Mealey's ERISA
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October 04, 2023
Preexisting Conditions Exclusion Applies Based On Prior Treatment, Judge Says
ATLANTA — A disability insurer’s denial of a long-term disability (LTD) claim was reasonable because the policy’s preexisting conditions exclusion bars coverage, a Georgia federal judge said after determining that an actual diagnosis for a sickness for which the claimant was treated prior to becoming an insured under the disability plan is not required for the exclusion to apply.
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October 04, 2023
Disability Claimant’s Suit Dismissed Following Settlement Reached During Mediation
SAN FRANCISCO — A California federal judge dismissed a disability claimant’s suit seeking a declaration that she is entitled to long-term disability (LTD) benefits after the claimant and the disability insurer agreed to a settlement during a mediation proceeding.
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October 03, 2023
Rehearing Bid Over 5th Circuit Affirmation Of Big ERISA Class Draws More Feedback
NEW ORLEANS — Contending that “which [standing] test applies does not affect the outcome” and that the other issue raised focuses on factual determinations, appellees on Oct. 2 urged the Fifth Circuit U.S. Court of Appeals not to grant rehearing en banc in a case where a panel upheld certification of a large multiplan class.
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October 03, 2023
Federal Magistrate Judge Awards Disability Claimant $42,851 In Attorney Fees
MADISON, Wis. — A Wisconsin federal magistrate judge awarded a disability claimant more than $42,000 in attorney fees after determining that a 40% overall reduction in the billed amount of fees was necessary despite the claimant’s success on the merits of his long-term disability (LTD) benefits claim.
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October 02, 2023
Big TPA Seeks Dismissal Of Backward-Looking Claims In DOL’s ERISA Case
MADISON, Wis. — Arguing in part that Acting U.S. Department of Labor Secretary Julie A. Su “invokes two inapposite causes of action,” the third-party administrator (TPA) of hundreds of self-funded employee welfare benefit plans in a Sept. 29 motion asked a Wisconsin federal court to dismiss backward-looking claims in the suit over hospital emergency services claims and urinary drug screening claims.
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October 02, 2023
High Court Denies Certiorari Bid Over Arizona Ruling In ERISA Preemption Row
WASHINGTON, D.C. — A certiorari bid regarding an Arizona Court of Appeals ruling in an Employee Retirement Income Security Act case involving a preemption dispute has failed, with the U.S. Supreme Court issuing a denial on Oct. 2.
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October 02, 2023
U.S. High Court Won’t Review Criminal Restitution Case Concerning ERISA, CCPA
WASHINGTON, D.C. — A petitioner argued unsuccessfully that a Fourth Circuit U.S. Court of Appeals panel wrongly “held that neither” the Employee Retirement Income Security Act nor the Consumer Credit Protection Act of 1968 (CCPA) “posed an obstacle to garnishment of [his] retirement funds,” with the U.S. Supreme Court denying his certiorari bid on Oct. 2.
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October 02, 2023
Rehearing Opposed In ERISA Case Where 10th Circuit Ordered Claim Reprocessing
DENVER —Contending in part that an “extreme argument” against remand for claim reprocessing was raised too late to be considered and “has no legal or logical basis,” United Health Insurance Co. and related entities urge the 10th Circuit U.S. Court of Appeals not to rehear a case involving residential treatment claims for mental health and substance use.
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October 02, 2023
High Court Won’t Review ERISA Class Action Over Residual Annuities
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 2 denied a certiorari petition regarding a Second Circuit U.S. Court of Appeals ruling in an Employee Retirement Income Security Act class action over residual annuities.
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September 29, 2023
Dismissal Bid Fails In Excess Loss Reinsurance Row With ERISA, Bad Faith Claims
PITTSBURGH — Ruling the arguments “more appropriately handled at the summary judgment stage,” a Pennsylvania federal judge on Sept. 28 denied a dismissal motion in an Employee Retirement Income Security Act suit over an excess loss reinsurance contract.
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September 29, 2023
Judge: Plaintiffs Have Right To Jury Trial On Some Claims In ERISA Fees Row
NEW YORK — An Employee Retirement Income Security Act class action over a multiple employer retirement plan’s record-keeping and administration fees will go before a jury under a New York federal judge’s ruling.
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September 29, 2023
$15M Settlement Gets Final Approval In ERISA Fees, Funds Row
NEW HAVEN, Conn. — A Connecticut federal judge has granted final approval to a $15 million settlement in a class action challenging retirement plan fees and funds including Fidelity “active” target date funds (TDFs).
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September 29, 2023
Judge: Vague Health Plan References Can’t Save Bariatric Surgery Case
LOS ANGELES — Allegations that bariatric surgery providers obtained assignment of rights suffice for standing under the Employee Retirement Income Security Act, but the failure to identify the plans or terms in question require dismissal, a federal judge in California said while granting leave to amend.
