Employee Benefits & Executive Compensation Blog

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

Todd Mobley

Todd Mobley

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Mental Health Parity Act: A Litigation Update

The Federal Mental Health Parity and Addiction Equity Act (the “Federal Parity Act”), like many similar state parity laws, mandates that financial requirements (e.g., copayments, coinsurance, or deductibles) and treatment limitations (e.g., limitations on the frequency of treatment, number of out-patient visits, or amount of days covered for in-patient stays) applicable to mental health benefits … Continue Reading

Fourth Circuit Rejects Widow’s Claim for Equitable Relief

The Fourth Circuit recently rejected fiduciary breach and equitable estoppel claims for life insurance coverage by Leslie Moon, the widow of a deceased employee, who claimed that the employer’s actions resulted in Mr. Moon’s failure to convert his life insurance to an individual policy following the onset of his disability.  In so ruling, the Court … Continue Reading

Transgender Woman Seeks Coverage Under ACA

A transgender woman recently filed a complaint in the U.S. District Court for the Central District of Illinois against her primary care physician, as well as the not-for-profit health-care clinic with which her physician is affiliated, for alleged violation of the anti-discrimination provision of the Affordable Care Act (ACA). Taylor v. Lystila, No. 14-cv-2072 (C.D. … Continue Reading

Courts Continue to Apply Presumption of Prudence While Awaiting the USSC’s Views

As the employee benefits world awaits the U.S. Supreme Court’s decision in Dudenhoeffer v. Fifth Third Bancorp, two federal courts recently dismissed employer stock-drop cases brought under ERISA on the ground that plaintiffs failed to overcome the presumption that a fiduciary’s decision to remain invested in employer stock was prudent. See Smith v. Delta Air … Continue Reading

Court Rejects Plaintiff’s Attempt to Prevent Plan from Recouping $250,000 Overpayment

A federal district court in the Northern District of California dismissed an equitable estoppel claim brought by a pension-plan participant seeking to prevent the plan from recouping an overpayment. See Groves v. Kaiser Found. Health Plan, Inc., No. 13-cv-2259, 2014 U.S. Dist. LEXIS 38755 (N.D. Cal. Mar. 24, 2014). Relying on defendants’ representations that participants … Continue Reading

Defendants See Success With Limitations Defenses Post Heimeshoff

Defendants have recently received three favorable decisions involving contractual and statutory limitations defenses. In each case, a federal court held that claims for benefits under ERISA plans were time-barred. Costa v. Astoria Fed. Sav. and Loan Ass’n, 2014 U.S. Dist. LEXIS 14292 (E.D.N.Y. Feb. 4, 2014); Paulus v. Isola USA Corp. Ret. Plan, 2014 U.S. … Continue Reading

U.S. Supreme Court: A Decision on the Merits Triggers the Time to Appeal Irrespective of a Pending Contractual or Statutory Attorneys’ Fee Application

The U.S. Supreme Court ruled in a unanimous opinion that an unresolved claim for attorney’s fees does not prevent a decision on the merits of an ERISA suit from becoming final for purposes of the deadline to file a notice of appeal to a federal appellate court. Ray Haluch Gravel Co. v. Cent. Pension Fund … Continue Reading

District Court Upholds Validity of IRS Rule Authorizing Premium Tax Credits to Individuals Who Enroll in Health-Care Coverage through Federally-Facilitated Exchanges

A district court in the District of Columbia recently held that the Internal Revenue Service’s (“IRS”) rule authorizing premium tax credits to individuals who enroll in health-care coverage through federal exchanges was unambiguously consistent with the “text, structure, and purpose” of the Affordable Care Act (“ACA”). Halbig v. Sebelius, No. 13-cv-0623, 2014 U.S. Dist. LEXIS … Continue Reading

New FAQs Provide Guidance Regarding Effect of ACA on the MHPAEA

As previously reported, the federal agencies responsible for drafting the rules implementing the Affordable Care Act (“ACA”) (the U.S. Department of Labor, the U.S. Department of Health and Human Services, and the U.S. Treasury Department) recently issued FAQ Part XVIII, regarding implementation of the market reform provisions of the ACA. Question 12 in FAQ Part … Continue Reading

Federal District Court Tosses $450 Million Retiree Health Care Suit Against GM

A federal district court in Michigan dismissed a breach-of-contract suit against General Motors over a $450 million payment for retiree medical benefits.  Int’l Union, UAW v. Gen. Motors, LLC, No. 10-11366, 2013 U.S. Dist. LEXIS 173793 (E.D. Mich. Dec. 10, 2013).  As part of a settlement agreement with the UAW in 2007, General Motors promised … Continue Reading

Valid Assignment Confers Beneficiary Status on Chiropractor

A federal district court in Illinois recently issued a pair of rulings in cases where insurers sought to recoup payments from practitioners.  Pennsylvania Chiropractic Association v. Blue Cross Blue Shield Association, 2013 U.S. Dist. LEXIS 159331 (N.D. Ill. Nov. 7, 2013); 2013 U.S. Dist. LEXIS 159491 (N.D. Ill. Nov. 7, 2013).  Plaintiffs, three individual chiropractors … Continue Reading

Seventh Circuit Again Grants Class Certification In Excessive Fee Case

On remand from the Seventh Circuit, a federal district court in Illinois granted class certification in a case where participants in a Boeing 401(k) plan alleged that Boeing breached its fiduciary duties under ERISA by: (i) causing the plan to pay excessive administrative fees; (ii) failing to disclose material information regarding administrative fees; and (iii) … Continue Reading

The Post-DOMA World Relating to ERISA-Governed Employee Benefit Plans

As a result of the U.S. Supreme Court’s decision in United States v. Windsor, 133 S. Ct. 2675 (2013), in which the Court held that Section 3 of the federal Defense of Marriage Act (“DOMA”) was unconstitutional, same-sex marriages will be recognized for purposes of federal laws, protections, and obligations.  Because the Court did not … Continue Reading
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