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Preview: LexisNexis® Mealey's™ ERISA Legal News

LexisNexis® Mealey's™ ERISA Legal News



Headline ERISA Legal News from LexisNexis®



 



No Profits To Award From Bank's Pension Plan Transfer Strategy, Judge Says
CHARLOTTE, N.C. - Plaintiff employees 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 failed to show that any profit was retained by the bank as a result of the transfer, a North Carolina federal judge ruled March 17 in awarding judgment in favor of the bank on the plaintiffs' accounting-for-profit claim (William L. Pender, et al. v. Bank of America Corp., et al., No. 3:05-cv-00238, W.D. N.C., 2017 U.S. Dist. LEXIS 38771).



6th Circuit Panel Rules University ERISA Case Belongs In Federal Court
CINCINNATI - Calling it a matter of first impression, a Sixth Circuit U.S. Court of Appeals panel on March 14 joined with six other circuits in holding that participants or beneficiaries need not exhaust administrative remedies before proceeding to federal court when they assert statutory violations under the Employee Retirement Income Security Act (Eloise Hitchcock, et al. v. Cumberland University 403(b) DC Plan, et al., No. 16-5942, 6th Cir., 2017 U.S. App. LEXIS 4410).



8th Circuit Panel Remands ABB Retirement Plan Case For Recalculation Of Losses
ST. LOUIS - An Eighth Circuit U.S. Court of Appeals panel on March 9 remanded to Missouri federal court a case in which ABB Inc. fiduciaries were found to have abused their discretion and breached their fiduciary duties in choosing investment options for their 401(k) retirement plans, saying that the lower court seems to have mistook a recommendation on how to measure plan losses (Ronald C. Tussey, et al. v. ABB Inc., et al., No. 15-2792, 8th Cir., 2017 U.S. App. LEXIS 4225).



3rd Circuit Finds DuPont Miscalculated Part Of Retiree's Pension Benefit
PHILADELPHIA - The Employee Retirement Income Security Act does not permit an employer to recalculate a state court's formula related to a retiree's spouse's payments under a pension plan, a Third Circuit U.S. Court of Appeals panel ruled March 16, reversing a trial court's judgment in favor of the employer in a benefits dispute with the retiree (Mark Matthews v. E.I. DuPont De Nemours & Co., et al., No. 16-3237, 3rd Cir., 2017 U.S. App. LEXIS 4606).



5th Circuit Denies Motion For Injunction Pending Appeal Of DOL Fiduciary Rule
NEW ORLEANS - With no comment, a Fifth Circuit U.S. Court of Appeals panel on April 5 denied an emergency motion filed by a consortium of eight national and Texas-based trade associations that sell annuities and other life insurance products for an injunction pending appeal of the U.S. Department of Labor's (DOL) new fiduciary duty rule (Chamber of Commerce of the USA, et al. v. United States Department of Labor, et al., No. 17-10238, 5th Cir.).



California Federal Judge Denies USC Defendants' Motion To Compel Arbitration
LOS ANGELES - A California federal judge on March 23 denied the defendants' motion to compel arbitration in a putative class action alleging that the University of Southern California's (USC) 403(b) retirement plans charged excessive fees, saying that the plan participants can bring claims of breach of fiduciary duties to court (Allen L. Munro, et al. v. University of Southern California, et al., No. 2:16-cv-06191, C.D. Calif.).



Missouri Federal Judge Follows Dudenhoeffer In Tossing Peabody Breach Claims
ST. LOUIS - A Missouri federal judge on March 30 granted a motion to dismiss a putative class action brought under the Employee Retirement Income Security Act alleging that the fiduciaries of three employee stock ownership plans (ESOPs) breached their fiduciary duties by keeping a company stock fund as an investment option after the company began having financial difficulties, saying the claims did not meet the high standard for stating a claim set by the U.S. Supreme Court in Fifth Third Bancorp. v. Dudenhoeffer (Lori J. Lynn, et al. v. Peabody Energy Corp., et al., No. 4:15-cv-00916, E.D. Mo., Eastern Div., 2017 U.S. Dist. LEXIS 48468).



6th Circuit Affirms Ruling Dismissing ERISA Suit Against Cliffs Natural Resources
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on April 7 affirmed an Ohio federal judge's decision to dismiss a class action filed by members of the Cliffs Natural Resources Inc. employee stock ownership plan (ESOP) alleging breach of fiduciary duty under the Employee Retirement Income Security Act, saying that the decision is in line with the U.S. Supreme Court's decision in Fifth Third Bancorp. v. Dudenhoeffer that allowed fiduciaries for ESOPs to rely solely on the market price of a security as a risk barometer (Paul Saumer, et al. v. Cliffs Natural Resources Inc., et al., No. 16-3449, 6th Cir., 2017 U.S. App. LEXIS 6015).



