The Tenth Circuit recently concluded that, as a matter of federal common law, a choice-of-law provision in a long-term disability insurance policy, which was part of the plaintiff’s employer’s ERISA plan, must be enforced...more
Editor’s Overview -
Of course, on the top of everyone’s minds these days is COVID-19. In this edition of Proskauer’s ERISA Newsletter, our colleagues discuss some of the legislation and guidance that has been issued over...more
Since the beginning of 2016, the ERISA plaintiffs’ bar has filed nearly two dozen complaints targeting university-sponsored 403(b) plans. The majority of these lawsuits assert that plan fiduciaries breached their duties and...more
As recent history has shown, ERISA claims seeking recovery of investment losses tend to proliferate during times of market volatility. The Coronavirus (COVID-19) pandemic presents a unique opportunity for plaintiffs to...more
Editor's Overview -
Happy New Year. We wrap-up 2019 with an article that reflects on significant developments in ERISA litigation during 2019, and takes a look at what's on the horizon for 2020. The courts (at all levels)...more
1/17/2020
/ 401k ,
Affordable Care Act ,
American Arbitration Association ,
Arbitration ,
Article III ,
Benefit Plan Sponsors ,
Best Practices ,
Breach of Duty ,
Cadillac Tax ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Liability Issues ,
Individual Mandate ,
Intel Corp. Investment Policy Committee v. Sulyma ,
IRS ,
Loss Causation ,
Multiemployer Plan ,
Pleading Standards ,
Retirement Plan ,
SCOTUS ,
Standing ,
Thole v U.S. Bank ,
Venue
As we shifted focus last week from a plan’s administrative claims procedures to defending against a claim for benefits in court, we explained how a well-documented administrative record can enhance the chances of getting a...more
12/19/2019
/ Arbitration ,
Benefit Plan Sponsors ,
Breach of Contract ,
Claim Procedures ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Forum Selection ,
Mandatory Arbitration Clauses ,
Statute of Limitations ,
Summary Plan Description ,
Venue
Up to now, our blog series has focused on best practices for implementing a plan’s claims and appeals procedure. We shift gears this week to see how following these best practices pays dividends if a participant’s (or...more
It’s Week #6, and we have turned the corner in our Top 10 Best Practices in Administering Benefit Claims. In case you missed any (or all) of the first five best practices, links to each of them appear below. This week we...more
This week we discuss the importance of establishing good claims procedures and the benefits of following those procedures.
A plan’s claims procedures should be spelled out clearly in both the plan document and the summary...more
11/8/2019
/ Attorney-Client Privilege ,
Benefit Plan Sponsors ,
Best Practices ,
Claim Procedures ,
Compensation & Benefits ,
Discovery ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Fiduciary Duty ,
Summary Plan Description
This week in our blog series on best practices in administering benefit claims, we discuss the importance of knowing and, importantly, understanding the laws governing benefit claim administration.
Section 503 of ERISA...more
Our blog series on best practices in administering benefit claims has thus far stressed the importance of knowing and reading the plan document and summary plan description. This week, we take a look at a plan term that has...more
Last week, we kicked off our blog series on the fundamentals of benefit claim administration with an explanation of how important it is to know and read your plan document. The plan document is the legally binding contract...more
In this edition of our Newsletter, we take a look at a pair of cases that, while unrelated, together remind us of the importance of having clear plan rules in place that reflect the plan sponsor’s intention. The first article...more
10/11/2019
/ 401k ,
403(b) Plans ,
Affordable Care Act ,
Benefit Plan Sponsors ,
Breach of Duty ,
Class Action ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Fiduciary Duty ,
Foreign Nationals ,
Hardship Distributions ,
Health Insurance ,
IRS ,
Mental Health Parity Rule ,
Multiemployer Pension Plan Amendments Act (MPPAA) ,
Pensions ,
Retirement Plan ,
Safe Harbors ,
Standing ,
Statute of Limitations ,
Withdrawal Liability
Our ERISA Practice Center blog posts often discuss many complex, and sometimes esoteric, substantive and procedural ERISA issues, as well as related agency guidance and case law. In this new ten-part blog series, however, we...more
