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United States Tells High Court Church Plan Exemption Applies To Church Agencies
WASHINGTON, D.C. - The United States on Jan. 24 in an amicus brief asked the U.S. Supreme Court to follow the Internal Revenue Service, the Department of Labor and the Pension Benefit Guaranty Corp.'s longstanding conclusion that a plan need only be "maintained" by a qualifying church-affiliated organization and not be "established" by a church to qualify for the church plan exemption to the Employee Retirement Income Security Act (Advocate Health Care Network, et al. v. Maria Stapleton, et al., No. 16-74, Saint Peter's Healthcare System, et al. v. Laurence Kaplan, No. 16-86, Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.).



Puerto Rico Federal Judge Denies Motion To Dismiss Church Plan Class Action
SAN JUAN, Puerto Rico - A Puerto Rico federal judge on Jan. 27 adopted a magistrate judge's report and recommendation and denied pension plans' motion to dismiss an amended class action complaint alleging breaches of fiduciary duties under the Employee Retirement Income Security Act, saying the factual record must be developed before a summary judgment motion could be considered (Ivette M. Martinez-Gonzalez, et al. v. Catholic Schools of the Archioceses of San Juan Pension Plan, et al., No. 16-2077, D. Puerto Rico, 2017 U.S. Dist. LEXIS 11903).



8th Circuits Finds ERISA Preempts Iowa Generic Drug Pricing Law
ST. PAUL, Minn. - Finding that an Iowa law pertaining to generic drug pricing expressly and implicitly refers to the Employee Retirement Income Security Act, an Eighth Circuit U.S. Court of Appeals panel on Jan. 11 ruled that the state law is preempted by ERISA, reversing a trial court judgment dismissing the declaratory action brought against Iowa's insurance commissioner and attorney general (Pharmaceutical Care Management Association v. Nick Gerhart, et al., No. 15-3292, 8th Cir., 2017 U.S. App. LEXIS 476).



1st Circuit: Dispute Between Union, Employer Belongs In Arbitration
BOSTON - A decision on whether a nurses union may proceed with allegations that a successor employer violated an agreement when it refused to submit a pending grievance to arbitration should be made by an arbitrator and not the courts, the First Circuit U.S. Court of Appeals ruled Feb. 3 (Prime Healthcare Services - Landmark LLC v. United Nurses and Allied Professionals, Local 5067, No. 16-1161, 1st Cir., 2017 U.S. App. LEXIS 2038).



4th Circuit Panel Affirms State Law Claims Are Preempted By ERISA
RICHMOND, Va. - In a case in which an employee alleged that his employer improperly administered life insurance benefits, a Fourth Circuit U.S. Court of Appeals panel on Jan. 27 affirmed a federal judge's decision dismissing the complaint alleging misrepresentation, constructive fraud and infliction of emotional distress because the Employee Retirement Income Security Act completely preempts these state law claims (Billy E. Prince, et al. v. Sears Holdings Corp., No. 16-1075, 4th Cir., 2017 U.S. App. LEXIS 1512).



Plaintiff's Claims Are Preempted By ERISA, Illinois Federal Judge Says
CHICAGO - An Illinois federal judge on Jan. 12 denied a plaintiff's motion to remand after determining that her state law claims arising out of the disclosure of medical records without consent are preempted by the Employment Retirement Income Security Act (Jane Doe v. Aetna Inc., et al., No. 16-8390, N.D. Ill.; 2017 U.S. Dist. LEXIS 4866).



Supreme Court Won't Review 6th Circuit ERISA Preemption Ruling
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 9 let stand a Sixth Circuit U.S. Court of Appeals' ruling that affirmed the dismissal of claims that the Michigan Health Insurance Claims Assessment Act is preempted by the Employee Retirement Income Security Act (Self-Insurance Institute of America Inc. v. Rick Snyder, et al., No. 16-593, U.S. Sup.).



High Court Asks Government To Express Views In ERISA Indemnification Case
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 9 asked the U.S. solicitor general to file a brief expressing the government's views in a case that asks whether the Employee Retirement Income Security Act permits a cause of action for indemnity or contribution by a person found liable for breach of fiduciary duty (David B. Fenkell v. Alliance Holdings Inc., et al., No. 16-473, U.S. Sup.).



Judge: Bank Did Not Breach Fiduciary Duty In Its Response To Directions
NEW YORK - The Bank of New York Mellon's response to investment directions provided by representatives of a pension plan in investing a portion of the plan's in cash equivalents instead of equities did not "fall below the floor" imposed by the Employee Retirement Income Security Act, a federal judge in New York ruled Jan. 9 (Richard Harley, et al. v. The Bank of New York Mellon, No. 15-8898, S.D. N.Y., 2017 U.S. Dist. LEXIS 3068).



Missouri Federal Judge Lets ERISA Class Action Against Edward D. Jones Proceed
ST. LOUIS - A Missouri federal judge on Jan. 26 refused to dismiss a putative class action alleging breach of fiduciary duties under the Employee Retirement Income Security Act, saying that a participant in an employer profit-sharing and 401(k) plan's complaint provided sufficient facts to plausibly state these claims (Charlene F. McDonald, et al. v. Edward D. Jones & Co., et al., No. 4:16 CV 1346, E.D. Mo., 2017 U.S. Dist. LEXIS 10820).



