Circuit U.S. Court of Appeals held Aug. 30 (Saginaw Chippewa Indian Tribe of Michigan, et al. v. Blue Cross Blue Shield of Michigan, No. 17-1932, 6th Cir., 2018 U.S. App. LEXIS 24692).
WASHINGTON, D.C. — A pension plan sponsored by U.S. Bancorp. for its employees told the U.S. Supreme Court in an Aug. 22 response brief that an Eighth Circuit U.S. Court of Appeals panel did not err when affirming dismissal of the employees’ suit accusing the fiduciaries responsible for investment of the plan’s assets of violating the Employee Retirement Income Security Act because the plaintiffs lacked standing to bring their suit (James J. Thole, et al. v. U.S. Bank, N.A., et al., No. 17-1712, U.S. Sup.).
SAN FRANCISCO — An Employee Retirement Income Security Act plan participant’s knowledge of two conflicting statements by his employer related to “bridging” his plan benefits with earlier years of employment does not establish an “actual knowledge of a fiduciary breach,” the U.S. secretary of Labor argues in an Aug. 22 brief filed in the Ninth Circuit U.S. Court of Appeals (Charles Guenther v. Lockheed Martin Corporation, et al., No. 17-16984, 9th Cir.).
ST. LOUIS — A Missouri federal judge held on Aug. 27 that because Mercy Health's employee pension plan satisfies the statutory requirements for church-plan exemption under the Employee Retirement Income Security Act, no federal question jurisdiction exists over claims that it underfunded the plan in violation of ERISA (Sally Sanzone, et al. v. Mercy Health, et al., No. 16-923, E.D. Mo., 2018 U.S. Dist. LEXIS 145195).
COLUMBUS, Ohio — An Ohio federal judge on Aug. 24 denied a motion to dismiss filed by a 401(k) plan service provider after determining that the plan beneficiary adequately alleged facts supporting her claim that the service provider had constructive knowledge of the unreasonableness of its asset-based fees charged to plan participants (Alana Schmitt et al. v. Nationwide Life Insurance Co. et. al., No. 17-558, S.D. Ohio, 2018 U.S. Dist. LEXIS 144362).
ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Aug. 23 found that a lower federal court legally erred in applying the alter-ego doctrine to justify an award of unpaid contributions for an alleged employee’s work, reversing and remanding (Rod Marshall, Trustee, et al. v. Anderson Excavating & Wrecking Company, also known as Anderson Excavating Co., No. 17-1887, 8th Cir., 2018 U.S. App. LEXIS 23856).
NEW YORK — Plaintiffs claiming that New York University made imprudent investments in retirement plans for members of faculty, research staff and school administration on Aug. 14 asked a federal judge in New York to amend a July 31 ruling to reflect that two fiduciaries on committees for the plans are unqualified and should be barred from serving on the committees (Dr. Alan Sacerdote, et al. v. New York University, No. 16 Civ. 6284, S.D. N.Y.).
ATLANTA — A dermatologist’s suit against a health plan and a plan administrator was properly dismissed, the 11th Circuit U.S. Court of Appeals said Aug. 24 after determining that the plan administrator did not violate the Employee Retirement and Income Security Act by failing to provide the dermatologist with a copy of the summary plan description because the dermatologist had no right to obtain the plan document (W.A. Griffin, M.D. v. Aetna Health Inc., et al., No. 17-13113, 11th Cir., 2018 U.S. App. LEXIS 24050).
ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Aug. 23 reversed a district court’s ruling in favor of a disability claimant after determining that the insurer did not abuse its discretion in relying on the opinions of two independent medical reviewers when it denied the claim for benefits (Damon Zaeske v. Liberty Life Assurance Company of Boston, No. 17-2496, 8th Cir., 2018 U.S. App. LEXIS 23768).