News Archive

"This case will limit ADA claims by retirees against their former employers, but ... Justice Gorsuch opined ... that retired employees may be able to proceed with ADA claims if they can plead and prove that they were disabled and a 'qualified individual' under the ADA when their employer adopted a discriminatory retirement benefits policy, even if they later happen to be retired when they bring suit." [Stanley v. City of Sanford, FL, No. 23-997 (S. Ct. Jun. 20, 2025)]  MORE >>

29 pages. "What's New: [1] Social security and Medicare taxes for 2025.... [2] Moving expense reimbursements.... [3] Employer contributions to Trump accounts."  MORE >>

"The case highlights the consequences of procedural lapses in claim handling and reinforces that remand, not immediate benefits, is typically the appropriate remedy when no administrative record exists." [Chalk v. Life Ins. Co. of N. Am., No. 25-0133 (W.D. Ky. Oct. 27, 2025)]  MORE >>

"Courts increasingly recognize that: ... [1] The limitations period typically begins after the full benefit period ends -- not when the disability starts. [2] California law overrides less favorable policy terms.... [3] Courts examine when proof of loss was truly due, whether the claimant had notice of coverage, and if delays were reasonable."  MORE >>

"Key Takeaways ... [1] Courts may compel insurers to produce documents required under ERISA's own procedural rules.... [2] Plaintiffs must present evidence suggesting the insurer's conflict actually affected the claim decision.... [3] Plaintiffs who tie discovery requests directly to regulatory entitlements, rather than broad fairness concerns, are more likely to succeed." [Gannon v. Hartford Life and Accident Ins. Co., No. 24-1955 (D. Conn. Oct. 3, 2025)]  MORE >>

11 pages. "The current study of 2015-2022 calendar years contains about 294 million life-years exposed and about 1.2 million claims over the study period. The results include analysis of claim incidence and can be used by actuaries in the management of their own group long-term disability business."  MORE >>

"In the second quarter of 2025, total workplace life insurance new premium ticked up 1% year over year to $666 million. Year to date (YTD), total workplace life insurance new premium was $2.65 billion, down 7% from the same period in 2024.... Total workplace disability insurance new premium was $618 million in the second quarter of 2025, a 3% increase year-over-year. In the second quarter, short-term disability insurance new premium grew 7% and long-term disability insurance premium fell 3%."  MORE >>

"Federal courts normally have jurisdiction over ERISA claims ... However, the [Railway Labor Act] provides that disputes growing out of grievances or the 'interpretation or application' of CBAs ... must be resolved through arbitration before an SBA, not in court.... [T]he court found the LTD plan was 'inextricably intertwined' with the JCBA. While ERISA creates a right to bring claims for benefits, Eldredge's alleged right to LTD benefits existed only because the JCBA required the airline to provide the plan. Thus, the JCBA was the true source of the claim." [Eldredge v. Am. Airlines Inc., No. 25-0823 (D. Ariz. Sept. 4, 2025)]  MORE >>

"[Premiums for the short-term disability insurance program administered by the Puerto Rico DOL-HR (SINOT)] are relatively high vis-à-vis its covered benefits. As a result, many, if not most, companies doing business in Puerto Rico prefer to comply with the Mandate through their own STD plans ... This article provides an overview of the Mandate and SINOT; it then describes the process that employers should follow to comply with the Mandate through an STD plan."  MORE >>

"[T]he Second Circuit ruled that no reasonable jury 'could conclude that Schuyler actually believed that she was waiving her claim for LTD benefits from Sun Life when she signed the agreement,' and thus she 'didn't knowingly and voluntarily waive her right to pursue her LTD against Sun Life.' The court therefore reversed the judgment below and remanded for further proceedings." [Schuyler v. Sun Life Assurance Co. of Canada, No. 23-498 (2d Cir. Aug. 14, 2025)]  MORE >>

"[T]he Second Circuit ... [held] that a former employee's separation agreement with her employer did not amount to a knowing and voluntary waiver of her ERISA claim for long-term disability (LTD) benefits. The court emphasized that the employer's explicit pre-execution assurances that the agreement would not affect the LTD claim were dispositive, even though the contract contained broad release language that arguably covered related entities and ERISA claims." [Schuyler v. Sun Life Assurance Co. of Canada, No. 23-498 (2d Cir. Aug. 14, 2025)]  MORE >>

"The court found no clear error in the district court's determination that LINA's medical and vocational evidence outweighed the claimant's proof of disability under [ERISA]." [Walker v. Life Ins. Co. of N. Amer., No. 24-13066 (11th Cir. Aug. 13, 2025)]  MORE >>