Rhode Island Magistrate Again Recommends Dismissal Of Investment Option Lawsuit
PROVIDENCE, R.I. - A Rhode Island magistrate judge in a Jan. 31 report recommended dismissal of an amended complaint arising under the Employee Retirement Income Security Act alleging that CVS Health Corp., its employee benefits plan committee and the manager of one of the plan's investment options breached their fiduciary duties, saying that new material in the complaint is insufficient to permit an inference of imprudence (Mary Barchock, et al. v. CVS Health Corp., et al., No. 1:16-cv-00061, D. R.I.).



Judge: Hospital Has Standing To Sue Insurer For Breach Of Fiduciary Duty Under ERISA
DAVENPORT, Iowa - A federal judge in Iowa on Jan. 7 held that a hospital has standing to sue its health benefits plan sponsor and administrator for breach of fiduciary duty under the Employee Retirement Income Security Act (Keokuk Area Hospital Inc. v. Two Rivers Insurance Company, d/b/a Employee Benefit Systems, Inc., No. 16-00066, S.D. Iowa, 2017 U.S. Dist. LEXIS 2449).



DOL Releases FAQs On New Fiduciary Duty Rules To Take Affect April 10
WASHINGTON, D.C. - The U.S. Department of Labor (DOL) in a January report released a frequently asked questions (FAQs) publication to tell investors about their rights as consumers of products and services governed by the Employee Retirement Income Security Act.



Michigan Tribe, Blue Cross Settle ERISA Plan Administration Claims
DETROIT - Michigan's Little River Band of Ottawa Indians and Blue Cross Blue Shield have settled the tribe's claims that Blue Cross breached its fiduciary duty and violated the Employee Retirement Income Security Act (ERISA) in administering the tribe's health care plan for employees, according to a dismissal order filed Jan. 11 in federal court (Little River Band of Ottawa Indians, et al. v. Blue Cross Blue Shield of Michigan, No. 2:15-cv-13708, E.D. Mich.).



J.C. Penney To Settle Plan Losses Class Suit For $4.5 Million
TYLER, Texas - A Texas federal judge on Jan. 3 granted preliminary approval of a $4.5 million settlement to be paid by J.C. Penney Corp. Inc. to end a class suit accusing the retailer of violating the Employee Retirement Income Security Act by allowing the J.C. Penney Corporation Inc. Savings, Profit Sharing and Stock Ownership Plan (the plan) to remain invested in the J.C. Penney Common Stock Fund when it should have known the stock was being traded at an artificially inflated price due to misrepresentations by J.C. Penney senior officers (Roberto Ramirez, et al. v. J.C. Penney Corporation, Inc., et al., No. 14-601, E.D. Texas; 2017 U.S. Dist. LEXIS 389).



Panel Says Administrator Reasonably Determined Plaintiff's Years Of Service
BOSTON - The First Circuit U.S. Court of Appeals on Jan. 11 affirmed a district court's finding that an administrative committee of a pension plan correctly calculated a plaintiff's pension benefits based on the plaintiff having accrued only 12 years of benefit service (George J. Vendura Jr. v. Jonathan Boxer, et al., No. 15-2387, 1st Cir., 2017 U.S. App. LEXIS 528).



6th Circuit: Nunc Pro Tunc Order Did Not Restart Limitations Period
CINCINNATI - A woman's lawsuit accusing Chrysler Group LLC's pension plan of violating the Employee Retirement Income Security Act by denying her request for benefits from her ex-husband's pension was not timely, a Sixth Circuit U.S. Court of Appeals panel ruled Jan. 11, holding that a state court's nunc pro tunc order did not restart the statute of limitations (Ardella Patterson v. Chrysler Group, LLC, et al., No. 16-1365, 6th Cir., 2017 U.S. App. LEXIS 507).



Supreme Court Lets Stand 9th Circuit's Ruling On ERISA Pension Plan Definition
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 9 declined to review a Ninth Circuit U.S. Court of Appeals' ruling that affirmed the dismissal of claims under the Employee Retirement Income Security Act against Booz Allen Hamilton Inc. (BAH) based on its conclusion that BAH's Stock Rights Plan did not qualify as an ERISA plan because its primary purpose was not to provide deferred compensation or other retirement benefits (Foster Rich v. Ralph W. Shrader, et al., No. 16-415, U.S. Sup.).



Judge Orders Health Care Fraud Defendant To Turn Over Retirement Funds
CHICAGO - A cardiologist who pleaded guilty to one count of health care fraud for fraudulently billing Medicare and other insurance companies was ordered by a federal judge in Illinois to turn over three retirement funds valued at $300,738.60 after finding that forfeiture of the funds would not result in an overpayment of the $12 million he owes in restitution (United States of America v. Sushil Sheth, No. 09 CR 69-1, N.D. Ill.; 2017 U.S. Dist. LEXIS 2281).



High Court Will Not Weigh In On Application Of Single-Employer Doctrine
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 17 let stand a Seventh Circuit U.S. Court of Appeals ruling that reversed the grant of summary judgment to four carpenter union fringe benefit funds that alleged that a general contractor failed to pay fringe benefits for work performed by nonunion labor as required by a collective bargaining agreement in violation of the Labor Management Relations Act (LMRA) and the Employee Retirement Income Security Act (Chicago Regional Council of Carpenters Pension Fund, et al. v. Schal Bovis, Inc., No. 16-690, U.S. Sup.).



9th Circuit Panel Tosses Contract Appeal For Lack Of Subject Matter Jurisdiction
SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on Jan. 30 dismissed for lack of subject matter jurisdiction an appeal of a California federal judge's dismissal of a breach of contract claim by a union pension plan against a national union pension fund (Trustees of the U.A. Local 38 Defined Benefit Pension Plan, et al. v. Trustees of the Plumber and Pipe Fitters National Pension Fund, et al., No. 14-16543, 9th Cir., 2017 U.S. App. LEXIS 1612).



