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Mealey's ERISA

August 01, 2025
6th Circuit Affirms Denial Of ‘Fees For Fees’ Motion In ERISA Coverage Row

CINCINNATI — The Sixth Circuit U.S. Court of Appeals issued an unpublished opinion affirming denial of a request to award $75,460 in attorney fees for work that happened in an Employee Retirement Income Security Act coverage dispute over back surgery after the insurer decided during court-ordered reprocessing that it would pay the claim.
July 31, 2025
Ark. Federal Judge Says Law Banning PBMs From Owning Pharmacies Likely To Fail

LITTLE ROCK, Ark. — A recently signed law that bans pharmacy benefits managers (PBMs) from owning a pharmacy business in Arkansas likely violates the U.S. Constitution’s commerce clause and is likely preempted by federal law, an Arkansas federal judge ruled, granting motions for a preliminary injunction.
July 31, 2025
Class Members To Net Over $3,400 Apiece In COBRA Notice Deal Granted Initial OK

ANN ARBOR, Mich. — A $1 million proposal to settle a suit over allegedly deficient Consolidated Omnibus Budget Reconciliation Act (COBRA) notice on a class basis won preliminary approval in Michigan federal court; in the granted motion, the named plaintiff estimated that about 184 class members would net approximately $3,451 apiece in a recovery “significantly higher than many other class action settlements in cases involving similar alleged violations.”
July 31, 2025
Judge Affirms Insurer’s ‘Incarceration’ Interpretation In LTD Benefits Row

PITTSBURGH — Saying, “On the record before it, this Court finds that the term ‘incarceration’ is ambiguous, as it could mean post-conviction penal confinement or it could simply mean confinement,” a Pennsylvania federal judge on July 30 upheld termination of long-term disability (LTD) benefits under arbitrary and capricious review upon concluding that interpreting the term to mean confinement was within the insurer’s discretionary authority.
July 31, 2025
Federal Judge Upholds LTD Benefits Termination Under Residency Provision

SEATTLE — Addressing cross-motions for judgment on the record on de novo review of a long-term disability (LDT) benefits dispute, a Washington federal judge upheld termination of benefits under an international residency provision despite the fact that the COVID-19 pandemic hit during the time at issue.
July 30, 2025
Part Of ERISA Putative Class Action Over Tobacco Surcharge Survives Dismissal

ST. PAUL, Minn. — As the number of recent cases challenging health plans’ so-called tobacco surcharges continues to grow, a Minnesota federal judge on July 29 ruled that one of three claims in a putative class action over such surcharges survives dismissal “to the extent that it is premised on the failure to notify Plan participants that recommendations of an individual’s personal physician will be accommodated.”
July 29, 2025
6th Circuit Affirms Rulings For Administrator Of Tribe’s Health Care Plan

CINCINNATI — Rejecting a variety of arguments advanced by a Native American tribe and its health plan, the Sixth Circuit U.S. Court of Appeals on July 28 affirmed rulings for the health plan’s third-party administrator (TPA) in a long-running dispute involving the Michigan Health Care False Claims Act (HCFCA) and Medicare-like rate (MLR) regulations.
July 29, 2025
Proxy Advisory Firm Challenges New Texas Law Concerning ESG, DEI Issues

AUSTIN, Texas — A new Texas law concerning proxy advisers’ consideration of environmental, social and governance (ESG), diversity, equity and inclusion (DEI) and sustainability factors is being challenged in Texas federal court, with the plaintiff arguing that, among other things, the law constitutes impermissible viewpoint discrimination and is preempted by the Employee Retirement Income Security Act.
July 28, 2025
5th Circuit Rules That LTD Benefits Termination Was Sufficiently Supported

NEW ORLEANS — In an unpublished per curiam opinion noting that the challenged termination of long-term disability (LTD) benefits “was supported by reports from at least four healthcare professionals,” the Fifth Circuit U.S. Court of Appeals affirmed judgment for an insurer in a case over whether the claimant was able to perform any gainful sedentary occupation.
July 28, 2025
5th Circuit ERISA Appeal Involving Promise Not To Sue Is Dropped

NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on July 25 granted a former retirement plan participant’s motion to voluntarily dismiss his challenge to a ruling that he lacks standing to bring a putative class action because he signed a promise not to sue that applies to his Employee Retirement Income Security Act claims.
July 25, 2025
In Advisory Opinion, DOL Tackles ERISA Question Regarding LTD Plan

WASHINGTON, D.C. — In one of its first advisory opinions issued under President Donald J. Trump, the U.S. Department of Labor (DOL) took the view that the self-funded long-term disability (LTD) plan of a mutual benefit corporation for California firefighters “does not constitute an employee welfare benefit plan within the meaning of” part of the Employee Retirement Income Security Act — with a caveat.
July 24, 2025
$5.9M Settlement Of Class Action Against Former ESOP Trustee Gets Final OK

CHICAGO — An Illinois federal judge granted final approval to a $5.9 million class settlement resolving an Employee Retirement Income Security Act against the former trustee of an employee stock ownership plan (ESOP); according to the named plaintiff, the net settlement averages more than $2,000 per class member.
July 24, 2025
Judge: Common Interest Agreement Isn’t License To Violate Protective Order