Most Breach Of Duty Claims Against 401(k) Plan Administrator Survive Dismissal Bid
INDIANAPOLIS - An Indiana federal judge on March 23 declined to dismiss most claims of current and former participants of one of the largest 401(k) plans in the nation challenging the management of the plan under the Employee Retirement Income Security Act (Mary Bell, et al. v. Pension Committee of ATH Holding Company, LLC, et al., No. 1:15-cv-2062, S.D. Ind., 2017 U.S. Dist. LEXIS 42107).



New York Federal Judge: Record-Keeper Services Didn't Give Rise To Fiduciary Duty
NEW YORK - A New York federal judge on March 7 granted a motion to dismiss an Employee Retirement Income Security Act lawsuit alleging that a record-keeper breached its fiduciary duty by preventing ERISA plans from getting a more competitive rate for record-keeping services, finding that the record-keeper was not a fiduciary of the plans (Elaine Malone, et al. v. Teachers Insurance and Annuity Association of America, No. 15-cv-08038, S.D. N.Y., 2017 U.S. Dist. LEXIS 32308).



Georgia Federal Judge Denies Motions To Dismiss Excessive Fees Lawsuit
ATLANTA - A Georgia federal judge on March 7 mostly denied two motions to dismiss an Employee Retirement Income Security Act lawsuit against 401(k) investment manager Reliance Trust Co. and Insperity Inc., a professional employer organization, saying that plaintiffs sufficiently alleged that the defendants acted as fiduciaries concerning administrative and record-keeping fees for the 401(k) plan (Ronda A. Pledger, et al. v. Reliance Trust Co., et al., No. 1:15-cv-04444, N.D. Ga.).



Texas Federal Judge Denies Motion To Amend ERISA Complaint Against BP
HOUSTON - A Texas federal judge on March 8 denied a motion filed by participants and beneficiaries of BP entities' employee investment and savings plans covered by the Employee Retirement Income Security Act to file an amended complaint related to the Deepwater Horizon Gulf of Mexico oil spill that resulted in a steep drop in the BP stock price for failure to state a claim (In Re: BP P.L.C. Securities Litigation, In re: BP ERISA Litigation, No. 4:10-cv-4214, S.D. Texas, 2017 U.S. Dist. LEXIS 33302).



Supreme Court Denies Cert In ERISA Class Action Against Verizon Communications
WASHINGTON, D.C. - In a two-sentence order, the U.S. Supreme on March 27 denied a petition for writ of certiorari filed by a defined-benefit pension plan participant and the Pension Rights Center in which they asked the court to consider whether the participant has standing to file a breach of fiduciary duty suit challenging the transfer of plan assets to a group annuity contract, regardless of loss to the participant's benefits (Edward Pundt, et al. v. Verizon Communications, Incorporated, et al., No. 16-762, U.S. Sup.).



NLRB's Jurisdictional Award Precludes ERISA Claims, Majority Affirms
CINCINNATI - A majority of the Sixth Circuit U.S. Court of Appeals on March 30 affirmed a lower federal court's ruling that a jurisdictional award by the National Labor Relations Board bars claims by plaintiffs in an Employee Retirement Income Security Act contribution action (Raymond Orrand, et al. v. Hunt Construction Group, Inc., et al., No. 16-3822, 6th Cir., 2017 U.S. App. LEXIS 5515).



2nd Circuit Rules Against Louis C.K. In Dispute Over Plan Contributions
NEW YORK - Comedian Louis C.K.'s company is subject to the "controlling-employee" provisions in three employee benefit plan agreements and therefore must make plan contributions at the 40-hour workweek rate, even though C.K. worked fewer hours as editor of his TV show, the Second Circuit U.S. Court of Appeals ruled March 21 (Pig Newton, Inc. v. Boards of Directors of Motion Picture Industry Pension Plan, Motion Picture Industry Individual Account Plan, Motion Picture Industry Health Plan, No. 15-1029, 2nd Cir., 2017 U.S. App. LEXIS 4974).



U.S. Supreme Court Hears Oral Arguments On ERISA's Church-Plan Exemption
WASHINGTON, D.C. - Whether a church establishes a plan or not, pension plans for religious nonprofits are and have been exempt from the minimum funding and reporting and disclosure requirements of the Employee Retirement Income Security Act, the attorney representing three religious hospitals and health care providers argued March 27 before the U.S. Supreme Court (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.).



