Mealey's ERISA

  • September 24, 2026

    $8.95M Deal Gets Initial OK In Case That Is Part Of Tobacco Surcharge Wave

    CHICAGO — One of the cases in a wave of tobacco surcharge challenges would be resolved for $8.95 million under a class settlement an Illinois federal judge has granted preliminary approval.

  • September 24, 2026

    4th Circuit Sets Argument In ERISA Case Concerning Opt-Out Class

    RICHMOND, Va. — Following briefing that was conducted on an accelerated schedule, the Fourth Circuit has scheduled oral argument for Oct. 30 in an interlocutory appeal concerning certification of an opt-out class in an Employee Retirement Income Security Act case where the initial certification of a mandatory class was vacated under the Trauernicht v. Genworth Fin. Inc. ruling the appellate court handed down in March.

  • September 24, 2026

    Judge: Early $13.4M Payment Was Condition Of ERISA Fees, Funds Settlement

    SPRINGFIELD, Mass. — Noting that interest from the defendants’ early payment of $13.4 million had grown the common fund to $13,524,410.05, a Massachusetts federal judge gave final approval to the class settlement of a case in which 401(k) plan participants challenged recordkeeping and managed account fees and inclusion of two allegedly underperforming investment options.

  • September 23, 2026

    TPA Responds To Agency’s Amicus Brief Before En Banc Hearing On Surcharge

    NEW ORLEANS — Ahead of Sept. 24 oral argument before the en banc Fifth Circuit U.S. Court of Appeals, the third-party administrator (TPA) of group health plans responded to an amicus curiae brief in which the U.S. Department of Labor (DOL) urges a ruling “that surcharge is an equitable remedy in suits brought under” the Employee Retirement Income Security Act, and the appellate court granted the DOL’s request to participate in the argument.

  • September 23, 2026

    Amended Complaint Filed Alleging Insurers Failed To Pay Claims For COVID Tests

    SAN DIEGO — A diagnostic lab filed an amended complaint in California federal court, alleging that health care plans and their administrators failed to pay and process claims for diagnostic tests for COVID-19 provided by the lab to individuals with benefit plans governed by the Employee Retirement Income Security Act (ERISA) or with Medicare Advantage (MA) plans.

  • September 22, 2026

    2nd Circuit: NSA Doesn’t Imply Private Right Of Action To Enforce IDR Awards

    NEW YORK — Saying that it was joining a sister circuit in holding that the No Surprises Act (NSA) “does not imply a private right of action to enforce” independent dispute resolution (IDR) awards, the Second Circuit U.S. Court of Appeals affirmed dismissal of a suit that an out-of-network health care provider filed against companies that administer “private employer-sponsored group health plans.”

  • September 22, 2026

    Judge Lets Benefits Termination Stand In LTD Case Involving Long COVID

    ALEXANDRIA, Va. — Saying in part that the health care professionals who treated the claimant or reviewed her medical file concluded “nearly unanimously . . . that her Long Covid diagnosis and subjective symptoms did not render her disabled within the meaning of the Policy,” a Virginia federal judge let the challenged termination of long-term disability (LTD) benefits stand following de novo review.

  • September 21, 2026

    LTD, Other Voluntary Benefits Are Focus Of Putative Class Complaint

    WHITE PLAINS, N.Y. — An employee welfare benefit plan that offered voluntary benefits including long-term disability (LTD), life insurance and critical illness coverage is the focus of a putative class complaint filed in New York federal court, with plan participants accusing their employer of violating the Employee Retirement Income Security Act by making choices that resulted in “excessive charges embedded in premiums, diminished Plan and participant assets, and the loss of value and loyalty owed by a fiduciary operating free of self-dealing.”

  • September 21, 2026

    Judge Affirms Denial Of Pilot’s LTD Claim For Preexisting Conditions

    CHARLOTTE, N.C. — Finding no abuse of discretion in a long-term disability (LTD) insurer’s decision to deny a claim under a preexisting conditions exclusion, a North Carolina federal judge entered judgment against a former pilot who had throat and breathing problems.

