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Mealey's ERISA

November 27, 2023
Judge Orders Insurer To Fully Compensate Man For Proton Beam Therapy

ALEXANDRIA, La. — An insurer found liable for proton beam therapy (PBT) treatments a man paid for out of pocket after being denied coverage may not retroactively try to compensate him at in-network rates, a federal judge in Louisiana said in granting a motion to enforce judgment and ordering the insurer to fully compensate him after the Fifth Circuit U.S. Court of Appeals affirmed the award.
November 22, 2023
$4.5M Deal Proposed In ERISA Lawsuit Over Proprietary Index Funds

NEW YORK — A New York federal court has been asked to preliminarily approve a $4.5 million class settlement in an Employee Retirement Income Security Act case over the selection and retention of proprietary index fund products.
November 22, 2023
Class Settlement Of Nearly $4M Proposed In ERISA Revenue-Sharing Row

ATLANTA — Plaintiffs in an Employee Retirement Income Security Act case alleging mismanagement of a 401(k) plan have asked a Georgia federal court for preliminary approval of a $3,925,000 settlement under which they say an estimated 40,000 class members would get an average of about $100 apiece before expenses and attorney fees.
November 22, 2023
Plaintiff Loses Fiduciary Exception Dispute In ERISA Privilege Ruling

SAN DIEGO — Finding that fiduciary exception to attorney-client privilege does not apply to the communications in issue in the Employee Retirement Income Security Act case, a California federal magistrate judge ruled for the defendants in a discovery dispute involving a qualified domestic relations order (QDRO).
November 21, 2023
DOL Files Amicus Brief In ERISA Effective Vindication Row Involving ESOP

NEW ORLEANS — Urging a ruling like those issued in three other circuits under the “effective vindication” exception, acting U.S. Department of Labor Secretary Julie Su filed an amicus curiae brief asking the Fifth Circuit U.S. Court of Appeals to uphold a decision declining to compel arbitration in a putative Employee Retirement Income Security Act class case.
November 20, 2023
9th Circuit Finds No Error In Judgment Entered In Favor Of Disability Insurer

SAN JOSE, Calif. — The Ninth Circuit U.S. Court of Appeals affirmed a district court’s judgment in favor of a disability insurer, rejecting the disability claimant’s argument that the lower court adopted new rationales that were not included in the administrative record in finding that the insurer’s termination of benefits was reasonable based on the evidence.
November 17, 2023
Judge Directs Recalculation In ERISA Suit Over ‘Leveled’ Retirement Benefits

COLUMBUS, Ohio — Saying he denied both parties’ motions for judgment as a matter of law, an Ohio federal judge directed recalculation of a retired UPS driver’s benefits in an Employee Retirement Income Security Act suit over pension benefits that the retiree opted to receive in the form of the “Social Security Leveling Option.”
November 16, 2023
9th Circuit Won’t Rehear ERISA Dispute Over Fees And Prohibited Transactions

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals has denied a motion for panel or en banc rehearing in which the appellees said the ruling that the Employee Retirement Income Security Act’s prohibited transaction provision requires a plan administrator to consider third-party compensation its record-keeper received “departs from Supreme Court precedent and creates a circuit split.”
November 16, 2023
4th Circuit Dismisses Appeal In ERISA Case Involving Retiree Benefit Changes

RICHMOND, Va. — Saying in a Nov. 15 unpublished per curiam opinion that the challenged ruling “is neither a final order nor an appealable interlocutory or collateral order,” a Fourth Circuit U.S. Court of Appeals panel dismissed an appeal involving Employee Retirement Income Security Act claims over changes to retiree health benefits.
November 15, 2023
2nd Circuit Tackles ERISA’s Prohibited Transaction Provision, Won’t Revive Case

NEW YORK — In a Nov. 14 opinion upholding two challenged rulings concerning Cornell University retirement plans, a Second Circuit U.S. Court of Appeals panel partly accepted an invitation to adopt an “expansive” interpretation of the Employee Retirement Income Security Act’s prohibited transaction provision regarding a party in interest.
November 13, 2023
Lipedema Sufferers Keep Insurance Class, Can’t Secure Summary Judgment

SAN FRANCISCO — Recent precedent does not require decertifying an Employee Retirement Income Security Act class action seeking reprocessing of lipedema sufferers’ liposuction coverage claims, but because a dispute remains over whether the insurer categorically denied coverage, summary judgment for the insureds is also inappropriate, a federal judge in California said.
November 13, 2023
9th Circuit Upholds Dismissal Of Mechanics’ Suit Against Airline And Unions

SAN FRANCISCO — Ruling in part that Employee Retirement Income Security Act claims were properly dismissed, a Ninth Circuit U.S. Court of Appeals panel upheld dismissal of airline mechanics’ putative class suit over disputes involving a collective bargaining agreement (CBA).
November 10, 2023
Alabama Federal Judge Refuses To Deviate From Precedent In Disability Suit

