Employee Benefits & Executive Compensation Blog

The View from Proskauer on Developments in the World of Employee Benefits, Executive Compensation & ERISA Litigation

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Sixth Circuit Expands Availability of Remedies Under ERISA

The Sixth Circuit recently concluded that a disability plan participant was entitled to relief consisting of benefits under the plan and disgorgement of defendant’s profits for delaying payment. In so ruling, the Court found that this case presented a “a logical extension” of its precedent allowing a plaintiff to pursue in limited circumstances both a … Continue Reading

Supreme Court to Resolve Circuit Split in Health Care Reform Cases

The Supreme Court will review two of the numerous lawsuits challenging the Affordable Care Act’s (ACA) requirement that group health plans and insurers cover, without cost-sharing, contraceptives and/or abortifacients (the “Contraceptive Mandate”). The plaintiffs in these suits are secular, for-profit corporations and their owners, and they assert that being forced to comply with the Contraceptive … Continue Reading

Claims Administrator Not Liable Under ERISA For Alleged Failure to Follow ACA’s Enhanced Benefit Claim Procedures

A federal court in New York appears to have issued the first published decision addressing alleged violations of the enhanced benefit claim procedures arising out of the Affordable Care Act (ACA). The new procedures contain various participant-friendly provisions, such as the right to external review, that alter ERISA’s existing benefit claim procedures for non-grandfathered welfare … Continue Reading

Sixth Circuit Rejects Challenge to ACA Based on Religious Beliefs

The Affordable Care Act (ACA) requires non-grandfathered health plans to cover certain preventative health services. In a case seeking an injunction to bar enforcement of ACA’s so-called “contraception mandate” on the ground that it infringed plaintiffs’ deeply held religious beliefs, the Sixth Circuit held that secular, closely held for-profit corporations were not “persons” protected by … Continue Reading

Rule 23 Requirements are “Heightened” for Proposed Class Settlements

In Rodriguez v. Nat’l City Bank, — F.3d —, 2013 WL 4046385 (3d Cir. Aug. 12, 2013), the Third Circuit refused to certify a proposed class for settlement purposes to amicably resolve mortgage discrimination claims because those claims failed to satisfy Rule 23 under the Supreme Court’s recent ruling in  Dukes v. Wal-Mart.  Rejecting plaintiffs’ contention … Continue Reading

Oklahoma’s Challenge to Health Care Reform’s “Employer Mandate” May Proceed

A federal district court recently ruled that, at the pleadings stage, Oklahoma established standing to pursue its suit to bar enforcement of the Affordable Care Act’s (“ACA”) shared responsibility penalty provisions. Oklahoma ex rel. Pruitt v. Sebelius, No. CIV-11-30, 2013 WL 4052610 (E.D. Okla. Aug. 12, 2013). ACA contains a shared responsibility provision (also known … Continue Reading

No Fiduciary Status For 401(k) Plan Service Provider

The Third Circuit affirmed dismissal of plaintiff Nicholas Danza’s claims that Fidelity breached its fiduciary duties and engaged in prohibited transactions by charging excessive service fees for reviewing and qualifying Domestic Relations Orders (DROs) for a 401(k) plan. Danza v. Fidelity Management Trust Co., 2013 WL 3872118 (3d Cir. July 29, 2013) (unpublished).  Danza filed suit … Continue Reading

No Fiduciary Status For 401(k) Plan Service Provider

John Hancock Life Insurance Company is the most recent 401(k) plan service provider to prevail in a case by the plaintiffs’ bar asserting ERISA fiduciary breach claims based on allegations that it charged excessive 401(k) plan fees and received excessive revenue sharing payments.  Santomenno v. John Hancock Life Ins. Co., No. 2:10-cv-01655 (WJM), 2013 WL … Continue Reading

The View From Proskauer: Health Care Reform Litigation Risks —The Intersection of ERISA Section 510 and the Affordable Care Act’s Whistleblower Provisions

The Affordable Care Act (ACA) is significantly changing employer health care obligations under the Employee Retirement Income Security Act (ERISA).  Prior to ACA, the Supreme Court held that ERISA did not require employers to offer any level or type of welfare benefits, such as health care benefits. Now that ACA has passed constitutional muster, effective … Continue Reading

Monetary Damages Potentially Available For Inadequate Disclosure

In Weaver Bros. Ins. Assoc., Inc. v. Braunstein, No. 11-5407, 2013 WL 1195529 (E.D. Pa. Mar. 25, 2013), a district court denied the plan administrator’s motion for judgment on the pleadings, ruling that monetary relief may be available for ERISA violations associated with the plan administrator’s failure to properly communicate the participant’s benefit rights following … Continue Reading

District Court Permits ERISA Claim for Benefits of IRO Review, Holding Such Review Is Not an Arbitration

In Yox v. Providence Health Plan, No. 12–cv–01348, 2013 WL 865968 (D. Or. Mar. 8, 2013), a federal district court held that the review of benefit denials by an independent review organization (IRO) is not akin to an arbitration proceeding, and thus did not preclude a plan participant from seeking judicial review under ERISA of … Continue Reading
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