  • September 18, 2026

    7th Circuit Interpretation Of MPPAA Creates Circuit Split On Withdrawal Liability

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on Sept. 17 affirmed a withdrawal liability ruling that is contrary to decisions by two sister circuits, saying in part that the case involves “complex” statutory provisions “and both sides offer plausible arguments”; the Pension Benefit Guaranty Corp. (PBGC) and the Chamber of Commerce of the United States of America had both filed amicus curiae briefs supporting affirmance.

  • September 18, 2026

    Judge Lets Denials Stand In Case Involving LTD, Disability Insurance Benefits

    CLEVELAND — Granting judgment on the administrative record against a claimant who has epilepsy, an Ohio federal judge concluded that it was not arbitrary and capricious to deny his claims for benefits under a group long-term disability (LTD) policy and an individual disability income policy.

  • September 18, 2026

    Attorney Fee Motions Are Resolved In ‘Contentious’ Deferred Compensation Row

    BURLINGTON, Vt. — Noting that the long-running Employee Retirement Income Security Act dispute concerning deferred compensation “was in the top three percent of contentious cases” she had encountered, a Vermont federal judge awarded less than half of the amounts the parties requested for attorney fees, directing a plaintiff who was a breaching co-fiduciary to pay $189,478.92 for the defendants’ attorney fees and the defendants to pay $320,272.39 for the remaining plaintiffs’ attorney fees and costs.

  • September 17, 2026

    Judge: LTD Claimant With Tinnitus Didn’t Prove He Was Disabled

    OAKLAND, Calif. — After upholding denial of the long-term disability (LTD) the claim of an account executive who argued that conditions including tinnitus and anxiety rendered him disabled, a California federal judge entered judgment against the claimant on Sept. 16; reviewing the denial de novo, the judge said in part that it rested on the claimant’s “failure to demonstrate that the diagnoses resulted in a disability that prevented him from working in his Own Occupation.”

  • September 17, 2026

    LTD Claimant With Parkinson’s Deemed Entitled To Reinstatement

    PORTLAND, Ore. — On de novo review, an Oregon federal magistrate judge ruled that a claimant diagnosed with young-onset Parkinson’s disease (YOPD) is entitled to have her long-term disability (LTD) benefits reinstated under the plan’s “any gainful occupation” definition of disability because the evidence demonstrates that she “suffers from a chronic, degenerative condition that results in cognitive impairments and fatigue which prevent plaintiff from attending work on a reliable and consistent basis, and, when at work, concentrating on her duties.”

  • September 16, 2026

    Judge Imposes $5,000 ERISA Penalty For Late LTD Plan Document Disclosure

    BOSTON — In a memorandum and order citing the prejudice a long-term disability (LTD) claimant suffered and the LTD plan administrator’s “lack of concern for its” statutory obligations under the Employee Retirement Income Security Act, a Massachusetts federal judge decided that the claimant is entitled to a “modest” penalty of $5,000 because the administrator provided plan documents only 230 days after the first of the claimant’s many requests.

  • September 16, 2026

    Judge Sends LTD Claim Back To Insurer Over Mental Health Issue

    SALT LAKE CITY — On de novo review, a Utah federal judge ruled that a long-term disability (LTD) insurer must reconsider whether a claimant qualifies for benefits under an any-occupation definition of disability because it relied on an employability analysis report that was based on a medical case manager review that “missed all evidence of mental health treatment and care in the record.”

  • September 15, 2026

    Claimant Takes Dispute Over ‘Any-Occupation’ LTD Benefits To 11th Circuit

    TAMPA, Fla. — A claimant who unsuccessfully challenged termination of her long-term disability (LTD) benefits under an any-occupation definition of disability filed a Sept. 14 notice in Florida federal court that she is taking the case to the 11th Circuit U.S. Court of Appeals.

