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Mealey's ERISA

  • September 10, 2025

    Judge: Integration Brought Owners-Only LTD Policy Under ERISA

    SAN JOSE, Calif. — Dismissing bad faith and breach of contract claims that a PricewaterhouseCoopers LLP (PwC) equity owner who unsuccessfully sought long-term disability (LTD) benefits because of symptoms he attributed to long COVID asserted under California law, a California federal judge concluded that when “an employer integrates a pre-existing” policy that is not governed by the Employee Retirement Income Security Act “into a broader ERISA-governed plan, the non-ERISA policy becomes a part of the ERISA plan and is subject to the requirements and preemptive effect of ERISA.”

  • September 10, 2025

    LTD Claimant Urges 11th Circuit To Reverse Summary Judgment In Tax Returns Row

    ATLANTA — Urging the 11th Circuit U.S. Court of Appeals to take the position outlined in a report and recommendation that the lower court declined to adopt, a deaf engineer who received long-term disability (LTD) benefits for about a decade before they were terminated due to his refusal to provide personal tax returns argues in part that the insurer isn’t entitled to interpret the term “work” because it is not ambiguous.

  • September 10, 2025

    Insurer Faulted For Terminating LTD Benefits In Case Involving Fatigue, COVID

    TRENTON, N.J. — Citing “procedural irregularities and substantive errors” in an insurer’s handling of a long-term disability (LTD) claim for an individual whose diagnoses include myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, a New Jersey federal judge issued an unpublished opinion directing that the claimant receive about seven months of retroactive benefits and that her claim be remanded for a determination as to whether she remained eligible after her administrative appeal was denied.

  • September 09, 2025

    6th Circuit Challenge To Ruling That PBM Is Partly Preempted Draws Amicus Input

    CINCINNATI — An appeal of a ruling that parts of a Tennessee law regarding pharmacy benefit managers (PBMs) are “preempted to the extent they purport to govern self-funded [Employee Retirement Income Security Act] plans” has drawn input from numerous advocacy organizations, with two amicus curiae briefs supporting the appellee in urging the Sixth Circuit U.S. Court of Appeals to affirm the decision.

  • September 09, 2025

    Challenge To Tobacco, Vaccination Surcharges Partly Survives Dismissal

    CHARLOTTE, N.C. — Continuing a string of at least partial victories for plaintiffs in putative class cases over health plan tobacco surcharges, a North Carolina federal judge ruled that two of three claims against GardaWorld Cash Service Inc. survive dismissal; one of the surviving claims concerns the tobacco surcharge, and the other concerns a surcharge levied against those who didn’t show that they were fully vaccinated against COVID-19 by a certain date.

  • September 08, 2025

    Defendants Get Reduced Attorney Fees In ERISA Liquidation Time Lawsuit

    RICHMOND, Va. — A plaintiff dissatisfied that it took 10 days to liquidate his 401(k) plan has been ordered to pay attorney fees totaling $122,951 after a Virginia federal judge concluded in part that “a majority of this prolonged litigation could have been avoided had Plaintiff reviewed and authenticated” call transcripts that were at the heart of the Employee Retirement Income Security Act case.

  • September 08, 2025

    8th Circuit Affirms Ruling Against Short-Term Disability Claimant

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Sept. 5 briefly affirmed summary judgment against a short-term disability (STD) claimant in an unpublished per curiam opinion, saying in part that the insurer “did not abuse its discretion by relying on the opinions of its nurse consultants over those of [claimant Monty] Jones’s counselor” and was not “required to provide an independent medical examination (IME) of Jones before deciding his claim.”

  • September 05, 2025

    Class Settlement Wins Final Approval In ERISA Case Over Alleged Cost-Shifting

    ASHEVILLE, N.C. — A North Carolina federal judge granted final approval to a class settlement that resolves a long-running Employee Retirement Income Security Act suit over an alleged cost-shifting scheme concerning health plan administrative fees for chiropractic and physical therapy treatment; the deal includes gross amounts of $4.8 million for members of individual and plan classes and a separate $3.55 million for attorney fees and costs.