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September 28, 2023
Parties Stipulate To Dismissal Of ERISA Drug Prices Suit Against Insurer
NEW HAVEN, Conn. — Parties in an Employee Retirement Income Security Act suit over allegations that Cigna Health and Life Insurance Co. “had no right under its prescription drug plans to charge ‘spread’ and then ‘claw back’ the member copayment or deductible ‘overpayments’” have filed a joint stipulation in Connecticut federal court to dismissal with prejudice.
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September 26, 2023
Differentiating Allegations, Judge Lets Some Claims Survive In BlackRock TDF Row
RICHMOND, Va. — Differentiating the allegations from those in what were initially similar Employee Retirement Income Security Act cases over BlackRock LifePath Index target date funds (TDFs), a Virginia federal judge ruled in part that the plaintiffs stated a claim against Genworth Financial Inc. for breach of the duty of prudence.
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September 26, 2023
$975,000 Class Settlement Proposed In ERISA Imprudence Lawsuit
NEW YORK — Plaintiffs in an Employee Retirement Income Security Act case alleging breach of the duty of prudence on Sept. 25 moved in New York federal court for preliminary approval of a class settlement including a $975,000 payment and nonmonetary relief.
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September 25, 2023
$2.9M Class Settlement Gets Final OK In ERISA Fees, Funds Case
BOSTON — A Massachusetts federal judge on Sept. 22 granted final approval to a class settlement in which a $2.9 million payment plus an agreement to boost monitoring of investment and service provider monitoring resolve a suit challenging fees and funds in jointly administered retirement plans.
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September 25, 2023
Mental Health Insurer Never Meaningfully Engaged With Insureds, Judge Says
SALT LAKE CITY — An insurer’s apparent failure to recognize that the program for which it originally approved treatment included both residential and transitional levels, its “cryptic denials” and its dismissal of the opinions of treating physicians evidence a failure to participate in meaningful dialogue with the insureds, a federal judge in Utah said in granting summary judgment on both Employee Retirement Income Security Act (ERISA) and Parity Act claims.
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September 25, 2023
Texas Federal Judge Grants DOL Summary Judgment In ESG Investing Rule Case
AMARILLO, Texas — Granting summary judgment for the U.S. Department of Labor (DOL) on a challenge to its 2022 investment rule concerning environmental, social and governance (ESG) factors, a Texas federal judge asserted that the rule “changes little in substance from the 2020 Rule and other rulemakings” and does not violate the Employee Retirement Income Security Act and the Administrative Procedure Act (APA).
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September 20, 2023
Some Claims Proceed In Health Care Repricing Scheme Case Against UnitedHealth
NEW YORK — Claims that various UnitedHealth Group Inc. entities collected billions of dollars in fees under a repricing scheme providing Employee Retirement Income Security Act plans with largely illusory savings suffice to overcome a motion to dismiss, a federal judge in New York said Sept. 19 in partly denying the motion.
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September 18, 2023
Government Urges High Court To Uphold ‘Bedrock Principle’ Of Chevron Deference
WASHINGTON, D.C. — The U.S. secretary of Commerce, two National Oceanic and Atmospheric Administration (NOAA) officials and the National Marine Fisheries Service (NMFS) (collectively, the government) urge the U.S. Supreme Court in a Sept. 15 brief to not overrule the doctrine of Chevron deference in a challenge to fishery regulations that were upheld by the District of Columbia Circuit U.S. Court of Appeals, writing that doing so could “cause disruption” to complex federal regulatory schemes.
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September 15, 2023
Certified Class: Insurer Used Single Experimental Treatment For Blanket Denials
UTICA, N.Y. — A federal judge in New York on Sept. 14 certified a class of insureds who claim that United Behavioral Health violated the Employee Retirement Income Security Act by issuing blanket denials for residential treatments when it considered even a single aspect of the facility’s treatment experimental.
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September 14, 2023
11th Circuit Upholds Ruling Against Former Exec In ERISA Severance Row
ATLANTA — In an unpublished per curiam opinion explaining only that “we find no reversible error in the district court’s judgment,” an 11th Circuit U.S. Court of Appeals panel upheld summary judgment against a former CSX Transportation Inc. executive in a dispute concerning what is known as a “top hat” severance plan.
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September 14, 2023
Parties In ERISA Case With Large Class Denied Permission For Interlocutory Appeal
RICHMOND, Va. — Bids by a health insurer and subcontractor for permission to file interlocutory appeals to the Fourth Circuit U.S. Court of Appeals over a class certification order in a suit concerning an alleged cost-shifting scheme were denied without explanation in a Sept. 13 order.
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September 13, 2023
Split 4th Circuit Panel Partly Remands ERISA Case In Equitable Remedy Ruling
RICHMOND, Va. — Partly vacating dismissal of an Employee Retirement Income Security Act case over denial of a heart transplant, a Fourth Circuit U.S. Court of Appeals panel focused on the question of when monetary relief is equitable, splitting on an issue involving interpretation of a 2016 U.S. Supreme Court decision.