A federal district court in New Jersey granted summary judgment in favor of New Jersey Bac Health Fund, finding the limitations provision set forth in the Fund’s SPD to be reasonable. Barriero v. NJ Bac Health Fund, 2013 U.S. Dist. LEXIS 181277 (D.N.J. Dec. 27, 2013). Under the welfare plan limitations provision, participants seeking to file suit pursuant to section 502(a)(1)(B) of ERISA must do so within “3 years after the end of the year in which medical . . . services were provided.” Plaintiff underwent surgeries in March and April of 2009 and appealed the total amount paid by the plan. On April 1, 2011, Plaintiff’s final appeal was denied. He subsequently filed suit on January 28, 2013, three years and one month after the end of the year he received medical services.

Plaintiff argued that the SPD’s three-year limitations period was inherently unfair because it began to run prior to the time when a participant could seek judicial review. Plaintiff contended that the deadline for filing the suit should have been April 1, 2014, three years after the exhaustion of all internal administrative appeals. The court, relying on the recent Supreme Court decision in Heimeshoff v. Hartford Life & Accident Ins. Co., 134 S. Ct. 604 (2013),disagreed, holding that effect must be given to a plan’s limitations provision unless the provision is determined to be unreasonable. Here, the court found the three-year limitations period reasonable and noted that the plaintiff could have filed suit at any time between April 1, 2011 and December 31, 2012.

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Photo of Tulio Chirinos Tulio Chirinos

Tulio D. Chirinos is an associate in the Labor & Employment Law Department and a member of the Employee Benefits & Executive Compensation Group and the Workplace Investigations Practice Group.

Tulio works on a wide variety of ERISA and non-ERISA plan litigation matters…

Tulio D. Chirinos is an associate in the Labor & Employment Law Department and a member of the Employee Benefits & Executive Compensation Group and the Workplace Investigations Practice Group.

Tulio works on a wide variety of ERISA and non-ERISA plan litigation matters, including fee and investment litigation cases, breach of fiduciary duty claims and benefits claims. He also represents management in workplace investigations and litigation of employment-related matters, including claims of unlawful discrimination, harassment and retaliation. Tulio focuses his pro bono efforts on immigration matters where he has represented several juveniles from Central America in their asylum petitions and special immigrant juvenile status (SIJ) petitions.

Tulio is the author of several ERISA-related articles, including several focusing on ERISA fee and investment litigation that appeared in the Benefits Law Journal (2016-2023), Bloomberg BNA, and Law360. He is a contributing author to Chapter 10 (Fiduciary Responsibility) of BNA’s Employee Benefits Law treatise. He is also the co-editor and a frequent contributor to Proskauer’s Employee Benefits & Executive Compensation Blog.

Prior to joining Proskauer, Tulio clerked for the Federal Public Defender’s office for the Middle District of Florida. Tulio is a retired Lieutenant Colonel in the Army National Guard and served three tours of duty in Iraq, Kuwait, and Jordan.