BOSTON — Medical records and communications predating a woman’s bulimia treatments and evidence of her long struggle with the disease were not part of an insurer’s process in denying her coverage and cannot be made part of the judicial record, a federal judge in Massachusetts said July 13 in denying a motion to expand the record in an ERISA case (Addie Fisher v. Harvard Pilgrim Health Care of New England Inc., No. 17-11232, D. Mass., 2018 U.S. Dist. LEXIS 116751).
CAMDEN, N.J. — Third Circuit U.S. Court of Appeals precedent recently confirmed the validity of anti-assignment clauses in the Employee Retirement Income Security Act setting, and a health insurer’s interactions with a provider during the administrative appeals process did not waive the defense, a federal judge in New Jersey held July 13 (Rahul Shah, et al. v. Horizon Blue Cross Blue Shield of New Jersey, et al., No. 17-166, D. N.J.).
COLUMBUS, Ohio — An Ohio federal judge on July 12 dismissed a breach of fiduciary lawsuit filed against the sponsor, administrator and fiduciaries of 401(k) retirement plan, finding that the claims are foreclosed by the Employee Retirement Income Security Act’s statute of limitations (Enrique Bernaola v. Checksmart Financial LLC, et al., No. 16-684, S.D. Ohio, 2018 U.S. Dist. LEXIS 115882).
PROVIDENCE, R.I. — Allegations that Brown University engaged in prohibited transactions with regard to two retirement plans were dismissed July 11, but in the same ruling a Rhode Island federal judge agreed to let other claims by a purported class of plan participants and beneficiaries move forward (Diane G. Short, et al., v. Brown University, No. 17-318, D. R.I., 2018 U.S. Dist. LEXIS 115065).
CHICAGO — The Seventh Circuit U.S. Court of Appeals on July 11 affirmed a district court’s summary judgment ruling in favor of a beneficiary of a life insurance policy, agreeing with the lower court that the death benefits can be paid only to the designated beneficiary under the Employee Retirement Income Security Act (Emma Cehovic-Dixneuf v. Lisa Wong, No. 17-1532, 7th Cir., 2018 U.S. App. LEXIS 18853).
OAKLAND, Calif. — A California federal judge on July 9 refused to reconsider a Jan. 18 ruling that a former employee's claims against Charles Schwab & Co. Inc. and numerous related entities and individuals under the Employee Retirement Income Security Act could not be compelled to arbitration because they did not fall within the scope of arbitration provisions in several underlying documents that were signed by the employee (Michael F. Dorman, et al. v. Charles Schwab & Co. Inc., et al., No. 17-cv-00285, N.D. Calif.).
NEW YORK — The Second Circuit U.S. Court of Appeals on July 10 affirmed a district court’s dismissal of claims against five defendants named in a class action complaint against 12 banks and their affiliates under the Employee Retirement Income Security Act, agreeing with the district court’s conclusion that the plaintiffs failed to adequately plead that the defendants were ERISA fiduciaries or “parties in interest” (Doris Sue Allen, et al. v. Credit Suisse Securities [USA] LLC, et al., Nos. 16-3327, 16-3571, 2nd Cir., 2018 U.S. App. LEXIS 18756).
CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 9 affirmed the dismissal of a disability claimant’s suit after determining that the claimant failed to provide support for the state law claims that were not preempted under the Employee Retirement Income Security Act (Surrinder Arora v. Henry Ford Health System, et al., No. 17-2252, 6th Cir., 2018 U.S. App. LEXIS 18712).
NEWARK, N.J. — A federal judge in New Jersey on July 2 dismissed a consolidated class action suit brought by employees of Allergan PLC contending that the company, its board of directors and the committees and individuals who oversaw the Allergan Inc. Savings and Investment Plan violated the Employee Retirement Income Security Act by artificially inflating the value of the company’s stock price when offering it as an investment option in the plan, finding that the plaintiffs failed to state a claim upon which relief could be granted (In re Allergan ERISA Litigation, No. 17-1554, D. N.J., 2018 U.S. Dist. LEXIS 112127).
