Mealey's ERISA
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August 13, 2024
3rd Circuit Appeal Filed Over Summary Judgment Against Class In ERISA Row
PHILADELPHIA — Retirement plan participants have filed a notice of appeal to the Third Circuit U.S. Court of Appeals challenging summary judgment for Evonik Corp. and related entities in their Employee Retirement Income Security Act class action.
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August 12, 2024
3rd Circuit Won’t Rehear ERISA Case Over Belated Withdrawal Liability Bill
PHILADELPHIA — The Third Circuit U.S. Court of Appeals has denied rehearing of a case where a panel affirmed vacation of an arbitration award in an Employee Retirement Income Security Act dispute over withdrawal liability because a statutory requirement of the Multiemployer Pension Plan Amendments Act (MPPAA) was not met.
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August 12, 2024
Putative Class Action Focuses On TIAA Tool That Allegedly Favored Proprietary Annuities
NEW YORK — Alleging “an ongoing unlawful scheme to enhance corporate profits” based on a tool that they claim favored two proprietary annuities, plaintiffs who participate in university retirement plans filed a putative class action against Teachers Insurance and Annuity Association of America (TIAA) and Morningstar Inc. and related entities.
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August 12, 2024
2nd Circuit Sets Oral Argument In ERISA Appeal Of Jury Ruling Against Class
NEW YORK — The Second Circuit U.S. Court of Appeals has set oral argument for Sept. 25 in an appeal involving whether the “could have” standard used in damages instructions is grounds for overturning judgment in an Employee Retirement Income Security Act class action that went before a jury, and Yale University and related appellees have filed a notice of supplemental authority regarding a sister circuit’s ruling.
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August 12, 2024
Respondents To High Court: ERISA Doesn’t Need A New ‘Arms-Length’ Carveout
WASHINGTON, D.C. — Asserting in their Aug. 9 respondent brief that the “case would have come out differently in exactly zero circuits,” retirement plan participants urge the U.S. Supreme Court to deny review of a Ninth Circuit U.S. Court of Appeals decision regarding the Employee Retirement Income Security Act’s prohibited transaction provision.
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August 12, 2024
TPA Urges 9th Circuit To Reverse ACA Discrimination Ruling Over Exclusions
PASADENA, Calif. — In a reply brief urging the Ninth Circuit U.S. Court of Appeals to reverse a ruling that it violated the Patient Protection and Affordable Care Act (ACA)’s discrimination provision by administering exclusions of gender-affirming care, a third-party administrator (TPA) argues in part that it “‘exercised no control’ over the plan design.”
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August 12, 2024
Following Belknap, Judge Dismisses ERISA Annuity Row Over Mortality Assumptions
GAINESVILLE, Ga. — Agreeing with the reasoning of a 2022 decision the plaintiffs called an outlier, a Georgia federal judge granted dismissal of a putative class suit in which Southern Company Services Inc. retirees argued that using outdated, “unreasonable” assumptions and mortality tables to calculate pension benefits violates actuarial equivalence requirements of the Employee Retirement Income Security Act.
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August 09, 2024
5th Circuit Upholds Vacatur Of Agencies’ No Surprises Act Arbitration Regulation
NEW ORLEANS — In a ruling that drew a partial concurrence, a Fifth Circuit U.S. Court of Appeals panel upheld vacation of regulations that three federal departments promulgated to “establish[] priorities for independent arbitrators appointed to resolve insurance reimbursement disputes pursuant” to the No Surprises Act (NSA).
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August 09, 2024
LTD Insurer Must Pay Retroactive, Future Benefits, Minnesota Federal Judge Says
MINNEAPOLIS — A disability plan participant is entitled to retroactive long-term disability (LTD) benefits and future LTD benefits because the plan participant met her burden of proving by a preponderance of the evidence that cognitive difficulties rendered her disabled from performing the duties of her own occupation as an attorney, a Minneapolis federal judge said in granting the plan participant’s motion for judgment on the administrative record.
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August 08, 2024
7th Circuit Affirms Parity Act Ruling For Insurer In Autism Treatment Coverage Row
CHICAGO — Affirming summary judgment for an insurer in a Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA or Parity Act) suit over autism spectrum disorder (ASD) treatments, a Seventh Circuit U.S. Court of Appeals panel said a key shortcoming of the appellants’ argument was that their comparison focused only on pediatric chiropractic care while the statutory provision says “substantially all medical and surgical benefits.”
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August 08, 2024
LTD Insurer’s Denial Of Benefits Was Not Abuse Of Discretion, Judge Says
PHILADELPHIA — A long-term disability (LTD) insurer did not abuse its discretion in denying a claim for LTD benefits because the claimant did not suffer any lost income based on the employer’s decision to continue paying the employee after he stopped working, a Pennsylvania federal judge said Aug. 7 in granting the insurer’s motion for summary judgment.
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August 08, 2024
Stay Of DOL’s New Investment Advice Fiduciary Rule Expanded To Rest Of Changes
FORT WORTH, Texas — Agreeing with the reasoning of a peer who entered a nationwide stay of the effective date of a new U.S. Department of Labor (DOL) rule that redefines and broadens who is an investment advice fiduciary under the Employee Retirement Income Security Act, a Texas federal judge expanded the stay to related prohibited transaction exemption (PTE) amendments that weren’t at issue in the other suit.
