Mealey's ERISA
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December 09, 2024
U.S. High Court Won’t Review Big ERISA Multiplan Opt-Out Class Ruling
WASHINGTON, D.C. — The U.S. Supreme Court on Dec. 9 declined to review a Fifth Circuit U.S. Court of Appeals decision that three service providers said “raises serious constitutional concerns as to the allowable breadth of class actions brought on behalf of hundreds of thousands of participants in thousands of unrelated employer-sponsored [Employee Retirement Income Security Act] benefit plans.”
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December 09, 2024
Alleging Price-Fixing, Doctors Sue MultiPlan, Insurers In Federal Court
CHICAGO — Alleging that they were paid only about 8% of what they billed for out-of-network services because of “a buyers’ cartel dating back to at least 2015,” medical practices that refer to themselves as doctors sued MultiPlan Corp., Aetna Inc., The Cigna Group, UnitedHealth Group Inc., Elevance Health Inc. and other entities in Illinois federal court, asserting numerous claims including some under the Employee Retirement Income Security Act.
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December 09, 2024
Bankruptcy Judge Still Upholds PBGC Regulations In Withdrawal Liability Row
WILMINGTON, Del. — A Delaware federal bankruptcy judge has declined to reconsider rejecting challenges to two Pension Benefit Guaranty Corp. (PBGC) regulations regarding federal funds awarded to multiemployer pension plans.
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December 06, 2024
New Jersey Federal Magistrate Allows Limited Discovery In Disability Dispute
NEWARK, N.J. — A New Jersey federal magistrate judge on Dec. 5 determined that an attorney who alleges that his claim for long-term disability (LTD) benefits was wrongfully denied is entitled to take very limited discovery regarding compensation and performance evaluations of personnel used by the disability insurer in evaluating his LTD claim.
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December 06, 2024
Reconsideration Sought On Dismissal Of Claims Against Exec In Stock Sale Challenge
BOISE, Idaho — The U.S. Department of Labor (DOL) has asked an Idaho federal court to reconsider its dismissal of claims against a former CEO and board chair who sold part of his stock in an allegedly inflated deal that is being challenged under the Employee Retirement Income Security Act.
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December 06, 2024
$2.5M Class Settlement Would Be Almost 17% Of Max Damages, ERISA Plaintiffs Say
OAKLAND, Calif. — Plaintiffs challenging a 401(k) plan’s record-keeping fees and fund offerings under the Employee Retirement Income Security Act have asked a California federal court for preliminary approval of a $2.5 million class settlement they say works out to about 16.86% of their “maximum possible damages.”
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December 06, 2024
Claimant Appeals Ruling That She Failed To Meet Burden Of Proving Disability
CINCINNATI — A disability claimant filed a notice of appeal to the Sixth Circuit U.S. Court of Appeals, challenging a Michigan federal judge’s finding that she failed to prove by a preponderance of the evidence that she was disabled from performing the duties of her own occupation.
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December 06, 2024
Disability Insurer Properly Terminated LTD Benefits Based On Policy Limitation
ST. LOUIS — A disability insurer’s termination of a disability claimant’s long-term disability (LTD) benefits was reasonable because the insurer properly found that the claimant’s disability was the result of a mental illness, which limited the claimant’s benefits to 24 months, a Missouri federal judge said in granting the insurer’s motion for partial summary judgment.
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December 06, 2024
LTD Benefits Wrongfully Terminated Based On Policy Limitation, Claimant Says
DENVER — A disability insurer and its claims administrator wrongfully terminated a claim for long-term disability (LTD) benefits based on the policy’s limitation for mental or nervous disorders, a disability claimant contends in a complaint filed in Colorado federal court.
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December 06, 2024
Denial Of STD Claim Was Not Arbitrary, Capricious, Minnesota Federal Judge Says
MINNEAPOLIS — The denial of a short-term disability (STD) claim was not arbitrary and capricious because a reasonable person could have reached the same decision as the disability insurer and because the claimant’s medical records do not show that his conditions worsened to a point where he was unable to work, a Minnesota federal judge said in granting the insurer’s motion for summary judgment.
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December 06, 2024
New York Federal Judge Says Disability Claimant Met Burden, Is Owed Benefits
NEW YORK — A New York federal judge granted judgment in favor of a disability claimant after determining that the claimant met her burden of proving by a preponderance of the evidence that she was disabled from performing the duties of her own occupation as a result of symptoms caused by depression, anxiety and posttraumatic stress disorder (PTSD)
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December 05, 2024
Doctor Entitled To Almost $98K In Attorney Fees For Success On Disability Claim
SAN FRANCISCO — A pediatrician who successfully prevailed on her claim for long-term disability (LTD) benefits based on her high risk of exposure to the COVID-19 virus is entitled to $97,965 in attorney fees and $625 in costs because the pediatrician succeeded on the merits of her disability claim and the disability insurer presented no special circumstances that would warrant against an award, a California federal judge said in granting the pediatrician’s motion for attorney fees and costs.
