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Preview: LexisNexis® Mealey's™ ERISA Legal News

LexisNexis® Mealey's™ ERISA Legal News



Headline ERISA Legal News from LexisNexis®



 



D.C. Federal Judge Denies NAFA Preliminary Injunction Against Labor Department Fiduciary Rule
WASHINGTON, D.C. - A District of Columbia federal judge on Nov. 4 denied the National Association for Fixed Annuities' (NAFA) motion for a preliminary injunction against the U.S. Department of Labor's (DOL) fiduciary rule and granted the DOL's request for summary judgment, saying that the DOL did not go beyond its statutory authority when it extended the reach of the Employee Retirement Income Security Act to individual retirement accounts (The National Association of Fixed Annuities v. Thomas E. Perez, et al., No. 16-1035, D. D.C.; 2016 U.S. Dist. LEXIS 153214).



Wells Fargo 401(k) Plan Participant Files Class Action Under ERISA
MINNEAPOLIS - A former Wells Fargo & Co. employee and participant in its 401(k) plan on Oct. 14 filed a class action complaint under the Employee Retirement Income Security Act against the company, former and current executives and investment committee members, alleging that they breached their fiduciary duty by, among other things, retaining common stock of Wells Fargo as an investment option in the plan when a reasonable fiduciary using the "care, skill prudence, and diligence . . . that a prudent man acting in a like capacity and familiar with such matters" would have done otherwise (Lynette Fletcher, et al. v. Wells Fargo & Co., et al., No. 0:16-cv-03495, D. Minn.).



New York Federal Judge Allows 3 Counts In Action Against Deutsche Bank
NEW YORK - A New York federal judge on Oct. 13 allowed three counts in a putative class action complaint alleging that Deutsche Bank entities mismanaged their 401(k) plan in violation of the Employee Retirement Income Security Act to proceed, saying that the plaintiffs' breach of fiduciary duty claim plausibly alleges that the plan fiduciaries breached their duties to act in the best interest of the plan and with due care by failing to remove excessively costly proprietary mutual funds (Ramon Moreno, et al. v. Deutsche Bank Americas Holding Corp., et al., No. 1:15cv9936, S.D. N.Y.; 2016 U.S. Dist. LEXIS 142601).



Virginia Federal Judge Grants Partial Summary Judgment To ESOP Participant
ALEXANDRIA, Va. - A Virginia federal judge on Nov. 3 granted partial summary judgment to an employee stock ownership plan (ESOP) participant on his claim that a trustee violated the Employee Retirement Income Security Act by conducting a transaction with a "party in interest" but said that the holding does not mean defendant Wilmington Trust N.A. is liable because it has properly raised a Section 1108 affirmative defense (Tim P. Brundle, et al. v. Wilmington Trust N.A., No. 1:15-cv-1494, E.D. Va.; 2016 U.S. Dist. LEXIS 152908).



California Federal Judge Sets Payments To ESOP, Bank Plan Participants
SAN FRANCISCO - A California federal judge on Oct. 24 ordered the fiduciaries of the California Pacific Bank employee stock ownership plan (ESOP) to pay more than $150,000 in principal and lost interest to the plan and set the principal and interest owed to plan participants for the plan's failure to liquidate and distribute plan assets to them after the ESOP was terminated (Thomas E. Perez v. California Pacific Bank, et al., No. 3:13-cv-03792, N.D. Calif.; 2016 U.S. Dist. LEXIS 147090).



Maryland Federal Judge Finds Plan Trustee Jointly Liable For Alleged Breaches
BALTIMORE - A Maryland federal judge on Oct. 20 denied a motion to dismiss five counts in a 10-count complaint brought by U.S. Secretary of Labor Thomas E. Perez against Chimes District of Columbia Inc. alleging that an employee benefit plan sponsored by Chimes paid millions of dollars in excessive fees, finding that a plan trustee has joint and several liability for the alleged breaches of her co-fiduciaries (Thomas E. Perez v. Chimes District of Columbia Inc., et al., No. 15-3315, D. Md.; 2016 U.S. Dist. LEXIS 145272).



Michigan Federal Judge Dismisses Case Against Blue Cross With Prejudice
DETROIT - A Michigan federal judge on Oct. 28 granted Blue Cross Blue Shield of Michigan's (BCBSM) motion to dismiss the fourth amended complaint of a putative class action alleging that BCBSM violated the Employee Retirement Income Security Act by charging plaintiffs' ERISA health care plans "hidden" fees because of "defects" in the plaintiffs' pleading and failure to allege sufficient constitutional standing to pursue their claims for injunctive relief (Kimberly Cox, et al. v. Blue Cross Blue Shield of Michigan, No. 14-cv-13556, E.D. Mich., Southern Div.; 2016 U.S. Dist. LEXIS 149582).



North Carolina Federal Judge Allows Expert Witnesses To Testify In Benefit Plan Case
CHARLOTTE, N.C. - A North Carolina federal judge on Oct. 20 denied a motion to exclude the testimony of two expert witnesses in a long-running case over NationsBank's decision to allow its employees to transfer their 401(k) assets to a cash balance defined benefit plan, saying that he can freely accept or reject an expert's testimony during an upcoming bench trial and that the defense will be able to point out any inadmissible opinions (William L. Pender, et al. v. Bank of America Corp., et al., No. 3:05-cv-00238, W.D. N.C.; 2016 U.S. Dist. LEXIS 145497).



Plaintiffs Seek Preliminary Approval Of $14 Million Class Action Settlement
SAN FRANCISCO - Plaintiff attorneys on Oct. 26 filed a motion for preliminary approval of a proposed $14 million settlement in a class action over an amendment that eliminated the ability of pension plan participants to "age into" a subsidized early retirement benefit (Juan R. Reyes v. Bakery and Confectionary Union and Industry International Pension Fund, No. 14-5596, N.D. Calif.).



7th Circuit Panel Finds Suit Against Insurers Not Allowed By Section 502(a)(3)
CHICAGO - Joining its sister circuits, a Seventh Circuit U.S. Court of Appeals panel on Oct. 24 held that a health plan trustee's suit against insurers to recoup amounts it paid for the beneficiaries' medical care seeks legal relief, not equitable relief, and as such is not authorized by Employee Retirement Income Security Act Section 502(a)(3) (Central States, Southeast and Southwest Areas Health and Welfare Fund, et al. v. American International Group Inc., et al., No. 15-2237, 7th Cir.; 2016 U.S. App. LEXIS 19165).



Supreme Court Asked If ERISA Permits Cause For Indemnification
WASHINGTON, D.C. - A defendant in a class action under the Employee Retirement Income Security Act on Oct. 7 filed a petition for writ of certiorari asking the U.S. Supreme Court to review a Seventh Circuit U.S. Court of Appeals opinion and rule on whether ERISA 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.; 2016 U.S. S. Ct. Briefs LEXIS 3658).