Texas Federal Judge Dismisses Gender Identity Discrimination Claims
DALLAS - A Texas federal judge on Jan. 13 dismissed claims alleging gender identity discrimination under Section 1557 of the Patient Protection and Affordable Care Act (ACA) against an insurer and an employer because the plaintiff failed to cite any controlling precedent that recognizes a cause of action under Section 1557 for gender identity discrimination (Charlize Marie Baker v. Aetna Life Insurance Co., et al., No. 15-3679, N.D. Texas; 2017 U.S. Dist. LEXIS 5665).



Disability Insurer Waived Right To Assert Claimant Was Ineligible For Coverage
BIRMINGHAM, Ala. - An Alabama federal judge on Jan. 13 determined that by continuing to accept a disability claimant's premium payments, an insurer waived its right to assert that the claimant was ineligible for coverage under the policy (Arturo J. Otero v. Unum Life Insurance Company of America, No. 14-2253, N.D. Ala.; 2017 U.S. Dist. LEXIS 5119).



11th Circuit Affirms Insurer Did Not Abuse Its Discretion In Denying Benefits Claim
ATLANTA - A disability insurer did not abuse its discretion in denying a claim for long-term disability benefits because the claimant failed to prove that she was disabled under the plan and the insurer's denial was reasonable based on the available evidence, the 11th Circuit U.S. Court of Appeals said Jan. 30 (Susan Till v. Lincoln National Life Insurance Co., et al., No. 16-14799, 11th Cir., 2017 U.S. App. LEXIS 1589).



Plan Administrator Abused Its Discretion In Terminating Benefits, 4th Circuit Affirms
RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals on Jan. 5 said a district court did not improperly find that a disability plan administrator abused its discretion in terminating a claimant's benefits because the evidence supports a finding that the claimant was disabled and the plan administrator's decision was not reasoned and principled (Stephen Wilkinson v. Sun Life and Health Insurance Co., et al., No. 15-2105, 4th Cir.; 2017 U.S. App. LEXIS 201).



High Court Will Not Hear Issue Of Forum-Selection Clause In ERISA Disability Plan
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 17 denied review of a ruling by the Eighth Circuit U.S. Court of Appeals that enforced a forum-selection clause in a disability plan governed by the Employee Retirement Income Security Act (Lorna Clause v. U.S. District Court for the Eastern District of Missouri, et al., No. 16-641, U.S. Sup.).



3rd Circuit Says Man Must Reimburse Health Plan Based On Third-Party Settlement
PHILADELPHIA - A panel of the Third Circuit U.S. Court of Appeals on Jan. 6 affirmed a ruling in which a man was ordered to reimburse a health benefit plan after he obtained a settlement from a third party for injuries he suffered in an accident, finding that the settlement was not a legal judgment prohibited by the Employee Retirement Income Security Act (National Elevator Industry Health Benefit Plan Board of Trustees v. Bernard McLaughlin, No. 16-1352, 3rd Cir., 2017 U.S. App. LEXIS 280).



Final Approval Granted To United Healthcare's Settlement Of Harvoni Drug Coverage
MIAMI - A federal judge in Florida on Feb. 2 granted final approval to a class action settlement in which United Healthcare Inc. agreed to remove certain restrictions on coverage for treatment of hepatitis C with the prescription drug Harvoni (Ilissa M. Jones, et al. v. United Healthcare Services, Inc., et al., No. 15-cv-6114-RLR, S.D. Fla.).



California Woman Files Class Action Over Denial Of Breastfeeding Support
OAKLAND, Calif. - A California woman on Jan. 13 filed a class action complaint in federal court alleging that she and other women have been wrongfully denied access to and coverage for a vital women's preventive service - breastfeeding support, supplies and counseling - for which coverage is mandated by the Patient Protection and Affordable Care Act (ACA) (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 4:17-cv-00183, N.D. Calif.).



Amended UnitedHealth, OptumRx Class Action 'Clawback' Lawsuit Includes ERISA, RICO Claims
MINNEAPOLIS - An amended class action complaint filed Jan. 20 in Minnesota federal court against UnitedHealth Group Inc. and its subsidiaries and OptumRx Inc. over an allegedly deceptive "clawback" billing scheme includes claims of violations of the Employee Retirement Income Security Act and the Racketeer Influenced and Corrupt Organizations (RICO) Act (Kathy L. Fellgren, et al. v. UnitedHealth Group Inc., et al., No. 0:16-cv-03914, D. Minn.).



Judge Finds ERISA Exempts Self-Funded Plan From ACA Requirements
MINNEAPOLIS - A self-funded Employee Retirement Income Security Act (ERISA) plan falls outside the Patient Protection and Affordable Care Act (ACA)'s essential health benefits requirement, a federal judge in Minnesota said Feb. 2 in adopting a report and recommendation partially rejecting insurance coverage claims arising from a fireworks accident (Jeffrey Jay Henrikson v. Choice Products USA LLC, et al., No. 16-1317, D. Minn.).



Federal Magistrate Grants Motion To Keep Insurer's Trade Secrets Confidential
OWENSBORO, Ky. - A Kentucky federal magistrate judge on Dec. 14 granted a disability insurer's motion for a protective order of confidentiality, finding that the information it wants to keep confidential qualifies as trade secrets because a competitor could gain an advantage over the insurer if it had access to the information (Paulette Owens v. Liberty Life Assurance Co. of Boston, No. 4:15-cv-00071, W.D. Ky.; 2016 U.S. Dist. LEXIS 172540).



