Search the News Archive

Proposed Changes to DOL Regs on ESG and Other Investments by Fiduciaries: What You Should Know and How The Wagner Law Group Responded

"The proposed rule ... goes beyond its stated objectives to affect how fiduciaries make all investment decisions.... In addition, the Proposed Rule would require fiduciaries to consider 'available alternative investments' in making investment decisions, without guidance as to what this would mean, and without recognizing that the best practice of comparing investment alternatives is not universally applicable to all circumstances.... The Proposed Rule does not define ESG Factors."

The Wagner Law Group Asks DOL for Cybersecurity Guidance

"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."

Ninth Circuit: Group Health Plan's Denial of Benefits Violates ERISA Claims Procedure

"The Ninth Circuit agreed with the district court that the plan's denial was insufficient to meet the regulatory standards of the [DOL], observing that the plan had failed to identify a particular plan provision upon which the denial was based.... The Ninth Circuit also found that the plan's 'denials were conclusory, twice using non-committal phrases such as 'may be' without any further explanation.' " [Solis v. T-Mobile US, Inc., No. 24-2412 (9th Cir. July 15, 2025; unpub.)

Fifth Circuit Weighs in on a Recurrent Problem: When Operational Errors Eliminate Group Life Insurance Benefits

"Group life is the redheaded stepchild of employee benefits, often added on by insurers on top of the primary products being sold to plan sponsors and employers, such as disability insurance.... [P]roblems tend to crop up in the administration of group life plans and in the payment of claims due to nothing more than the lack of attention that comes with being a relative afterthought." [Edwards v. Guardian Life Ins. of Am., No. 24-60381 (5th Cir. June 20, 2025)]

Experimental and Investigational Treatments and Procedures Under ERISA Group Health Plans (PDF)

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."

SECURE 2.0 Modifies Controlled Group and Affiliated Service Group Rules

"SECURE Act 2.0 changes the family attribution rules to allow disaggregation of the entities if the only common ownership is the indirect ownership of the entities by a child under the age of 21 due to the attribution of the parents' ownership interests to the child.... [A second change disregards] community property laws when determining ownership for purposes of controlled groups and affiliated service groups."

Supreme Court Denies Petition for Review of ERISA Preemption Case Involving State PBM Law

"The 10th Circuit's position stands for now ... It will have a ripple effect on other states even though it is the law only for states within the 10th Circuit. Presumably, it means that ERISA does not preempt state rate/pricing mechanisms, but ERISA does preempt state level regulation of plan design or coverage requirements." [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023; cert pet. denied Jun. 30, 2025, No. 23-1213]

Ninth Circuit: Employer Failed to Adequately Notify Participant of Group Life Insurance Conversion Rights

"After reviewing both the certificate of coverage and the SPD, the Ninth Circuit determined that they were ambiguous as to exactly when the employee's 31-day conversion period began.... The court also observed that the employer: [1] had continued to pay premiums for the employee after February 29 (thereby increasing the potential for confusion on when the 31-day conversion period began); and [2] was aware of the employee's terminal condition, and should have realized that the employee would be interested in maintaining his life insurance coverage." [Estate of Foster v. American Marine SVS Group Benefit Plan, No. 20-35023 (9th Cir. Feb. 9, 2021)]

Court Finds Employer, Not Group Life Insurer, Liable for $314,000 Death Benefit

"The court ultimately ruled in favor of the plaintiffs, finding that the employer had breached its fiduciary duty by administering the plan in a way that allowed the employee to believe incorrectly that a certain level of life insurance coverage was in place. As a result, the court ordered the employer, and not the insurer, to pay $314,000, the amount of the supplemental coverage." [Van Loo v. Cajun Operating Co. dba Church's Chicken, No. 14-10604 (E.D. Mich June 6, 2016)]

Ninth Circuit: ERISA Group Health Plan's Self-Help Provision Is Enforceable

"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)]