ERISA Not The Vehicle For Health Centers' Suits Against Insurers, 9th Circuit Says
SAN FRANCISCO - Health care centers designated to receive direct payment from a health plan administrator for medical services cannot file suit in federal court under the Employee Retirement Income Security Act because they lack both direct statutory authority and derivative authority through assignment under ERISA's civil enforcement provisions, a Ninth Circuit U.S. Court of Appeals panel held March 22 (DB Healthcare, LLC, et al. v. Blue Cross Blue Shield of Arizona, Inc., No. 14-16518, Advanced Women's Health Center, Inc. v. Anthem Blue Cross Life and Health Insurance Company, No. 14-16612, 9th Cir., 2017 U.S. App. LEXIS 5082).



Minnesota Federal Judge Certifies Cross-Plan Question For Immediate Appeal
MINNEAPOLIS - A Minnesota federal judge on March 14 certified for immediate appeal to the Eighth Circuit U.S. Court of Appeals the question of whether a health insurer acted reasonably in permitting cross-plan offsetting, a method to recoup overpayments it made to medical providers, saying that immediate appellate review of the issue will significantly advance the litigation and also reduce the time that the insurer will spend in "legal limbo" (Louis J. Peterson, et al. v. UnitedHealth Group Inc., et al., Nos. 14-cv-2101, 15-cv-3064, D. Minn., 2017 U.S. Dist. LEXIS 36730).



Judge Finds Provider's State Law Claims Preempted By ERISA
NEWARK, N.J. - A medical provider's state law claims attempting to recover almost $98,000 clawed back by an insurer implicate claims-processing issues governed by the Employee Retirement Income Security Act and are preempted, a federal judge in New Jersey held March 31 (Jason D. Cohen, M.D., FACS and professional orthopaedic Associates, et al. v. Horizon Blue Cross Blue Shield of New Jersey, No. 15-4528, D. N.J., 2017 U.S. Dist. LEXIS 49291).



Nevada High Court: NLRA, ERISA Don't Preempt Minimum Wage Amendment
CARSON CITY, Nev. - Nevada's Minimum Wage Amendment (MWA), which allows employers to pay a lower minimum wage if they provide health benefits, is not preempted by the National Labor Relations Act (NLRA) or the Employee Retirement Income Security Act of 1974 (ERISA) and is not unconstitutionally vague, the Nevada Supreme Court ruled March 16 (Western Cab Company v. The Eighth Judicial District Court of the State of Nevada, in and for the County of Clark, et al., No. 69408, Nev. Sup., 2017 Nev. LEXIS 16).



Plan Excludes 'Educational Setting' Mental Health Treatment, 1st Circuit Finds
BOSTON - A Blue Cross Blue Shield company correctly denied coverage for a teenager's residential center treatment for his mental health problems because his father's group health insurance plan did not provide coverage for services rendered in an educational setting and the services at issue were not medically necessary under the plan, the First Circuit U.S. Court of Appeals found March 24 (Stephanie C. v. Blue Cross Blue Shield of Massachusetts HMO Blue, Inc., No. 16-1997, 1st Cir., 2017 U.S. App. LEXIS 5231).



Oregon Federal Judge Refuses To Certify Class Of Naturopath Patients
PORTLAND, Ore. - An Oregon federal judge on March 9 denied a motion to certify a class of persons who were enrolled in an employer-issued health plan administered by Health Net Health Plan of Oregon who claimed that the plan discriminated against naturopathic physicians, finding that the plaintiffs lacked standing to sue because they could not show that they suffered an injury-in-fact (Eileen Fox-Quamme, et al. v. Health Net Health Plan of Oregon Inc., et al., No. 3:15-cv-01248, D. Ore., 2017 U.S. Dist. LEXIS 35964).



Judge Hands Insurer Mixed Results In Colorectal Cancer Test Coverage Case
GREENSBORO, N.C. - An insurer received mixed results in its challenge to claims that it failed to properly compensate the developer of a colorectal cancer screening test, with a federal judge in North Carolina dismissing some of the claims on March 27 but largely allowing Employee Retirement Income Security Act claims to proceed (Exact Sciences Corp. and Exact Sciences Laboratories LLC v. Blue Cross and Blue Shield of North Carolina, No. 16-125, M.D. N.C., 2017 U.S. Dist. LEXIS 44679).



Judge Approves Website For Class Of Autism Treatment Plaintiffs
BOWLING GREEN, Ky. - A class of plaintiffs alleging that an insurer improperly restricted coverage for applied behavioral analysis may use a supplemental website as a method of communicating with the class, a federal judge in Kentucky held March 21 (Margaret Wilson, et al. v. Anthem Health Plans of Kentucky Inc., No. 14-743, W.D. Ky.).