2nd Circuit Panel Affirms Health Plan Not Entitled To Fees In ERISA Action
NEW YORK - In a Jan. 31 summary order, a Second Circuit U.S. Court of Appeals panel upheld a New York federal judge's ruling that a health plan is not entitled to attorney fees under the Employee Retirement Income Security Act because a restitution claim against it was dismissed on summary judgment (Nicholas Scarangella v. Group Health Inc., et al., No. 16-568, 2nd Cir., 2017 U.S. App. LEXIS 1684).



Full 9th Circuit Remands Tibble For Trial Of Breach Of Fiduciary Duty Claims
SAN FRANCISCO - On remand from the U.S. Supreme Court, the en banc Ninth Circuit U.S. Court of Appeals on Dec. 16 unanimously voted to vacate a California federal judge's ruling in favor of an employer and its benefits plan administrator on breach of fiduciary duty claims in the selection and retention of certain mutual funds for a defined contribution 401(k) savings plan governed by the Employee Retirement Income Security Act, saying a trial is needed to determine if the defendants should have switched from retail-class fund shares to institutional-class fund shares to fulfill their continuing duty to monitor the appropriateness of investments (Glenn Tibble, et al. v. Edison International, et al., No. 10-56406, 9th Cir.; 2016 U.S. App. LEXIS 22366).



D.C. Circuit Panel Affirms Fiduciary Duty Claims Fall Short Under Dudenhoeffer
WASHINGTON, D.C. - The District of Columbia Circuit U.S. Court of Appeals on Dec. 30 affirmed a District of Columbia federal judge's ruling rejecting allegations that the fiduciary of an employee stock ownership plan (ESOP) breached its duty by failing to prevent participants from purchasing or holding "doomed" stock, finding that the claims fall far short under the U.S. Supreme Court's ruling in Fifth Third Bancorp v. Dudenhoeffer (Donna Marie Coburn, et al. v. Evercore Trust Company N.A., No. 16-7029, D.C. Cir.; 2016 U.S. App. LEXIS 23396).



Defendants In USC 403(b) Plan Class Action File Motion To Dismiss Or Compel Arbitration
LOS ANGELES - The defendants in a putative class action alleging that the University of Southern California's (USC) 403(b) retirement plans charged excessive fees moved Dec. 19 in California federal court for an order compelling individual, nonclass arbitration and dismissal or, in the alternative, staying all proceedings pending the resolution of arbitration (Allen L. Munro, et al. v. University of Southern California, et al., No. 2:16-cv-06191, C.D. Calif.).



D.C. Circuit Panel Denies NAFA Motion For Injunction Pending Fiduciary Rule Appeal
WASHINGTON, D.C. - A District of Columbia Circuit U.S. Court of Appeals panel on Dec. 15 denied an emergency motion filed by the National Association of Fixed Annuities (NAFA) for an injunction pending appeal from an order and opinion of the U.S. District Court for the District of Columbia denying NAFA's application for a preliminary injunction and motion for summary judgment in its lawsuit against the U.S. Department of Labor's (DOL) fiduciary rule, which is set to be implemented April 10 (National Association for Fixed Annuities v. U.S. Department of Labor, et al., No. 16-5345, D.C. Cir.).



AARP, 6 Other Organizations Express Support for DOL In Minnesota Fiduciary Rule Suit
MINNEAPOLIS - A Minnesota federal judge on Dec. 21 granted a motion for AARP and six other organizations to appear as amici curiae in the support of the defendants in a case in which a membership-owned and member-governed fraternal benefit society of Christians sued the U.S. Department of Labor (DOL) and Labor Secretary Thomas E. Perez seeking judicial review of the DOL's issuance of regulations promulgating a new definition of investment advice fiduciary under the Employee Retirement Income Security Act, which it says could expose it to breach of contract and class action lawsuits (Thrivent Financial for Lutherans v. Thomas E. Perez, et al., No. 0:16-cv-03289, D. Minn.).



2nd Circuit Panel Affirms Ponzi Scheme Investments Weren't A Breach Of Duty
NEW YORK - A Second Circuit U.S. Court of Appeals panel on Dec. 8 affirmed a New York federal judge's dismissal of an Employee Retirement Income Security Act lawsuit brought by pension fund trustees alleging that the fund's investment manager and its principals knew that investing in a Ponzi scheme was imprudent, saying that the facts did not establish U.S. Constitution Article III standing because there was no cognizable investment loss and a breach of fiduciary duty under ERISA does not constitute an injury in fact sufficient for constitutional standing (Trustees of the Upstate New York Engineers Pension Fund v. Ivy Asset Management, et al., No. 15-31124, 2nd Cir.; 2016 U.S. App. LEXIS 21823).



D.C. Federal Judge Orders Document Production In Lawsuit Against PBGC
WASHINGTON, D.C. - A District of Columbia federal judge on Dec. 20 ordered the U.S. Treasury Department to produce more than 100 documents it has withheld in a civil action against the Pension Benefit Guaranty Corp. (PBGC), saying that Treasury has "miserably failed" to explain its deliberative process privilege claims (U.S. Department of the Treasury v. Pension Benefit Guaranty Corp., v. Dennis Black, et al., No. 12-mc-100, D. D.C.; 2016 U.S. Dist. LEXIS 175656).



