In Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., June 19, 2013), the court granted Quest Diagnostic’s (“Quest”) motion for summary judgment, ruling that Quest, as the fiduciary to its self-insured medical plan, could recover medical benefits paid to its employee after the employee was injured in an accident and recovered a settlement from the responsible third-party. Citing the Supreme Court’s recent ruling in U.S. Airways, Inc. v. McCutchen, the district court ruled that the plan had a right under ERISA Section 502(a)(3) to recover the medical benefits paid to the employee based on the reimbursement provision of the plan, which clearly stated that the employee was “responsible for reimbursing the plan for 100% of the amounts paid by the medical plan…regardless of whether [the employee] ha[s] been made whole.” The court rejected the defendants’ argument that the “make-whole doctrine,” which would prevent the employee from paying monies from his personal injury recovery until he was “fully compensated for his injuries,” limited the plan’s right to recovery, reasoning that the explicit terms of the plan “unambiguously foreclose[d] the application of the make-whole doctrine.” The court also ruled that Connecticut’s anti-subrogation statue, which prohibits insurers from pursing recovery from third-party tort settlements, was preempted by ERISA and did not apply, because Quest’s plan was self-insured.

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Photo of Anthony Cacace Anthony Cacace

Anthony S. Cacace is a partner in Proskauer’s Labor & Employment Law Department and a member of the Employee Benefits & Executive Compensation Group. Anthony serves as legal counsel to the boards of trustees and other fiduciaries of Taft-Hartley multiemployer pension and welfare…

Anthony S. Cacace is a partner in Proskauer’s Labor & Employment Law Department and a member of the Employee Benefits & Executive Compensation Group. Anthony serves as legal counsel to the boards of trustees and other fiduciaries of Taft-Hartley multiemployer pension and welfare benefit plans subject to ERISA in a variety of industries. These include construction, transportation, private sanitation, trucking, industrial, health care and maritime.

Anthony’s representation of trustees and other fiduciaries ranges from counseling on the day-to-day operations of multiemployer funds, including:

  • drafting plan documents, amendments and procedures;
  • negotiating and drafting fund service provider agreements;
  • counseling with respect to participant claims; and
  • providing legal advice with respect to requirements of ERISA and the IRC.

His practice also includes more complex and high stakes scenarios, such as:

  • advising on fund mergers;
  • advising on fund acquisitions of real property;
  • drafting and submitting corrective applications to the IRS; and
  • counseling fiduciaries in investigations and audits by governmental agencies (including the U.S. DOL, U.S. DOJ and the IRS).

Anthony’s practice is unique because of his specialization in ERISA litigation. He advises trustees and fiduciaries from a litigation avoidance perspective, solving problems and rendering advice in risk exposure situations before they evolve into disputes or litigations. A skilled litigator, he often defends trustees and fiduciaries in lawsuits brought pursuant to ERISA, alleging claims for breaches of fiduciary duty, benefit claim denials, plan investment losses and improper plan amendments. In addition, he regularly represents his fund clients as plaintiffs in court, seeking to collect withdrawal liability and delinquent contributions from contributing employers.

Anthony is an accomplished author and speaker on issues confronting trustees of multiemployer funds. He has authored several articles featured in Bloomberg Law Reports and Benefits Magazine, and also serves as a chapter editor of the withdrawal liability section of the American Bar Association’s Employee Benefits Law treatise published by BNA. Anthony is routinely invited to speak at International Foundation of Employee Benefit Plans conferences and the ABA Employee Benefits Committee mid-winter meetings.