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Text of Amicus Brief Urging Supreme Court Review of Ninth Circuit Decision Allowing Participant to Seek Recovery of Benefits from Claims Administrator (PDF)
American Benefits Council and America's Health Insurance Plans [AHIP]
May 27, 2015 26 pages. "The question in this case is not whether an ERISA plan beneficiary may bring suit under 29 U.S.C. Section 1132(a)(1)(B) to recover benefits due to him. Rather, the question is who he may sue.... The Ninth Circuit's reasoning appears to rest on a misconception that amici and their members are uniquely positioned to dispel. The panel seemed to believe that there is no difference between an ERISA plan administrator and a mere claims administrator.... As amici's members know well from serving as plan sponsors, insurers, and claims administrators, those roles are different indeed. In fact, the record in this very case highlights the stark contrasts between plan administrators and claims administrators. Unfortunately, however, the panel failed to appreciate that crucial distinction." [Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc., No. 12-17604 (9th Cir. Nov. 5, 2014; cert. pet. filed Apr. 24, 2015)] MORE >> |
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