Appellee To Supreme Court: Dignity Health Pension Plan Not Exempt From ERISA
WASHINGTON, D.C. - The Employee Retirement Income Security Act's definition of a "church plan" makes clear that pension plans such as Dignity Health's - which were not established by any church - are not exempt from ERISA's funding, reporting, disclosure and fiduciary requirements, Starla Rollins argues in her Oct. 17 appellee brief in opposition to Dignity's petition for writ of certiorari filed in the U.S. Supreme Court (Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.; 2016 U.S. S. Ct. Briefs LEXIS 3828).



Providence Health & Services Plan Members File Motion For $351.9 Million Settlement
SEATTLE - Named plaintiffs in a class action against Providence Health & Services for denying Employee Retirement Income Security Act protections for its retirement plan participants by incorrectly claiming that it was an ERISA exempt "church plan" on Oct. 20 filed an unopposed motion for preliminary approval of a $351.9 million settlement in Washington federal court (Linda Griffith, et al. v. Providence Health & Services, et al., No. 2:14-cv-01720, W.D. Wash.).



6th Circuit Panel Finds Withdrawal Liability Claims Barred By Res Judicata
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Oct. 31 affirmed dismissal of a lawsuit arguing that the Employee Retirement Income Security Act's imposition of withdrawal liability on a pension fund was unconstitutional, saying the claims are barred by the doctrine of res judicata (Old Blast Inc., et al. v. Operating Engineers Local 324 Pension Fund, No. 16-1260, 6th Cir.; 2016 U.S. App. LEXIS 19745).



Supreme Court Won't Review 7th Circuit Ruling That AAA May Impose Higher Fees
WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 31 denied a petition for writ of certiorari asking it to review a Seventh Circuit U.S. Court of Appeals decision affirming an Illinois federal judge's determination that a pension fund need not refund contributions made by an employer on behalf of an erroneously classified employee (Bulk Transport Corp. v. Central States, Southeast and Southwest Areas Pension Fund, et al., No. 16-457, U.S. Sup.).



Evidence Shows Claimant Not Able To Work In Sedentary Position, Panel Says
SAN FRANCISCO - A district court erred in determining that a disability claimant was capable of working in a sedentary position because the evidence shows that the claimant was able to sit for only four hours in an eight-hour workday, the Ninth Circuit U.S. Court of Appeals said Nov. 4 (Avery Armani v. Northwestern Mutual Life Insurance Co., No. 14-56866, 9th Cir.; 2016 U.S. App. LEXIS 19925).



Termination Of Benefits Was Reasonable, Majority Of 9th Circuit Panel Determines
SAN FRANCISCO - The majority of a Ninth Circuit U.S. Court of Appeals panel on Oct. 28 denied a disability claimant's motion for rehearing and reiterated that the termination of the claimant's benefits was reasonable because the claimant did not undergo an independent medical exam as requested by the insurer and as required under the plan (Curtis F. Lee v. ING Groep, N.V., et al., No. 14-15848, 9th Cir.; 2016 U.S. App. LEXIS 19513).



Evidence Supports Finding That Claimant Could Perform Duties Of Usual Occupation
SAN FRANCISCO - A district court did not err in concluding that a disability claimant was not totally disabled by fibromyalgia because the evidence supports the insurer's determination that the claimant could perform the material and substantial duties of her usual occupation, the Ninth Circuit U.S. Court of Appeals said Oct. 26 (Cheryl Leslie v. United of Omaha Life Insurance Co., No. 14-56775, 9th Cir.; 2016 U.S. App. LEXIS 19348).



Claimant Capable Of Working In Sedentary Position, Panel Affirms
ATLANTA - A district court did not err in granting summary judgment in favor of an employer and a disability insurer because the evidence supported the disability insurer's conclusion that the disability claimant was capable of working in a sedentary position, the 11th Circuit U.S. Court of Appeals said Oct. 21 (Andrew Ramdeen v. Prudential Insurance Company of America, et al., No. 16-11179, 11th Cir.; 2016 U.S. App. LEXIS 18962).



Plan Defendants Argue Plan Is Not Bound By SSA's Disability Onset Date
RICHMOND, Va. - A district court misinterpreted a disability plan's provisions when it determined that the plan and its administrator are bound by the disability onset date determined by the Social Security Administration (SSA), the plan defendants argue in a Nov. 2 brief filed in the Fourth Circuit U.S. Court of Appeals (Jesse Solomon v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, et al., No. 16-1730, 4th Cir.).



Texas Federal Judge Lets ERISA Claim Stand In Action Against Employer
DALLAS - A Texas federal judge on Oct. 24 partially denied a motion to dismiss for failure to state a claim in an action in which a man says he was illegally fired by his employer so it could stop paying for his medical expenses under its medical insurance plan, finding that he has sufficiently alleged facts that would support a claim under Employee Retirement Income Security Act Section 510 (Steve Wesley Culver, et al. v. United Commerce Centers Inc., et al., No. 3:16-cv-01055, N.D. Texas; 2016 U.S. Dist. LEXIS 146939).



Federal Judge: Tribe's ERISA Claim Over 'Hidden' Plan Fees Can Proceed
BAY CITY, Mich. - A Michigan federal judge on Oct. 27 stood by his dismissal of an Indian tribe's claim that its health care plan administrator breached its fiduciary duty under the Employee Retirement Income Security Act by failing to pay Medicare-like rates (MLRs) for certain health services but agreed with the parties that the tribe can still proceed with an ERISA claim based on the allegation that the administrator had a practice of hiding certain access fees (Saginaw Chippewa Indian Tribe of Michigan, et al. v. Blue Cross Blue Shield of Michigan, No. 16-cv-10317, E.D. Mich.; 2016 U.S. Dist. LEXIS 148615).



3 Class Actions Filed Seeking Coverage For Maternity Expenses
Three class action complaints were filed in recent weeks alleging that health benefit providers who are fiduciaries as defined in the Employee Retirement Income Security Act are obligated to administer plan benefits in accordance with the terms of plan documents and applicable law and cover maternity-related expenses such as breastfeeding (Laura Briscoe, et al. v. Health Care Service Corp., et al., No. 1:16-cv-10294, N.D. Ill.; Jance Hoy, et al. v. United Healthcare Services Inc., No. 2:16-cv-05579, E.D. Pa.; Lindsay Ferrer, et al. v. Carefirst Inc., et al., No. 1:16-cv-02162, D. D.C.).



Hawaii Federal Judge Says Health Insurer Plan Acted In Participants' Interest
HONOLULU - A Hawaii federal judge on Oct. 31 granted a motion for partial summary judgment on several claims filed against Kaiser Permanente Insurance Co. (KPIC) and Kaiser Foundation Health Plan Inc. (KFHP) in a class action alleging that they underpaid for emergency air transport, saying that KFHP, the plan fiduciary, discharged its duties solely in the interest of the participants and beneficiaries (Toby Sidlo, et al. v. Kaiser Permanente Insurance Co., et al., No. 1:15-cv-00269, D. Hawaii; 2016 U.S. Dist. LEXIS 150768).