  • September 09, 2026

    Judge Sends LTD Claim Back To Insurer Over Cognitive Demands Issue

    DENVER — Reversing the denial of a claim for long-term disability (LTD) benefits, a Colorado federal judge said that “none of the evidence” the insurer relied on compared the claimant’s “cognitive functioning to the actual requirements of his position as a software engineer, or his ability to perform those functions on a continuous work schedule” and therefore the decision “is not founded on substantial evidence” and must go back to the insurer “for further consideration.”

  • September 09, 2026

    11th Circuit Affirms Judgment For LTD Insurer In Dispute Over Tax Returns

    ATLANTA — Affirming summary judgment for an insurer that terminated a claimant’s long-term disability (LTD) benefits, the 11th Circuit U.S. Court of Appeals said in an unpublished opinion that the insurer needed the documents to evaluate whether the claimant “satisfied the Test of Disability, so his refusal to provide them justified termination under the Plan.”

  • September 09, 2026

    Citing Bakery Drivers, Plans Ask Court To Get Them Off Agency’s SFA Waitlist

    WASHINGTON, D.C. — Under a stipulation a District of Columbia federal judge granted in a text-only docket entry, the Pension Benefit Guaranty Corp. (PBGC) has until Sept. 16 to respond to a preliminary injunction request from 22 terminated multiemployer pension plans that allege that the agency is using an improper “waitlist scheme” to prevent them and their “25,000 participants and beneficiaries” from claiming special financial assistance (SFA) funding “that is likely to total in the hundreds of millions of dollars.”

  • September 08, 2026

    DOL Files Amicus Brief Before Full 5th Circuit Hears Surcharge Dispute

    NEW ORLEANS — Oral argument before the en banc Fifth Circuit U.S. Court of Appeals is scheduled for Sept. 24 in a case that group health plans and related entities filed against a third-party administrator (TPA), and the U.S. Department of Labor (DOL) has filed an amicus curiae brief urging the appellate court to “reaffirm that surcharge is an equitable remedy in suits brought under” the Employee Retirement Income Security Act.

  • September 08, 2026

    2nd Circuit Reverses Remand Orders, Says Opioid Cases Belong In Federal Court

    NEW YORK — New York municipalities suing pharmacy benefit managers (PBMs) over their alleged role in the opioid epidemic cannot prevent federal officer removal by disclaiming claims arising from the PBMs’ work for federal clients, the Second Circuit U.S. Court of Appeals held in a case presenting an issue of first impression, reversing orders by district courts to remand the cases to state court.

  • September 04, 2026

    Colorado Federal Judge Adds ‘No Standing’ Ruling In Wave Of PRT Cases

    DENVER — Saying there is a lack of “controlling authority to guide the Court’s analysis,” a Colorado federal judge found that retirees lacked standing to bring a putative class case that is part of a wave of pension risk transfer (PRT) challenges; he therefore granted dismissal without prejudice of all the claims in the Employee Retirement Income Security Act case.

  • September 04, 2026

    1st Argument In Appeals From Wave Of Tobacco Surcharge Cases Is Set

    The First Circuit U.S. Court of Appeals has scheduled oral argument for Sept. 16 in the most advanced appeal arising from a wave of putative class Employee Retirement Income Security Act challenges to tobacco surcharges, and at least five similar appeals are under way.

  • September 03, 2026

    Judge Grants Preliminary Injunction As To Part Of Illinois PBM Law

    SPRINGFIELD, Ill. — Granting a trade association’s motion for a preliminary injunction, an Illinois federal judge enjoined the Illinois Department of Insurance from enforcing a state law’s reporting requirements against the association’s members that are pharmacy benefit managers (PBMs) serving health plans sponsored by employers and unions that are subject to the Employee Retirement Income Security Act.