Mealey's ERISA
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January 27, 2025
Disability Claimant Failed To Meet Necessary Heightened Standard, Panel Says
CINCINNATI — A district court did not err in dismissing a disability claimant’s suit because the claimant failed to meet a heightened standard that is necessary to prevail on an estoppel claim when a plan’s terms are unambiguous, the Sixth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
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January 24, 2025
Any-Occupation Ruling Must Be Reversed, Disability Claimant Tells 11th Circuit
ATLANTA — A district court’s ruling that a disability insurer’s termination of benefits after 11 years was not arbitrary and capricious must be reversed because the evidence shows that the claimant’s disability worsened and that the insurer’s handling of the medical evidence was unreasonable, a disability claimant tells the 11th Circuit U.S. Court of Appeals in her appellant brief.
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January 24, 2025
Regulatory Freeze Hits ‘Adequate Consideration’ Proposed Regulation For ESOPs
WASHINGTON, D.C. — A regulatory freeze that President Donald J. Trump instituted as part of his first official acts has affected a long-awaited revised proposed regulation and a proposed class exemption in an Employee Retirement Income Security Act issue that has seen significant litigation — employee stock ownership plan (ESOP) transactions.
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January 24, 2025
Response Waived To U.S. High Court Petition On ERISA Benefits Denial Ruling
WASHINGTON, D.C. — The administrator of an accidental death and dismemberment (AD&D) insurance plan has waived its right to respond to a petition for U.S. Supreme Court review of a per curiam unpublished opinion upholding denial of benefits.
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January 23, 2025
7th Circuit Upholds Summary Judgment, Discovery Ruling In ‘Tragic’ ERISA Case
CHICAGO — Affirming a summary judgment and discovery ruling for a multiemployer health plan in “a tragic case” over refusal to reimburse close to $200,000 in out-of-network medical care, a Seventh Circuit U.S. Court of Appeals panel said the discretion the plan gave its administrator and the “deferential standard of review” compelled the result.
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January 22, 2025
High Court Hears Argument On Stating ERISA Prohibited Transaction Claims
WASHINGTON, D.C. — The U.S. Supreme Court on Jan. 22 heard oral argument concerning what is necessary to state an Employee Retirement Income Security Act prohibited transaction claim involving a service provider, with respondents seeking affirmation of a ruling that makes exemptions claim elements that must be negated and petitioners and amicus curiae the U.S. government urging reversal on grounds including that the exemptions are affirmative defenses for which defendants bear the burden.
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January 22, 2025
Judgment In Favor Of Disability Insurer Should Be Reversed, Claimant Says
ATLANTA — A district court erred in entering judgment in favor of a disability insurer because objective medical evidence supports a finding that a disability claimant’s medical conditions and limitations prevented her from performing the material duties of any occupation, the claimant says in an appellant brief filed in the 11th Circuit U.S. Court of Appeals.
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January 21, 2025
Disability Claimant To 7th Circuit: Lower Court Erred In Finding Burden Not Met
CHICAGO — A district court erred in finding that a disability claimant failed to meet her burden of proving by a preponderance of the evidence that she remained disabled from working in a sedentary occupation as a result of symptoms related to fibromyalgia because the lower court ignored relevant precedent in finding that the claimant was no longer disabled, the claimant says in an appellant brief filed in the Seventh Circuit U.S. Court of Appeals.
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January 21, 2025
Latest Parity Act Rules Are Focus Of Lawsuit Against DOL, Other Agencies
WASHINGTON, D.C. — The ERISA Industry Committee (ERIC) on Jan. 17 sued three U.S. agencies in a District of Columbia federal court over Mental Health Parity and Addiction Equity Act (MHPAEA or Parity Act) final rules released in September, which it argues upend “the regulatory and compliance framework that has evolved over decades pursuant to the limits established by Congress” and impose “entirely new, ambiguous requirements.”
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January 21, 2025
Settlement Of Just Over $1.4M Gets Initial OK In Suit Over Insurer’s Denials
UTICA, N.Y. — A New York federal judge on Jan. 17 granted preliminary approval to a $1,415,000 settlement in a class action over allegations that United Behavioral Health violated the Employee Retirement Income Security Act by issuing blanket denials for residential treatments for mental health and chemical dependency claims when it considered even a single aspect of the facility’s treatment experimental.
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January 17, 2025
$4.95M Class Settlement Gets Preliminary OK In ERISA Tobacco Surcharge Suit
SPRINGFIELD, Mo. — A Missouri federal judge on Jan. 16 granted preliminary approval to a $4.95 million class settlement proposed in a suit that was filed months before a recent wave of similar Employee Retirement Income Security Act challenges to health plans’ tobacco surcharges.
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January 16, 2025
DOL Issues Long-Awaited ‘Adequate Consideration’ Proposed Regulation For ESOPs
WASHINGTON, D.C. — The U.S. Department of Labor (DOL) on Jan. 16 released a long-awaited revised proposed regulation and a proposed class exemption on an Employee Retirement Income Security Act of 1974 issue that has seen significant litigation — employee stock ownership plan (ESOP) transactions.
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January 16, 2025
Unspecified Deal Reported Just Before Bench Trial In ERISA Suit Over TDFs
ALLENTOWN, Pa. — Saying she was notified by email “that the Parties have settled this matter,” a Pennsylvania federal judge on Jan. 15 adjourned “all trial-related proceedings” in an Employee Retirement Income Security Act class action against electricity provider PPL Corp. and related defendants challenging the inclusion of Northern Trust target date funds (TDFs) in four defined-contribution pension benefit plans.