OAKLAND, Calif. — Saying, “A common interest agreement with a third party does not give plaintiffs the right to violate the protective order governing this case,” a California federal judge briefly granted an administrative motion filed by defendants in in an Employee Retirement Income Security Act suit over alleged underpayment for out-of-network behavioral health treatment.
July 24, 2025
Partial, Limited Preliminary Injunction Granted In Iowa PBM Law Challenge

DES MOINES, Iowa — Citing the First Amendment, the Employee Retirement Income Security Act and a recent U.S. Supreme Court ruling, an Iowa federal judge issued a preliminary injunction order enjoining Iowa state regulators from enforcing 11 provisions of a new state pharmacy benefit manager (PBM) law against the plaintiffs “and their contractors and agents who assist in the administration of their health benefit plans.”
July 23, 2025
Interlocutory Appeal Certified On Standing In PRT Case That Survived Dismissal

GREENBELT, Md. — Part of a key ruling in a putative class lawsuit that is part of a much-watched recent string of Employee Retirement Income Security Act cases challenging pension risk transfers (PRTs) is headed to the Fourth Circuit U.S. Court of Appeals after a Maryland federal judge on July 22 granted an opposed motion to certify for interlocutory appeal.
July 23, 2025
9th Circuit Reverses Ruling For Fund In Withdrawal Liability Row

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals has issued an unpublished memorandum disposition reversing and remanding a ruling against a multiemployer fund and its trustees in a withdrawal liability dispute involving the question of whether there was a “controlled group.”
July 22, 2025
Citing Deemed Admissions, 2nd Circuit Affirms Ruling For Multiemployer Funds

NEW YORK — Affirming summary judgment against two corporations in an Employee Retirement Income Security Act lawsuit over allegedly delinquent fringe benefit contributions and dues checkoffs, the Second Circuit U.S. Court of Appeals on July 21 upheld a lower court’s handling of deemed implicit admissions and concluded that the corporations failed to raise any genuine disputes of material fact.
July 22, 2025
DOL Kicks Off Advisory Opinion Program With Focus On Racial Equity Program

WASHINGTON, D.C. — The U.S. Department of Labor (DOL) Office of Regulations and Interpretations on July 21 issued its first advisory opinion under President Donald J. Trump; rescinding a 2023 advisory opinion regarding an Action for Racial Equity Asset Manager Program, the DOL said Citigroup Inc. (Citi) “should take immediate action to end all illegal activity within its Racial Equity Program and any other initiative, plan, program, or scheme it operates under the banner of diversity, equity, and inclusion.”
July 22, 2025
Ruling Policy Limitation Enforceable, 9th Circuit Upholds LTD Claim Denial

SAN FRANCISCO — Issuing an unpublished memorandum disposition affirming that the preexisting conditions limitation (PECL) “is enforceable as applied” in the denial of a long-term disability (LTD) benefits claim, the Ninth Circuit U.S. Court of Appeals did not reach a dispute regarding the applicable standard of review.
July 22, 2025
Suit Over Allegedly Outdated Pension Assumptions Mostly Survives Summary Judgment

SAN FRANCISCO — A putative class action challenging the use of allegedly outdated assumptions to calculate annuities for married pension plan participants is proceeding toward a bench trial after a California federal judge mostly denied the defendants’ motion for summary judgment and denied their motion to exclude the plaintiffs’ expert.
July 21, 2025
7th Circuit Reverses Summary Judgment In ERISA Delinquent Contributions Row

ST. LOUIS — Concluding that there is a genuine dispute regarding an agent’s “intent to be personally bound by the terms of the trust agreement,” the Seventh Circuit U.S. Court of Appeals reversed summary judgment against the sole member of a dissolved company in a multiemployer plan Employee Retirement Income Security Act case, also vacating an associated award of attorney fees.
July 18, 2025
6th Circuit Rules Against Top Hat Plan Participants In Preemption, Remedies Row

CINCINNATI — Ruling that the Employee Retirement Income Security Act expressly preempts state law claims and that lost monetary benefits are not equitable relief, the Sixth Circuit U.S. Court of Appeals on July 17 affirmed judgment for the administrator of so-called “top hat” deferred compensation and retirement plans.
July 18, 2025
9th Circuit Vacates ERISA Ruling Over Record Augmentation Issue

PASADENA, Calif. — Ruling in an unpublished memorandum disposition that a trial court erred “by not allowing for augmentation of the administrative record despite finding [appellee UnitedHealthcare Insurance Co.’s] initial claims denial explanations deficient under” the Employee Retirement Income Security Act, the Ninth Circuit U.S. Circuit Court of Appeals vacated and remanded a ruling over health plan coverage for surgical sessions in which two procedures were performed.
July 17, 2025
Appellants, Amici Express Many Criticisms Re ERISA Conversion Row To 5th Circuit

HOUSTON — Advancing arguments regarding issues of standing, statute of repose, successor liability and class certification, appellants and prominent amici curiae filed briefs urging the Fifth Circuit U.S. Court of Appeals to reverse judgment for the class in an Employee Retirement Income Security Act suit over the 1989 conversion of a defined benefit plan that used a final average pay formula to a retirement accumulation plan (RAP) cash balance plan.
July 15, 2025
COMMENTARY: Update On ERISA Class Actions In 2025

By Gerald L. Maatman, Jr. and Jennifer A. Riley