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51 Matching News Items

1.  Audio: Oral Argument in Texas v. Azar Before the Fifth Circuit Court of Appeals (MP3)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
July 9, 2019
Recording of oral argument on July 9, 2019 (one hour and 46 minutes). [Texas v. Azar, No. 19-10011 (5th Cir. oral arg. Jul. 9, 2019)]
2.  Text of Fifth Circuit Opinion Reversing District Court's Dismissal of BP Stock Drop Claim (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Sept. 27, 2016
"[T]he district court here erred when it altered the language of Fifth Third to reach its holding. In Fifth Third, the Supreme Court stated that the plaintiff's proposed alternative must be one that 'a prudent fiduciary in the same circumstances would not have viewed as more likely to harm the fund than to help it.' ... But here the district court stated that it could not determine, 'on the basis of the pleadings alone, that no prudent fiduciary would have concluded that [the alternatives] would do more good than harm' ... These statements are not equivalent. Under the Supreme Court's formulation, the plaintiff bears the significant burden of proposing an alternative course of action so clearly beneficial that a prudent fiduciary could not conclude that it would be more likely to harm the fund than to help it. Here, the stockholders have failed to do so." [Whitley v. BP, No. 15-20282 (5th Cir. Sept. 26, 2016)]
3.  Fifth Circuit Reverses Award of Benefits to Stepchildren in Absence of Valid Beneficiary Designation (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Aug. 9, 2012
Participant died without a valid beneficiary designation; the Thrift Plan document provided for distribution of benefits to various relatives. The Plan Administrator interpreted the term "children" as used in the plan to mean biological or legally adopted children. The Fifth Circuit Court of Appeals ruled that the district court erred when it set aside the Plan Administrator's decision and granted judgment for the deceased's stepchildren, because (1) the Plan Administrator's interpretation of the term "children" was legally correct; and (2) nothing in the plan or ERISA required the Plan Administrator to incorporate the concept of equitable adoption into the plan's definition of "children." [Herring v. Campbell, 5th Cir. No. 11-40953 (August 7, 2012)]
4.  Text of Fifth Circuit Opinion: ACA Individual Mandate Is Unconstitutional; Remanding to District Court as to Severability (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Dec. 18, 2019
98 pages. "First, there is a live case or controversy because the intervenor-defendant states have standing to appeal and, even if they did not, there remains a live case or controversy between the plaintiffs and the federal defendants. Second, the plaintiffs have Article III standing to bring this challenge to the ACA; the individual mandate injures both the individual plaintiffs, by requiring them to buy insurance that they do not want, and the state plaintiffs, by increasing their costs of complying with the reporting requirements that accompany the individual mandate. Third, the individual mandate is unconstitutional because it can no longer be read as a tax, and there is no other constitutional provision that justifies this exercise of congressional power. Fourth, on the severability question, we remand to the district court to provide additional analysis of the provisions of the ACA as they currently exist.... "We [direct] the district court to employ a finer-toothed comb on remand and conduct a more searching inquiry into which provisions of the ACA Congress intended to be inseverable from the individual mandate.... It may still be that none of the ACA is severable from the individual mandate, even after this inquiry is concluded. It may be that all of the ACA is severable from the individual mandate. It may also be that some of the ACA is severable from the individual mandate, and some is not. But it is no small thing for unelected, life-tenured judges to declare duly enacted legislation passed by the elected representatives of the American people unconstitutional. The rule of law demands a careful, precise explanation of whether the provisions of the ACA are affected by the unconstitutionality of the individual mandate as it exists today.... "Remand is appropriate in this case for a second reason: so that the district court may consider the federal defendants' new arguments as to the proper scope of relief in this case. The relief the plaintiffs sought in the district court was a universal nationwide injunction ... Now [the defendants] have changed their litigation position to argue that relief in this case should be tailored to enjoin enforcement of the ACA in only the plaintiff states -- and not just that, but that the declaratory judgment should only reach ACA provisions that injure the plaintiffs." [Texas v. U.S., No. 19-10011 (5th Cir. Dec. 18, 2019)]
5.  Fifth Circuit Finds Broad Fiduciary Responsibility in the Handling of U.S. Plan Document Requests
Osler, Hoskin & Harcourt LLP Link to more items from this source
Oct. 24, 2011
In Kujanek v. Houston Poly Bag Ltd, the Court of Appeals for the Fifth Circuit required a profit sharing administrator who had not responded to requests for documents and distribution/rollover forms to make up almost $184,000 in account losses incurred by the participant while his distribution was delayed.'
