PHILADELPHIA — A Pennsylvania federal judge correctly determined that the administrative record in a disability coverage dispute supports the insurer’s conclusion that a plan’s pre-existing condition exclusion bars coverage for the claimant’s disability, which stems from her pre-existing depression, the Third Circuit U.S. Court of Appeals said Nov. 26 (Yvonne Hilbert v. The Lincoln National Life Insurance Co., 17-2583, 3rd Cir., 2018 U.S. App. LEXIS 33133).
CHICAGO — The Seventh Circuit U.S. Court of Appeals on Nov. 26 vacated and remanded a lower federal court’s dismissal of two out of three claims in a doctor’s lawsuit alleging that health plan administrators underpaid for her services and failed to furnish requested plan documents, finding that the doctor adequately asserted that she is eligible for additional benefits and statutory damages (W.A. Griffin v. TeamCare, No. 18-2374, 7th Cir., 2018 U.S. App. LEXIS 33117).
TRENTON, N.J. — The conclusion that not all of an insurer’s overpayment letters to medical providers constituted a demand for payment or adverse benefit denial made class certification of plaintiffs’ Employee Retirement Income Security Act claims improper, a federal judge in New Jersey held in denying reconsideration on Nov. 26 (Association of New Jersey Chiropractors, et al. v. Aetna Inc., et al., TRI3 Enterprises LLC, et al. v. Aetna Inc., et al., Nos. 09-3761, 11-3921, D. N.J., 2018 U.S. Dist. LEXIS 199431).
RALEIGH, N.C. — In a Nov. 19 putative class action complaint, five plaintiffs assert that their former employer — described as a nonprofit “healthcare conglomerate” — has falsely claimed entitlement to the Employee Retirement Income Security Act “governmental plan” exemption, to the detriment of more than 65,000 workers (Della Shore, et al. v. Charlotte Mecklenburg Hospital Authority, No. 18-961, M.D. N.C.).
NEW YORK — A former Dave & Buster’s Inc. employee accusing the chain of violating the Employee Retirement Income Security Act by reducing the hours of its work force in 2013 to avoid the costs associated with providing health insurance to its full-time employees in compliance with the Patient Protection and Affordable Care Act (ACA) on Nov. 20 filed a second motion in New York federal court for approval of a $7.4 million offer to resolve the suit (Maria De Lourdes Parra Marin v. Dave & Buster’s, Inc., et al., No. 15-3608, S.D. N.Y.).
BALTIMORE — A Maryland federal judge on Nov. 21 held that the U.S. secretary of Labor is time-barred under Section 413 of the Employee Retirement Income Security Act from bringing any claims that arise more than three years from the date when Chimes D.C. Inc. Health & Welfare Plan and its alleged fiduciaries and service providers entered into their respective tolling agreements with the secretary, granting the defendants’ motion for partial summary judgment in a lawsuit alleging that they charged the employee benefit plan excessive fees for services and engaged in prohibited transactions (R. Alexander Acosta v. Chimes District of Columbia, Inc., et al., No. 15-3315, D. Md., 2018 U.S. Dist. LEXIS 198385).
ST. LOUIS — Wells Fargo & Co. and others accused of violating the Employee Retirement Income Securities Act by encouraging and causing employees to sign up customers for unauthorized and unwanted accounts and other banking products to generate inflated share price growth told the Eighth Circuit U.S. Court of Appeals Nov. 16 that a federal judge in Minnesota did not err in dismissing the class action lawsuit because the statute does not require the disclosure of nonpublic information to plan participants (Francesca Allen, et al. v. Wells Fargo & Co., et al., No. 18-2781, 8th Cir.)
DETROIT — A Michigan federal judge on Nov. 19 approved a $4.25 million class action settlement in a dispute over the continuation of health benefits for retirees of the city of Pontiac, Mich. (The City of Pontiac Retired Employees Association et al., v. Louis Schimmel, et al., No. 12-12830, E.D. Mich.).
CINCINNATI — A district court did not err in concluding that a disability claimant was not disabled from his own occupation as an anesthesiologist because the medical evidence supported the disability insurer’s conclusion that the claimant could perform the duties of his own occupation with appropriate accommodations, the Sixth Circuit U.S. Court of Appeals said Nov. 19 (Timothy O’Neill D.O. v. Unum Life Insurance Company of America, No. 18-1382, 6th Cir., 2018 U.S. App. LEXIS 32781).
