In a recent opinion, Smith et al. v. UnitedHealth Group Inc. et al., the US Court of Appeals for the Eighth Circuit affirmed the dismissal of an Employee Retirement Income Security Act (ERISA) class action suit brought by...more
On April 23, the US Department of Labor (DOL) released a final rule significantly expanding the definition of who qualifies as a fiduciary under the Employee Retirement Income Security Act (ERISA) (the Retirement Security...more
5/15/2024
/ Biden Administration ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Exemptions ,
Fiduciary ,
Final Rules ,
Internal Revenue Code (IRC) ,
Investment ,
Pensions ,
Prohibited Transactions ,
Retirement Plan ,
Securities and Exchange Commission (SEC)
Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage...more
On December 5, 2022, the US District Court for the Middle District of North Carolina held that the North Carolina State Health Plan (NCSHP) constitutes a “Health Program or Activity” under the Affordable Care Act (ACA). In so...more
12/14/2022
/ Affordable Care Act ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
Employee Retirement Income Security Act (ERISA) ,
Gender Discrimination ,
Health Insurance ,
North Carolina ,
Rulemaking Process ,
SCOTUS ,
Summary Judgment ,
Transgender
Earlier this month, the US District Court for the Western District of Washington certified a class of individuals who were denied gender-affirming care by a third-party administrator, Blue Cross Blue Shield of Illinois...more
11/22/2022
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Blue Cross ,
Blue Shield ,
Declaratory Relief ,
Employee Retirement Income Security Act (ERISA) ,
Gender Discrimination ,
Motion for Summary Judgment ,
Preliminary Injunctions ,
Religious Freedom Restoration Act (RFRA) ,
Transgender
The Ninth Circuit Court of Appeals recently reversed the Northern District of California’s landmark decision against UnitedHealth Group Inc.’s behavioral health unit, United Behavioral Health (“UBH”), under which UBH had been...more
In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more
2/8/2022
/ Amicus Briefs ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Health Insurance ,
Healthcare ,
Petition for Writ of Certiorari ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
SCOTUS
With nearly 150 similar class action lawsuits pending nationwide, the ruling is a win for the ERISA plaintiff's bar, potentially supporting their expansive view of plan fiduciaries' duty to monitor investments.
As...more
The U.S. Supreme Court heard oral argument to decide a circuit split and determine what ERISA requires of ERISA-governed pension plan fiduciaries with respect to investment fees and recordkeeping. A decision is expected in...more
The Department of Labor (DOL) recently issued new guidance on best practices for maintaining cybersecurity in connection with ERISA plans (the Guidance).
The Guidance, which is intended for sponsors, fiduciaries, record...more
8/9/2021
/ Benefit Plan Sponsors ,
Best Practices ,
Cybersecurity ,
Data Protection ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
New Guidance ,
Plan Administrators ,
Plan Participants ,
Popular ,
Retirement Plan ,
Third-Party Service Provider
States seeking to regulate pharmacy benefit managers (PBMs) and prescription drug pricing received a win from the Supreme Court, which reversed an Eighth Circuit decision that had invalidated an Arkansas law governing...more
The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not...more
Last month, in Pharmaceutical Care Management Association v. Tufte et al. No. 18-2926 (8th Cir. August 7, 2020), the United States Court of Appeals for the Eighth Circuit invalidated legislation in North Dakota on the grounds...more
Medical providers treating patients covered by ERISA-governed health plans on an out-of-network basis can assert state-law claims to hold plans to their payment promises without running afoul of ERISA’s preemption provision...more
In January, the Supreme Court issued its highly anticipated opinion in Retirement Plans Committee of IBM v. Jander, No. 18-1165, a case that promised to clarify the pleading standard applicable to ERISA stock-drop cases. But...more
2/4/2020
/ Breach of Duty ,
Certiorari ,
Corporate Officers ,
Defined Benefit Plans ,
Dismissals ,
Duty of Prudence ,
Employee Retirement Income Security Act (ERISA) ,
Employee Stock Purchase Plans ,
ESOP ,
Failure To Disclose ,
Fiduciary Duty ,
FIfth Third Bancorp v Dudenhoeffer ,
Fraud ,
Insider Information ,
Plan Participants ,
Pleading Standards ,
Pleadings ,
Remand ,
Retirement Plan ,
Retirement Plans Committee of IBM v Jander ,
SCOTUS ,
Securities Violations ,
Stock Drop Litigation ,
Vacated
A federal court in Nebraska recently rejected a health plan’s fiduciary breach claims under the Employee Retirement Income Security Act of 1974 (ERISA) against third-party service providers, holding that the service providers...more
The US Court of Appeals for the Third Circuit recently confirmed that “anti-assignment” provisions — provisions prohibiting insureds from assigning their rights under a health plan to third parties, including medical...more