In a unanimous decision reversing dismissal of prohibited transaction claims based on fees paid to defined contribution plan recordkeepers, the Supreme Court held that ERISA’s prohibited transaction exemptions are affirmative...more
4/18/2025
/ Appeals ,
Benefit Plan Sponsors ,
Class Action ,
Compensation & Benefits ,
Cunningham v Cornell University ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Fiduciary Duty ,
Motion to Dismiss ,
Pleading Standards ,
Popular ,
Prohibited Transactions ,
Retirement Plan ,
SCOTUS
Following through on a campaign theme focused on transgender issues and access to gender-affirming health care, on Friday, January 28, President Trump signed an Executive Order, titled “Protecting Children from Chemical and...more
2/12/2025
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Employee Retirement Income Security Act (ERISA) ,
Equal Access ,
Executive Orders ,
Gender Expression ,
Gender Identity ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Reform ,
LGBTQ ,
Medicaid ,
Medicare ,
Patient Access ,
Section 1557 ,
Transgender
The Second Circuit recently ruled that an ERISA plan’s arbitration provision was not enforceable because the provision barred plan-wide relief. Cedeno v. Sasson, 2024 WL 1895053 (2d Cir. May 1, 2024). The Court decision...more
The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more
2/26/2024
/ 401k ,
Breach of Duty ,
Consolidated Appropriations Act (CAA) ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Rule ,
Health and Welfare Plans ,
Health Insurance ,
Johnson & Johnson ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Putative Class Actions ,
Retirement Plan
Seyfarth Synopsis: A recent district court decision highlights the continued uncertainties about what it means to include an arbitration clause in an ERISA plan. While courts generally agree that such clauses are, in theory,...more
Seyfarth Synopsis: Recognizing that the Plan contained an unambiguous arbitration provision, and that “ERISA claims are generally arbitrable,” the Seventh Circuit Court of Appeals nonetheless found that arbitration could not...more
Seyfarth Synopsis: A recent 10th Circuit decision holding that in order for the abuse of discretion standard to apply in litigation the claims administrator must provide participants with actual notice of discretionary...more
8/10/2020
/ Abuse of Discretion ,
Claim Procedures ,
De Novo Standard of Review ,
Disability Benefits ,
Disclosure Requirements ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Judicial Review ,
Notice Requirements ,
Plan Administrators ,
Standard of Review
In an unpublished decision dated May 16, 2019, the Ninth Circuit held that a plan administrator abused its discretion by denying surviving spouse benefits under an ERISA retirement benefit plan to a participant’s domestic...more
6/7/2019
/ Abuse of Discretion ,
Annuities ,
DOMA ,
Domestic Partnership ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Life Insurance ,
Plan Administrators ,
Remand ,
Surviving Spouse ,
Survivor Benefits
This is the one hundred and nineteenth issue in our series of alerts for employers on selected topics on health care reform. ...more
Seyfarth Synopsis: A recent case from the Eastern District of Pennsylvania reaffirms the basic principle that a threshold element of any ERISA claim is pleading the existence of an ERISA plan....more
Seyfarth Synopsis: In a win for ERISA plan and claims administrators, the Third Circuit has affirmed the broad enforcement of a long-term disability plan’s mental or nervous limitation period....more
Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more
Seyfarth Synopsis: In an opinion that may result in increasingly complex ERISA benefits litigation, the Eighth Circuit has allowed a breach of fiduciary duty claim premised on alleged faulty claims handling practices to...more
In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174 (5th Cir. Apr. 21, 2017), the Firth Circuit concluded that Texas’ ban on discretionary clauses in certain insurance policies did not require a de novo review of...more
Seyfarth Synopsis: The Sixth Circuit becomes the seventh circuit court to not require administrative exhaustion for statutory ERISA claims (as opposed to denial of benefit claims), while two circuit courts still do.
In...more
Seyfarth Synopsis: Adding to the body of conflicting authority on the scope of the attorney-client privilege in ERISA lawsuits, a district court has found that the fiduciary exception to attorney-client privilege applies to...more
3/9/2017
/ Attorney-Client Privilege ,
Benefit Plan Sponsors ,
Compensation & Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Exception ,
Insurance Industry ,
Long Term Disability Insurance ,
Privileged Communication ,
Retirement Plan
Seyfarth Synopsis: A Court ruled that under the Affordable Care Act, an ERISA governed plan exclusion cannot unequivocally bar emergency medical care related to injuries sustained in a fireworks explosion.
Recently, a...more
Seyfarth Synopsis: Currently before the Supreme Court are two petitions regarding the thorny legal question of which organizations can qualify for ERISA’s Church-plan exemption. If the Supreme Court grants certiorari and...more
10/12/2016
/ Anti-Discrimination Policies ,
Benefit Plan Sponsors ,
Church Plans ,
Churches ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Exemptions ,
First Amendment ,
Health Insurance ,
Healthcare ,
Hospitals ,
Petition for Writ of Certiorari ,
Religious Institutions ,
SCOTUS
Seyfarth Synopsis: A recent decision district court ruling affirms that in a benefit discrimination claim, just as in a typical claim of employment discrimination, to survive summary judgment a plaintiff must demonstrate that...more
In a closely observed federalism battle over the scope of ERISA preemption, the Supreme Court came down on the side of Federal power. Specifically, in Gobeille v. Liberty Mutual Insurance Company, the Court, in a 6-2 ruling,...more
It’s a common fact pattern. A plan participant is injured and received benefits for treatment of his injuries. The participant then sues a third party for damages based on his injuries. The plan then seeks to recover a...more
In last week’s oral argument on the constitutionality of same-sex marriage bans, Chief Justice Roberts asked the following question:
Counsel, I’m not sure it’s necessary to get into sexual orientation to resolve the...more
In last week’s oral argument on the constitutionality of same-sex marriage bans, Chief Justice Roberts asked the following question:
Counsel, I’m, I’m not sure it’s necessary to get into sexual orientation to resolve...more
5/7/2015
/ Benefit Plan Sponsors ,
Discrimination ,
Employee Retirement Income Security Act (ERISA) ,
Equal Employment Opportunity Commission (EEOC) ,
Fourteenth Amendment ,
LGBTQ ,
Oral Argument ,
Popular ,
Same-Sex Marriage ,
SCOTUS ,
Sex Discrimination ,
Sexual Orientation Discrimination ,
Title VII
Background -
Today, the U.S. Supreme Court heard oral argument on two questions regarding the Constitutionality of state laws limiting marriage to opposite-sex couples. In 2013, the Supreme Court side-stepped the issue...more
4/28/2015
/ Anti-Discrimination Policies ,
Employee Retirement Income Security Act (ERISA) ,
Equal Employment Opportunity Commission (EEOC) ,
Hollingsworth v Perry ,
LGBTQ ,
Marriage Equality ,
Same-Sex Marriage ,
Same-Sex Marriage Bans ,
SCOTUS ,
Title VII ,
US v Windsor