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January 15, 2025
Attorney Fees Of Over $4.2M Awarded in $14.5M Settlement Of ESOP Deal Challenge
WILMINGTON, Del. — A Delaware federal judge on Jan. 14 granted final approval to two class settlements that the plaintiffs said sit “at the high end of the range of settlements resolving” similar employee stock ownership plan (ESOP) claims, with a combined recovery of $14.5 million that averages “about $35,109 per Class Member before fees, costs, and expenses.”
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January 15, 2025
Plaintiffs Fight Bid For Disclosure Log In Suit Over Repricing Method
OAKLAND, Calif. — Alleging ulterior motives and arguing that they have a common interest agreement (CIA) with the U.S. Department of Labor (DOL) that “embodies the protections of [a protective order] and ensures the confidentiality of documents is maintained,” plaintiffs in a suit over alleged underpayment for out-of-network behavioral health treatment claims urge a California federal court to deny an administrative motion.
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January 14, 2025
Judge Affirms Discovery Orders Involving DOL Common Interest Agreement
DENVER — Saying that a decision by the U.S. Department of Labor (DOL) not to file a challenge “ends the issue” but that she addressed objections anyway “out of caution,” a Colorado federal judge on Jan. 13 upheld related discovery rulings concerning a common interest agreement (CIA) in an Employee Retirement Income Security Act suit challenging a deal.
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January 14, 2025
DOL Will Argue As Amicus In 6th Circuit ERISA Case Against Health Plan TPA
CINCINNATI — The U.S. Department of Labor (DOL) has won permission to participate as amicus curiae in Feb. 6 oral argument before a Sixth Circuit U.S. Court of Appeals panel supporting revival of an Employee Retirement Income Security Act suit against the third-party administrator (TPA) of a self-funded health benefits plan.
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January 13, 2025
Amicus Brief Proposed On Remand Of Tennessee ERISA Preemption Row
CHATTANOOGA, Tenn. — On remand after a dismissal order was vacated, the ERISA Industry Committee (ERIC) has asked a Tennessee federal court for leave to file an amicus curiae brief supporting summary judgment for the plaintiff who is arguing that the Employee Retirement Income Security Act preempts Tennessee law affecting pharmacy benefit managers (PBMs).
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January 13, 2025
High Court Seeks Response To Review Bid For ERISA Ruling On Burden-Shifting
WASHINGTON, D.C. — The U.S. Supreme Court on Jan. 13 requested a response to a certiorari petition in which 401(k) plan participants ask the high court to weigh in on “whether, consistent with trust law, burden-shifting applies to the element of causation under” part of the Employee Retirement Income Security Act.
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January 13, 2025
Review Bid Fails For 6th Circuit Effective Vindication Ruling In ERISA Row
WASHINGTON, D.C. — In a Jan. 13 order list, the U.S. Supreme Court denied the latest of several certiorari petitions seeking review of decisions applying the effective vindication doctrine in Employee Retirement Income Security Act cases; this one focused on a Sixth Circuit U.S. Court of Appeals ruling in a putative class action over management of defined-contribution retirement plans.
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January 13, 2025
After Trial, Judge Finds Disloyalty In ERISA Suit Over Fund Manager’s ESG Efforts
FORT WORTH, Texas — In a Jan. 10 ruling issued after a bench trial in a class action over environmental, social and governance (ESG) considerations and the purported proxy voting activism of investment management firms, a Texas federal judge found that American Airlines Inc. and its employee benefits committee breached their fiduciary duty of loyalty but not their duty of prudence.
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January 13, 2025
Appellees To 9th Circuit: Uphold Dismissal Of ERISA Suit Over Severance Benefits
SAN FRANCISCO — Urging the Ninth Circuit U.S. Court of Appeals to affirm dismissal of a putative class case filed by former Twitter employees and reject arguments that the U.S. Department of Labor (DOL) makes as amicus curiae, Elon Musk and related entities argue in part in a Jan. 10 brief that precedent supports the ruling that the workers didn’t plausibly allege that a purported severance plan is governed by the Employee Retirement Income Security Act.
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January 10, 2025
After Revival, Defendants Win ERISA Disclosure Case With Release Agreement
NEW YORK — After the putative class action over annual benefit statements provided after a traditional defined benefit retirement plan was converted to a cash balance plan was partly revived on different grounds, a New York federal judge ruled against the plaintiff on all remaining claims, which she said were “barred by the release the plaintiff executed in exchange for receipt of his severance package.”
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January 10, 2025
Disability Insurer Wrongfully Terminated Benefits, Woman With Long COVID Says
RIVERSIDE, Calif. — A woman who was diagnosed with long COVID filed suit on Jan. 9 in California federal court against her disability insurer, alleging that the insurer wrongfully terminated her long-term disability (LTD) benefits after determining that she was able to perform the duties of her own occupation as the director of operations at a museum.
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January 10, 2025
Federal Judge Says Application Of Mental Health Limitation Was Not Unreasonable
FORT LAUDERDALE, Fla. — A Florida federal judge granted summary judgment in favor of a disability insurer after finding that the insurer did not incorrectly determine the claimant’s date of disability and did not unreasonably apply a mental health limitation to limit the payment of long-term disability (LTD) benefits to the claimant.