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ERISA Claim Defense Blog

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Attorneys' Fees

D.N.J. Rejects Plaintiff’s Fee Request In Connection With State Court Remand Of Action Removed Under ERISA, Scaling Back Earlier Charge That Defendant’s Removal Was NonsensicalRemand Directing Change in Standard of Judicial Review Is Not Sufficient Success on the Merits to Support Attorneys’ Fee AwardSecond Circuit Upholds Reduction of Attorneys’ Fees Sought in ERISA Benefits Case

Coronavirus

Developments in Disability Claims During the COVID-19 PandemicNew EBSA Relief Notice Affects Extension of ERISA Claim DeadlinesWhen COBRA Meets COVID-19: Concerns for Plan Administrators and TPAs

Disability

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISASecond Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute “Adverse Benefit Determination” Under ERISA Claims Procedures RegulationDevelopments in Disability Claims During the COVID-19 Pandemic

Discovery

Upcoming Amendments to Federal Rules Will Impact ERISA Litigation

Discretionary Authority

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISAFifth Circuit Joins Sister Circuits by Overruling Default Deferential Standard of ReviewFifth Circuit Maintains Default Deferential Standard Of Review In Denial Of Benefit Claims, But Suggests It May Soon Be Overruled

Equitable Claims

Second Circuit Addresses Limitations Periods Governing Fraudulent Billing Claims Against Non-Participating ProvidersIt May Be Time to Start Thinking About Equitable Claims AgainERISA Plan Administrator’s Failure to Notify Beneficiary of Life Insurance Conversion Rights Breaches Fiduciary Duty

Equitable Remedies

Second Circuit Upholds District Court’s Choice of Equitable Remedies Under ERISA and Its Decision to Award Prejudgment Interest at the Federal Prime RateCourt Upholds Dismissal of Breach of Fiduciary Claim, Finding Plaintiff Had an Adequate Remedy Under ERISA § 501(a)(1)(B)

Exhaustion of Administrative Remedies

Second Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute “Adverse Benefit Determination” Under ERISA Claims Procedures RegulationWhere Administrative Appeal Deadline Ends on Saturday, Monday Appeal Is TimelyFailure to Understand Exhaustion Requirement Does Not Excuse Compliance

Fiduciary Duties

Sixth Circuit Rejects Arbitration Of Certain ERISA § 502(a)(2) Claims, Ruling That Employee Consent To Arbitration May Not Bind Plan In Putative Class ActionSecond Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute “Adverse Benefit Determination” Under ERISA Claims Procedures RegulationThird Circuit Clarifies Sufficiency Of Discussions Of Social Security Disability Insurance Awards In Adverse Disability Benefit Determinations Under Pre-2018 ERISA Claims Procedure Regulation

Health

Implementing Regulations for The No Surprises Act: Part ISecond Circuit Addresses Limitations Periods Governing Fraudulent Billing Claims Against Non-Participating ProvidersSupreme Court Rules that ERISA Does Not Preempt State Law Regulating PBM Reimbursements

Insurance Benefits

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISASecond Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute “Adverse Benefit Determination” Under ERISA Claims Procedures RegulationImplementing Regulations for The No Surprises Act: Part I

Jurisdiction

Sixth Circuit Rejects Arbitration Of Certain ERISA § 502(a)(2) Claims, Ruling That Employee Consent To Arbitration May Not Bind Plan In Putative Class ActionD.N.J. Rejects Plaintiff’s Fee Request In Connection With State Court Remand Of Action Removed Under ERISA, Scaling Back Earlier Charge That Defendant’s Removal Was NonsensicalERISA Does Not Preempt Third Party Providers’ Unfair And Deceptive Business Practice Claims Against Health Insurer, Rules Ninth Circuit

Life

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISASixth Circuit Finds No Fiduciary Duty To Give Notice Of Conversion/Portability Rights On Termination Of EmploymentSecond Circuit Upholds Dismissal of ERISA Claims Against Plan Defendants for Alleged “Cross-Subsidization” Scheme

Limitations - Statutory/Contractual

Second Circuit Addresses Limitations Periods Governing Fraudulent Billing Claims Against Non-Participating ProvidersSupreme Court’s Sulyma Decision May Complicate Plan Administrators’ Consideration of the DOL’s New Proposed Electronic Safe Harbor Disclosure RuleSupreme Court Decision on ERISA Statute of Limitations May Help Defendants Defeat Class Certification

Pension Benefits

Supreme Court’s Sulyma Decision May Complicate Plan Administrators’ Consideration of the DOL’s New Proposed Electronic Safe Harbor Disclosure RuleCould We See Retirement Reform in a Lame Duck Congress?Ninth Circuit Holds That Employees’ ERISA Breach of Fiduciary Duty Claim Against Their Employer is Not Subject to the Mandatory Arbitration Clause in Their Employment Contracts

Plan Interpretation

Sixth Circuit Rejects Arbitration Of Certain ERISA § 502(a)(2) Claims, Ruling That Employee Consent To Arbitration May Not Bind Plan In Putative Class ActionU.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISAWhen is a Severance Plan NOT an ERISA Plan

Preemption

D.N.J. Rejects Plaintiff’s Fee Request In Connection With State Court Remand Of Action Removed Under ERISA, Scaling Back Earlier Charge That Defendant’s Removal Was NonsensicalSupreme Court Rules that ERISA Does Not Preempt State Law Regulating PBM ReimbursementsERISA Does Not Preempt Third Party Providers’ Unfair And Deceptive Business Practice Claims Against Health Insurer, Rules Ninth Circuit

Regulations

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISASecond Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute “Adverse Benefit Determination” Under ERISA Claims Procedures RegulationImplementing Regulations for The No Surprises Act: Part I

Standing

To Sue Or Not To Sue Under ERISA: Circuit Split about Proper Party Defendants and Service of Process May Be ResolvedNinth Circuit Rejects Arguments Challenging the Enforceability of an ERISA Plan Anti-Assignment ProvisionEmployer lacks standing to sue multi-employer plan for violation of ERISA and PPACA

Statute

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The Meaning Of A “Full and Fair Review” Under ERISAImplementing Regulations for The No Surprises Act: Part IWhen is a Severance Plan NOT an ERISA Plan

Subrogation

Second Circuit Clarifies New York Anti-Subrogation Law Prohibits Offsets For Settlements; Declares Plan’s Choice-of-Law Provisions May Not Govern Offset And Subrogation RightsAnother SCOTUS subrogation decision, and another deep dive into equity treatisesSPD can be governing plan document when there is no actual plan

Uncategorized

Welcome Kate Katchen!Irreconcilable Differences: In Dorman v. Charles Schwab Corp., Ninth Circuit Overrules 35-Year-Old Authority; Concludes ERISA Claims Subject to Mandatory Arbitration.DOL Seeks to Extend Transition Period under the Fiduciary Rule

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Robinson+Cole’s Managed Care + Employee Benefit Litigation Group provides comprehensive employee benefits services to a wide range of clients, including publicly held and privately held companies, tax-exempt organizations, educational institutions, municipalities and other governmental entities, trust companies, and financial institutions.

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