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557 Matching News Items

1.  Follow the Numbers: the Evolution in ERISA Law
Stephen Rosenberg, The Wagner Law Group Link to more items from this source
June 2, 2008
Excerpt: I have noted two things - well, many things, only two of which are relevant to this post - in the past, one the line that Marx was wrong about a lot of things, but he was right that everything is economics, and the second that we are beginning to see an incremental evolution in the law of ERISA to account for the reality that pensions - predominant at the time of many of the earlier, key court rulings on ERISA - have been supplanted by defined contribution plans.
2.  Law Group Argues That Court Misapplied 'Thole' Ruling in ERISA Case
planadviser Link to more items from this source
Aug. 11, 2021
"A nonprofit law group has asked an appellate court to narrow the standing for plaintiffs suing Universal Health Services over investments in its defined contribution (DC) plan to only those investments in which the plaintiffs were invested." [Boley v. Universal Health Serv. Inc., No. 21-2104 (3d Cir. amicus brief filed Aug. 9, 2021)]
3.  The Wagner Law Group Asks DOL for Cybersecurity Guidance
The Wagner Law Group Link to more items from this source
Oct. 5, 2020
"A number of legal questions remain unanswered and there is an acute need for comprehensive guidance from the DOL. These questions include: [1] what is the specific personal and/or confidential participant information that must be safeguarded by plan fiduciaries; [2] what standard of care applies to the protection of participant personal information; [3] what is the plan administrator's responsibility with respect to disclosing to participants the unauthorized appropriation of participant information; and [4] whether state cybersecurity, privacy, consumer protection or other laws are pre-empted by ERISA."
4.  Church Plan Litigation: Out of the ERISA Woods Into the State Law Forest
Groom Law Group Link to more items from this source
Dec. 28, 2021
"A recent slip opinion in a case involving a church plan maintained by a hospital in upstate New York reminds us that being a non-ERISA plan brings its own set of challenges because state law is not preempted. In particular, the case illustrates that, if a church plan starts to fail to pay benefits, its sponsor -- as well as related entities such as the church it is controlled by or associated with -- may find themselves subject to various pension-related claims under state law." [Hartshorne v. The Roman Catholic Diocese of Albany, New York, 2021 NY Slip Op. 07329 (3rd App. Div., Dec. 23, 2021)]
5.  Supreme Court Holds That ERISA Does Not Preempt Arkansas PBM Law: The Impact on Employer Sponsored Group Health Plans
Mintz Link to more items from this source
Jan. 3, 2021
"The decision gives the green light for state-by-state regulations of PBM networks and payment practices. The impact of Rutledge on employer-sponsored group health plans, particularly multi-state arrangements, is difficult to underestimate. Employers will need to grapple with the inevitable proliferation of state PBM laws that, while purporting to regulate the relationship between a PBM and a pharmacy, will in all likelihood have unintended and unwelcome consequences for their group health plans." [Rutledge v. Pharmaceutical Care Mgmt. Assoc., No. 18-540 (S. Ct. Dec. 10, 2020)]
6.  Attorney Work Product in the ERISA Context (PDF)
The Wagner Law Group, via Benefits Law Journal Link to more items from this source
Mar. 25, 2022
17 pages. "Rooted in the common law of trusts, the fiduciary exception is based upon the rationale that the benefit of any legal advice obtained by a trustee regarding matters of plan administration runs to the beneficiaries. ... Applying the ERISA fiduciary's role to the role of trustees at common law, courts have relied upon one of two related rationales in recognizing the fiduciary exception."
7.  Respondeat Superior in the ERISA Context (PDF)
The Wagner Law Group, via Benefits Law Journal Link to more items from this source
Mar. 5, 2019
"Respondeat superior claims in the ERISA context may be made in one of two ways; while there is no circuit split on this issue, there is a split of authority as to the manner in which these claims should be addressed, and this article considers these rulings."
