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Employee Retirement Income Security Act (ERISA) Contract Terms

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - August 2025

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This month’s Friday Five explores recent decisions including deference to initial benefits decisions in de novo reviews, the recovery of fees incurred in pre-litigation administrative proceedings, proof of disability due to...more

Polsinelli

Sixth Circuit Holds TPAs Do Not Get a Free Pass from ERISA’s Fiduciary Duties

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In a decision about ERISA’s fiduciary duties and transparency, the Sixth Circuit in Tiara Yachts, Inc. v. Blue Cross Blue Shield of Michigan held that Blue Cross Blue Shield of Michigan (BCBSM), a third-party administrator...more

Hall Benefits Law

How Plan Sponsors Can Mitigate Risk in PBM Contracts

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For employers offering benefit plans, fiduciary responsibility is not just a legal designation. Under the Employee Retirement Income Security Act of 1974, as amended, the fiduciary duty is the highest standard of care...more

Hall Benefits Law

PBM Contracts Could Expose Plan Sponsors to Fiduciary Liability

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A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and reputational harm, say Hall...more

ArentFox Schiff

Federal Court Holds That Pathology Group States Viable Claims Against Multiplan and Cigna for Failing to Ensure In-Network Payment

ArentFox Schiff on

A federal court recently rejected arguments by MultiPlan, Inc. and Cigna Health and Life Insurance Company that they had no obligation to ensure payments at the contractually negotiated, in-network rate to Anatomic and...more

Maynard Nexsen

Can ERISA Plans Avoid California Insurance Code Section 10110.6 with Choice-of-Law Provisions?

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The Ninth Circuit is considering the enforceability of a choice of law provision in an ERISA plan in William White v. Guardian Life Insurance Company, et al., Case No. 24-2681, appeal pending from the United States District...more

Morgan Lewis - ML Benefits

Dont Forget to Invite the Committee to the Party Fiduciary Committees as Parties to a Vendor Contract

In many situations, practitioners recommend establishing a fiduciary committee to oversee ERISA-covered employee benefit plans. There are several reasons for this, including providing a well-defined process for...more

Fuerst Ittleman David & Joseph

The Role of Delegation Clauses in Motions to Compel Arbitration When Your Family Member Signs an Arbitration Agreement

It happens every so often: someone signs an agreement to arbitrate legal claims, the agreement has a solid clause delegating arbitrability issues to an arbitrator, and then a member of that person’s family files a claim in...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - May 2024

The May Monthly Minute highlights litigation wins for plan fiduciaries in a 401(k) fee case and a wilderness therapy exclusion case, and also sets out the 2025 HSA, HDHP, and excepted benefit HRA COLA adjustments....more

Goulston & Storrs PC

What's Market: Stand Alone Indemnities

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According to the American Bar Association's nine Private Target Mergers and Acquisitions Deal Point Studies, the use of stand-alone indemnities in reported private company M&A transactions has increased from 69% in its 2007...more

Proskauer - Employee Benefits & Executive...

Sixth Circuit Rejects Arbitration for Proposed Fiduciary Breach Class Action

The Sixth Circuit, in a matter of first impression for that Circuit, held an arbitration clause contained in an individual employment agreement did not apply to ERISA fiduciary breach claims brought on behalf of a defined...more

Patterson Belknap Webb & Tyler LLP

Commercial Division Reiterates Broad Scope of ERISA Preemption and Difficulty of Pleading Breach of Fiduciary Duty and Conversion...

The Commercial Division’s decision in Rockmore v. Plastic Surgery Associates, LLP demonstrates the broad scope of ERISA preemption and the difficulty of pleading breach of fiduciary duty and conversion claims alongside breach...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Joins Fourth Circuit in Holding that Equitable Estoppel is Barred Where Use Would Contradict...

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In Wong v. Flynn-Kerper, 999 F.3d 1205 (9th Cir. 2021), the Ninth Circuit barred the use of equitable estoppel to challenge the purchase price of company shares under an ERISA stock ownership plan when such use would...more

Jenner & Block

The “Defensive” 401(k) Plan

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No good deed goes unpunished. Those of us working with 401(k) plans are familiar with this sentiment. An employee benefit plan, as the name implies, is supposed to benefit employees. Yet benefit plans – particularly 401(k)...more

Holland & Knight LLP

Courts Split on Class Action Waivers, Arbitration Provisions in ERISA Litigation

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Courts have struggled through the years when considering the enforceability of mandatory class action waivers and arbitration provisions contained within Employee Retirement Income Security Act of 1974 (ERISA) plans and other...more

Alston & Bird

Class Action & MDL Roundup – Winter 2021

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Welcome back to the Class Action & MDL Roundup! Our winter edition covers notable class actions from the fourth quarter of 2020. In this edition, we find a common theme among COVID-19 class actions, the Tampa 2 defends...more

Faegre Drinker Biddle & Reath LLP

ERISA Benefit Denial Letter Must Identify Contractual Limitations Period

An Illinois federal court recently held that the failure to identify a contractual limitations period in a benefits denial letter renders the limitations period unenforceable, even before applicable regulations were changed...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Second Circuit Allows Breach of Fiduciary Duty Claim to Proceed Based on Misrepresentation...

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In Sullivan-Mestecky v. Verizon Communs. Inc., 961 F.3d 91 (2d Cir. 2020), the Second Circuit held that a claim under Section 502(a)(3) of ERISA could proceed, where the beneficiary pled that the plan and its agents...more

Seyfarth Shaw LLP

How to Minimize Judicial Review of ERISA Fiduciary Decisions

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Seyfarth Synopsis:  The courts have stated that their review of fiduciary decisions is both exacting and deferential.  A recent decision from the Court of Appeals for the Seventh Circuit offers help to ERISA benefit...more

Epstein Becker & Green

Addressing Data Privacy and Security Provisions in COVID-19 Related Service Provider Agreements and Beyond

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Employers’ engagement and use of various types of vendors has expanded recently, to include vendors who assist with office re-entry screening and contact tracing as employees return to work during the COVID-19 pandemic. ...more

Littler

Second Circuit Rules ERISA Plan Can Be Reformed Absent Any Mistakes, Fraud or Other Inequitable Conduct

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The Second Circuit recently considered for the first time whether the equitable remedy of reformation was available under the Employee Retirement Income Security Act (ERISA) where a court determined that the written terms of...more

Proskauer - Employee Benefits & Executive...

No Class Arbitration Available in PBM Case

The Eighth Circuit recently concluded that there was no contractual basis to conclude that a pharmacy benefit manager agreed to class arbitration with four pharmacies because the agreement did not use the word “class” or...more

Proskauer - Employee Benefits & Executive...

District Court Enforces Forum Selection Clause in Employer’s Benefits Plan

A federal district court in North Carolina enforced a forum selection clause in a short-term disability plan and on that basis transferred the case to Wisconsin federal court. In so ruling, the court explained that ERISA’s...more

Seyfarth Shaw LLP

Stunning Development — The Ninth Circuit Enforces an ERISA Plan Arbitration and Class Action Waiver Provision

Seyfarth Shaw LLP on

Seyfarth Synopsis: Reversing course and overruling previous precedent, the Court of Appeals for the Ninth Circuit now holds that ERISA plan mandatory arbitration and class action waiver provisions are enforceable, and can...more

Carlton Fields

Ninth Circuit Steps In-Line on Arbitrability of ERISA Claims

Carlton Fields on

The Ninth Circuit, in back-to-back opinion and memorandum decisions in Dorman v. Charles Schwab Corp., overruled long-standing precedent that ERISA claims are not arbitrable. The plaintiff, a former Schwab employee, filed a...more

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