Texas Magistrate Judge: ERISA Section 502(a)(1)(B) Claims Should Proceed
HOUSTON - A Texas magistrate judge on Oct. 4 recommended that a Houston-area health insurer's motion to dismiss claims under Employee Retirement Income Security Act Section 502(a)(1)(B) for allegedly denying or underpaying health care claims should be denied because the allegations are definite enough to plead an ERISA violation under the Dillingham test adopted by the Fifth Circuit (Elite Center for Minimally Invasive Surgery LLC v. Health Care Service Corp., d/b/a BlueCross Blue Shield of Illinois, No. 4:15-cv-00954, S.D. Texas; 2016 U.S. Dist. LEXIS 146887).



Illinois Federal Judge Certifies Class Of Health Care Plan Participants Suing Insurer
SPRINGFIELD, Ill. - An Illinois federal judge, in a decision filed Oct. 11, certified a class of participants who filed a breach of fiduciary duty lawsuit against a mutual insurance company for allegedly using premiums it obtained through payments made by them for health care coverage to enrich itself, saying that the plaintiffs satisfied all of the Federal Rule of Civil Procedure 23 requirements for certification and that a class action is superior to all other methods of adjudicating the action (Susan Priddy, et al. v. Health Care Services Corp., No. 14-3360, C.D. Ill.; 2016 U.S. Dist. LEXIS 140414).



Reconsideration Of Class Certification Denied In Suits Over Denial Of Care
SAN FRANCISCO - A California federal magistrate judge on Oct. 12 denied a motion filed by United Behavioral Health (UBH) to either reconsider his Sept. 19 certification of a class of insureds accusing UBH of wrongly denying coverage of mental health and substance abuse treatment to thousands or certify the order for interlocutory appeal (David Wit, et al. v. United Behavioral Health, No. 14-2346, Gary Alexander, et al. v. United Behavioral Health, No. 14-5337, N.D. Calif.; 2016 U.S. Dist. LEXIS 141441).



High Court Won't Review Reversal Of Benefits Ruling For Moen Inc. Retirees
WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 31 denied a petition for writ of certiorari asking it to review a divided Sixth Circuit U.S. Court of Appeals panel decision that reversed a district court's ruling in favor of a class of retirees from Moen Inc. who argued that their collective bargaining agreements guaranteed them health care benefits for life (John L. Gallo, et al. v. Moen Incorporated, No. 16-222, U.S. Sup.).



Health Insurer Pays $33 Million To Settle Chiropractors' Payment Suit
NEWARK, N.J. - Horizon Healthcare Service Inc. and related companies (collectively, Horizon) has already transferred $33 million to an interest-bearing, federally insured escrow account that will be used to pay class members, settlement administration costs above the $160,000 that Horizon is obligated to pay and any attorney fees and costs under a settlement granted final approval by a New Jersey federal judge on Oct. 18, ending a class complaint filed by chiropractors alleging that Horizon systematically denied payment for certain services rendered (Alphonse A. DeMaria, et al. v. Horizon Healthcare Services, Inc. d/b/a Horizon Blue Cross Blue Shield of New Jersey, et al., No. 11-7298, D. N.J.; 2016 U.S. Dist. LEXIS 143941).



New York Federal Judge Orders Disclosure Of Fees In Xerox Pension Benefit Dispute
ROCHESTER, N.Y. - A New York federal judge on Oct. 19 ordered Xerox to disclose the amount of fees it was charged and paid to its law firms in an action over Xerox's violation of the notice requirements of the Employee Retirement Income Security Act when it applied an offset to pension benefits of rehired workers (Paul J. Frommert, et al. v. Sally L. Conkright, et al., No. 00-CV-6311, W.D. N.Y.; 2016 U.S. Dist. LEXIS 144746).



Kentucky Federal Judge Orders Production Of Confidential Documents
LOUISVILLE, Ky. - A Kentucky federal judge in an order filed Oct. 17 directed insurer defendants in a class action challenging the lump-sum payment method used to calculate interest earned by pension plan members' accounts to produce several dozen allegedly privileged documents based on the fiduciary exception to the attorney-client and work product privileges (Jennifer Durand, et al. v. The Hanover Insurance Group Inc., et al., No. 3:07-cv-00130, W.D. Ky.; 2016 U.S. Dist. LEXIS 143064).



Illinois Federal Judge Denies Wheaton Plan Cases Transfer To Eastern Missouri District
CHICAGO - An Illinois federal judge on Oct. 31 denied defense motions to transfer two putative class actions alleging violations of the Employee Retirement Income Security Act to the Eastern District of Missouri because the alleged ERISA breaches occurred in Illinois, and Missouri is not among the states where Wheaton Franciscan Services Inc. has employees or retirees who will be affected (Diann M. Curtis, et al. v. Wheaton Franciscan Services Inc., et al., No. 16-cv-4232, and Bruce Bowen, et al. v. Wheaton Franciscan Services Inc., et al., No. 16-cv-6782, N.D. Ill.; 2016 U.S. Dist. LEXIS 150227).



5th Circuit Panel: Complaint Against BP Doesn't Satisfy Dudenhoeffer Standard
NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Sept. 26 held that a Texas federal judge erred in holding that a consolidated Employee Retirement Income Security Act action against BP PLC that was filed after the Deepwater Horizon explosion and oil spill satisfies the pleading standard set by the U.S. Supreme Court in Fifth Third Bancorp v. Dudenhoeffer (134 S. Ct. 2459 [2014]) because the complaint failed to propose an alternative course of action that a prudent fiduciary would recognize was more likely to help a retirement fund than harm it (Ralph Whitley, et al. v. BP PLC, et al., No. 15-20282, 5th Cir.; 2016 U.S. App. LEXIS 17501).



Class Action Accuses Wells Fargo & Co. Of 'Cross-Selling' Scheme
MINNEAPOLIS - A participant in and beneficiary of the Wells Fargo & Co.'s 401(k) Plan filed a putative class action lawsuit in Minnesota federal court Oct. 7, alleging violations of Sections 409 and 502 of the Employee Retirement Income Security Act for allegedly encouraging and causing employees to sign up customers for unauthorized and unwanted accounts and other banking products to generate inflated share price growth (Francesca Allen, et al. v. Wells Fargo & Co., et al., No. 16-3405, D. Minn.).



New York Federal Judge Finds Material Facts In Dispute In ESOP Case
NEW YORK - A New York federal judge on Sept. 28 denied both parties' motions for summary judgment in a case in which the U.S. secretary of Labor alleges that an independent trustee violated the Employee Retirement Income Security Act by approving the sale of a private label denim manufacturer to the Maran Employee Stock Ownership Plan (ESOP), saying that there are several material facts in dispute (Thomas E. Perez, Secretary of Labor, et al. v. First Bankers Trust Services, Inc., et al., No. 12-cv-8648, S.D. N.Y.; 2016 U.S. Dist. LEXIS 134063).



