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Employee Benefits Appeals Health Insurance

Venable LLP

SCOTUS Limits ADA Lawsuits by Retirees Over Post-Employment Benefits

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In a June decision, the Supreme Court limited retirees' ability to bring Americans with Disabilities Act (ADA) lawsuits, finding that the ADA generally does not allow claims by retirees or protect post-employment health...more

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

Holland & Knight LLP

Sixth Circuit Reverses Dismissal of ERISA Healthcare Fee Suit Against Third-Party Administrator

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There has been a recent rise in Employee Retirement Income Security Act of 1974 (ERISA) litigation against third-party administrators (TPAs) and other service providers challenging their management of self-funded health...more

Amundsen Davis LLC

Court Ruling Hamstrings IRS Enforcement of ACA Employer Mandate

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On April 10, 2025, a federal court in Texas issued an opinion in the case of Faulk Co. v. Becerra that significantly impacts how the Affordable Care Act’s (ACA) employer mandate can be enforced. The ruling effectively...more

ArentFox Schiff

Mental Health Parity: In a Pair of Decisions, California Federal Court Rejects United’s Efforts to Kick Behavioral Health Class...

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Within the last month, the US District Court for the Northern District of California rejected efforts by United Behavioral Health (UBH) to dismiss and decertify two class actions seeking relief related to UBH’s processing of...more

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

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A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more

Faegre Drinker Biddle & Reath LLP

Another U.S. Supreme Court Review of Affordable Care Act Could Impact Employer Health Plans

On March 2, 2020, the U.S. Supreme Court granted two petitions by interested states asking the Court to review the constitutionality of the individual health coverage mandate in the Affordable Care Act (ACA) and, if...more

Seyfarth Shaw LLP

Fifth Circuit Affirms Striking Down Individual Mandate of Affordable Care Act and Remands on Issue of Severability

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In a bold but conservative 2-1 decision Wednesday, The United States Court of Appeals for the Fifth Circuit affirmed the ruling of a federal district judge in Texas striking down the individual mandate of the Affordable Care...more

Ballard Spahr LLP

Fifth Circuit Rules Individual Mandate Unconstitutional; Fate of Rest of ACA Remains in Doubt

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In a 2-1 decision, the Fifth Circuit Court of Appeals has upheld a district court ruling that the individual mandate under the Affordable Care Act is unconstitutional. However, the Fifth Circuit has sent the case back to the...more

Robinson+Cole ERISA Claim Defense Blog

Remand Directing Change in Standard of Judicial Review Is Not Sufficient Success on the Merits to Support Attorneys’ Fee Award

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 18-20700, 2019 WL 5866677 (5th Cir. Nov. 8, 2019), the Fifth Circuit Court of Appeals rejected a plaintiff’s petition for attorneys’ fees under 29 U.S.C. § 1132(g).  This...more

Seyfarth Shaw LLP

ERISA Preemption — The Courts of Appeal Continue to Rule As They Await Further Supreme Court Attempts To Define, Once and for All,...

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Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more

Robinson+Cole ERISA Claim Defense Blog

Second Circuit Upholds Reduction of Attorneys’ Fees Sought in ERISA Benefits Case

In a recent summary order in an ERISA LTD benefits case, the Second Circuit Court of Appeals rejected a plaintiff’s appeal concerning the amount of attorneys’ fees awarded by the district court. In Solnin v. Sun Life and...more

Genova Burns LLC

Appellate Division Holds Former Employee Should Have the Opportunity to Show Her Employer’s Reason for Firing Her was Mere Pretext

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In an unpublished opinion, the New Jersey Appellate Division ruled in Caballero v. Cablevision Systems Corp. that a former Cablevision employee is entitled to present her claims of age and disability discrimination to a jury,...more

Spilman Thomas & Battle, PLLC

Careful, Careful: Arbitration of Benefit Claims Under Collective Bargaining Agreements

In Cup v. Ampco Pittsburgh Co., 2018 WL 4101049 (3rd Cir. Aug. 29, 2018), the Third Circuit addressed a case concerning the arbitrability of benefit claims by retirees in the context of collective bargaining agreements...more

Winstead PC

Post-Flores v. City of San Gabriel: What Other Benefits Should Employers Be Wary Of

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Flores v. City of San Gabriel altered the way employers consider opt-out payments to employees for not taking health insurance.1 The U.S. Court of Appeals for the Ninth Circuit determined that opt-out payments were required...more

Robinson+Cole ERISA Claim Defense Blog

Ninth Circuit Rejects Arguments Challenging the Enforceability of an ERISA Plan Anti-Assignment Provision

In Eden Surgical Ctr. v. Cognizant Tech. Sols. Corp., No. 16-56422, 2018 U.S. App. LEXIS 10597 (9th Cir., Apr. 26, 2018), the U.S. Court of Appeals for the Ninth Circuit upheld the District Court’s Order dismissing the...more

Verrill

Near Unity Among the Circuits: Anti-Assignment Provisions are Enforceable

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U.S. Courts of Appeals in all but four Circuits have now held that anti-assignment provisions in health insurance plans governed by ERISA are enforceable. In American Orthopaedic & Sports Medicine v. Independence Blue Cross...more

Seyfarth Shaw LLP

Game Over? Ninth Circuit Doubles Down on Its Commitment To Enforcing Anti-Assignment Provisions In ERISA Plans To Bar Suits By...

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SEYFARTH SYNOPSIS: The Ninth Circuit recently dealt another major blow to healthcare providers that attempt to bring suits as assignees of their individual patients, holding that an ERISA plan’s anti-assignment provision bars...more

Fisher Phillips

Web Exclusive: January 2018: The Top 18 Labor And Employment Law Stories

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It’s hard to keep up with all the recent changes to labor and employment law. While the law always seems to evolve at a rapid pace, there were an unprecedented number of changes each month in 2017—and if January is any...more

Burr & Forman

Employee or independent contractor? Right to control is key

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A continuing point of contention in employment law revolves around who is an employee versus who is an independent contractor. The issue seems to come up often in wage and hour cases and workers’ compensation or unemployment...more

Hogan Lovells

Employment News - September 2017

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Don’t look now – European Court decides monitoring employee's email account did breach privacy right - In Barbulescu v Romania the Grand Chamber of the European Court of Human Rights has decided that an employee's right to...more

Genova Burns LLC

Appellate Division Finds c.78 Health Benefits Contributions Requirements Do Not Apply to Public Sector Disability Retirees

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Last month, in Brick Twp. PBA Local 230 v. Twp. of Brick, the Appellate Division of the Superior Court of New Jersey confirmed that N.J.S.A. 40A:10-21.1, P.L. 2011, c. 78, § 42, more commonly known as Chapter 78, does not...more

Baker Donelson

Court of Appeals to Plan Administrators: Inform Claimants of Time Limits on Front End of Discussions

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Recently, in Mirza v. Insurance Administrator of Am., Inc., __ F.3d__ (3d. Cir. 2015), the United States Court of Appeals for the Third Circuit was asked to determine whether plan administrators are required to include a...more

Pullman & Comley, LLC

Appellate Court Notes

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- Supreme Court Advance Release Opinions: - SC19422 - Awdziewicz v. Meriden Certain police officers retired, entitling them to pension benefits under the City Charter as previously modified in a separate lawsuit...more

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