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Third Circuit limits relief available to ERISA welfare plans seeking reimbursement of medical expenses

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • November 17 2011

In a case of significant importance for plan sponsors and fiduciaries, the U.S. Court of Appeals for the Third Circuit held in US Airways, Inc. v. McCutchen, No. 10-3836 (3d Cir. Nov. 16, 2011), that an employee benefit plan was not entitled to full reimbursement of medical expenses it paid to a participant even though the plan provided that the participant was required to reimburse the plan for all amounts paid "out of any monies recovered from a third party."

Second Circuit holds Taft-Hartley funds are inherently conflicted, potentially affects outcome and scope of future benefit claims litigation

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • June 29 2010

On June 24, 2010, the U.S. Court of Appeals for the Second Circuit held, in Durakovic v. Building Service 32 BJ Pension Fund, 2010 WL 2519645 (2d Cir. 2010), that Taft-Hartley funds (administered by boards of trustees consisting of an equal number of union and employer representatives) are inherently conflicted when making benefit determinations, and that this conflict needs to be considered by federal district courts when reviewing plan determinations under an arbitrary and capricious standard of review

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • June 7 2010

In Golden Gate Restaurant Assoc. v. City and County of San Francisco, No. 08-1515 (U.S.), the U.S. Solicitor General requested that the Supreme Court deny certiorari in light of the recent enactment of the Patient Protection and Affordable Care Act (PPACA