Judge Dismisses ERISA Action Involving Proton Beam Therapy Coverage Denial
BIRMINGHAM, Ala. - A man's Employee Retirement Income Security Act (ERISA) suit impermissibly seeks equitable relief in the face of other available remedies, a federal magistrate judge in Alabama held March 23 (Jeffrey Woodruff v. Blue Cross and Blue Shield of Alabama, et al., 2017 U.S. Dist. LEXIS 41921).



Drug Makers, Benefit Managers Hit With Class Suit Alleging Insulin Pricing Scheme
NEWARK, N.J. - Three drug makers and the three largest pharmacy benefit managers have engaged in a pricing scheme to drive up the cost of diabetes insulin - by more than 150 percent in the last five years - in violation of the Racketeer Influenced and Corrupt Organizations Act, the Employee Retirement Income Security Act of 1974, the Sherman Act and numerous state laws, four consumers and Type 1 Diabetes Defense Foundation allege in a March 17 class complaint filed in the U.S. District Court for the District of New Jersey (Julia Boss, et al. v. CVS Health Corporation, et al., No. 17-1823, D. N.J.).



4th Circuit: CBA Language Kills Retirees' Claim That Health Benefits Had Vested
RICHMOND, Va. - Health benefits for United Steel Workers retirees of a West Virginia aluminum manufacturer did not vest and were properly altered unilaterally by the company because union contracts expressly provided that the benefits remained in effect only for the term of the contracts, which had expired, the Fourth Circuit U.S. Court of Appeals held March 22 (Ronald Barton, et al v. Constellium Rolled Products-Ravenswood, LLC, et al., No. 16-1103, 4th Cir., 2017 U.S. App. LEXIS 5087).



Procedural Violation Does Not Justify Award Of Disability Benefits, 9th Circuit Says
SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on April 4 vacated and remanded a district court's ruling in a disability benefits suit after determining that the disability insurer's failure to comply with procedural requirements does not, on its own, justify an award of benefits in favor of the claimant (Gregory Smith v. Reliance Standard Life Insurance Co., Nos. 16-15319, No. 16-15413, 9th Cir., 2017 U.S. App. LEXIS 5835).



Insurer Acted Arbitrarily In Determining Disability Onset Date, 1st Circuit Panel Says
BOSTON - The First Circuit U.S. Court of Appeals on March 24 determined that a disability insurer acted arbitrarily and capriciously by relying on a job description of a generic "lawyer" rather than a job description of a specialized "environmental lawyer" when it determined the onset date of a claimant's disability (Jane Doe v. Standard Insurance Co., No. 16-2085, 1st Cir., 2017 U.S. App. LEXIS 5232).



Claimant Failed To Prove He Was Disabled Under Policy, 6th Circuit Panel Affirms
CINCINNATI - A disability insurer's decision to terminate a claimant's long-term disability benefits is supported by the medical evidence, the Sixth Circuit U.S. Court of Appeals said March 22, agreeing with a district court's finding that the claimant failed to show that his depression prevented him from performing the duties of his occupation (Les A. Gilewski v. Provident Life and Accident Insurance Co., No. 16-2028, 6th Cir., 2017 U.S. App. LEXIS 5240).



6th Circuit Affirms Court's Decision To Uphold Denial Of ERISA Benefits
CINCINNATI - The Sixth Circuit U.S. Court of Appeals on March 9 held that an insurer's decision to deny an insured's benefits is supported by substantial evidence notwithstanding the insurer's inherent conflict of interest as both the plan administrator and payer, affirming a lower federal court's decision to uphold the denial of benefits sought under Section 502(a) of the Employee Retirement Income Security Act (Daniel Collins v. Unum Life Insurance Company of America, No. 16-3918, 6th Cir., 2017 U.S. App. LEXIS 4322).



Disability Insurer's Reliance On Mental Health Limitation Was In Error, Judge Says
LOS ANGELES - Because a disability claimant established that his disability was caused by brain damage and not depression and anxiety, a disability insurer's reliance on the plan's mental illness limitation to terminate his benefits was in error, a California federal judge said March 27 (John Doe v. Prudential Insurance Company of America, et al., 15-04089, C.D. Calif.. 2017 U.S. Dist. LEXIS 45774).



Disability Plan's Provision Granting Discretionary Authority Is Void
SAN FRANCISCO - A de novo standard of review must be applied in a claimant's suit seeking long-term disability benefits because the plan's discretionary authority provision is void under California state law, a California federal judge said March 27 (Peter Englert v. The Prudential Insurance Company of America, No. 15-4814, N.D. Calif.; 2017 U.S. Dist. LEXIS 44833).



