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
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
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
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
Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on Issues of First Impression in Both CircuitsImplementing Regulations for The No Surprises Act: Part ISecond Circuit Addresses Limitations Periods Governing Fraudulent Billing Claims Against Non-Participating Providers
Insurance Benefits
Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on Issues of First Impression in Both CircuitsU.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 Regulation
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
Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on Issues of First Impression in Both CircuitsD.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 Reimbursements
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
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