The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more
2/26/2024
/ 401k ,
Breach of Duty ,
Consolidated Appropriations Act (CAA) ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Rule ,
Health and Welfare Plans ,
Health Insurance ,
Johnson & Johnson ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Putative Class Actions ,
Retirement Plan
Seyfarth Synopsis: A recent district court decision highlights the continued uncertainties about what it means to include an arbitration clause in an ERISA plan. While courts generally agree that such clauses are, in theory,...more
Seyfarth Synopsis: As more employers announce that they cover travel benefits under their medical plans that will allow participants to be reimbursed for certain travel expenses necessary in order to access otherwise covered...more
Seyfarth Synopsis: A recent 10th Circuit decision holding that in order for the abuse of discretion standard to apply in litigation the claims administrator must provide participants with actual notice of discretionary...more
8/10/2020
/ Abuse of Discretion ,
Claim Procedures ,
De Novo Standard of Review ,
Disability Benefits ,
Disclosure Requirements ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Judicial Review ,
Notice Requirements ,
Plan Administrators ,
Standard of Review
In an unpublished decision dated May 16, 2019, the Ninth Circuit held that a plan administrator abused its discretion by denying surviving spouse benefits under an ERISA retirement benefit plan to a participant’s domestic...more
6/7/2019
/ Abuse of Discretion ,
Annuities ,
DOMA ,
Domestic Partnership ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Life Insurance ,
Plan Administrators ,
Remand ,
Surviving Spouse ,
Survivor Benefits
This is the one hundred and nineteenth issue in our series of alerts for employers on selected topics on health care reform. ...more
Seyfarth Synopsis: A recent case from the Eastern District of Pennsylvania reaffirms the basic principle that a threshold element of any ERISA claim is pleading the existence of an ERISA plan....more
The Fourth Circuit found in favor of an insurer on a claim for life insurance benefits, finding the insured’s failure to submit the required evidence of insurability was not excused by his employer having wrongly deducted...more
6/20/2018
/ Breach of Duty ,
Breach of Trust ,
Discovery ,
Eligibility ,
Employee Benefits ,
Evidence of Insurability (EIF) ,
Fiduciary Duty ,
Insurance Claims ,
Life Insurance ,
Putative Class Actions ,
Summary Judgment
Seyfarth Synopsis: In a win for ERISA plan and claims administrators, the Third Circuit has affirmed the broad enforcement of a long-term disability plan’s mental or nervous limitation period....more
Seyfarth Synopsis: The Supreme Court announced that it would not hear an appeal from the City of Houston in a case challenging the city’s ability to offer spousal benefits to same-sex spouses of municipal employees. By...more
Seyfarth Synopsis: The Texas Supreme Court held that the U.S. Supreme Court’s landmark marriage equality decision, Obergefell v. Hodges, did not dispositively address how far government employers must go in providing benefits...more
7/10/2017
/ Benefit Plan Sponsors ,
Employee Benefits ,
Equal Protection ,
First Amendment ,
Fourteenth Amendment ,
Free Exercise Clause ,
Free Speech ,
Freedom of Religion ,
Marriage Equality ,
Masterpiece Cakeshop Ltd v Colorado Civil Rights Commission ,
Obergefell v. Hodges ,
Public Accommodation ,
Same-Sex Marriage ,
SCOTUS ,
TX Supreme Court
Seyfarth Synopsis: The Eighth Circuit upheld dismissal of Title VII claims challenging an employee benefit plan’s blanket transgender exclusion because the exclusion impacted the employee’s transgender son, not the employee....more
5/31/2017
/ Affordable Care Act ,
Article III ,
Civil Rights Act ,
Corporate Counsel ,
Employee Benefits ,
Employer Group Health Plans ,
Gender Discrimination ,
Health Insurance ,
LGBTQ ,
Standing ,
Title VII ,
TPAs ,
Transgender
Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more
Seyfarth Synopsis: In an opinion that may result in increasingly complex ERISA benefits litigation, the Eighth Circuit has allowed a breach of fiduciary duty claim premised on alleged faulty claims handling practices to...more
In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174 (5th Cir. Apr. 21, 2017), the Firth Circuit concluded that Texas’ ban on discretionary clauses in certain insurance policies did not require a de novo review of...more
Seyfarth Synopsis: Adding to the body of conflicting authority on the scope of the attorney-client privilege in ERISA lawsuits, a district court has found that the fiduciary exception to attorney-client privilege applies to...more
3/9/2017
/ Attorney-Client Privilege ,
Benefit Plan Sponsors ,
Compensation & Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Fiduciary Exception ,
Insurance Industry ,
Long Term Disability Insurance ,
Privileged Communication ,
Retirement Plan
Seyfarth Synopsis: A Court ruled that under the Affordable Care Act, an ERISA governed plan exclusion cannot unequivocally bar emergency medical care related to injuries sustained in a fireworks explosion.
Recently, a...more
Seyfarth Synopsis: Currently before the Supreme Court are two petitions regarding the thorny legal question of which organizations can qualify for ERISA’s Church-plan exemption. If the Supreme Court grants certiorari and...more
10/12/2016
/ Anti-Discrimination Policies ,
Benefit Plan Sponsors ,
Church Plans ,
Churches ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Exemptions ,
First Amendment ,
Health Insurance ,
Healthcare ,
Hospitals ,
Petition for Writ of Certiorari ,
Religious Institutions ,
SCOTUS
Seyfarth Synopsis: A recent decision district court ruling affirms that in a benefit discrimination claim, just as in a typical claim of employment discrimination, to survive summary judgment a plaintiff must demonstrate that...more
In a landmark ruling on July 15, 2015 in _____ [name of charging party kept secret] v. Foxx, EEOC Appeal No. 2012-24738–FAA-03 (July 15, 2015), the U.S. Equal Employment Opportunity Commission (“EEOC’) held for the first time...more