8.  How The ERISA Landscape May Shift This Year (PDF)
Groom Law Group, via Law360 Link to more items from this source
Jan. 5, 2022
"Within the next few months, the U.S. Supreme Court will weigh in for the first time on the pleading standard for challenges to excessive fees in retirement plans.... At the circuit court level, there were important new decisions in 2021 regarding the enforceability of arbitration agreements and class action waivers under ERISA, and the U.S. Court of Appeals for the Third Circuit agreed to hear an important interlocutory appeal regarding whether defined contribution plan participants can challenge investment options in which they were not invested. And there continues to be a steady flow of health plan-related lawsuits in several areas, including with respect to [COBRA] notices and mental health parity."
9.  State Law Claims Under Group Life Insurance Policy Were Preempted by ERISA
Williams Mullen Link to more items from this source
Nov. 20, 2015
"On ERISA preemption grounds, a federal court has ruled against state law claims asserted by the beneficiary of a former school teacher who sought benefits from a group life insurance policy.... [A recent case] illustrates how a governmental employee's life insurance benefits may fall within the scope of ERISA when sponsored by a non-governmental 'employee organization' and be subject to the full weight of ERISA." [Woods v. American United Life Ins. Company, No. 1:15-cv-859 (N.D. Ala. Nov. 13, 2015)]
10.  Some More Thoughts on the Primacy of the ERISA Plan Document
Stephen Rosenberg, The Wagner Law Group Link to more items from this source
July 23, 2008
Excerpt: Although the court was not delving too deeply into this particular issue, the court noted that 'in more recent cases, the First Circuit has held that courts should not look beyond the express terms of an ERISA-regulated plan unless the disputed term is ambiguous,' and that '[i]n ERISA cases ... the central issue must always be what the plan promised ... and whether the plan delivered.'
11.  Experimental and Investigational Treatments and Procedures Under ERISA Group Health Plans (PDF)
The Wagner Law Group, via Benefits Law Journal Link to more items from this source
Nov. 3, 2016
17 pages. "While most group health plans contain an exclusion for medical and investigational procedures, the scope and the pace at which medical procedures and treatments are tested in the 21st century makes this an extremely difficult standard to apply. There is no bright-line test, experts frequently disagree as to when the line has been crossed, and in some instances the stakes are literally life and death. This article discusses some potential pitfalls for plan administrators and offers suggestions on how to address this difficult aspect of group health care administration."
12.  40th Anniversary of ERISA: What Is the Context? (PDF)
The ERISA Law Group Link to more items from this source
Mar. 6, 2017
"Many individuals, employers, businesses and institutions have forcefully challenged any number of changes in ERISA throughout its history.... Some assert government should not place additional restrictions on employers' plans.... But, if the employer wants any of the truly one-of-a-kind tax benefits for itself and its employees, then there are rules that are intended to advance policies that are laudable."
13.  Ninth Circuit: ERISA Group Health Plan's Self-Help Provision Is Enforceable
The Wagner Law Group Link to more items from this source
Jan. 4, 2023
"The Ninth Circuit Court of Appeals ... has determined that an ERISA-covered group health plan has the right to recoup payments made to a participant to cover medical benefits when she subsequently recovers the amounts from a third party. In deciding the matter, the Ninth Circuit held that the plan's 'self-help' remedy of recoupment did not violate or undermine ERISA." [Mull v. Motion Picture Industry Health Plan, No. 20-56315 (9th Cir. Jul. 25, 2022)]
14.  Canadian Court Rejects Multiemployer Plan's ERISA Controlled-Group Liability Claims (PDF)
Groom Law Group Link to more items from this source
May 14, 2017
"The court held that ERISA cannot be applied to hold Canadian entities liable for multiemployer withdrawal liability simply because those entities are owned by a common parent.... The decision marks one of the few instances to date that a court has analyzed ERISA's reach across the U.S. border, and may make it more difficult for multiemployer plans and the PBGC to seek payment from foreign entities of liabilities associated with underfunded multiemployer and single employer plans." [Walter Energy Canada Holdings, Inc. (Re), 2017 BCSC 709, May 1, 2017]
15.  New Illinois State Law Imposes Disclosure Requirements on Group Health Plans
Miller Johnson Link to more items from this source
Mar. 11, 2022
"The CCDA requires employers that sponsor group health plans with employees in Illinois to disclose a comparison of the plan's coverage to certain 'Essential Health Benefits' required by Illinois state law.... The CCDA broadly applies, regardless of the employer's size or its location, to fully insured and self-funded group health plans. Additionally, the Illinois [DOL] has taken the position that the CCDA also applies to ERISA-covered self-funded group health plans."