NEW YORK — A New York federal judge on Nov. 15 adopted a corrected joint stipulation for class certification in a suit alleging that Columbia University breached its duty of prudence to its retirement plan participants and beneficiaries by causing the university’s retirement plans to incur excessive administrative fees and by failing to monitor the plans’ investment options (Chandra Cates, et al v. The Trustees of Columbia University in the City of New York, et al., No. 16-6524, S.D. N.Y.).
WASHINGTON, D.C. — A dermatologist in a Nov. 6 petition asks the U.S. Supreme Court to answer whether an assignee of benefits has the authority to request Employee Retirement and Income Security Act plan documents from the plan administrator even if the original assignment does not confer rights to pursue statutory penalties claims (W.A. Griffin, M.D. v. Aetna Health Inc., et al., No. 18-613, U.S. Sup., 2018 U.S. S. Ct. Briefs LEXIS 4116).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Nov. 13 affirmed a California federal court’s dismissal of a class complaint alleging that Chevron Corp., the Chevron Investment Committee and 20 Doe defendants violated the Employee Retirement Income Security Act by acting disloyally and imprudently in the management of the Chevron Employee Saving Investment Plan (Charles E. White, Jr., et al. v. Chevron Corporation, et al., No. 17-16208, 9th Cir., 2018 U.S. App. LEXIS 32116).
WASHINGTON, D.C. — The U.S. Supreme Court on Nov. 13 denied a petition for writ of certiorari filed by plaintiffs who argued that the Sixth Circuit U.S. Court of Appeals erred in finding that Honeywell International Inc. is permitted to terminate health benefits for retirees of a Greenville, Ohio, oil filter plant (Barbara Fletcher, et al. v. Honeywell International Inc., No. 18-467, U.S. Sup.).
SEATTLE — A 2016 ordinance passed by the city of Seattle that requires hotel employers to provide a minimum specified level of health benefits to certain employees is preempted by federal law, a trade association representing the employers maintains in an Oct. 25 motion for summary judgment filed in a Washington federal court (ERISA Industry Committee v. Seattle, No. 18-1188, W.D. Wash.).
INDIANAPOLIS — An Indiana federal judge on Oct. 22 held that pension funds and their trustee failed to show that they would suffer irreparable harm if a temporary restraining order was not issued against an employer requiring it to pay unpaid contributions to the funds, denying the request (Mark McCleskey, et al. v. Hooks AV, LLC, No. 1:18-cv-02397, S.D. Ind., 2018 U.S. Dist. LEXIS 180575).
WASHINGTON, D.C. — Arkansas Attorney General Leslie Rutledge on Oct. 22 told the U.S. Supreme Court that the Eighth Circuit U.S. Court of Appeals erred when it found that a state law regulating drug reimbursement rates for pharmacy benefits managers (PBMs) is preempted by the Employee Retirement Income Security Act (Leslie Rutledge v. Pharmaceutical Care Management Association, No. 18-540, U.S. Sup.).
NASHVILLE, Tenn. — Plan participants accusing Vanderbilt University, the oversight committee and members of the committee of mismanaging an employee retirement plan in violation of the Employee Income Retirement Security Act on Nov. 5 objected to a federal magistrate judge’s Oct. 22 recommendation to strike their request for a jury trial, contending that their requests for damages should be decided by a jury because they are legal and not equitable (Loren L. Cassell, et al. v. Vanderbilt University, et al., No. 16-2086, M.D. Tenn.).
NEW YORK — A New York federal magistrate judge on Nov. 8 certified a class of plaintiffs in a suit alleging that Columbia University breached its duty of prudence to its retirement plan participants and beneficiaries by causing the university’s retirement plans to incur excessive administrative fees and by failing to monitor the plans’ investment options (Chandra Cates, et al v. The Trustees of Columbia University in the City of New York, et al., No. 16-6524, S.D. N.Y.).
WASHINGTON, D.C. — Bank employees and plan participants asked the U.S. Supreme Court on Oct. 30 to review the Fourth Circuit U.S. Court of Appeals finding that they failed to show that any profit was retained by the bank as a result of the illegal transfer of assets from a 401(k) plan to an Employee Retirement Income Security Act pension plan after the Fourth Circuit denied their petition for rehearing en banc (William L. Pender, et al. v. Bank of America Corp., et al., No. 18-578, U.S. Sup.).
NEW YORK — Former SunEdison Inc. employees who participated in the company’s defined-contribution retirement savings plan on Oct. 29 asked the Second Circuit U.S. Court of Appeals to reverse a lower federal court’s dismissal of their lawsuit alleging breaches of fiduciary and loyalty duties against SunEdison’s board of directors and investment committee (Eric O’Day, et al. v Ahmad Chatila, et al., Nos. 18-2621 and 18-2632, 2nd Cir.).