10th Circuit Panel Affirms IRS Entitled To Collect ERISA Benefits For Tax Liabilities
DENVER - Denying two pro se plaintiffs' appeal, a 10th Circuit U.S. Court of Appeals panel on Dec. 16 affirmed a Kansas federal court judge's ruling that federal law permits the Internal Revenue Service to collect Employee Retirement Income Security Act benefits to satisfy outstanding tax liabilities (Edward Amador, et al. v. Boilermaker-Blacksmith National Pension Trust, No. 16-3090, 10th Cir.; 2016 U.S. App. LEXIS 22353).



7th Circuit Panel Affirms Employer Must Contribute To Multiemployer Funds
CHICAGO - A Seventh Circuit U.S. Court of Appeals panel on Dec. 20 affirmed three Illinois federal judges' decisions that an employer is required to reimburse multiemployer union welfare funds for delinquent contributions, saying that the decertification of three of its divisions' employee union does not absolve the employer from its obligation to make contributions to the plans (Midwest Operating Engineers Welfare Fund, et al. v. Cleveland Quarry, et al., Nos. 15-2628, 15-3221, 15-3861, 16-1870, 7th Cir.; 2016 U.S. App. LEXIS 22632).



7th Circuit Panel Affirms Teamster Funds Entitled To Contribution Shortfalls
CHICAGO - A Seventh Circuit U.S. Court of Appeals panel on Dec. 21 affirmed an Illinois federal judge's ruling that three Teamster pension and welfare funds are entitled to collect shortfalls in contributions due from an employer under collective bargaining agreements, finding the employer's audit report to be unreliable (Teamsters Local Union No. 727 Health and Welfare Fund, et al. v. L&R Group of Companies, No. 16-2037, 7th Cir.; 2016 U.S. App. LEXIS 22870).



9th Circuit Panel Affirms Properties Not Subject To Withdrawal Liability
SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on Dec. 23 affirmed a California federal judge's ruling that a husband and wife's rental properties were not subject to withdrawal liability under the Employee Retirement Income Security Act because they do not constitute a "trade or business" (Automotive Industries Pension Trust Fund, et al. v. Tractor Equipment Sales Inc., et al., No. 14-17371, 9th Cir.; 2016 U.S. App. LEXIS 23204).



6th Circuit Panel: Insureds Lack Sufficient Injury To Claim Insurer Shirked ERISA Duties
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Dec. 21 affirmed an Ohio federal judge's ruling that hypothetical situations lack the necessary concrete injury required to pursue claims that an insurer shirked its obligations under the Employee Retirement Income Security Act and the Patient Protection and Affordable Care Act (ACA) (Daniel Soehnlen, et al. v. Fleet Owners Insurance Fund, et al., No. 16-3124, 6th Cir.; 2016 U.S. App. LEXIS 22914).



California Federal Judge Grants Partial Dismissal Of Suit Over Hepatitis Drug
SAN FRANCISCO - A California federal judge on Dec. 22 once again granted in part a defendants' motion to dismiss a putative class action seeking injunctive relief from Blue Shield of California's denial of coverage for a drug to treat hepatitis C because Blue Shield has since amended its Harvoni policy and given notice to insureds that they can resubmit claims for treatment (Aram Homampour, et al. v. Blue Shield of California Life and Health Insurance Co., et al., No. 15-cv-05003, N.D. Calif.; 2016 U.S. Dist. LEXIS 177629).



11th Circuit Panel Affirms COBRA Ruling In Favor Of Fired Staffing Employee
ATLANTA - A 11th Circuit U.S. Court of Appeals panel on Dec. 30 affirmed an Alabama federal judge's ruling that a staffing business employer failed to notify a plaintiff of his rights under the Comprehensive Omnibus Budget Reconciliation Act (COBRA), saying that the evidence was sufficient that the former employee's health insurance was retroactively canceled in retaliation for filing an Equal Employment Opportunity Commission complaint and that the employer was not exempt from the COBRA requirement to provide notice to the employee of the right to continuation of health insurance coverage (Sam A. Virciglio v. Work Train Staffing LLC, et al., No. 15-10421, 11th Cir.; 2016 U.S. App. LEXIS 23422).



2nd Circuit Panel Remands Denial Of Benefits Case In Light Of Its Halo Ruling
NEW YORK - A Second Circuit U.S. Court of Appeals panel in a Dec. 21 summary order reversed in part and remanded for further proceedings a case in which a New York federal judge ruled that a health plan beneficiary failed to prove that a health plan fund was arbitrary and capricious in handling her claims for psychiatric treatment, saying that a subsequent Second Circuit ruling may warrant de novo review of the denial of benefits claim (Wendy A. Tedesco v. IBEW Local 1249 Insurance Fund, et al., No. 16-712, 2nd Cir.; 2016 U.S. App. LEXIS 22866).



Self-Insurance Institute Seeks Supreme Court Review Of 6th Circuit Preemption Ruling
WASHINGTON, D.C. - The Self-Insurance Institute of America Inc. (SIIA) on Oct. 31 filed a petition for writ of certiorari to the U.S. Supreme Court, seeking review of a Sixth Circuit U.S. Court of Appeals ruling affirming dismissal of claims that a Michigan law is preempted by the Employee Retirement Income Security Act (Self-Insurance Institute of America Inc. v. Rick Snyder, et al., No. 16-593, U.S. Sup.).



Offset Is Based On Amount 'Payable' To Claimant, 1st Circuit Panel Says
BOSTON - The First Circuit U.S. Court of Appeals on Dec. 16 affirmed that a disability administrator is not required to calculate an offset based on the amount of benefits received after taxes are taken from the claimant's Social Security disability payments, noting that the plan specifically states that the offset is based on the amount "payable" to the claimant (Debra Troiano v. Aetna Life Insurance Co. et al., No. 16-1307, 1st Cir.; 2016 U.S. App. LEXIS 22404).