NEWARK, N.J. — A New Jersey federal judge on June 30 denied motions for class certification brought by two groups of plaintiffs in an Employee Retirement Income Security Act dispute with Aetna over its out-of-network (ONET) reimbursement rates, finding that the “plethora of diverse contractual standards involved in this case drives the Court into highly individualized inquiries” (In Re: Aetna UCR Litigation, No. 07-3541, D. N.J., 2018 U.S. Dist. LEXIS 111130).
NEW YORK — A Second Circuit U.S. Court of Appeals panel, in the second appeal in a case over the denial of psychiatric treatment by a health plan fund, upheld a trial court’s ruling on a benefits claim but vacated an order denying the plaintiff attorney fees and remanded for further consideration in light of a change in the relevant legal standard and a partial settlement (Wendy A. Tedesco v. I.B.E.W. Local 1249 Insurance Fund, et al., No. 17-3404, 2nd Cir., 2018 U.S. App. LEXIS 18370).
WASHINGTON, D.C. — Pension plan participants who unsuccessfully sued their plan manager for allegedly committing fiduciary breaches that caused $750 million in losses to the plan filed a petition for writ of certiorari with the U.S. Supreme Court on June 22 asking the justices to decide if individual financial loss or the imminent risk thereof is necessary in order for Employee Retirement Income Security Act plan participants to seek injunctive relief and restoration of plan losses (James J. Thole, et al. v. U.S. Bank, N.A., et al., No. 17-1712, U.S. Sup.).
TRENTON, N.J. — An arbitrator’s assessment of $2.55 million in withdrawal liability following a car dealership’s withdrawal from a United Auto Workers (UAW) pension fund was upheld July 3, when a New Jersey federal judge granted the plan summary judgment (Manhattan Ford Lincoln Inc. v. UAW Local 259 Pension Fund, No. 17-5076, D. N.J., 2018 U.S. Dist. LEXIS 111969).
DETROIT — A Michigan federal judge on June 25 denied plan participants’ motion for leave to file a second amended complaint under the Employee Retirement Income Security Act over plan fees and granted a motion to dismiss by record keeper Xerox HR Solutions LLC, holding that the amended complaint failed to address deficiencies previously identified by the court (Patrick Chendes, et al. v. Xerox HR Solutions, LLC, No. 16-13980, E.D. Mich.).
By Ian S. Linker
RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals on July 3 denied a petition for rehearing en banc filed by the appellants in a decade-long case over a bank’s illegal transfer of assets from a 401(k) plan to an Employee Retirement Income Security Act pension plan (William L. Pender, et al. v. Bank of America Corp., et al., No. 17-1485, 4th Cir.).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on July 3 denied a petition for rehearing, refusing to reconsider a June 15 remand of a disability benefits dispute to a district court to determine whether the claimant is entitled to equitable relief based on the disability plan’s failure to properly offset the claimant’s disability benefits (Petar Mrkonjic v. Delta Family-Care and Survivorship Plan, et al., Nos. 16-56335 and 16-56487, 9th Cir., 2018 U.S. App. LEXIS 18228).
JACKSON, Miss. — Noting that a disability insurer engaged in a “decades-long pattern of arbitrary claim denials and other misdeeds,” a Mississippi federal judge on June 29 determined that the insurer’s denial of benefits to a claimant was an abuse of discretion because the denial was unsupported by the evidence (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 17-42, S.D. Miss., 2018 U.S. Dist. LEXIS 109526).
SAN FRANCISCO — The Patient Protection and Affordable Care Act (ACA) recognizes lactation support services as preventive care and does not carve out situations where women receive the services in response to symptoms, a federal judge in California held in partially granting judgment to named class members on ACA and ERISA claims June 27 (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 17-183, N.D. Calif.).
BOSTON — A Massachusetts federal judge on June 28 reduced an award of attorney fees to a disability claimant after determining that a number of the hours billed by the claimant’s attorney are not compensable because the hours were related to alleged misrepresentations made by the claimant’s attorney (Diahann L. Gross v. Sun Life Assurance Company of Canada, No. 09-11678, D. Mass., 2018 U.S. Dist. LEXIS 107918).