ERISA health care plans typically include reimbursement and subrogation clauses, which give plans a right to reimbursement of medical expenses paid on behalf of a beneficiary where the injury is caused by a third party. While...more
10/2/2019
/ Benefit Plan Sponsors ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Insurance Risk Pool ,
Jurisdiction ,
Medical Expenses ,
Medical Reimbursement ,
Preemption ,
Savings Clause ,
State Law Claims ,
Subrogation
Editor's Overview -
As the summer heats up, so too has the U.S. Supreme Court's docket for next term where it has already agreed to hear three ERISA cases and more may be in the works. On the docket already are ERISA...more
7/16/2019
/ 401k ,
Affordable Care Act ,
Anti-Assignment Clauses ,
Benefit Plan Sponsors ,
Certiorari ,
Collective Bargaining Agreements (CBA) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Federal Rules of Civil Procedure ,
Final Rules ,
HRA ,
IBM ,
Retirement Plan ,
Roth IRA ,
SCOTUS ,
Statute of Limitations ,
Stock Drop Litigation
The Third Circuit recently held that anti-assignment clauses in ERISA-governed healthcare plans are enforceable as long as they are unambiguous. The Court concluded that the anti-assignment clause clearly stated that...more
Over the past several years, the ERISA plaintiffs’ bar has targeted university-sponsored 403(b) plans, arguing that the plan fiduciaries breached their fiduciary duties and engaged in prohibited transactions in connection...more
Editor's Overview -
We often talk about the importance of evaluating whether there are any procedural obstacles to plaintiffs pursuing their ERISA claims, particularly in complex, class actions where it may not be...more
4/3/2019
/ Administrative Remedies ,
Article III ,
Breach of Duty ,
Defined Contribution Plans ,
Discovery ,
Electronically Stored Information ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Financial Harm ,
Injury-in-Fact ,
IRS ,
Notice Requirements ,
Standard of Review ,
Standing
As we closed the door on 2018, we were met by two surprising decisions—one from a panel of the Second Circuit addressing employer stock drop litigation, and one from a federal district court in Texas declaring the entire...more
1/11/2019
/ 403(b) Plans ,
Affordable Care Act ,
Amgen v Harris ,
Breach of Duty ,
Constitutional Challenges ,
Disclosure Requirements ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
FIfth Third Bancorp v Dudenhoeffer ,
Hardship Distributions ,
Health Insurance ,
IRS ,
Plan Administrators ,
Proposed Regulation ,
Section 409A ,
Securities and Exchange Commission (SEC) ,
Stock Drop Litigation ,
Tax Cuts and Jobs Act
Editor's Overview -
In last quarter's Newsletter, we commented that all eyes were on President Trump's nomination to the U.S. Supreme Court, as the outcome of the appointment process can have a significant impact on the...more
10/3/2018
/ 401k ,
403(b) Plans ,
Attorney's Fees ,
Discovery ,
Electronically Stored Information ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Federal Rules of Civil Procedure ,
Fiduciary Duty ,
Fiduciary Rule ,
FRCP 26(b)(1) ,
Preemption ,
Recordkeeping Requirements ,
Retirement Plan ,
Standing
The Ninth Circuit held that employees’ agreements to arbitrate all claims the employees may have did not extend to claims brought on behalf of two ERISA plans under ERISA § 502(a)(2). In so ruling, the Court explained that...more
As we head into the thick of summer, all eyes are on President Trump's nomination to the U.S. Supreme Court to replace retiring Justice Anthony Kennedy and the impact the new Justice will have on shaping the law for...more
7/11/2018
/ 21st Century Cures Act ,
401k ,
403(b) Plans ,
Beneficiaries ,
Bi-Partison Balanced Budget Act (BBA) ,
Breach of Duty ,
Clawbacks ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Rule ,
HDHP ,
Health Care Providers ,
Health Savings Accounts ,
Investment Adviser ,
Investment Management ,
IRS ,
MHPAEA ,
Murder ,
Plan Administrators ,
Preemption ,
Prescription Drugs ,
Retirement Plan ,
Slayer Statutes
After nearly a decade in the making, the Department of Labor’s fiduciary rule appears to be officially dead. On June 21st, the U.S. Court of Appeals for the Fifth Circuit issued its mandate that finalized its earlier...more
6/26/2018
/ Best Interest Contract Exemptions ,
Broker-Dealer ,
Conflicts of Interest ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Rule ,
Investment Adviser ,
Investment Management ,
New Guidance ,
Vacated
On May 7, 2018, the DOL issued a Field Assistance Bulletin (“FAB”) addressing the Department’s enforcement policy on the fiduciary rule that was recently vacated by the Fifth Circuit. Although the DOL has elected not to...more