Pennsylvania Federal Judge Allows Class Action Against Wawa To Proceed
PHILADELPHIA - A Pennsylvania federal judge on Oct. 6 denied most parts of a motion to dismiss a class action complaint accusing a man's former employer, Wawa Inc., of violating the Employee Retirement Income Security Act when it forced him and other terminated employees to sell their stock in the company because Wawa's reservation of a right to amend the plan "at any time" did not necessarily give it the authority to reduce the plaintiffs' benefits (Greg Pfeifer v. Wawa, Inc., et al., No. 16-497, E.D. Pa.).



Labor Secretary Asks 4th Circuit To Reaffirm 2014 Decision In Tatum
RICHMOND, Va. - Secretary of Labor Thomas E. Perez on Sept. 9 filed an amicus curiae brief urging the Fourth Circuit U.S. Court of Appeals to hold R.J. Reynolds Tobacco Co. (RJR) liable for losses suffered by its 401(k) retirement employee benefit plan after its 1999 decision to divest Nabisco stock from the plan (Richard G. Tatum, et al. v. R.J.R. Pension Investment Committee, et al., No. 16-1293, 4th Cir.).



Suit Against Whole Foods For Alleged Overpricing Scheme Dismissed In Texas
AUSTIN, Texas - A Texas federal judge on Sept. 28 dismissed without prejudice a putative class action brought under the Employee Retirement Income Security Act alleging that Whole Foods Market Inc. breached its fiduciary duty to participants in its 401(k) plan by allowing employees to continue to invest in the company while the company's stock was artificially inflated due to a widespread overpricing scheme (Thomas Martone, et al. v. Whole Foods Market Inc., No. 1:15-CV-877, W.D. Texas; 2016 U.S. Dist. LEXIS 133703).



Fraternal Benefit Society Sues DOL, Perez Over New Fiduciary Rule
MINNEAPOLIS - A membership-owned and member-governed fraternal benefit society of Christians on Sept. 29 filed a lawsuit in Minnesota federal court against 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.).



Appellees Tell High Court Advocate Health Care Plan Not Exempt From ERISA
WASHINGTON, D.C. - The Employee Retirement Income Security Act makes it clear that retirement plans like those established by Advocate Health Care Network are not church plans exempt from the requirements of ERISA, appellees say in an initial brief filed Sept. 14 with the U.S. Supreme Court (Advocate Health Care Network, et al. v. Maria Stapleton, et al., No. 16-74, U.S. Sup.; 2016 U.S. S. Ct. Briefs LEXIS 3379).



Saint Peter's Healthcare Plan Participant Files Opposition To Supreme Court Review
WASHINGTON, D.C. - The U.S. Supreme Court should deny Saint Peter's Healthcare System's (SPHS) petition for writ of certiorari seeking review of a circuit court decision affirming that its pension plan is not a "church plan" exempt from the requirements of the Employee Retirement Income Security Act because SPHS is not a church but a nonprofit health care entity, counsel for a plan participant say in a brief in opposition filed with the high court on Sept. 16 (Saint Peter's Healthcare System, et al. v. Laurence Kaplan, No. 16-86, U.S. Sup.; 2016 U.S. S. Ct. Briefs LEXIS 3400).



Supreme Court Issues Stay Of 9th Circuit Ruling On Church Plan Exemption
WASHINGTON, D.C. - The U.S. Supreme Court on Sept. 21 issued a stay of a Ninth Circuit U.S. Court of Appeals panel's decision that a pension plan operated by Dignity Health was not subject to the requirements of the Employee Retirement Income Security Act and does not qualify for ERISA's church plan exemption because it was not established by a church or by a convention or association of churches (Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.).



6th Circuit Panel Affirms Bridgestone Misrepresented Employee's Pension Credits
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Sept. 12 affirmed the grant of summary judgment to a Bridgestone Americas Inc. employee because he proved three violations of the Employee Retirement Income Security Act by his employer when it misrepresented the amount of pension credit he would receive for his time as a manager at a Canadian Bridgestone plant (Andre Deschamps v. Bridgestone Americas Inc. Salaried Employees Retirement Plan, et al., No. 15-6112, 6th Cir.; 20126 U.S. App. LEXIS 16839.)



9th Circuit Denies Motion For Rehearing In Pension Benefits Case
SAN FRANCISCO - A divided Ninth Circuit U.S. Court of Appeals on Sept. 20 denied a petition for rehearing en banc in an Employee Retirement Income Security Act case, with the majority saying that a plan administrator's decision in a dispute over a since-deceased plaintiff's entitlement to benefits was not illogical, implausible or without support (Estate of Bruce H. Barton v. ADT Security Services Pension Plan, et al., No. 13-56379, 9th Cir.; 2016 U.S. App. LEXIS 17146).



1st Circuit Panel Affirms Plan Participant's Untimely Death Prevents Payment To Children
BOSTON - A First Circuit U.S. Court of Appeals panel on Sept. 13 affirmed that an Employee Retirement Income Security Act plan participant's beneficiaries were not entitled to a guaranteed single-life annuity because he died before the beginning of the annuity payments (Brian O'Shea, et al. v. UPS Retirement Plan, et al., No. 15-1923, 1st Cir.; 2016 U.S. App. LEXIS 16734).



11th Circuit Panel Affirms Dismissal Of Complaint For Failure To State A Claim
ATLANTA - An 11th Circuit U.S. Court of Appeals panel ruled Sept. 19 that a Georgia federal judge did not err in dismissing a former Delta Air Lines Inc. employee's Employee Retirement Income Security Act complaint for failure to state a claim (Barry Steven Slakman v. Administrative Committee of Delta Air Lines Inc., No. 16-10572, 11th Cir.; 2016 U.S. App. LEXIS 17049).



Alabama Federal Judge Allows Most Retiree Claims In Suit Over Canceled Life Insurance
MONTGOMERY, Ala. - An Alabama federal judge on Sept. 27 allowed most claims to proceed in consolidated class actions alleging that Allstate Insurance Co. improperly ended retirees' promised lifetime benefits, saying the plaintiffs have stated a claim that Allstate's plan did not include, or was ambiguous as to whether it included, a provision under which Allstate reserved the right to cancel the retirees' life insurance policies (Garnet Turner, et al. v. Allstate Insurance Company, No. 2:13-cv-685, 2:15-cv-406, M.D. Ala.; 2016 U.S. Dist. LEXIS 132113).



Pennsylvania Health Systems File Lawsuit Over Actuarial Services
JOHNSTOWN, Pa. - Pennsylvania health care system operators on Sept. 16 filed a federal lawsuit against professional services companies alleging actuarial malpractice and negligent misrepresentation that has caused well more than $100 million in damages to their pension benefit plans (UPMC, et al. v. CBIZ Inc., et al., No. 3:16-cv-204, W.D. Pa.).