"[DOL Advisory Opinion 2025-02A found] that the California Association of Professional Firefighters (CAPF) Long Term Disability (LTD) Plan is not an ERISA-covered employee welfare benefit plan.... DOL determined that CAPF does not exist for the purpose of dealing with employers concerning an employee benefit plan. Therefore, CAPF is not an employee organization. [DOL] then ruled that while CAPF has some of the characteristics of an employees' beneficiary association in that it has a formal organization, it generally does not deal with employers ... However, in DOL's view, CAPF membership is not conditioned on employment status nor do employees 'participate' in CAPF."  MORE >>

"The court found that the plan's language was unambiguous: a beneficiary is deemed to reside outside the U.S. or Canada if they spend six or more months abroad during any 12-month benefit period.... Despite her arguments about pandemic travel barriers, the court held that U.S. citizens like Archer were exempt from border restrictions and that her failure to return to the U.S. was not legally excused under an 'impossibility' theory." [Archer v. Unum Life Ins. Co. of Am., No. 23-1128 (W.D. Wash. Jul. 28, 2025)]  MORE >>

"Unum's argument that Schwartz's condition was 'situational' and not disabling was roundly rejected. The court emphasized that her symptoms persisted both during and after her employment and had worsened upon attempts to return to work. Unum's failure to exercise its contractual right to conduct an in-person examination also undermined the credibility of its denial." [Schwartz v. Unum Life Insurance Company of America, No. 24-2444 (N.D. Cal. Jul. 1, 2025)]  MORE >>

"The court agreed with the majority of circuits holding that ERISA Section 1132(g)(1), which governs fee-shifting, does not authorize recovery of attorney's fees incurred during administrative proceedings.... [The case] serves as a cautionary tale for ERISA claimants: successful reinstatement of benefits may not open the door to broader monetary remedies, particularly when a claimant did not fully pursue administrative remedies. " [Stark v. Reliance Standard Life Ins. Co., No. 24-6137 (10th Cir. Jul. 8, 2025)]  MORE >>

"For disabled employees, RTO policies don't just represent a change in environment, they can become a tipping point that insurers use to challenge or deny disability claims. Understanding the interplay between workplace demands, disability accommodations, and the definition of disability in ERISA policies is essential to protecting your rights."  MORE >>

"Unum relied on the supposed absence of 'clinical findings' to justify termination ... [and] questioned the severity of her symptoms based on [surveillance footage of her] daily activities and a selective reading of her records. The court flatly rejected these rationales emphasizing that while the subjective nature of migraine and vestibular syndromes makes objective validation inherently difficult, it does not undermine their legitimacy as disabling conditions." [Jessica L. v. Unum Life Ins. Co. of Am., No. 24-2046 (N.D. Cal. June 24, 2025)]  MORE >>

"This guide provides a high-level reference resource, in a plan-by-plan format, on how to approach each type of compensation or benefit arrangement when an employee becomes disabled and offers up some practical tips on employee benefits issues that may come up as you manage your company's compensation and benefit administration for a disabled employee."  MORE >>

"Unum delayed pursuing the motion to transfer for seven months, waiting until one week before the close discovery and three weeks before the deadline for dispositive motions to file it. The impetus for doing so was the discovery of medical records outside the administrative record that favor Plaintiff's case. These extra-record documents are admissible in the 11th Circuit (Florida) but not in the 10th Circuit (Utah). The court found this legal difference was relevant in illuminating the parties' motivations." [Williams v. Unum Life Ins. Co. of Am., No. 24-24113 (S.D. Fla. June 5, 2025)]  MORE >>

"HR 3758, the Workers' Disability Benefits Parity Act of 2025 ... [would bar] disability plans from imposing restrictions on mental health or substance use claims that are more severe than those applied to physical conditions. The bill also ... empowers the [DOL] to impose civil monetary penalties for violations."  MORE >>

"the compound annual growth rate (CAGR) for Supplemental Health premium is expected to exceed 10% through 2030 – a stark contrast to the CAGR anticipated for life and disability products. If these forecasts are correct, it will make Supplemental Accident and Health products the fastest growing non-medical premium volume in the Health and Welfare space."  MORE >>

"[A recent LIMRA study found] more than half (51%) say they would rely on their personal savings should they lose the ability to earn an income, and ... more than a quarter (26%) would draw from their retirement savings accounts ... [J]ust 55% of employees can say definitively whether their employer even offers disability insurance, and less than half of workers say they have a strong understanding of these benefits."  MORE >>

"Providing employees with benefits such as life insurance and short- and long-term disability can help provide a sense of job security in the event of illness or injury. But for small businesses, providing access to those benefits is an uphill battle ... Insurance benefit rates across various company sizes [chart]."  MORE >>

"While standard group long-term disability coverage may appear sufficient on paper, it often falls short of providing true lifestyle protection for high-earning executives.... Individual disability insurance (IDI) and high-limit disability policies can effectively bridge the coverage gap.... Additional solutions that provide complete income protection ... might include executive carve-out plans, guaranteed standard issue programs or excess disability coverage, depending on the executive team's needs."  MORE >>