  • September 05, 2025

    En Banc Rehearing Approaches In 5th Circuit No Surprises Act Case

    NEW ORLEANS — En banc rehearing is scheduled for Sept. 24 in a dispute over regulations implementing the No Surprises Act (NSA), and three U.S. agencies have concluded the en banc briefing with a reply urging the Fifth Circuit U.S. Court of Appeals to reverse the lower court on the disputed qualifying payment amount (QPA) issues and rein in a “mistaken view” regarding universal vacatur.

  • September 05, 2025

    PBGC Can’t Avoid Immediately Reconsidering Special Financial Assistance Decision

    CENTRAL ISLIP, N.Y. — A government agency has been ordered to reconsider its decision that termination of a multiemployer fund rendered the fund ineligible for a special financial assistance (SFA) program under which the fund sought $132 million; the order is the result of a ruling that the agency has argued could cost the United States up to $6.6 billion and has shown interest in taking to the U.S. Supreme Court.

  • September 04, 2025

    Review Standard Is Focus Of 2nd Circuit Briefing In Appeal Of LTD Benefits Denial

    NEW YORK — Standard of review is the sole issue in a Second Circuit U.S. Court of Appeals challenge to a ruling upholding denial of long-term disability (LTD) benefits, with the insurer arguing in its answering brief first that it had discretionary authority under the plan and second that there are no grounds to disregard that grant because it complied with claim regulations.

  • September 04, 2025

    Judge: Immunocompromised Doctor Deserves LTD Benefits Due To COVID-19 Risk

    WINSTON-SALEM, N.C. — Following a bench trial on the administrative record regarding a clinical anesthesiologist with chronic lymphocytic leukemia (CLL) whose unsuccessful disability claim was based on his risk of exposure to COVID-19, a North Carolina federal judge concluded on de novo review that the anesthesiologist is entitled to retroactive long-term disability (LTD) benefits, prejudgment interest and the costs of the suit.

  • September 03, 2025

    Ruling Challenge Was A New Claim, 7th Circuit Affirms Denial Of LTD Benefits

    CHICAGO — Affirming summary judgment against a professional musician whose long-term disability (LTD) claim was denied under policy terms because she was not an active, full-time employee when she said long COVID symptoms made her unable to work, the Seventh Circuit U.S. Court of Appeals on Sept. 2 said the information submitted in her administrative appeal “in effect requested coverage for a different loss, and that meant she was submitting a new claim.”

  • September 03, 2025

    Dismissal Recommended In Putative Class Suit Challenging PRTs With Athene

    BOSTON — The tally on dismissal motions in a wave of putative class actions retirees have filed over pension risk transfers (PRTs) would stand at two granted, one denied if the recommendation of a Massachusetts federal magistrate judge were taken; among other things, the retirees allege that the use of offshore captive reinsurers makes annuity providers riskier.

  • September 03, 2025

    Citing Anderson, 9th Circuit Affirms Dismissal Of Challenge To Custom TDFs

    SAN FRANCISCO — Quoting Anderson v. Intel Corp. Investment Pol'y Committee, the Ninth Circuit U.S. Court of Appeals in an unpublished Sept. 2 memorandum disposition briefly affirmed dismissal of putative class claims concerning custom target-date funds (TDFs), saying that under the Employee Retirement Income Security Act, pleading “‘that a prudent fiduciary in like circumstances would have selected a different fund based on the cost or performance of the selected fund’” requires providing “‘a sound basis for comparison.’”

  • September 02, 2025

    For Now, Texas Can’t Enforce Law On ESG, DEI Issues Against 2 Proxy Advisory Firms

    AUSTIN, Texas — A Texas law concerning proxy advisers’ consideration of environmental, social and governance (ESG), diversity, equity and inclusion (DEI) and sustainability factors that otherwise went into effect Sept. 1 will not be enforced against two proxy advisory firms under preliminary injunctions that a Texas federal judge granted Aug. 29.

