News & Analysis as of

Plan Administrators Employee Retirement Income Security Act (ERISA) Appeals

Morris, Manning & Martin, LLP

A Friendly DOL Amicus Brief on Forfeitures

On July 9th, the Secretary of Labor filed an amicus brief with the Ninth Circuit relating to the appeal of Hutchins v. HP, Inc. In that case, a participant claimed that forfeitures should have been used to offset plan...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Ninth Circuit Affirms ERISA Plan Administrator’s Decision, Validates Use of Industry Guidelines and Medical Evidence

On March 5, 2019, Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California issued his opinion in Wit v. United Behavioral Health, in which he attempted to significantly change how...more

Proskauer - Employee Benefits & Executive...

Second Circuit Decision Illustrates Importance of Following Claims Procedures, and Drastic Consequences of Procedural Misstep

In McQuillin v. Hartford Life and Accident Ins. Co., 36 F.4th 416 (2d Cir. 2022), the U.S Court of Appeals for the Second Circuit restored a claimant’s action for disability benefits due to the plan administrator’s failure to...more

Verrill

Supreme Court Declines to Address Pleading Standards in Stock-Drop Litigation – Retirement Plans Committee of IBM v. Jander...

Verrill on

On November 9, 2020, the Supreme Court declined to consider an appeal from the Second Circuit Court of Appeals in Retirement Plans Committee of IBM v. Jander, leaving unresolved for now questions about the specificity...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020

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As we enter the final months of 2020, this is a time to reflect on a year of unprecedented challenges. Although Covid-19 changed our lives in many ways, it did not halt new legal developments in the life, health and...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

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Tenth Circuit Finds District Court Applied Wrong Standard of Review in Evaluating Plan...

Hinshaw & Culbertson LLP on

In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more

Faegre Drinker Biddle & Reath LLP

Tenth Circuit Interpretation of ERISA Notice Requirement Impacts Plan Administrator’s Right to Deferential Standard of Review

When an ERISA plan delegates authority to the plan administrator to interpret the plan documents for benefit determinations, the plan administrator typically is entitled to a deferential standard of judicial review, and...more

Rivkin Radler LLP

Employee Relations Law Journal – From the Courts

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North Carolina District Court Permits Plan’s Lawsuit Against Third Party Administrator to Continue A federal district court in North Carolina has ruled that a plan subject to the Employee Retirement Income Security Act of...more

Rivkin Radler LLP

Employee Benefit Plan Review – From the Courts

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Ninth Circuit Affirms Decision Rejecting Suit Seeking Early Retirement Benefits - The U.S. Court of Appeals for the Ninth Circuit has affirmed a district court’s decision rejecting a plaintiff’s lawsuit seeking to overturn...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: First Circuit Clarifies ERISA's Timing Requirements for Appealing Adverse Benefits Determination

In Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 (1st Cir. 2019) the U.S. Court of Appeals for the First Circuit clarified ERISA's timing requirements with respect to appealing an adverse benefits determination...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Fifth Circuit Defines Meaning of "Regular Occupation" Under LTD Policy

In Nichols v. Reliance Standard Life Ins. Co., 924 F.3d 80 (5th Cir. 2019), the U.S. Court of Appeals for the Fifth Circuit held that when an LTD policy funding an ERISA plan defines "regular occupation" as the way the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Reverses Award of Attorneys' Fees

In Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., 29 U.S. App. LEXIS 36542 (N.D. Cal. Dec. 10, 2019), the Ninth Circuit reversed a district court's award of attorneys' fees to an ERISA claimant as...more

Holland & Knight LLP

Eighth Circuit Upholds ESOP Administrator's Decision on Death Benefit Claim

Holland & Knight LLP on

• The U.S. Court of Appeals for the Eighth Circuit has affirmed a U.S. District Court's application of deferential standard to the review of an employee stock ownership plan (ESOP) administrator's decision based on broad...more

Holland & Knight LLP

Seventh Circuit Holds That ERISA Does Not Pre-empt Illinois Slayer Statute

Holland & Knight LLP on

• In Laborers' Pension Fund v. Miscevic, the U.S. Court of Appeals for the Seventh Circuit held that the Illinois slayer statute is one state statute that is not pre-empted by ERISA. A slayer statute is a law that prevents an...more

Seyfarth Shaw LLP

Vindication! Fifth Circuit Reverses Notorious District Court Health Care Fraud Decision

Seyfarth Shaw LLP on

Seyfarth Synopsis: In a major victory for ERISA plans and other payors, the Fifth Circuit recently overturned a district court’s notorious decision in favor of a healthcare provider and reinstated a plan administrator’s...more

BCLP

Seventh Circuit Holds that ERISA does not Preempt State “Slayer Statute”

BCLP on

We turn once again to the sad and difficult task that plan administrators face when distributing the benefits of a participant who has been murdered by his or her designated beneficiary. Sad for obvious reasons. Difficult...more

Mintz - Employment Viewpoints

The Ninth Circuit Weighs in on ERISA’s Plan Document and Summary Plan Description Requirements: Mull v. Motion Picture Ind. Health...

Mull v. Motion Picture Ind. Health Plan educates employers on the basics of the requirements of the Employee Retirement Income Security Act (ERISA) governing plan documents and summary plan descriptions. The lessons are...more

Snell & Wilmer

Dealing with Long-Winded Out-of-Network Provider Nuisance Letters

Snell & Wilmer on

Over the past couple years, more and more of my clients with self-funded plans have received letters from out-of-network providers appealing denied claims. The letters are usually 20 to 30 pages long, not very specific, and...more

McDermott Will & Emery

Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

McDermott Will & Emery on

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

Jackson Walker

Fifth Circuit Upholds ERISA Disability and Life Benefit Denials

Jackson Walker on

In two decisions issued last month, the Fifth Circuit upheld ERISA plan denials of disability and life benefits, confirming its deferential approach in most ERISA benefit cases....more

Baker Donelson

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

Baker Donelson on

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

Stinson - Benefits Notes Blog

Eighth Circuit Decisions Reminds Employers Of Importance Of Granting ERISA Plan Administrators Discretion To Interpret Plan Terms

Recently, the United States Court of Appeals for the Eighth Circuit released an opinion which highlights the importance of ensuring ERISA plan documents grant plan administrators the discretion to construe and interpret the...more

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