5th Circuit Affirms Plan Did Not Violate ERISA By Transferring Retiree Assets
NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Sept. 15 said that its previous conclusion that a plaintiff's bare allegation on the purported statutory right to "proper plan management" under the Employee Retirement Income Security Act is insufficient to meet the injury-in-fact prong of Article III standing remains as valid after the U.S. Supreme Court's ruling in Spokeo Inc. v. Robins (136 S. Ct. 1540, 194 L. Ed. 2d 635 [2016]), as it was before Spokeo was decided (William Lee, et al. v. Verizon Communications Inc., et al., No. 14-10554, 5th Cir.; 2016 U.S. App. LEXIS 16929).



8th Circuit Denies Petitioner Who Opposed Disability Plan's Forum-Selection Clause
ST. LOUIS - An Eighth Circuit U.S. Court of Appeals panel on Sept. 27 denied a disability plan participant's petition for writ of mandamus directing a Missouri federal judge to disregard the plan's forum-selection clause and transfer her case to Arizona, where she has lived and worked for more than a decade (In re Lorna Clause, No. 16-2607, 8th Cir.).



Judge Says Health Care Provider's Attempt To Amend Complaint 'Futile'
CHATTANOOGA, Tenn. - A Tennessee federal judge on Sept. 27 ruled that a health care provider's attempt to file an amended complaint against BlueCross BlueShield of Tennessee Inc. (BCBST) for alleged violations of the Employee Retirement Income Security Act was "futile" and accepted a magistrate judge's report and recommendation that the action should be dismissed because the plaintiff lacked standing to bring its ERISA claims (Apple Corporate Wellness Inc. v. BlueCross BlueShield of Tennessee Inc., No. 1:15-cv-324, E.D. Tenn.; 2016 U.S. Dist. LEXIS 131929).



High Court Denies Review Of Ruling On Standing To Sue Insurer Under ERISA
WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 11 denied a petition for writ of certiorari asking it to consider whether a party that is not an Employee Retirement Income Security Act plan participant, an ERISA beneficiary or a health care provider has standing to sue an insurer under ERISA for benefits (Gables Insurance Recovery Inc., as assignee of South Miami Chiropractic LLC, v. Blue Cross and Blue Shield of Florida Inc., No. 16-64, U.S. Sup.).



Indiana Federal Judge Says Arbitrary And Capricious Standard Of Review Applies
INDIANAPOLIS - After considering additional briefing on a recent decision by the Second Circuit U.S. Court of Appeals, an Indiana federal judge on Sept. 26 denied a disability claimant's motion to apply a de novo standard of review because the plan proved that its failure to comply with the claims-procedure regulation was harmless to the claimant (Donald Fessenden v. Reliance Standard Life Insurance Co., et al., No. 15-370, N.D. Ind.; 2016 U.S. Dist. LEXIS 131226).



Michigan Federal Judge Says Prejudgment Interest Owed For Wrongful Benefits Denial
DETROIT - On remand from the Sixth Circuit U.S. Court of Appeals, a Michigan federal judge on Sept. 29 ordered a disability insurer to calculate the amount of prejudgment interest it owes to the estate of a disability claimant for the time period of July 2002 through September 2016 after determining that prejudgment interest is warranted based on the insurer's wrongful denial of benefits (Todd R. Rochow, et al. v. Life Insurance Company of North America, No. 04-73628, E.D. Mich.; 2016 U.S. Dist. LEXIS 134229).



Denial Of Benefits Was Reasonable Based On Evidence, 6th Circuit Panel Says
CINCINNATI - A disability insurer's denial of long-term disability benefits was reasonable based on the substantial amount of evidence showing that the claimant was not disabled until after he was no longer covered under the disability plan at issue, the Sixth Circuit U.S. Court of Appeals said Oct. 4 (James J. Connelly v. Standard Insurance Co., No. 16-3036, 6th Cir.; 2016 U.S. App. LEXIS 18214).



Claimant Failed To Prove That He Suffered From Bipolar Disorder, Panel Says
SAN FRANCISCO - A district court did not err in determining that a disability insurer's termination of a claimant's benefits was reasonable based on the plan's mental illness limitation because the claimant failed to carry his burden of proving that he suffered from bipolar disorder, the Ninth Circuit U.S. Court of Appeal affirmed Sept. 26 (David Hoffmann v. Life Insurance Company of North America, et al., No. 15-55093, 9th Cir.; 2016 U.S. App. LEXIS 17491).



Denial Of Claims Was Not An Abuse Of Discretion, 9th Circuit Panel Says
PHOENIX - The denial of two short-term disability claims was not an abuse of discretion because the medical evidence did not support a finding that the claimant was disabled from performing the duties of her job, the Ninth Circuit U.S. Court of Appeals said Sept. 19 (Carol Molanick v. United Services Automobile Association, No. 14-16404, 9th Cir.; 2016 U.S. App. LEXIS 17087).



Class Certified In Suits Alleging Denial Of Mental Health, Abuse Treatment
SAN FRANCISCO - A California federal judge on Sept. 19 certified a class of insureds accusing their health insurance provider of wrongly denying coverage of mental health and substance abuse treatment to thousands and claiming that the provider is an ERISA fiduciary under 29 U.S. Code Section 1104(a) "and therefore owes a duty to discharge its duties 'with . . . care, skill, prudence, and diligence' and 'solely in the interest of the participants and beneficiaries'" (David Wit, et al. v. United Behavioral Health, No. 14-2346, Gary Alexander, et al. v. United Behavioral Health, No. 14-5337, N.D. Calif.; 2016 U.S. Dist. LEXIS 127435).



Top Court Declines Review In Case Involving ACA-ERISA Appeal Interplay
WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 3 declined to review a woman's case involving, among other issues, the proper way to handle external benefit denial appeal after the Patient Protection and Affordable Care Act (ACA)'s amendments to the Employee Retirement Income Security Act (S.M. v. Oxford Health Plans [NY] Inc., et al., No. 15-1540, U.S. Sup.).



Extracontractual Monetary Damages Are Recoverable Under ERISA, Panel Says, Reverses
LOS ANGELES - A California appeals panel held Oct. 6 that monetary relief for extracontractual harm is legally recoverable under Section 502(a)(3) of the Employee Retirement Income Security Act, reversing a lower court's ruling that insurers have no duty to defend a managed care company against underlying lawsuits (Health Net, Inc. v. American International Specialty Lines Insurance Co., et al., No. B262716, Calif. App., 2nd Dist., Div. 3; 2016 Cal. App. Unpub. LEXIS 7296).



