Mealey's ERISA
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December 06, 2024
Denial Of STD Claim Was Not Arbitrary, Capricious, Minnesota Federal Judge Says
MINNEAPOLIS — The denial of a short-term disability (STD) claim was not arbitrary and capricious because a reasonable person could have reached the same decision as the disability insurer and because the claimant’s medical records do not show that his conditions worsened to a point where he was unable to work, a Minnesota federal judge said in granting the insurer’s motion for summary judgment.
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December 06, 2024
New York Federal Judge Says Disability Claimant Met Burden, Is Owed Benefits
NEW YORK — A New York federal judge granted judgment in favor of a disability claimant after determining that the claimant met her burden of proving by a preponderance of the evidence that she was disabled from performing the duties of her own occupation as a result of symptoms caused by depression, anxiety and posttraumatic stress disorder (PTSD)
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December 05, 2024
Doctor Entitled To Almost $98K In Attorney Fees For Success On Disability Claim
SAN FRANCISCO — A pediatrician who successfully prevailed on her claim for long-term disability (LTD) benefits based on her high risk of exposure to the COVID-19 virus is entitled to $97,965 in attorney fees and $625 in costs because the pediatrician succeeded on the merits of her disability claim and the disability insurer presented no special circumstances that would warrant against an award, a California federal judge said in granting the pediatrician’s motion for attorney fees and costs.
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December 05, 2024
After Getting Claims Data, Health Plan And Sponsor Sue Third-Party Administrator
RICHMOND, Va. — Suing a third-party administrator (TPA) in Virginia federal court, an employer and its self-funded health plan allege that the TPA violated Employee Retirement Income Security Act fiduciary standards “by, among other things, (i) paying more for healthcare claims than was even billed, (ii) securing kickbacks from providers, (iii) double-paying claims, and (iv) pocketing rebates.”
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December 05, 2024
Denial Of LTD Benefits Claim Was Not Abuse Of Discretion, Texas Federal Judge Says
DALLAS — A disability insurer did not abuse its discretion in denying a claim for long-term disability (LTD) benefits following remand of the LTD claim because substantial evidence supports the insurer’s finding that the claimant was capable of working in a sedentary position, a Texas federal judge said in granting judgment in favor of the disability insurer.
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December 05, 2024
Judge Awards Plaintiffs Almost $60,000 For Discovery Row In Dialysis Case
COLUMBUS, Ohio — Awarding a little more than half of the amount the plaintiffs requested, an Ohio federal judge has ordered a hospital and its health plan to pay $59,629.38 in attorney fees and costs in connection with a discovery dispute in an Employee Retirement Income Security Act case over dialysis payment rates.
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December 05, 2024
Total Disability Questions Should Be Certified To La. High Court, Claimant Says
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals should withdraw an unpublished opinion entered in favor of a disability insurer and certify two questions of law to the Louisiana Supreme Court regarding whether a disability claimant was required to prove that she was disabled from performing all of the duties of her occupation as a pharmacist in order to meet the policy’s definition of total disability, the claimant maintains.
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December 05, 2024
GAO: Crypto Options Seem To Be A Small Part Of The 401(k) Market
WASHINGTON, D.C. — In a report released publicly Dec. 4 regarding crypto assets in 401(k)s, the U.S. Government Accountability Office (GAO) noted data and projection limitations, saying in part that “certain crypto assets continue to trade in markets that do not have investor protections or comprehensive oversight.”
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December 05, 2024
Amicus-Supported Bid For 3rd Circuit Rehearing Fails In Trust Benefits Dispute
PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Dec. 4 denied a motion for panel and en banc rehearing of a nonprecedential decision; the motion drew an amicus curiae brief in which the Pension Rights Center argued the that decision “seriously misreads” Gruber v. Hubbard Bert Karle Weber, Inc. and “will be read closely by those who can replicate it as an employer escape hatch from the responsibilities of” the Employee Retirement Income Security Act.
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December 04, 2024
Federal Judge Affirms Denial Of Disability Claimant’s Motion To Clarify Record
SPRINGFIELD, Mass. — A Massachusetts federal judge affirmed a magistrate judge’s denial of a disability claimant’s motion to clarify and complete a claim record after determining that no part of the magistrate judge’s order is clearly erroneous or contrary to law.
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December 04, 2024
Government Files Amicus Brief Urging Reversal Of 2nd Circuit ERISA Ruling
WASHINGTON, D.C. — A day after the U.S. government filed an amicus curiae brief in the U.S. Supreme Court supporting petitioners on the question of what is necessary to state an Employee Retirement Income Security Act claim for a prohibited transaction between a plan and a party in interest, the petitioners on Dec. 3 submitted a corrected merits brief.
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December 03, 2024
In Partial Reversal, Judge Addresses Standing In ERISA Pension Calculation Row
CENTRAL ISLIP, N.Y. — Partly reversing an earlier ruling in the Employee Retirement Income Security Act dispute over using a half-century-old mortality table to calculate joint and survivor annuities (JSAs), a New York federal judge allowed claims asserted on behalf of the plan to proceed in the putative class action while the plaintiffs’ individual claims are arbitrated.
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December 02, 2024
High Court’s Look At ERISA Prohibited Transaction Ruling Draws Amicus Input
WASHINGTON, D.C. — Four amicus curiae briefs, the most recent filed Nov. 27, have been filed in the U.S. Supreme Court supporting the petitioners in the high court’s review of what is necessary to state an Employee Retirement Income Security Act claim for a prohibited transaction between a plan fiduciary and a party in interest.
