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When is it proper to ignore a health plan's written provision?

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ERISA section 404(a)(1)(D) tells a fiduciary to discharge his, her, or its duties "in accordance with the documents and instruments governing the plan insofar as such documents and instruments are consistent with the provisions of [ERISA]."

The Supreme Court of the United States has made clear that the "insofar" exception at least permits, and might require, a fiduciary to disobey a plan's document if doing so is necessary to meet an ERISA fiduciary duty, including a duty of loyalty or prudence.

Does anyone know of a court decision in which the "insofar" exception applied concerning a situation concerning a health plan?

Peter Gulia PC

Fiduciary Guidance Counsel

Philadelphia, Pennsylvania



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The problem that I foresee with "insofar" is that if the Plan is operating under documents that are deficient enough to trigger "insofar" they probably would also trigger other fiduciary problems in addition to the Plan not being compliant.

I have not heard of any cases, as yet.

George D. Burns

Cost Reduction Strategies

Burns and Associates, Inc

www.costreductionstrategies.com(under construction)

www.employeebenefitsstrategies.com(under construction)

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