Pennsylvania Federal Judge Denies Motion To Certify Claims Against Prudential
PHILADELPHIA - A Pennsylvania federal judge on Sept. 30 denied a motion to certify a class of beneficiaries of employer-sponsored Prudential Insurance Company of America life insurance policies, saying that the plaintiffs have failed to satisfy Federal Rule of Civil Procedure 23(b)(3)'s predominance requirement (Clark R. Huffman, et al. v. The Prudential Insurance Company of America, No. 2:10-cv-05135, E.D. Pa.; 2016 U.S. Dist. LEXIS 135349).



6th Circuit Panel Affirms Judgment In ERISA Case Against Life Insurer
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Sept. 14 said an Ohio federal judge properly granted summary judgment to the beneficiary of an insured on the merits of his Employee Retirement Income Security Act claim against a life insurance company because the insurer acted arbitrarily and capriciously in denying his claim (Lloyd Brown III v. United of Omaha Life Insurance Co., et al., No. 15-4293, 6th Cir.; 2016 U.S. App. LEXIS 17021).



Ohio Federal Judge Finds Water Works Requirements Preempted By ERISA
CINCINNATI - An Ohio federal judge on Sept. 30 ruled that the City of Cincinnati's requirements for the award of construction contracts for water works jobs are preempted by the Employee Retirement Income Security Act because they impact the uniformity of the structure and administrative practice for ERISA plans and create "an impediment to uniform benefit administration" (Allied Construction Industries v. City of Cincinnati, No. 1:14cv450, S.D. Ohio; 2016 U.S Dis. LEXIS 135758).



New Jersey Federal Magistrate Denies Insurance Department Motion To Quash Subpoena
NEWARK, N.J. - A New Jersey federal magistrate judge on Sept. 30 denied the New Jersey Department of Banking and Insurance's motion to quash a subpoena related to the denial of a woman's mental health treatments, saying a confidentiality provision in the state Health Care Quality Act is preempted by the Employee Retirement Income Security Act (Rachel B. v. Horizon Blue Cross Blue Shield of New Jersey, No. 14-cv-01153, D. N.J.; 2016 U.S. Dist. LEXIS 135547).



Texas Federal Judge: Medical Provider's Claims Against Insurer Preempted By ERISA
HOUSTON - A Texas federal judge on Sept. 28 ruled that the breach of contract claims of an out-of-network hospital that Cigna Healthcare underpaid the hospital 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; 2016 U.S. Dist. LEXIS 133154).



Federal Judge Remands Claims By Sleep Centers For Payment To State Court
LOS ANGELES - A California federal judge on Sept. 12 granted a request to remand claims for violation of California's unfair competition law (UCL) and other claims asserted by operators of sleep centers in relation to allegedly unpaid medical care by insurers, finding that the district court lacked federal jurisdiction (Northern Va. Operating Co. LLC, et al. v. CIGNA Healthcare of Ca. Inc., et al., No. 16-5168, C.D. Calif.; 2016 U.S. Dist. LEXIS 124291).



North Carolina Federal Judge OKs $32 Million Settlement, Awards $10.7 Million In Fees
GREENSBORO, N.C. - A North Carolina federal judge on Sept. 29 awarded more than $10.7 million in attorney fees, costs and class representative awards after approving a $32 million settlement of a class action dispute over the fees charged to current and former Novant Health Inc. employees who were participants in Novant's retirement plans (Karolyn Kruger, M.D., et al. v. Novant Health Inc., et al., No. 14-208, M.D. N.C.).



New York Federal Judge Awards $2.5 Million In Fees In ESOP Case
ROCHESTER, N.Y. - A New York federal judge on Oct. 4 awarded more than $2.5 million in attorney fees, costs and class representative awards in a case alleging that various fiduciaries violated the Employee Retirement Income Security Act by permitting the Eastman Kodak Employees' Savings and Investment (SIP) and Kodak Employee Stock Ownership Plans (ESOP) to offer Kodak stock as an investment option even after an objective investigation would have revealed that the stock represented an "extremely risky investment" (In re: Eastman Kodak ERISA Litigation, No. 6:12cv6051, W.D. N.Y.; 2016 U.S. Dist. LEXIS 137744).



Benefit Plans' Appeal In Securities Suit Remanded To Federal District Court
NEW YORK - A Second Circuit U.S. Court of Appeals panel on Sept. 20 remanded an appeal by employee benefit plans in a securities class action lawsuit to a federal district court for further proceedings, ruling that such proceedings are necessary to determine whether the plans are considered "affiliates" of defendant American International Group Inc. (AIG) (Sharyn Rothstein, et al. v. American International Group Inc., et al., Nos. 14-4067 and 14-4603, 2nd Cir.; 2016 U.S. App. LEXIS 17201).



7th Circuit Panel: Breach Claims Against GreatBanc Were Plausibly Alleged
CHICAGO - A Seventh Circuit U.S. Court of Appeals panel on Aug. 25 reversed the dismissal of Employee Retirement Income Security Act claims against the trustee of an employee stock ownership plan (ESOP) because, it said, the plaintiffs plausibly alleged both a prohibited transaction and a breach of fiduciary duty (Lisa Allen, et al. v. GreatBanc Trust Co., No. 15-3569, 7th Cir.; 2016 U.S. App. LEXIS 15704).



New York Federal Judge Dismisses 5 Defendants From ERISA Class Action
NEW YORK - A New York federal judge on Aug. 23 granted five defendants' motion to dismiss claims against them in a second amended class action complaint against 12 banks and their affiliates under the Employee Retirement Income Security Act because the plaintiffs failed to adequately plead that the defendants were ERISA fiduciaries or "parties in interest" (Doris Sue Allen, et al. v. Bank of America Corp., et al., No. 1:15cv4285, S.D. N.Y.; 2016 U.S. Dist. LEXIS 112407).



11th Circuit Panel Affirms Dismissal Of Claims Against Third-Party Administrator
ATLANTA - An 11th Circuit U.S. Court of Appeals panel on Sept. 1 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. 15-14046, 11th Cir.; 2016 U.S. App. LEXIS 16162).



2 Organizations File Briefs In Support Of DOL's Fiduciary Rule
DALLAS - Two organizations filed amicus curiae briefs in Texas federal court in August supporting the U.S. Department of Labor's (DOL) fiduciary rule and opposing efforts to stop it from taking effect (Chamber of Commerce of the United States of America, et al. v. Thomas E. Perez, Secretary of Labor, et al., No. 3:16-cv-1476, N.D. Texas).



2nd Circuit Panel Affirms Investment Advisers Liable For Pension Plan Losses
NEW YORK - A Second Circuit U.S. Court of Appeals panel on Aug. 30 affirmed a ruling that the investment advisers for employee pension plans sponsored by Severstal Wheeling Inc. (SWI) and its predecessors are liable for the full amount of investment losses - $9.6 million - due to their failure to properly diversify and manage the plans (Severstal Wheeling, Inc. Retirement Committee, et al. v. WPN Corporation, et al., No. 15-2725, 2nd Cir.; 2016 U.S. App. LEXIS 15970).