Washington Federal Judge: Discretionary Clause Is Not Enforceable In Washington
TACOMA, Wash. - A Washington federal judge on Dec. 22 refused to enforce a disability plan's discretionary clause on the basis that enforcement of the clause would violate a strong public policy in the state of Washington (Anthony Flaaen v. Principal Life Insurance Co. Inc., No. 15-5899, W.D. Wash.; 2016 U.S. Dist. LEXIS 177638).



Negligence Claim Completely Preempted By ERISA, 6th Circuit Panel Affirms
CINCINNATI - Dismissal of a negligence suit filed against a company hired to review a disability claimant's medical records was proper because the negligence claim is completely preempted by the Employee Retirement Income Security Act, the Sixth Circuit U.S. Court of Appeals said Dec. 22 (Samantha Milby v. MCMC LLC, No. 16-5483, 6th Cir.; 2016 U.S. App. LEXIS 23112).



Appeals Panel Says Evidence Supports Insurer's Denial Of Disability Benefits
SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Dec. 23 affirmed a district court's ruling that a disability insurer's denial of benefits was reasonable after determining that the evidence does not support the contention that the claimant was permanently disabled (Fred Arko v. Hartford Life and Accident Insurance Co., No. 14-17287, 9th Cir.; 2016 U.S. App. LEXIS 23207).



Plan Administrator Did Not Abuse Discretion In Denying Claim, 9th Circuit Says
SAN FRANCISCO - A plan administrator did not abuse its discretion in denying a claim for disability pension benefits because the denial was reasonable based on the evidence and the terms of the plan, the Ninth Circuit U.S. Court of Appeals said Dec. 23 (Eun Sug Cha v. 1199SEIU Health Care Employees Pension Fund, No. 15-55435, 9th Cir.; 2016 U.S. App. LEXIS 23235).



7th Circuit Panel Finds Benefits Termination Was Not Arbitrary And Capricious
CHICAGO - A disability insurer's termination of benefits was not arbitrary and capricious because the evidence supported the termination and the insurer minimized any conflict of interest by employing a number of safeguards, the Seventh Circuit U.S. Court of Appeals said Jan. 6 (Donna Geiger v. Aetna Life Insurance Co., No. 16-2790, 7th Cir.; 2017 U.S. App. LEXIS 245).



Termination Of Benefits Was Arbitrary And Capricious, 6th Circuit Majority Says
CINCINNATI - The majority of the Sixth Circuit U.S. Court of Appeals on Dec. 15 determined that a disability plan administrator acted arbitrarily and capriciously when it terminated a claimant's benefits because the objective medical evidence did not support the administrator's decision (Jack B. Calhoun Jr. v. Life Insurance Company of North America, No. 15-3470, 6th Cir.; 2016 U.S. App. LEXIS 22426).



Claimant's Suit Is Time- Barred Under Disability Policy, Appeals Panel Says
NEW ORLEANS - A disability claimant's suit is time-barred under the terms of the policy at issue because the claimant failed to file the suit within three years of the date when written proof of loss was required under the policy, the Fifth Circuit U.S. Court of Appeals said Dec. 13 (Woodrow K. Wilson v. Provident Life & Accident Insurance Co., No. 16-30305, 5th Cir.; 2016 U.S. App. LEXIS 22143).



7th Circuit Panel Reverses Ruling For Insurer, Finding Accident Could Have Killed Man
CHICAGO - A Seventh Circuit U.S. Court of Appeals panel on Dec. 13 reversed an Illinois federal judge's decision in favor of Sun Life and Health Insurance Co., saying that the insurer must pay $92,000 in accidental death benefits to the widow of a man who died after undergoing surgery to repair an Achilles tendon he tore playing basketball because his accident alone could have been the cause of his death (Lee Ann Prather v. Sun Life and Health Insurance Co. (U.S.), No. 16-1861, 7th Cir.; 2016 U.S. App. LEXIS 22135).



5th Circuit Panel Affirms Unused Vacation Time Does Not Extend Date Insurance Ended
NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Dec. 19 affirmed a Louisiana federal judge's ruling that a group life insurance plan member's unused accrued vacation time did not extend the date his insurance ended, saying a terminated employee cannot perform his duties on a part-time or full-time basis and cannot return to work even if he has accrued vacation time (Tammy Briscoe, et al. v. Metropolitan Life Insurance Co., No. 16-30354, 5th Cir.; 2016 U.S. App. LEXIS 22568).



3rd Circuit Panel Affirms Dismissal Of Suit Alleging Racial Discrimination
PHILADELPHIA - A Third Circuit U.S. Court of Appeals panel on Dec. 8 affirmed dismissal of a plaintiff's racial discrimination complaint against his former employer, saying that the former employee never identifies any provision of the Employee Retirement Income Security Act that requires the defendants to provide him with the pension plan information he requested and that his request went "far beyond" ERISA disclosure requirements (Daniel Galman Jr. v. Sysco Food Services of Metro New York LLC, et al., No. 16-1744, 3rd Cir.; 2016 U.S. App. LEXIS 21841).



U.S. High Court Grants Certiorari To Review 3 'Church Plan' Lawsuits
WASHINGTON, D.C. - The U.S. Supreme Court on Dec. 2 granted petitions for writ of certiorari in three "church plan" Employee Retirement Income Security Act cases, consolidated them and allotted one hour for oral argument (Saint Peter's Healthcare System, et al. v. Laurence Kaplan, No. 16-86, Advocate Health Care Network, et al. v. Maria Stapleton, et al., No. 16-74, Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.).