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August 08, 2024
9th Circuit Reverses Dismissal Of ERISA Case Over Structured Alpha Funds
SAN FRANCISCO — Reversing dismissal of a putative class action against the fiduciaries of union carpenters’ retirement plans, a Ninth Circuit U.S. Court of Appeals panel said in an unpublished memorandum disposition that the carpenters “have sufficiently alleged a relative loss based on” investments “in two volatility hedge funds managed by Allianz Global Investors U.S. LLC.”
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August 07, 2024
District Court Erred In Finding Disability Plan Abused Its Discretion, Panel Says
PHILADELPHIA — A district court erred in finding that a disability plan abused its discretion when it terminated a claimant’s long-term disability (LTD) benefits for failure to provide proof of a continued disability because the plan properly considered all of the medical evidence and properly interpreted the plan’s “own occupation” language, the Third Circuit U.S. Court of Appeals said Aug. 6 in vacating and remanding the district court’s opinion.
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August 06, 2024
Disability Claimant Says Award Of Benefits, Not Remand, Is Appropriate Remedy
BALTIMORE — Reconsideration of a Maryland federal judge’s decision to remand a long-term disability (LTD) benefits claim is warranted because an award of benefits, rather than remand of the claim, is the appropriate form of relief, a disability claimant says in a reply brief in support of her motion for partial reconsideration of the judge’s ruling.
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August 06, 2024
Former NFL Player’s Motion To Reinstate Appeal Over Disability Benefits Granted
ATLANTA — The 11th Circuit U.S. Court of Appeals on Aug. 5 granted a former National Football League player’s motion to reinstate his appeal in a dispute over additional disability benefits owed under the NFL’s disability plan.
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August 06, 2024
Disability Insurer’s Denial Of LTD Claim Was Not De Novo Wrong, Judge Says
FORT MYERS, Fla. — A disability insurer’s denial of a long-term disability (LTD) claim was not de novo wrong because its decision is supported by the evidence in the administrative record and the claimant failed to provide any evidence to rebut the insurer’s basis for denial, a Florida federal judge said in granting the insurer’s motion for summary judgment.
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August 06, 2024
Denial Of STD Claim Reasonable Based On Lack Of Evidence, Federal Judge Says
BIRMINGHAM, Ala. — The denial of a short-term disability (STD) benefits claim following a treating physician’s failure to respond to the STD claims administrator’s repeated requests regarding the claimant’s medical condition and the claimant’s ability to return to work was reasonable and not wrong, an Alabama federal judge said in granting the disability plan defendants’ motion for summary judgment and in denying the claimant’s motion for summary judgment.
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August 05, 2024
Upholding ERISA Fees And Funds Ruling, 11th Circuit Declines To Shift Burden
ATLANTA — Declining to revive a class action over retirement plan fees and funds and rejecting a request to join circuits that have adopted a burden-shifting framework, an 11th Circuit U.S. Court of Appeals panel ruled on Aug. 2 that a 1992 decision is circuit precedent and “the burden of proving loss causation lies with the plaintiff” in such Employee Retirement Income Security Act cases.
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August 05, 2024
Association Urges U.S. High Court To Let 10th Circuit Ruling On PBM Law Stand
WASHINGTON, D.C. — Arguing in part that the case is “glaringly unsuitable as a vehicle for resolving either of the questions presented,” a trade association urged the U.S. Supreme Court to deny review of a ruling that the Employee Retirement Income Security Act and Medicare Part D partially preempt an Oklahoma pharmaceutical benefit manager (PBM) law.
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August 05, 2024
3rd Circuit Appeal Filed Over Summary Judgment, Exclusion Ruling In ERISA Fees Row
PHILADELPHIA — An Employee Retirement Income Security Act class action over allegedly excessive record-keeping fees is being taken to the Third Circuit U.S. Court of Appeals, with the named plaintiff filing a notice of appeal regarding a denial of summary judgment ruling that involved excluding an expert whose testimony has had mixed fates under Daubert v. Merrell Dow Pharmaceuticals challenges in other courts.
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August 02, 2024
Wells Fargo, Execs Sued Under ERISA For Prescription Drug Prices, PBM Fees
MINNEAPOLIS — In a putative class action similar to one pending against Johnson and Johnson, former participants in a Wells Fargo & Co. health plan filed a suit in Minnesota federal court under the Employee Retirement Income Security Act over alleged mismanagement of prescription drug benefits, with a focus on the plan’s pharmacy benefits manager (PBM).
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August 02, 2024
STD, LTD Claims Remanded To Plan Administrator For Full, Fair Review
LOUISVILLE, Ky. — The denial of claims for short-term disability (STD) and long-term disability (LTD) benefits was arbitrary and capricious because the denials were not the result of a deliberate and principled reasoning process, a Kentucky federal judge said in remanding the claims to the plan administrator for a full and fair review.
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August 01, 2024
District Court Properly Found Disability Claimant Is Totally Disabled, 8th Circuit Says
ST. LOUIS — A district court did not err in granting judgment in favor of a disability claimant because the claimant met her burden of showing that she is disabled from performing the duties of any occupation, the Eighth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
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July 29, 2024
Disability Claimant’s Suit Fails; Policy Rider Clearly Stated Terms, Judge Says
LOS ANGELES — A California federal judge granted a disability insurer’s motion for summary judgment and dismissed a breach of contract and bad faith suit filed against a disability income insurer after determining that the insurer’s termination of cost-of-living benefits was proper pursuant to the terms of the policy rider and its termination provision.