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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Proposed Mental Health Parity Guidance Focuses on Nonquantitative Treatment Limitations

On April 23, 2018, the Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (together, the “Agencies”) released proposed frequently asked questions (“FAQs”) related to nonquantitative treatment limitations (“NQTLs”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”).  The Agencies also provided guidance on new disclosure requirements (which were described in our … Continue Reading

New DOL FAB Further Delays Enforcement of Fiduciary Rule, But Does Not Undo The Rule In Its Entirety

On May 7, 2018, the DOL issued a Field Assistance Bulletin (“FAB”) addressing the Department’s enforcement policy on the fiduciary rule that was recently vacated by the Fifth Circuit.  Although the DOL has elected not to continue defending the rule before the Fifth Circuit, the FAB leaves the rule’s status in a holding pattern. Rather … Continue Reading

Anthem Settles Mental Health Parity Litigation Involving Autism Treatment

A federal district court in Indiana recently granted preliminary approval of a settlement between Anthem and a class seeking coverage of Applied Behavior Analysis (“ABA”) treatment for autism disorders. The three-year old litigation involved claims that Anthem violated the federal Mental Health Parity and Addiction Equity Act (“MHPAEA”) by limiting the hours of ABA therapy that … Continue Reading

Confusion Ensues After Appeal Over Fiduciary Rule in D.C. Circuit Dropped

On March 23, 2018, the National Association for Fixed Annuities (“NAFA”) and the Department of Labor filed a Joint Stipulation of Dismissal of litigation involving the Department’s fiduciary rule in the District of Columbia Circuit.  NAFA had appealed a district court decision that dismissed NAFA’s challenge to the fiduciary rule.  The decision to drop that … Continue Reading

Fifth Circuit Vacates DOL Fiduciary Rule

In a 2-1 decision, the U.S. Court of Appeals for the Fifth Circuit vacated the Department of Labor’s fiduciary rule, including the expanded definition of “investment advice fiduciary” and the associated exemptions. The decision nullifies the Department’s 2016 regulation—at least in the Fifth Circuit, which includes Texas, Louisiana, and Mississippi, and arguably nationwide—but is not … Continue Reading

Tenth Circuit Upholds DOL’s Authority to Impose New Conditions for PTEs and Leaves Door Open for Changes to Fiduciary Rule

The Tenth Circuit recently affirmed the Department of Labor’s authority to impose new conditions for exemption from prohibited transaction rules with respect to the sale of annuity contracts. The case related to the Department’s decision, as part of the 2016 “fiduciary rule,” to make sales of fixed indexed annuities ineligible for Prohibited Transaction Exemption 84-24, … Continue Reading

No Standing To Pursue Fiduciary-Breach Claim Where Plan Became Overfunded During Litigation

The Eighth Circuit held that defined benefit pension plan participants who alleged breach of fiduciary duty and prohibited transaction claims under ERISA lacked standing to assert their claims because, during the course of the litigation, the plan became overfunded. Plaintiffs brought suit after the plan lost $1.1 billion, which plaintiffs claimed arose from imprudent investments and … Continue Reading

New Class Action Lawsuits Asserting Violations of the MHPAEA

Banner Health and the Kaiser Foundation  were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage. In the case against Banner Health, plaintiffs challenge Banner Health’s exclusion of applied behavior analysis therapy from coverage for autism spectrum disorder as “experimental or investigational.” Plaintiffs allege that the failure to … Continue Reading

Ninth Circuit: Medical Providers Lack ERISA Standing

The Ninth Circuit affirmed two district court decisions that concluded medical providers were not “beneficiaries” under Section 502(a) of ERISA and therefore lacked standing to bring an ERISA claim. The Court explained that, in one case, the provider had an assignment from the participants, but the assignment was invalid because the plan contained a non-assignment clause … Continue Reading

Sixth Circuit: ERISA Exhaustion Not Required in Plan Amendment Suit

The Sixth Circuit held that retirement plan participants were not required to exhaust their administrative remedies prior to bringing a claim alleging that a plan amendment violated ERISA.  In so holding, the Court agreed with the opinions of the Third, Fourth, Fifth, Ninth, Tenth, and D.C. Circuits and disagreed with the opinions of the Seventh … Continue Reading

Class Certified in Claims for Autism Treatment Coverage

A federal district court in the Western District of Kentucky certified a class of participants and beneficiaries in plans sponsored by Anthem Health Plans of Kentucky, Inc. who had been denied coverage or reimbursement for Applied Behavior Analysis (ABA) for Autism Spectrum Disorder (ASD).  Plaintiff claimed that the time and dollar limitations violated ERISA and … Continue Reading

ERISA Section 510 Interference Claim Time Barred

A federal magistrate judge in Pennsylvania recommended that a class action complaint claiming that AlliedBarton terminated certain employees to prevent them from reaching eligibility for vacation benefits be dismissed as untimely.  Observing that ERISA section 510 does not provide a specific statute of limitations, the court determined that the most analogous state-law cause of action … Continue Reading

Challenge to Pension Fund Investment Decision Time Barred

A federal district court in California held that a complaint filed by members of the International Union of Operating Engineers that challenged pension plan trustees’ decision to make certain investments was filed five days too late and thus barred by ERISA’s six-year statute of limitations.  In so holding, the court ruled that the limitations period … Continue Reading

Pension Consultant Found Not to be an ERISA Fiduciary

The Tenth Circuit held that a pension plan consultant, who misstated the amount of monthly pension payments that a pension plan participant would receive in retirement, was not a fiduciary under ERISA. Plaintiffs Trent and Wendy Lebahn, who were participants in the National Farmers Union Uniform Pension Plan, claimed that the Plan, its Pension Committee … Continue Reading
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