Claimant Petitions High Court To Review Ruling That Remand Was Not Violation Of Mandate
WASHINGTON, D.C. - Because the Sixth Circuit U.S. Court of Appeals failed to follow the law-of-the-case doctrine when it determined that the remand of a disability retirement claim was not an abuse of discretion or a violation of a previous court mandate, the U.S. Supreme Court should grant certiorari, a disability claimant maintains in a March 13 petition for writ of certiorari (Kyle D. Kennard v. Means Industries Inc., No. 16-1117, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 954).



Judge Adopts Magistrate's Finding That Government Exclusion Negates Defense Duty
SHERMAN, Texas - A Texas federal judge on March 2 adopted a magistrate's report that recommended granting an insurer's request for a declaration that it has no duty to defend or indemnify its insureds against an underlying lawsuit because coverage is barred by the policy's government exclusion (Continental Casualty Co. v. Jeffrey Ramsey, et al., No. 16-00125, E.D. Texas).



Respondents, Amici Argue ERISA Requires Church Plans To Be Established By A Church
WASHINGTON, D.C. - The church plan exemption in the Employee Retirement Income Security Act unambiguously requires that a church plan be established by a church, the appellee-respondents in three cases consolidated before the U.S. Supreme Court say in their initial brief filed Feb. 16, a view shared by five amicus briefs filed in support of the respondents (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., 2017 U.S. S. Ct. Briefs LEXIS 515).



Texas Federal Judge Denies Groups' Motions Challenging DOL's Fiduciary Duty Rule
DALLAS - A Texas federal judge on Feb. 8 denied motions for summary judgment in consolidated cases filed by the U.S. Chamber of Commerce (COC) and other groups opposed to the U.S. Department of Labor's (DOL) new "fiduciary rule" set to take effect April 10, saying that the DOL has not exceeded its authority and that the new rule does not violate the Employee Retirement Income Security Act (Chamber of Commerce of the United States of America, et al. v. Edward Hugler, Acting Secretary of Labor, et al., No. 3:16-cv-1476, consolidated with 3:16-cv-1530, 3:16-cv-1537, N.D. Texas; 2017 U.S. Dist. LEXIS 17619).



Kansas Federal Judge Grants DOL Summary Judgment In Fiduciary Rule Lawsuit
TOPEKA, Kan. - A Kansas federal judge on Feb. 17 granted the U.S. Department of Labor's (DOL) motion for summary judgment in a lawsuit challenging the DOL's new fiduciary rule, saying that a plaintiff insurance agency failed to prove violations of the Administrative Procedure Act (APA) and the Regulatory Flexibility Act of 1980 (RFA) as a matter of law (Market Synergy Group Inc. v. United States Department of Labor, et al., No. 16-cv-4083, D. Kan., 2017 U.S. Dist. LEXIS 23155).



Labor Department Proposes Extension To Fiduciary Rule Applicability Date
WASHINGTON, D.C. - The U.S. Department of Labor (DOL) in a March 1 press release announced a proposed extension of the applicability dates of the new fiduciary rule and related exemptions from April 10 to June 9.



2nd Circuit Panel Says Pension Plan Participant Has Standing To File Suit
NEW YORK - A Second Circuit U.S. Court of Appeals panel on Feb. 10 issued a summary order vacating a New York federal judge's ruling that a pension plan participant does not have standing to sue on behalf of himself, his pension plan and other similarly situated Employee Retirement Income Security Act plans over alleged improper fiduciary conduct (Landol Fletcher v. Convergex Group LLC, et al., No. 16-734, 2nd Cir., 2017 U.S. App. LEXIS 2459).



Verizon Asks High Court To Deny Cert Petition In Defined-Benefit Plan Case
WASHINGTON, D.C. - In a Feb. 16 opposition brief, Verizon Communications Inc. says the U.S. Supreme Court should deny a petition for writ of certiorari asserting that a defined-benefit pension plan participant has standing to file a breach of fiduciary duty suit under the Employee Retirement Income Security Act because the lead plaintiff has not alleged a concrete injury (Edward Pundt, et al. v. Verizon Communications, Inc. et al., No. 16-762, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 537).



2nd Circuit Rejects Bid For Rehearing Of Ponzi Scheme Case
NEW YORK - In a two-sentence order, the Second Circuit U.S. Court of Appeals on Feb. 13 denied a motion to rehear 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 (Trustees of the Upstate New York Engineers Pension Fund v. Ivy Asset Management, et al., No. 15-3124, 2nd Cir.).