D.C. Federal Judge Denies Motion For Injunction Staying Fiduciary Rule
WASHINGTON, D.C. - A District of Columbia federal judge on Nov. 23 denied the National Association for Fixed Annuities' (NAFA) motion for a preliminary injunction staying the applicability date of the new U.S. Department of Labor (DOL) rule regulating conflicts of interest in the market for retirement investment advice, saying that NAFA has failed to show irreparable damage if the injunction is not granted and that harm could occur if the rule is not in force (National Association for Fixed Annuities v. Thomas E. Perez, No. 16-1035, D. D.C.; 2016 U.S. Dist. LEXIS 162428).



Texas Federal Judge Withholds Ruling On Proposed $8.8 Million ERISA Class Action Settlement
FORT WORTH, Texas - A Texas federal judge on Nov. 18 withheld ruling on a plaintiffs' motion for conditional certification and preliminary approval of an $8.8 million Employee Retirement Income Security Act class action settlement, saying that he did not have enough information to conclude that the proposed settlement should be approved as being fair, reasonable and adequate to the members of the proposed class (Salvador Ortiz, et al. v. American Airlines Inc., et al., No. 4:16-cv-151, N.D. Texas; 2016 U.S. Dist. LEXIS 160588).



California Federal Judge Dismisses Class Action Over Walt Disney Co. Plan's Fund Investment Option
LOS ANGELES - A California federal judge on Nov. 14 dismissed a putative Employee Retirement Income Security Act class action lawsuit filed by participants in the Walt Disney Co. retirement plan over a plan investment option, saying the plaintiffs have alleged no facts that plausibly show that the plan breached its duty to prudently monitor and review its inclusion of the Sequoia Fund as an investment option (In re Disney ERISA Litigation, No. 2:16-cv-02251, C.D. Calif.).



Pennsylvania Class Action Targets Plan That Offers Sequoia Fund As Option
PHILADELPHIA - A putative class action complaint alleging violations of the Employee Retirement Income Security Act was filed Nov. 18 in Pennsylvania federal court in which plan participants say that the fiduciaries of the FMC Corp. Savings and Investment Plan breached their fiduciary duties by continuing to offer as an investment option the Sequoia Fund, what they call a high-cost, nondiversified and underperforming mutual fund (Matthew B. Harmon, et al. v. FMC Corp., et al., No. 2:16-cv-06073, E.D. Pa.).



Wells Fargo And Co. 401(k) Class Action Filed Over Proprietary Target Date Funds
MINNEAPOLIS - A putative class action lawsuit under the Employee Retirement Income Security Act was filed Nov. 22 in Minnesota federal court against the sponsor and fiduciaries of the Wells Fargo and Co. 401(k) Plan, alleging that they violated their duties of loyalty and prudence in investing plan assets by selecting as investments proprietary Wells Fargo target date funds (TDFs) and designing a system to maximize the amount of plan assets invested into those mutual funds (John Meiners, et al. v. Wells Fargo & Co., et al., No. 0:16-cv-03981, D. Minn.).



Edward D. Jones Plan Participants File ERISA Class Action Complaint
ST. LOUIS - Participants in the Edward D. Jones & Co. retirement plan on Nov. 11 filed a putative class action complaint alleging that the company violated the Employee Retirement Income Security Act by including and maintaining a higher-fee share class of identical investment options in lieu of the lower-cost share class and including and maintaining an unreasonable number of high-risk investment options to the detriment of plan participants (Valeska Schultz, et al. v. Edward D. Jones & Co. LP, et al., No. 4:16-cv-01762, E.D. Mo.).



Class Action Alleges Breach Of Fiduciary Duty For Fees Charged Ford Plan Accounts
DETROIT - Participants in three Ford Motor Co. retirement plans filed a putative class action complaint Nov. 9 in Michigan federal court that alleges that Xerox HR Solutions LLC allowed excessive fees to be charged on participant accounts in violations of its fiduciary duty under the Employee Retirement Income Security Act (Patrick Chendes, et al. v. Xerox HR Solutions LLC, No. 2:16-cv-13980, E.D. Mich., Southern Div.).



6th Circuit Panel Affirms ERISA Preempts Age Discrimination Claim
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Nov. 8 affirmed that former Chrysler Corp. executives' age discrimination claim is preempted by the Employee Retirement Income Security Act because it was brought outside the statute of limitations applicable to the Age Discrimination in Employment Act (ADEA) (John Loffredo, et al. v. Daimler AG, et al., No. 15-1443, 6th Cir.).



Illinois Federal Judge Rules For Pension Fund In Dispute Over Benefits Payments
CHICAGO - An Illinois federal judge on Nov. 21 granted defendants' motions to dismiss a lawsuit alleging that a pension fund, its trustees and its lawyers conspired with each other to have the fund retain and convert the contributions made on a plaintiff's behalf, saying that the plaintiff's state law conversion claim is preempted by Employee Retirement Income Security Act Section 514 and that his conspiracy claim is untenable in light of controlling precedent (John P. Cooney v. Trustees of the Will County Carpenters Local 174 Pension Fund, et al., No. 13-cv-8819, N.D. Ill.; 2016 U.S. Dist. LEXIS 160603).