JASPER, Ala. — An Alabama federal judge denied motions to determine the appropriate standard of review in a disability benefits dispute filed by the disability insurer and disability claimant after determining that neither of the parties persuaded the court to deviate from the precedent set forth in an 11th Circuit U.S. Court of Appeals’ suit when determining the appropriate standard of review.
November 09, 2023
Panel Affirms Disability Insurer’s Benefits Termination Was Arbitrary, Capricious

PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Nov. 8 affirmed a district court’s ruling that a disability insurer acted arbitrarily and capriciously in terminating a disability claimant’s benefits because the insurer wrongfully reclassified the claimant’s occupation as an internal medical specialist after more than 10 years of correctly classifying the claimant’s occupation as a gastroenterologist.
November 10, 2023
Panel Refuses To Review District Court Decision In Disability Benefits Dispute

PHILADELPHIA — While acknowledging that a district court’s appointment of an independent medical expert to examine a disability claimant suffering from fibromyalgia and rheumatoid arthritis is “highly unusual,” the Third Circuit U.S. Court of Appeals refused to grant a disability insurer’s petition for a writ of mandamus because the district court indicated that the purpose of the appointment is to reinforce the district court’s belief that remand of the claim is the appropriate form of relief.
November 10, 2023
Airline Pilot Files Complaint Seeking Disability Benefits For Long-Haul COVID-19

PHILADELPHIA — A disability insurer abused its discretion and breached its duty to a commercial airline pilot suffering from the effects of long-haul COVID-19 when it denied the pilot’s claim for long-term disability (LTD) benefits, the pilot claims in a complaint filed in Pennsylvania federal court.
November 09, 2023
Judge Dismisses Hospital’s ACA Cost-Sharing Case, Grants Leave To Amend

SACRAMENTO, Calif. — The Patient Protection and Affordable Care Act (ACA) does not appear to preclude a health plan from not contracting with any hospitals and thus the cap on in-network out-of-pocket costs does not apply to a hospital’s attempt to recover $400,000 in uncompensated care, a federal judge in California said while granting leave to amend.
November 09, 2023
Trustees And Others Urge Reversal Of Liability Finding In ERISA Underfunding Row

PHILADELPHIA — In consolidated challenges to decisions in a case where they were ruled liable under the Employee Retirement Income Security Act for millions in underfunding of a pension trust established in 1947, trustees and grandchildren of the trust settlor tell the Third Circuit U.S. Court of Appeals that the federal statute does not apply and the lower court made numerous errors.
November 08, 2023
Parties In Disability Suit Allowed To File Administrative Record Under Seal

CINCINNATI — An Ohio federal judge granted a joint motion to seal the administrative record in a disability benefits suit after determining that the protection of the disability claimant’s private health information outweighs the public’s interest in having access to the records and documents in the administrative record.
November 08, 2023
$900,000 Class Settlement Gets Preliminary OK In ERISA Annuity Calculation Case

MILWAUKEE — A Wisconsin federal judge on Nov. 7 granted preliminary approval to a class action settlement with an estimated present value of $900,000 in a suit claiming that married retirees and beneficiaries were “shortchanged” by pension benefits calculated using allegedly outdated mortality and interest rate assumptions.
November 08, 2023
Magistrate Judge Recommends Disability Insurer’s Motion For Judgment Be Granted

CHATTANOOGA, Tenn. — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the medical evidence supported the insurer’s termination of benefits and the insurer “provided a reasoned basis” for its termination, a Tennessee federal magistrate judge said in recommending that the insurer’s motion for judgment as a matter of law (JMOL) be granted and the claimant’s motion for JMOL be denied.
November 07, 2023
Respondents To High Court: Fail-Safe Class Question ‘Is Not Presented Here’

WASHINGTON, D.C. — Arguing in part that the question of whether Federal Rule of Civil Procedure 23 allows certification of a fail-safe class “is not presented here,” respondents on Nov. 6 urged the U.S. Supreme Court to deny a certiorari petition in a suit over retirement plan vesting determinations.
November 07, 2023
Arizona Federal Judge Gives Preliminary OK To $2M Deal In ERISA Funds, Fees Row

PHOENIX — A $2 million class settlement has been granted preliminary approval in Arizona federal court in an Employee Retirement Income Security Act case where the plaintiffs allege mismanagement of their retirement plan and challenge certain funds and fees.
November 07, 2023
9th Circuit Hears Meaningful Benchmark Arguments In ERISA Imprudence Row

HONOLULU — Whether “meaningful benchmarks” are required at the dismissal stage of an Employee Retirement Income Security Act suit was the focus of oral argument in a Ninth Circuit U.S. Court of Appeals case over retirement plan investments in hedge funds and private equity investments, with participants arguing that the trial court improperly used a heightened pleading standard and plan fiduciaries contending that dismissal was correct.
November 07, 2023
Judge Gives Final OK To $100,000 Class Settlement With Last Defendant In ESOP Row

RIVERSIDE, Calif. — A California federal judge who previously approved two class settlements totaling $9 million in a suit challenging a 2015 employee stock ownership plan (ESOP) deal has approved a third class settlement of $100,000 with a defendant that obtained a summary judgment ruling.