6.  Text of Fifth Circuit Opinion Upholding Vacatur of DOL's Rejection of ERISA Coverage for Health Plan of Data-Mining Limited Partnership (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Aug. 18, 2022
17 pages. "The key factors the Department ignored were its prior advisory opinions discussing the term 'working owner' and its regulation adopting a definition of the term in a related context.... [T]he Department spills much ink in its response brief either explaining away the prior advisory opinions and the regulation or arguing that the definitions they adopted are consistent with the ones adopted elsewhere. But all those arguments were not made in the final agency action itself and thus aren't 'contemporaneous explanations.' ... They are instead 'impermissible post hoc rationalizations.' ... And these post hoc rationalizations confirm that the action here is arbitrary and capricious."   [Data Marketing Partnership, LP v. DOL, No. 20-11179 (5th Cir. Aug. 17, 2022)]
7.  Text of Fifth Circuit Opinion: Religious Accommodation for Contraceptive Coverage Does Not Violate RFRA (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
June 23, 2015
"Although the plaintiffs have identified several acts that offend their religious beliefs, the acts they are required to perform do not include providing or facilitating access to contraceptives. Instead, the acts that violate their faith. are those of third parties. Because RFRA confers no right to challenge the independent conduct of third parties, we join our sister circuits in concluding that the plaintiffs have not shown a substantial burden on their religious exercise."
8.  Fifth Circuit Opinion, Extending Stay of Enforcement of OSHA Vaccine Mandate (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Nov. 14, 2021
22 pages. "[T]he Mandate's strained prescriptions combine to make it the rare government pronouncement that is both overinclusive (applying to employers and employees in virtually all industries and workplaces in America, with little attempt to account for the obvious differences between the risks facing, say, a security guard on a lonely night shift, and a meatpacker working shoulder to shoulder in a cramped warehouse) and underinclusive (purporting to save employees with 99 or more coworkers from a 'grave danger' in the workplace, while making no attempt to shield employees with 98 or fewer coworkers from the very same threat). The Mandate's stated impetus -- a purported 'emergency' that the entire globe has now endured for nearly two years, and which OSHA itself spent nearly two months responding to -- is unavailing as well. And its promulgation grossly exceeds OSHA's statutory authority. " [BST Holdings v. OSHA, No. 21-60845 (5th Cir. stay upheld Nov. 12, 2021)]
9.  Text of Fifth Circuit Opinion: State Statute Requiring Plan to Honor Assignments Is Preempted by ERISA (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Sept. 12, 2019
"The anti-assignment clause at issue here articulates that the assignment of legal rights is prohibited in no less than five different ways ... An average plan participant would understand that language to mean exactly what is says ... [A] state statute requiring plan administrators to honor assignments made to third-party healthcare providers would necessarily 'relate to' the administration of those plans.... [We] hold that that [the Tennessee statute] is preempted by ERISA, and that the district court erred in reaching a determination to the contrary." [Dialysis Newco Inc. v. Community Health Systems Group Plan, No. 18-40863 (5th Cir. Sept. 11, 2019)]
10.  Fifth Circuit Rules Disabled Employee Can Assert Retaliation Claim Concerning Termination of Health Benefits (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Dec. 13, 2013
"[W]hen a current employee suffers a disability that (1) makes him unable to perform his job duties for a period of time; and (2) entitles him to benefits under a plan that qualifies as an ERISA plan, it would be unconscionable to require that employee -- who, but for his new disability was qualified for his position -- to demonstrate that he was qualified for his position at the time of his termination in order to prove a retaliation claim. If such a requirement were part of the employee's prima facie case, a disabled employee that was unable to perform his job for a period of time would never be able to establish a prima facie case of ERISA retaliation, even if it was otherwise undisputed that the employer terminated him solely to avoid paying ERISA benefits." [Jimmy Parker v. Cooper Tire & Rubber Company, 12-60503 (5th Cir. Dec. 12, 2013)]
11.  Text of Fifth Circuit Case Finding Wal-Mart Had No 'Insurable Interest' in COLI Policies (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Feb. 2, 2004
23 pages. Excerpt: We hold that: 1) Texas law, which requires an 'insurable interest' for valid life insurance policies, governs the dispute; 2) an employer has no insurable interest in an ordinary employee under Texas law; ... Wal-Mart acted in pursuit of tax benefits related to the deductibility of premium payments ... After Congress and the IRS eliminated the tax advantages of Wal-Mart's COLI program, Wal-Mart unwound the otherwise unprofitable program[.] [Mayo v. Hartford Life Ins. Co., No. 02-21059 (5th Cir. Jan. 5, 2004)]
12.  Text of Fifth Circuit Decision: Administrator of Self-Funded Plans Not Subject to Texas Prompt Payment Law (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Feb. 12, 2016