California Federal Judge Dismisses ERISA Class Action Against Chevron Corp.
OAKLAND, Calif. - A California federal judge on Aug. 29 granted Chevron Corp.'s motion to dismiss an Employee Retirement Income Security Act class action against it alleging breach of fiduciary duty for failure to state a claim (Charles E. White, et al. v. Chevron Corp., et al., No. 16-cv-0793, N.D. Calif.; 2016 U.S. Dist. LEXIS 115875).



Separate Class Actions Filed Against Large Universities Alleging Plan Mishandling
The Massachusetts Institute of Technology (MIT), New York University (NYU) and Yale University were sued Aug. 9 in separate putative class action lawsuits on behalf of more than 60,000 employees in their defined contribution retirement plans who claim that the universities, as plan sponsors, breached their duties of loyalty and prudence under the Employee Retirement Income Security Act by causing plan participants to pay millions of dollars in unreasonable and excessive administrative fees (David B. Tracey, et al. v. Massachusetts Institute of Technology, et al., No. 1:16cv11620, D. Mass.; Dr. Alan Sacerdote, et al. v. New York University, et al., No. 1:16cv6284, S.D. N.Y.; Joseph Vellali, et al. v. Yale University, et al., No. 3:16cv1345, D. Conn.).



More ERISA Class Actions Filed Against Universities Alleging Plan Mishandling
A second wave of putative class action lawsuits accusing universities of mismanaging their employee retirement plans by charging excessive fees, using multiple record keepers to operate their plans and handle administrative services and offering too many high-cost and poorly performing investment options were filed Aug. 10 and 11 (David Clark, et al. v. Duke University, et al., No. 1:16-cv-01044, M.D. N.C.; Loren L. Cassell, et al. v. Vanderbilt University, et al., No. 3:16-cv-02086, M.D. Tenn.; Jennifer Sweda, et al. v. University of Pennsylvania, et al., No. 2:16-cv-04329; Margaret E. Kelly, et al. v. The Johns Hopkins University, No. 1:16-cv-02835, D. Md.).



Georgia Federal Judge Allows Some ESOP Claims To Proceed
AUGUSTA, Ga. - A Georgia federal judge on Aug. 26 held that a plaintiff has stated a claim for breach of the fiduciary duty of prudence in a case in which she alleges that her employer's employee stock ownership plan (ESOP) imprudently continued to invest in company stock, the value of which dropped significantly (Carrie Brannen, et al. v. First Citizens Bankshares Inc. Employee Stock Ownership Plan with 401(k) Provisions, et al., No. 6:15-cv-30, S.D. Ga.; 2016 U.S. Dist. LEXIS 114775).



3rd Circuit Panel Affirms MEWA Marketer Ruling, Remands Trustee Decision
PHILADELPHIA - A Third Circuit U.S. Court of Appeals panel on Aug. 18 affirmed that the marketer of a multiemployer welfare arrangement (MEWA) breached his fiduciary duties to the fund by diverting plan assets within the meaning of the Employee Retirement Income Security Act but vacated and remanded a lower court ruling against a named trustee of the plan, finding that more evidence is needed to determine when she became aware of the diversion of funds (Secretary of Labor v. James Doyle, et al., Nos. 15-1380 and 15-1574, 3rd Cir.; 2016 U.S. App. LEXIS 15169).



North Carolina Federal Judge Refuses To Dismiss ERISA Claims Against Aetna
ASHEVILLE, N.C. - A North Carolina federal judge on Aug. 31 denied defendants' motion to dismiss two claims for breach of fiduciary duty brought under the Employee Retirement Income Security Act because the plaintiff sufficiently alleged an injury in fact (Sandra M. Peters, et al. v. Aetna Inc., et al., No. 1:15-cv-00109, W.D. N.C.; 2016 U.S. Dist. LEXIS 117326).



California Federal Judge Lets Class Action Against Asset Management Firm Proceed
SANTA ANA, Calif. - A California federal judge on Aug. 5 denied in part defendants' motion to dismiss a first amended class action complaint alleging that mismanagement of their asset management company's 401(k) plan led to "outrageously high" expenses for plan participants, rejecting their arguments that the claims are time-barred and that the plaintiffs do not have standing to challenge plan investment options (Aleksandr Urakhchin, et al. v. Allianz Asset Management of America LP, et al., No. 8:15cv1614, C.D. Calif.; 2016 U.S. Dist. LEXIS 104244).



Georgia Federal Judge Certifies Class Of SunTrust 401(k) Plan Participants
ATLANTA - a Georgia federal judge on Aug. 17 certified a class of participants in or beneficiaries of the SunTrust Banks Inc. 401(k) Savings Plan who allege that they sustained a loss to their account as a result of investment in SunTrust stock, saying it would "help bring an efficient resolution to this case" (In re SunTrust Banks Inc. ERISA Litigation, No. 1:08-CV-03384, N.D. Ga.; 2016 U.S. Dist. LEXIS 108916).



5 Groups Support Petitioners Seeking High Court Review Of Church Plan Rulings
WASHINGTON, D.C. - Five organizations in August filed amicus briefs with the U.S. Supreme Court in support of petitioners seeking clarification of what constitutes a "church plan" exempt from the requirements of 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, U.S. Sup.).



Dignity Health Seeks High Court Review Of Church Plan Rulings
WASHINGTON, D.C. - Lower courts and religious employers "desperately need definitive resolution" of the recurring question of the Employee Retirement Income Security Act's "church plan" exemption, Dignity Health argues in a petition for a writ of certiorari filed Aug. 29 in the U.S. Supreme Court (Dignity Health, et al. v. Starla Rollins, No. 16-258, U.S. Sup.; 2016 U.S. S. Ct. Briefs LEXIS 3166).



Maryland Federal Judge Consolidates ERISA Cases, Appoints Lead Counsel
BALTIMORE - A Maryland federal judge on Aug. 24 consolidated two Employee Retirement Income Security Act class actions against Bon Secours Health System Inc. and appointed interim lead class counsel (Arlene Hodges, et al. v. Bon Secours Health System Inc., et al., No. RDB-16-1079, Carolyn Miller, et al. v. Bon Secours Health System Inc., et al., No. RDB-16-1150, D. Md.; 2016 U.S. Dist. LEXIS 113414).



Proposed Settlement Filed In Alabama Federal Court In 'Church Plan' Class Action
BIRMINGHAM, Ala. - A plaintiff on Aug. 26 submitted in Alabama federal court an unopposed motion and brief in support of a proposed settlement of a class action that alleges that the Baptist Health System Inc. Retirement Plan was improperly classified as a "church plan" under the Employee Retirement Income Security Act and significantly underfunded (Jeffrey Tucker, et al. v. Baptist Health System Inc., et al., No. 2:15-cv-00382, N.D. Ala.).