Alabama Federal Judge Says Prudential Insured's Remand Motion Preempted By ERISA
SELMA, Ala. - An Alabama federal judge on Nov. 18 denied a Prudential Insurance Co. insured's motion to remand to state court an action alleging that the insured failed to pay any policy benefits, saying that his state law claims are completely preempted by the Employee Retirement Income Security Act, which authorizes a plan participant or beneficiary to bring a civil suit "to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan" (Marion McIntosh v. Prudential Insurance Co., No. 16-0523, S.D. Ala.; 2016 U.S. Dist. LEXIS 159869).



Pennsylvania Federal Judge: ERISA Controls Breach Of Contract, Fiduciary Duty Claims
PHILADELPHIA - A Pennsylvania federal judge in an opinion filed Nov. 18 denied a plaintiff's motion to remand a case alleging improper denial of claims under an Employee Retirement Income Security Act-qualified health plan to state court, saying that claims for breach of contract and breach of fiduciary duty are properly brought under ERISA (Eric A. Shore P.C. v. Independence Blue Cross, et al., No. 16-5224, E.D. Pa.; 2016 U.S. Dist. LEXIS 160022).



Insurers Claim Asbestos Lawyers Facilitate Double Dipping, Seek Injunction
GALVESTON, Texas - Insurers on Nov. 4 asked a federal judge in Texas to enjoin five law firms from distributing the proceeds from asbestos actions, saying the firms collected millions from tortfeasers while helping thousands of clients sidestep health insurance contract reimbursement provisions (Humana Inc., et al. v. Brent W. Coon P.C., a/k/a Brent Coon & Associates, et al., No. 16-240, S.D. Texas).



Evidence Shows Claimant Is Not Disabled From Any Occupation, Panel Affirms
CINCINNATI - Because six medical experts unanimously agreed that a disability claimant was not disabled from performing any occupation, the disability insurer did not act arbitrarily and capriciously in terminating the claimant's long-term disability (LTD) benefits, the Sixth Circuit U.S. Court of Appeals said Nov. 29 (Dana Leppert v. Liberty Life Assurance Company of Boston, No. 16-3387, 6th Cir.; 2016 U.S. App. LEXIS 21438).



New York Federal Judge Remands Disability Case To Aetna Life Insurance
ROCHESTER, N.Y. - A New York federal judge in an opinion filed Nov. 18 granted partial summary judgment to a man whose long-term disability claims were denied, saying that the defendants failed to adequately explain all of the reasons for denying the claim in violation of the Employee Retirement Income Security Act (Charles Standish v. Federal Express Corp. Long Term Disability Plan, et al., No. 6:15-cv-6226, W.D. N.Y.; 2016 U.S. Dist. LEXIS 160093).



Pension Rights Center Urges High Court To Review Issue Of Forum-Selection Clauses
WASHINGTON, D.C. - In an amicus curiae brief filed on Dec. 2 in the U.S. Supreme Court, the Pension Rights Center urges the high court to review a decision by the Eighth Circuit U.S. Court of Appeals that enforced a disability plan's forum-selection clause, arguing that the allowance of forum-selection clauses in disability plans does not provide plan participants with ready access to federal courts and forces participants to sue in a court chosen by a plan (Lorna Clause v. U.S. District Court for the Eastern District of Missouri, et al., No. 16-641, U.S. Sup.; 2016 U.S. S. Ct. Briefs LEXIS 4420; 2016 U.S. S. Ct. Briefs LEXIS 4114).



Illinois Federal Judge Enforces Settlement, Grants Plumbers Union $82,707
ROCK ISLAND, Ill. - An Illinois federal judge on Nov. 21 granted a motion to enforce the terms of an agreement to settle an Employee Retirement Income Security Act lawsuit and ordered defendant Midwest Underground Inc. to pay the plaintiff plumber union funds $82,707 (Plumbers and Pipefitters Local Union No. 25 Welfare Fund, et al. v. Midwest Underground Inc., No. 4:15-cv-04144, C.D. Ill.; 2016 U.S. Dist. LEXIS 160599).



Pension Plan Participants: Fiduciaries Could Revert To Alleged Illegal Activities
ST. LOUIS - U.S. Bancorp pension plan participants filed a reply brief Oct. 13 with the Eighth Circuit U.S. Court of Appeals, saying that a Minnesota federal judge erred in dismissing as moot and time-barred their putative class action alleging violations of the Employee Retirement Income Security Act because there is no assurance that the plan fiduciaries will not revert to their allegedly illegal actions (Sherry Smith, et al. v. U.S. Bank, et al., No. 0:13-cv-02687, 8th Cir.).



High Court Denies Cert In ERISA Class Action Against Citigroup Inc.
WASHINGTON, D.C. - The U.S. Supreme Court on Dec. 5 denied a petition for writ of certiorari in a case in which a New York federal judge dismissed a class action against Citigroup Inc. brought under the Employee Retirement Income Security Act on the grounds that it is barred by the law's three-year statute of limitations (Steven Muehlgay, et al. v. Citigroup Inc., et al., No. 16-251, U.S. Sup.; 2016 U.S. LEXIS 7391).



Tribe Denies Sanctionable Discovery Conduct By Counsel In ERISA Suit
DETROIT - A Native American tribe filed a brief on Nov. 29 asking a Michigan federal court to deny a motion for sanctions brought against the tribe's counsel by a health insurance provider, arguing that the law firm's contacting of subpoenaed third parties did not violate federal procedure and was not a tactic to delay proceedings in a lawsuit brought under the Employee Retirement Income Security Act (ERISA) (Little River Band of Ottawa Indians, et al. v. Blue Cross Blue Shield of Michigan, No. 2:15-cv-13708, E.D. Mich.).