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U.S. Supreme Court rules that plan terms trump equitable defenses
- Proskauer Rose LLP
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- USA
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- April 16 2013
Today, the U.S. Supreme Court issued its ruling in U.S. Airways, Inc. v. McCutchen in which the Court unanimously ruled that a clearly drafted
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
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- November 9 2012
In Access Mediquip, L.L.C. v. UnitedHealthcare Insurance Co., F.3d , No. 10-20868, 2012 WL 4747260 (5th Cir. Oct. 5, 2012), the Fifth Circuit, en banc, held that ERISA does not preempt a third-party medical provider's state law claims based on a health plan insurer's misrepresentations of coverage
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
- -
- USA
- -
- October 12 2012
In Reese v. CNH Am. LLC, Nos. 11-1359, 11-1857, 11-1969, --- F.3d ---, 2012 WL 40009695 (6th Cir. Sept. 13, 2012), the Sixth Circuit for the second time reversed the decision of the district court and held that an employer could reasonably yet unilaterally alter lifetime healthcare benefits for retirees without engaging in collective bargaining
Sixth Circuit distinguishes itself and rules that presumption of prudence should not be applied on a motion to dismiss
- Proskauer Rose LLP
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- USA
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- February 23 2012
The Sixth Circuit issued a ruling on February 22, 2012 in Pfeil v. State Street Bank and Trust Co., No. 10-2302, 2012 WL 555481 (6th Cir. Feb. 22, 2012) that distinguishes itself from other Circuit Courts concerning the application of the presumption of prudence that applies to an ERISA plan fiduciary's decision to invest in an employer stock fund
Third Circuit limits relief available to ERISA welfare plans seeking reimbursement of medical expenses
- Proskauer Rose LLP
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- USA
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- 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."
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
- -
- October 5 2011
In Franco v. Connecticut General Life Ins. Co., No. 07-cv-6039, 2011 U.S. Dist. LEXIS 109022 (D.N.J. Sept. 23, 2011), plaintiffs, who were plan subscribers, health care providers, and several associations whose members consisted of out-of-network ("ONET") providers who provided ONET services to patients insured by CIGNA, alleged that CIGNA violated its contractual obligations to pay for ONET services at the "usual, customary and reasonable" ("UCR") rate by relying on the flawed database maintained by Ingenix, which generated artificially low UCRs to underpay ONET benefits to CIGNA plan members
"Surcharge" as monetary relief after Amara
- Proskauer Rose LLP
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- USA
- -
- September 9 2011
In CIGNA Corporation v. Amara, 131 S. Ct. 1866 (U.S. 2011), the Supreme Court held that ERISA plaintiffs who seek anything other than benefits pursuant to the governing plan document cannot assert their claims under ERISA Section 502(a)(1)(B
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
- -
- USA
- -
- September 9 2011
In Florida v. United States Dep't of Health and Human Servs., 11-11021-cv, 2011 WL 3519178 (11th Cir. Aug. 12, 2011), the Eleventh Circuit affirmed in part and reversed in part the district court's ruling that the Affordable Care Act was unconstitutional
CIGNA Corp. v. Amara: changing the landscape of ERISA litigation
- Proskauer Rose LLP
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- USA
- -
- June 7 2011
This month, we lead with an article addressing the Supreme Court's decision in CIGNA Corp. v. Amara
U.S. Supreme Court rejects class-wide relief for summary plan description miscommunication
- Proskauer Rose LLP
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- USA
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- May 16 2011
In Amara v. Cigna, No. 09-804 (U.S. May 16, 2011), the Supreme Court reversed and remanded a lower court ruling that had posed a substantial threat to employer plan sponsors by subjecting them to class-wide relief for a miscommunication without requiring any showing of harm
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- Workarea - Employee Benefits & Pensions
- Workarea - Litigation
- Author - Myron D Rumeld
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