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December 05, 2024
After Getting Claims Data, Health Plan And Sponsor Sue Third-Party Administrator
RICHMOND, Va. — Suing a third-party administrator (TPA) in Virginia federal court, an employer and its self-funded health plan allege that the TPA violated Employee Retirement Income Security Act fiduciary standards “by, among other things, (i) paying more for healthcare claims than was even billed, (ii) securing kickbacks from providers, (iii) double-paying claims, and (iv) pocketing rebates.”
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December 05, 2024
Denial Of LTD Benefits Claim Was Not Abuse Of Discretion, Texas Federal Judge Says
DALLAS — A disability insurer did not abuse its discretion in denying a claim for long-term disability (LTD) benefits following remand of the LTD claim because substantial evidence supports the insurer’s finding that the claimant was capable of working in a sedentary position, a Texas federal judge said in granting judgment in favor of the disability insurer.
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December 05, 2024
Judge Awards Plaintiffs Almost $60,000 For Discovery Row In Dialysis Case
COLUMBUS, Ohio — Awarding a little more than half of the amount the plaintiffs requested, an Ohio federal judge has ordered a hospital and its health plan to pay $59,629.38 in attorney fees and costs in connection with a discovery dispute in an Employee Retirement Income Security Act case over dialysis payment rates.
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December 05, 2024
Total Disability Questions Should Be Certified To La. High Court, Claimant Says
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals should withdraw an unpublished opinion entered in favor of a disability insurer and certify two questions of law to the Louisiana Supreme Court regarding whether a disability claimant was required to prove that she was disabled from performing all of the duties of her occupation as a pharmacist in order to meet the policy’s definition of total disability, the claimant maintains.
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December 05, 2024
GAO: Crypto Options Seem To Be A Small Part Of The 401(k) Market
WASHINGTON, D.C. — In a report released publicly Dec. 4 regarding crypto assets in 401(k)s, the U.S. Government Accountability Office (GAO) noted data and projection limitations, saying in part that “certain crypto assets continue to trade in markets that do not have investor protections or comprehensive oversight.”
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December 05, 2024
Amicus-Supported Bid For 3rd Circuit Rehearing Fails In Trust Benefits Dispute
PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Dec. 4 denied a motion for panel and en banc rehearing of a nonprecedential decision; the motion drew an amicus curiae brief in which the Pension Rights Center argued the that decision “seriously misreads” Gruber v. Hubbard Bert Karle Weber, Inc. and “will be read closely by those who can replicate it as an employer escape hatch from the responsibilities of” the Employee Retirement Income Security Act.
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December 04, 2024
Federal Judge Affirms Denial Of Disability Claimant’s Motion To Clarify Record
SPRINGFIELD, Mass. — A Massachusetts federal judge affirmed a magistrate judge’s denial of a disability claimant’s motion to clarify and complete a claim record after determining that no part of the magistrate judge’s order is clearly erroneous or contrary to law.
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December 04, 2024
Government Files Amicus Brief Urging Reversal Of 2nd Circuit ERISA Ruling
WASHINGTON, D.C. — A day after the U.S. government filed an amicus curiae brief in the U.S. Supreme Court supporting petitioners on the question of what is necessary to state an Employee Retirement Income Security Act claim for a prohibited transaction between a plan and a party in interest, the petitioners on Dec. 3 submitted a corrected merits brief.
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December 03, 2024
In Partial Reversal, Judge Addresses Standing In ERISA Pension Calculation Row
CENTRAL ISLIP, N.Y. — Partly reversing an earlier ruling in the Employee Retirement Income Security Act dispute over using a half-century-old mortality table to calculate joint and survivor annuities (JSAs), a New York federal judge allowed claims asserted on behalf of the plan to proceed in the putative class action while the plaintiffs’ individual claims are arbitrated.
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December 02, 2024
High Court’s Look At ERISA Prohibited Transaction Ruling Draws Amicus Input
WASHINGTON, D.C. — Four amicus curiae briefs, the most recent filed Nov. 27, have been filed in the U.S. Supreme Court supporting the petitioners in the high court’s review of what is necessary to state an Employee Retirement Income Security Act claim for a prohibited transaction between a plan fiduciary and a party in interest.
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December 02, 2024
$5M Class Settlement In ERISA Fees, Funds Case Gets Preliminary Approval
PHILADELPHIA — A Pennsylvania federal judge has granted preliminary approval to a $5 million class settlement in an Employee Retirement Income Security Act suit challenging a multiemployer retirement plan’s fund choices, share classes and record-keeping fees.
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December 02, 2024
Amicus Bid To Support Dismissal In Pension Risk Transfer Case Draws Opposition
ALBANY, N.Y. — The ERISA Industry Committee (ERIC) has asked a New York federal court for permission to file an amicus curiae brief in a pension risk transfer (PRT) case it says is “pursuing a novel, speculative theory that would limit plan sponsors’ ability to manage future pension expenses,” drawing opposition from retirees who argue that the proposed brief is too late, too long, “offers no unique information or insight that can assist the Court, and would prejudice Plaintiffs.”
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November 27, 2024
Partial Judgment On Pleadings Granted In Long-Running ERISA Case
NEW YORK — A company that provided investment advice to two retirement plans saw its motion for judgment on the pleadings partly granted in a long-running Employee Retirement Income Security Act putative class action challenging fees and funds, with a New York federal judge ruling that issue preclusion applies to some of the allegations.