16.  Lame Duck Congress Finds Courage to Repeal ERISA; Employers to Use Honor System (PDF)
The ERISA Law Group Link to more items from this source
Dec. 30, 2014
[BenefitsLink note: A bit of holiday humor.] "Under the new honor system, employers can deduct on their income tax returns whatever amounts they deem appropriate for their health care and retirement plan contributions, instead relying upon their notions of reasonableness, patriotism and government utility as their guide. No longer shackled with eligibility, vesting, investment, nondiscrimination, disclosure or any rules of any kind, employers and fiduciaries should now redesign their plans and operate them as their conscience and business acumen dictate."
17.  Tenth Circuit: ERISA Preempts Oklahoma Law Regulating PBMs
The Wagner Law Group Link to more items from this source
Oct. 1, 2023
"[The court] opined that the Act's discount prohibition requires that cost-sharing and copayments be the same for all network pharmacies 'whether retail or mail-order; standard or preferred.' ... [It] found that this prohibition ... directs or forbids an element of plan structure or benefit design. Next, the court noted that the Act's provider participation requirement forces plans to 'include many more brick-and-mortar pharmacies…. Because adding pharmacies costs plans money, this is a choice that plans might not otherwise make.' It found that this requirement also impermissibly affects plan structure or benefit design." [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023)]
18.  What Happens When ERISA and the Law of Insurance Coverage Collide?
Stephen Rosenberg, The Wagner Law Group Link to more items from this source
Apr. 13, 2008
Excerpt: Wow, I guess this is really Seventh Circuit week here, with, I guess, a particular focus on the jurisprudence of Judge Easterbrook, whose opinion in Baxter I discussed in my last post. This time, I turn to his decision from Wednesday in Federal Insurance Co. v. Arthur Andersen, which strikes right at the intersection of the two subject areas in the title of this blog, insurance and ERISA.
19.  Employers' State Law Claims of Insurer Misrepresentation Not Preempted by ERISA
The Wagner Law Group Link to more items from this source
May 2, 2019
"Three employers provided their employees with health care insurance based on the insurer's representations that the monthly premiums would reflect only the cost of providing benefits. The employers later said these representations were false and that the insurer padded the premiums with hidden surcharges, which it used to pay kickbacks and to buy unauthorized insurance products.... [T]he Ninth Circuit upheld the employers' right to sue under state law ... [ruling] that the duties implicated in the employers' state-law claims do not derive from ERISA." [The Depot, Inc. v. Caring for Montanans, Inc., No. 17-35597 (9th Cir. Feb. 6, 2019)]
20.  ERISA Doesn't Preempt Montana's Mental Health Parity Law
The Wagner Law Group Link to more items from this source
Jan. 29, 2018
"A federal district court ... determined that ERISA did not preempt Montana's mental health parity law and that the state law was therefore applicable against [a] long-term disability insurer. The court reached this conclusion because the state law regulated health insurance policies and was directed at entities that engage in insurance." [Sand-Smith v. Liberty Life Assurance Co. of Boston, No. 17-0004 (D. Mont. Sept. 20, 2017)]
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