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December 02, 2024
$5M Class Settlement In ERISA Fees, Funds Case Gets Preliminary Approval
PHILADELPHIA — A Pennsylvania federal judge has granted preliminary approval to a $5 million class settlement in an Employee Retirement Income Security Act suit challenging a multiemployer retirement plan’s fund choices, share classes and record-keeping fees.
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December 02, 2024
Amicus Bid To Support Dismissal In Pension Risk Transfer Case Draws Opposition
ALBANY, N.Y. — The ERISA Industry Committee (ERIC) has asked a New York federal court for permission to file an amicus curiae brief in a pension risk transfer (PRT) case it says is “pursuing a novel, speculative theory that would limit plan sponsors’ ability to manage future pension expenses,” drawing opposition from retirees who argue that the proposed brief is too late, too long, “offers no unique information or insight that can assist the Court, and would prejudice Plaintiffs.”
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November 27, 2024
Partial Judgment On Pleadings Granted In Long-Running ERISA Case
NEW YORK — A company that provided investment advice to two retirement plans saw its motion for judgment on the pleadings partly granted in a long-running Employee Retirement Income Security Act putative class action challenging fees and funds, with a New York federal judge ruling that issue preclusion applies to some of the allegations.
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November 27, 2024
Split 9th Circuit Addresses Retirement Contributions In Chapter 13 Bankruptcy
SAN FRANCISCO — In a reversal urged by amici curiae the National Association of Consumer Bankruptcy Attorneys (NACBA) and the National Consumer Bankruptcy Rights Center (NCBRC), a split Ninth Circuit U.S. Court of Appeals panel joined “the majority of courts that have considered the question in concluding that voluntary retirement contributions do not constitute disposable income” in Chapter 13 bankruptcies.
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November 27, 2024
Effort To Revive Pension Row That Was Ruled Untimely Draws 2nd Amicus Brief
NEW YORK — Weighing in on an Employee Retirement Income Security Act appeal that already drew an amicus curiae brief from the U.S. Department of Labor (DOL), the American Benefits Council and two other amici support part of the appellees’ argument that the Second Circuit U.S. Court of Appeals should affirm that all claims are time-barred in the putative class action in a joint and survivor annuity (JSA) dispute over allegedly outdated mortality tables.
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November 26, 2024
Citing Loper Bright, Macy’s Again Seeks Dismissal In Tobacco Surcharge Lawsuit
COLUMBUS, Ohio — Amid a recent wave of at least 15 putative class actions challenging health plan tobacco surcharges, defendants in a similar suit the U.S. Department of Labor initiated seven years ago filed Nov. 25 motions in Ohio federal court calling Loper Bright Enterprises v. Raimondo “a landmark change in the law” that supports dismissing the remaining claims against them.
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November 22, 2024
COMMENTARY: 2024 Key Insurance Decisions, Trends & Developments & A Look Ahead To 2025
By Scott M. Seaman, Pedro E. Hernandez and Lisa M. Roccanova
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November 22, 2024
Rehearing Bid For 9th Circuit’s Mandamus Grant In Behavioral Health Row Fails
SAN FRANCISCO — With no substantive explanation for rejecting a petition for rehearing en banc regarding an unpublished ruling granting a mandamus petition, the Ninth Circuit U.S. Court of Appeals let stand its latest ruling in an Employee Retirement Income Security Act case where health insurance plan participants sought reprocessing of nearly 67,000 mental health and substance use disorder treatmentclaims.
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November 22, 2024
Discovery Row Over Info DOL Gave Plaintiffs Grabs House Committee’s Attention
DENVER — Discovery developments in a putative class action challenging an employee stock ownership plan (ESOP) deal are the focus of a Nov. 21 letter in which the chairwoman of U.S. House Committee on Education and the Workforce asks the inspector general of the U.S. Department of Labor (DOL) for an investigation because “DOL appears to be working in concert with plaintiffs’ attorneys to circumvent the discovery protections” of the Federal Rules of Civil Procedure.
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November 21, 2024
U.S. High Court Is Again Asked To Review An ERISA Effective Vindication Decision
WASHINGTON, D.C. — Arguing in part that “statutory construction errors caused the Sixth Circuit to find that a participant has a statutory right to represent other participants’ financial interests that Congress did not provide for” in the Employee Retirement Income Security Act, 401(k) plan fiduciaries asked the U.S. Supreme Court to review the decision involving application of the effective vindication doctrine.
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November 21, 2024
Amicus Supports Rehearing Bid In 3rd Circuit Trust Benefits Row
PHILADELPHIA — The Pension Rights Center has been granted permission to file an amicus curiae brief in which it urges panel and en banc rehearing of a nonprecedential Third Circuit U.S. Court of Appeals decision it argues “seriously misreads” Gruber v. Hubbard Bert Karle Weber, Inc. and “will be read closely by those who can replicate it as an employer escape hatch from the responsibilities of” the Employee Retirement Income Security Act.
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November 21, 2024
Split 6th Circuit Reverses Dismissal Of ERISA Funds, Share Classes Challenge
CINCINNATI — A split Sixth Circuit U.S. Court of Appeals panel on Nov. 20 revived a challenge to a retirement plan’s retention of the passively managed Northern Trust Focus Funds suite of target date funds (TDFs) and choice of share classes, with the majority saying in part that the dissent sets “an inappropriately exacting standard” and the dissenter opining that “my colleagues open the door to ‘speculative’” lawsuits.