Missouri Federal Judge Won't Dismiss Employee Lawsuit Over Excessive 401(k) Fees
KANSAS CITY, Mo. - A Missouri federal judge on Feb. 27 denied a defense motion to dismiss an Employee Retirement Income Security Act class action alleging that American Century Services LLC charged excessive investment management and record-keeping fees for its 401(k) plan and filled the retirement plan with proprietary investment options for its own benefit, saying that the plaintiffs' allegations state a claim for breach of fiduciary duty (Steve Wildman, et al. v. American Century Services LLC, et al., No. 4:16-cv-00737, W.D. Mo.).



Colorado Magistrate Says Class Action Lawsuit Against Oracle Corp. Should Proceed
DENVER - A Colorado magistrate judge on Feb. 16 recommended that a proposed class action challenging the fees in Oracle Corp.'s 401(k) plan proceed, saying that the plaintiffs have met their pleading obligations (Deborah Troudt, et al. v. Oracle Corp., et al., No. 1:16-cv-00175, D. Colo., 2017 U.S. Dist. LEXIS 22194).



High Court Denies Cert In Stock-Drop Case Arising Under ERISA
WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 21 denied a petition for writ of certiorari in a stock-drop case arising under the Employee Retirement Income Security Act (Alex E. Rinehart, et al. v. John F. Akers, et al., No. 16-562, U.S. Sup.).



High Court Won't Review Ruling Tossing Claims Against Third-Party Administrator
WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 21 denied a petition for a writ of certiorari in a case in which an 11th Circuit U.S. Court of Appeals panel affirmed the dismissal of claims against a third-party administrator of an employee pension benefit plan because it was not a fiduciary of the plan and a self-dealing claim was time-barred (Carolinas Electrical Workers Retirement Plan, et al. v. Zenith American Solutions Inc., et al., No. 16-731, U.S. Sup.).



Arkansas Federal Judge: ERISA Preempts State Law That Regulates PBMs
LITTLE ROCK, Ark. - An Arkansas federal judge on March 1 granted a pharmacy benefit managers (PBM) trade association summary judgment on its claim that Arkansas Act 900, a law that requires PBMs to pay pharmacies the amounts those pharmacies spent to buy generic drugs from wholesalers, is preempted by the Employee Retirement Income Security Act and denied the state of Arkansas' motion for summary judgment because Act 900 is invalid as applied to PBMs in their administration and management of ERISA plans (Pharmaceutical Care Management Association v. Leslie Rutledge, No. 4:15-cv-00510 BSM, E.D. Ark.).



Data Breach Class Claims Against Premera Mostly Survive Dismissal Motion
PORTLAND, Ore. - Although an Oregon federal judge on Feb. 9 found that some fraud and contract-based claims related to a 2014 data breach experienced by Premera Blue Cross merited dismissal, he held that the plaintiffs cured some previous deficiencies and concluded that their claims are not preempted by the Employee Retirement Income Security Act of 1974 (ERISA) (In Re: Premera Blue Cross Customer Data Security Breach Litigation, No. 3:15-md-02633, D. Ore., 2017 U.S. Dist. LEXIS 18322).



Texas Federal Judge Lets Cigna Units' Claims Against Surgical Centers Proceed
HOUSTON - A Texas federal judge on Feb. 15 ruled that two Cigna units may proceed on their claims under the Employee Retirement Income Security Act for fraud, negligent misrepresentation, civil conspiracy and injunctive and declaratory relief in an action alleging that ambulatory surgical centers waived payments for out-of-network patients but billed insurers as if the patients had paid (Connecticut General Life Insurance Co., et al. v. Elite Center for Minimally Invasive Surgery LLC, et al., No. 4:16-cv-00571, S.D. Texas, 2017 U.S. Dist. LEXIS 21026).



Texas Federal Judge Denies Parties' Motions To Reconsider ERISA Preemption Ruling
HOUSTON - A Texas federal judge on Feb. 6 denied motions to reconsider a Sept. 28 ruling that the breach of contract claims of an out-of-network hospital that Cigna Healthcare allegedly underpaid by using flawed data to calculate usual, customary and reasonable rates to reimburse out-of-network and emergent care services are preempted by the Employee Retirement Income Security Act (North Cypress Medical Center Operating Company, et al. v. Cigna Healthcare, et al., No. 4:09-cv-2556, S.D. Texas; 2017 U.S. Dist. LEXIS 16076).



Judge Remands Implied Insurance Contract Claims As Outside ERISA
NEWARK, N.J. - A neurosurgical specialist's claim seeking payment for out-of-network care is based on an implied contract providing a separate and independent basis for recovery and thus is not preempted by ERISA, a federal judge in New Jersey held Feb. 17 in remanding the case (North Jersey Brain & Spine Center v. Aetna Life Insurance Co., et al., No. 16-1544, D. N.J., 2017 U.S. Dist. LEXIS 22710).