21 pages. "A Texas statute ... requires healthcare insurers to make coverage determinations and pay claims made by preferred healthcare providers within a specified time or face penalties.... HCSC is a mutual legal reserve company that operates in Texas as Blue Cross and Blue Shield of Texas ... BCBSTX acts as the administrator for employer self-funded plans ... [We hold that the Texas statute] is not applicable to BCBSTX's activities as administrator of the self-funded plans or state government plans[.]" [Health Care Service Corporation v. Methodist Hospitals of Dallas, No. 15-10154 (5th Cir. Feb. 10, 2016)]
13.  Text of Fifth Circuit Opinion Affirming Dismissal of Whole Foods Stock Drop Case (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Sept. 6, 2018
15 pages. "There is an inevitable tension between an employer-fiduciary's duty of prudence and the use of a fund primarily to invest in the employer's stock.... While a prudent fiduciary might have looked at purchasing trends, no fiduciary could have known with certainty that the Plan would be a net purchaser over the course of the Class Period. And even if a prudent fiduciary could have predicted that the Plan would be a net purchaser over time, that fact alone does not show that an earlier disclosure would be 'so clearly beneficial' that no prudent fiduciary would consider it more likely to harm than help." [Martone v. Robb, No. 17-50702 (5th Cir. Sept. 4, 2018)]
14.  Text of Fifth Circuit Opinion: Purchase of Group Annuity by Verizon DB Plan Did Not Violate ERISA Despite Resulting Loss of PBGC Guarantees (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Aug. 18, 2015
"[T]he Transferee Class also asserts that the phrase 'loss of benefits' encompasses federal protections under ERISA and the [PBGC].... [T]his interpretation of 'benefits' is more expansive than the ERISA regulation governing the purchase of annuities by plan fiduciaries ... which requires that such transactions guarantee a participant's 'entire benefit rights.'... [We] hold that the transfer of pension liabilities from an ongoing plan through an annuity transaction amendment is a settlor function, permitted under ERISA, or, alternatively, that such transactions are not subject to fiduciary duty requirements." [Lee v. Verizon Comm. Inc., No. 14-10553 (5th Cir. Aug. 17, 2015)]
15.  Text of Fifth Circuit Opinion Rejecting Insurer's Argument That Discretionary Authority Transfers to SPD (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Nov. 7, 2017
"The Summary Plan Description explains that certain benefits offset the long-term disability benefit amount, including '[p]ension benefits from a Verizon pension plan, if [the beneficiary] elect[s] to receive them.'... MetLife argues that selecting a trustee-to-trustee transfer constitutes 'electing to receive' pension benefits, while Thomason argues that such a transfer cannot be an election to receive the funds because he has no control over them ... We do not reach the actual meaning of 'elect to receive' under the Plan. Instead, we determine that the Summary Plan Description is ambiguous and thus we construe it in Thomason's favor." [Thomason v. MetLife, No. 16-10634 (5th Cir. July 18, 2017)]
16.  Fifth Circuit: Texas Law Prohibiting Waivers of Unemployment Compensation Is Not Preempted by ERISA (PDF)
U.S. Court of Appeals for the Fifth Circuit, via FindLaw Link to more items from this source
Nov. 27, 2002
Mitchell Energy & Development Corporation v. Fain, No. 01-21265 (5th Cir. Nov. 19, 2002). Excerpt: Because ERISA does not preempt TEX. LAB. CODE Section 207.071, signatories of the [voluntary incentive retirement program] did not release claims for unemployment compensation.
17.  Fifth Circuit Denies Motions to Intervene in DOL Fiduciary Lawsuit (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
May 2, 2018
"[T]he opposed motion of the States of California, New York, and Oregon, for leave to intervene is DENIED.... [T]he opposed motion of AARP, for leave to intervene is DENIED." [U.S. Chamber of Commerce v. DOL, No. 17-10238 (5th Cir. May 2, 2018)]
18.  Fifth Circuit: DB Plan Properly Applied 'Banded' Benefit Formula to Commissioned Employees (PDF)
U.S. Court of Appeals for the Fifth Circuit Link to more items from this source
Nov. 26, 2001
"In answering the first question, i.e., whether the administrator's interpretation of the plan was legally correct, a court must consider: [1] whether the administrator has given the plan a uniform construction, [2] whether the interpretation is consistent with a fair reading of the plan, and [3] any unanticipated costs resulting from different interpretations of the plan." [Gosselink v. American Telephone & Telegraph Inc., No. 00-20887 (5th Cir. Nov. 7, 2001)]
19.  Fifth Circuit: Grocer Violated ERISA Using Unvested Voucher Benefit (PDF)
U.S. Court of Appeals for the Fifth Circuit, via FindLaw Link to more items from this source
June 16, 2003
27 pages. Musmeci v. Schwegmann Giant Supermarkets, Inc., No. 02-30246 (5th Cir. Jun. 11, 2003). Excerpt: [SCSM, the grocery store chain partnership,] did not set up a trust to fund the Voucher Plan. Rather, the Voucher Plan was funded out of the partnership"s general revenue.... [I]n 1997, it sold the business. A week before the sale, Mr. Schwegmann sent a letter to all voucher recipients informing them that they would no longer receive vouchers because of the sale of the business.
20.  Fifth Circuit: Change in Shift Did Not Constitute Adverse Employment Action Under FMLA
U.S. Court of Appeals for the Fifth Circuit, via FindLaw Link to more items from this source
Dec. 31, 2001
"Hunt argues that by offering her the night shift position, knowing she would not accept it, the Medical Center 'forced' her to accept the part-time 'pool nurse' job, in retaliation for taking FMLA leave. Hunt argues that the decline in compensation and feeling of demotion resulting from the part-time position left her no alternative to resignation." [Hunt v. Rapides Healthcare System, LLC, No. 00-31260 (5th Cir. Dec. 26, 2001)]
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