3rd Circuit Appeals Panel Vacates, Remands Case Over 'Active-Service' Clause
PHILADELPHIA - A Third Circuit U.S. Court of Appeals panel on Aug. 19 vacated a decision denying a woman's claim for benefits under the Employee Retirement Income Security Act because of an "active-service" clause in her husband's employee benefit plan and remanded for a determination of the terms of the plan at the time her benefits, if any, vested (Lou Ann Woerner, et al. v. Fram Group Operations LLC, et al., No. 15-2813, 3rd Cir.; 2016 U.S. App. LEXIS 15248).



5th Circuit Panel Affirms Bonus Arrangement Is Not An ERISA Plan
NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Aug. 31 affirmed that a bonus agreement offered by an employer to a select number of employees does not qualify as an Employee Retirement Income Security Act employee welfare benefit plan because "the purchase of insurance alone is insufficient to demonstrate an ERISA plan" (Sarah Mozingo Martin, et al. v. Trend Personnel Services, et al., No. 15-11263, 5th Cir.; 2016 U.S. App. LEXIS 16146).



Panel Majority Says District Court Failed To Consider Effect Of Medications
SAN FRANCISCO - A district court erred in entering judgment in favor of a disability plan and a disability insurer because it failed to consider how medications taken by the disability claimant would affect his ability to function in a workplace under the "any occupation" test, the majority of a Ninth Circuit U.S. Court of Appeals panel said Aug. 26 (Daniel G. Demer v. IBM Corporation LTD Plan, et al., No. 13-17196, 9th Cir.; 2016 U.S. App. LEXIS 15788).



6th Circuit Majority Says Remand To Plan Administrator Was Not Violation Of Mandate
CINCINNATI - The majority of a Sixth Circuit U.S. Court of Appeals panel on Aug. 19 determined that remanding a disability retirement claim to the plan administrator was not an abuse of discretion because the remand remained within the purview of an earlier mandate issued by the Sixth Circuit (Kyle D. Kennard v. Means Industries Inc., No. 15-1872, 6th Cir.; 2016 U.S. App. LEXIS 15308).



Denial Of Benefits Was Not Rational, 6th Circuit Appeals Panel Says In Reversing
CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Sept. 7 reversed and remanded a district court's ruling that a disability claimant is not entitled to long-term disability benefits beyond the plan's one-year limitation for mental disorders because the plan administrator's decision was arbitrary and capricious (Patti Okuno v. Reliance Standard Life Insurance Co., No. 15-4043, 6th Cir.; 2016 U.S. App. LEXIS 16423).



Claimant Failed To Prove She Is Totally Disabled, 6th Circuit Panel Says
CINCINNATI - A district court did not err in finding that a disability claimant's long-term benefits were properly terminated because the claimant failed to show by a preponderance of the evidence that she is totally disabled as defined by the plan, the Sixth Circuit U.S. Court of Appeals said Aug. 23 (Christina Saunders v. Procter & Gamble Health & Long-Term Disability Benefit Plan, No. 16-3043, 6th Cir.; 2016 U.S. App. LEXIS 15743).



Denial Of Claim Was Proper; Lawsuit Was Untimely Filed, 8th Circuit Panel Determines
ST. LOUIS - The Eighth Circuit U.S. Court of Appeals on Aug. 22 affirmed a disability insurer's denial of a long-term disability (LTD) claim on the basis that the claimant's lawsuit was not filed within the plan's contractual limitations period (Jeff Schmitz v. Sun Life Assurance Company of Canada, No. 14-3701, 8th Cir.; 2016 U.S. App. LEXIS 15319).



11th Circuit: External Medical Necessity Review Not Binding On Parties
ATLANTA - An 11th Circuit U.S. Court of Appeals panel on Aug. 16 held that a federal judge erred in determining that an external review of the medical necessity of a woman's anorexia treatment was binding on the parties and precluded her from challenging Oxford Health Insurance Inc.'s denial of her claim under the Employee Retirement Income Security Act because the external review had not finally decided the issue against her (Alexandra H. v. Oxford Health Insurance Inc. Freedom Access Plan, et al., No. 15-11513, 11th Cir.; 2016 U.S. App. LEXIS 15030).



Alaska Federal Judge: Lab Claims Preempted By ERISA, FEHBA
ANCHORAGE, Alaska - An Alaska federal judge on Aug. 16 ruled that Alaska's Prompt Pay Statute, requiring insurers to pay benefit claims within 30 days, is preempted by the Employee Retirement Income Security Act for claims related to employee benefit plans and the Federal Employees Health Benefits Act (FEHBA) for claims related to federal worker benefit plans (John D. Zipperer Jr. v. Premera Blue Cross Blue Shield of Alaska, No. 3:15-CV-00208, D. Alaska; 2016 U.S. Dist. LEXIS 109531).



Statute Voiding Discretionary Clauses Does Not Apply To Health Plan, Judge Says
SAN FRANCISCO - A California statute voiding discretionary clauses in disability and life insurance policies does not apply to a claim for medical expenses under a health insurance policy because New York law applies to the dispute and because health insurance is not a form of disability insurance, a California federal judge said Aug. 30 (David Bain et al., v. United Healthcare Inc., No. 15-3305, N.D. Calif.; 2016 U.S. Dist. LEXIS 116805).



California Federal Judge Dismisses Part Of Suit Over Hepatitis C Drug
SAN FRANCISCO - A California federal judge on Aug. 31 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. 3:15-cv-05003, N.D.. Calif.; 2016 U.S. Dist. LEXIS 117632).



Judge Reverses Course, Reinstates Man's ACA Claim Against Government Plan
CENTRAL ISLIP, N.Y. - A man's claims invoke the Patient Protection and Affordable Care Act (ACA), which unlike other regulations does not specifically exclude government-sponsored plans, a federal judge in New York held in granting reconsideration and reinstating the claims on Sept. 6 (Raymond A. Semente, D.C., P.C. v. Empire Healthcare, et al., No. 14-5823, E.D. N.Y.).



Virginia Federal Judge: 'Serial Litigant' Lawsuit Barred By Res Judicata
LYNCHBURG, Va. - A Virginia federal judge on Aug. 10 granted a health insurer's motion to dismiss a lawsuit alleging that it unlawfully ignored requests to provide plan documents and breached co-fiduciary duties owed under the Employee Retirement Income Security Act because it is barred by res judicata (W.A. Griffin v. Areva Inc., No. 6:16-cv-00029, W.D. Va.; 2016 U.S. Dist. LEXIS 105887).



9th Circuit Reverses Award Of Equitable Remedies In Retaliatory Discharge Case
PASADENA, Calif. - A Ninth Circuit U.S. Court of Appeals panel on Aug. 26 reversed a district court award of front pay and reinstatement as equitable remedies under the Employee Retirement Income Security Act for a retaliatory discharge after the plaintiff had already sought and been awarded front pay damages to compensate for the harm by a jury (Scott Teutscher, et al. v. William Nathaniel Woodson III, et al., No. 13-56659, 13-56411, 9th Cir.; 2016 U.S. App. LEXIS 15790).