  • September 02, 2025

    Judge Trims Attorney Fees, Prejudgment Interest Rate In LTD Lawsuit

    NEW YORK — Saying in part that the requested 21.8% prejudgment interest rate “is far outside the norm in this District,” a New York federal judge awarded modified amounts totaling $230,083.65 for attorney fees and $139,497.54 for prejudgment interest in a long-term disability (LTD) case in which the claimant won $928,954.90 in retroactive benefits.

  • September 02, 2025

    $332M Deal Would End Residual Annuities Class Action Filed Under ERISA

    NEW YORK — A long-running Employee Retirement Income Security Act lawsuit over residual annuities would be resolved under a proposed $332 million settlement that the 1,177-member class of retirees partly unveiled Aug. 29 in a New York federal court.

  • September 02, 2025

    Judge On Remand: Benefits Never Vested In Life Insurance Termination Case

    WHEELING, W.V. — On remand from a split Fourth Circuit U.S. Court of Appeals panel, a West Virginia federal judge conducted a two-day bench trial in the class action that unsuccessfully challenged termination of retiree life insurance coverage, then ruled that the benefits “never vested during the relevant period” and entered judgment in favor of the defendants on what had been the sole remaining claim.

  • August 29, 2025

    Citing Ace-Saginaw, 6th Circuit Affirms Partial Withdrawal Liability Ruling

    CINCINNATI — Citing the recent first-impression ruling Ace-Saginaw Paving Co. v. Operating Engineers Local 324 Pension Fund, the Sixth Circuit U.S. Court of Appeals issued an unpublished per curiam opinion affirming a ruling that was the subject of cross-appeals and remanding for the actuary of a multiemployer pension fund to recalculate partial withdrawal liability “using assumptions and methods that are consistent with” the requirements of the Employee Retirement Income Security Act.

  • August 28, 2025

    1st Circuit: Insurer Didn’t Abuse Its Discretion In Ending LTD Benefits

    BOSTON — Saying in part that “[t]he administrative record supportably shows that” a marketing executive who had been awarded long-term disability (LTD) benefits based on chronic back pain “could meet every enumerated physical demand by the time” those benefits were terminated, the First Circuit U.S. Court of Appeals on Aug. 27 upheld summary judgment for an insurer.

  • August 27, 2025

    11th Circuit: Lump-Sum Payments Shortchanged Top Hat Plan Participants

    ATLANTA — Affirming summary judgment and remedies rulings for a class of nearly 200 executives who participated in so-called “top hat” plans, the 11th Circuit U.S. Court of Appeals on Aug. 26 agreed with the lower court that the 2013 lump-sum payments at issue violated the plan terms because they “‘adversely affected’ the ‘accrued benefit’ of at least some participants.”

  • August 27, 2025

    2 Class Settlements Totaling $60 Million Get Final OK In Church Plan Suit

    JACKSON, Tenn. — A Tennessee federal judge has granted final approval to class settlements initially grossing $60 million before interest in multidistrict litigation over a religious denomination’s retirement plan, also awarding attorney fees of a third of that amount and a $20,000 service award to each of the 10 named plaintiffs; claims against numerous nonsettling defendants remain.

  • August 25, 2025

    11th Circuit Skirts Exhaustion Issue, Won’t Revive Case Over NFL Disability Benefits

    ATLANTA — Affirming dismissal on two alternate grounds without deciding whether the appellant exhausted his administrative remedies, the 11th Circuit U.S. Court of Appeals in a per curiam Aug. 22 opinion declined to revive a former NFL player’s suit over total and permanent (T&P) disability benefits that he argued he should have been awarded under a 2006 application.

  • August 25, 2025

    ERISA Forfeiture Developments Include 2 More Rulings Denying Dismissal

    Just over two years after a wave of Employee Retirement Income Security Act suits challenging a common use of forfeited nonvested matching retirement contributions were filed, the case law is developing rapidly; although the majority of dismissal motions have been granted, federal judges in North Carolina and Florida recently denied dismissal in putative class cases filed against Bank of America Corp. (BOA) and NextEra Energy Inc.