Connecticut Federal Judge Rules For, Against Honeywell In Medical Coverage Dispute
HARTFORD, Conn. - A Connecticut federal judge on Feb. 28 granted summary judgment in favor of Honeywell International Inc., finding that union employees who retired after the expiration of collective bargaining and related agreements that offered them lifetime medical coverage benefits are not contractually vested (David Kelly, et al. v. Honeywell International Inc., No. 3:16-cv-00543, D. Conn., 2017 U.S. Dist. LEXIS 28203).



Ohio Federal Judge Rules Honeywell Can't Cut Retiree Lifetime Health Benefits
DAYTON, Ohio - An Ohio federal judge on Feb. 28 found that plaintiffs satisfied their burden of proving that Honeywell International Inc. agreed to provide lifetime health care benefits to retirees from its Greenville, Ohio, plant and permanently enjoined the company from dropping the benefits for those who retired from the plant before June 1, 2012, and their eligible spouses and dependents (Barbara Fletcher, et al. v. Honeywell International Inc., No. 3:16-cv-302, S.D. Ohio, Western Div., 2017 U.S. Dist. LEXIS 28324).



New Jersey Federal Judge Remands Health Insurance Case For Further Review
TRENTON, N.J. - A New Jersey federal judge on Feb. 14 remanded for further administrative review a case in which a plaintiff challenged a health insurance benefits determination, saying the claims processor had not provided enough evidence related to the determination for the court to make a ruling (Patient C.E. v. Excellus Blue Cross Blue Shield, No. 14-6950, D. N.J., 2017 U.S. Dist. LEXIS 20343).



Judge: ERISA Preempts Provider's Contract Claim Against Insurer
GREENSBORO, N.C. - A substance abuse provider's claims that an insurer failed to pay for medically necessary treatments are preempted by ERISA or fail to state a claim, a federal judge in North Carolina held Feb. 9 (Bobby P. Kearney, M.D., PLLC, v. Blue Cross and Blue Shield of North Carolina, et al., No. 16-191, M.D. N.C., 2017 U.S. Dist. LEXIS 18428).



Judge Permits Late Class Claims In Insurance Spat Involving Autism Treatment
BENTON, Ill. - Plaintiffs' failure to include class allegations in their complaint does not excuse the oversight, but because an insurer was on notice of the claims, the late addition does not warrant denying leave to amend in a case challenging the reduction of coverage for autism treatments, a federal judge in Indiana held Feb. 15 (W.P., et al. v. Anthem Insurance Companies Inc., No. 15-562, S.D. Ind., 2017 U.S. Dist. LEXIS 21424).



8th Circuit Panel Affirms Ruling On Enhanced Benefits For Anheuser Busch Pensioners
ST. LOUIS - An Eighth Circuit U.S. Court of Appeals panel on Feb. 22 affirmed in part a Missouri federal judge's ruling that participants in the Anheuser-Busch Cos. Pension Plan are entitled to enhanced pension benefits, saying that a plan administrator cannot contradict the plain language of an Employee Retirement Income Security Act plan to deny benefits, but reversed and remanded for a calculation of benefits owed to individual class members (Brian Knowlton, et al. v. Anheuser-Busch Cos. Pension Plan, et al., No. 15-3538, 8th Cir., 2017 U.S. App. LEXIS 3115).



Kentucky Federal Judge: Dispute Over Agreement Fails To State Claim Under ERISA
LONDON, Ky. - A Kentucky federal judge on Feb. 7 granted a university's motion to dismiss a claim that a disputed agreement that would give the university's former president lifetime retirement benefits, including health insurance, was a denial of Employee Retirement Income Security Act-protected benefits because the agreement is not governed by ERISA (Dr. James Taylor, et al. v. University of the Cumberlands, No. 6:16-cv-109, E.D. Ky., Southern Div., 2017 U.S. Dist. LEXIS 17005).



Washington Appeals Panel: Garnishment Of Plan Assets Proper Under ERISA, State Law
SEATTLE - A Washington appellate panel on Feb. 13 affirmed that garnishment of a pension's assets was proper under both the Employee Retirement Income Security Act and Washington state's garnishment law, Revised Code of Washington (RCW) 6.15020, because Washington law does not "relate to" ERISA and, therefore, neither is preempted (Jack A. Johnson v. Clyde E. Carlson, et al., No. 7424001, Wash. App., Div. 1, 2017 Wash. App. LEXIS 342).



New York Federal Magistrate Advises $4.5 Million Fee For Pension Plan Withdrawal
CENTRAL ISLIP, N.Y. - A New York federal magistrate judge on Feb. 7 recommended that a federal judge require a trucking company to pay more than $4.5 million in withdrawal liability for allegedly withholding payments from multiemployer pension plan funds pending an arbitrator's determination of the reasonableness of the amount (Thomas Gesualdi, et al. v. Scara-Mix Inc., No. 2:14cv765, E.D. N.Y., 2017 U.S. Dist. LEXIS 18059).



9th Circuit Panel: Judge Erred In Holding Job Resignation 'Voluntary'
PASADENA, Calif. - A Ninth Circuit U.S. Court of Appeals panel on Feb. 17 remanded an Employee Retirement Income Security Act case with instructions to enter summary judgment in favor of a man whose late wife lost her severance pay when she was forced to leave her job because of a disabling illness, saying a California judge erred in ruling that it was a "voluntary resignation" (Stanley Hoffman, et al. v. American Society for Techion-Israel Institute of Technology, No. 15-55756, 9th Cir., 2017 U.S. App. LEXIS 2837).



LTD Plan Was Not Granted Discretionary Authority, 1st Circuit Panel Determines
BOSTON - The First Circuit U.S. Court of Appeals on March 1 reversed a federal court's ruling that a disability insurer was delegated with discretionary authority and directed the lower court to review a claimant's termination of benefits under a de novo standard of review (Nilda Rodriguez-Lopez v. Triple-S Vida, Inc., No. 15-2413, 1st Cir., 2017 U.S. App. LEXIS 3729).



New York Federal Judge Says Administrator Failed To Prove Extension Was Warranted
NEW YORK - Because a plan administrator failed to prove that special circumstances existed when it extended the allowable time to issue a decision on appeal, a New York federal judge on Feb. 28 concluded that a de novo standard of review is appropriate (Katherine Salisbury v. Prudential Insurance Company of America, No. 15-9799, S.D. N.Y., 2017 U.S. Dist. LEXIS 27983).



California Federal Judge OKs Settlement In Dispute Over Offset Of Veterans' Benefits
OAKLAND, Calif. - A California federal on March 1 approved a class action settlement between former U.S. veterans and Liberty Life Assurance Company of Boston after determining that the terms of the settlement, which provides compensation to class members whose disability benefits were offset or reduced by Liberty Life, are reasonable (James L. Bush v. Liberty Life Assurance Company of Boston, et al., No. 14-1507, N.D. Calif.).



6th Circuit Finds Disability Coverage Claims Preempted By ERISA
CINCINNATI - After finding that a former marketing director's claims for coverage against a medical review company were completely preempted by the Employee Retirement Income Security Act, the Sixth Circuit U.S. Court of Appeals on Feb. 17 affirmed dismissal of the claims and found that a previous lawsuit filed against a plan administrator was the proper recourse (James Hackney v. Allmed Healthcare Management Inc., No. 16-5651, 6th Cir., 2017 U.S. App. LEXIS 2877).



9th Circuit Panel Upholds Plan's Offset Of Disability Benefits
SAN FRANCISCO - Plan language clearly allowed an insurer to offset permanent partial disability benefits by the amount of long-term disability benefits the employee received, a Ninth Circuit U.S. Court of Appeals panel held Feb. 16 in an unpublished opinion (John Del Gallego v. Wells Fargo & Co. Long Term Disability Plan, et al., No. 15-15294, 9th Cir., 2017 U.S. App. LEXIS 2753).



10th Circuit Panel Finds No Evidence That Employer Created Hostile Environment
DENVER - The 10th Circuit U.S. Court of Appeals on Feb. 24 affirmed that an employer did not create a hostile work environment after learning of an employee's disability because the employee failed to submit sufficient evidence that he was subject to a hostile work environment as a result of his disability (Steven R. Williams v. FedEx Corporate Services, et al., No. 16-4032, 10th Cir., 2017 U.S. App. LEXIS 3364).



High Court Denies Cert In Case Over Termination Of Long-Term Benefits
WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 21 denied a petition for a writ of certiorari in a case in which the 11th Circuit U.S. Court of Appeals said a district court did not err in determining that a disability plan did not wrongfully terminate a claimant's long-term disability benefits (Elizabeth Jenkins v. Grant Thornton LLP, et al., No. 16-682, U.S. Sup.).



Federal Judge: ERISA Stock Ownership Plan Cannot Seek Recovery Under Crime Policy
HOUSTON - A federal judge in Texas on Feb. 9 held that a third-party holding corporate stock cannot seek coverage under an insurance policy's plain language that limits coverage to "direct" losses when a corporate officer committed fraud that caused the devaluation of the corporation's stock (HC4, Inc. Employee Stock Ownership Plan v. Travelers Casualty and Surety Company of America, No. 16-00090, S.D. Texas, 2017 U.S. Dist. LEXIS 19605).



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.).