Michael Graham

Michael Graham

McDermott Will & Emery

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Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

5/21/2016 - Administrative Review Appeals Burden of Proof Civil Monetary Penalty Claim Procedures Corporate Counsel De Novo Standard of Review Denial of Benefits DOL Employee Benefits ERISA Plan Administrators Standard of Review

More Paid Sick Leave – The New Trend Sweeping California

California’s Healthy Workplaces, Healthy Families Act of 2014 (California’s Sick Leave Law) took full effect statewide on July 1, 2015, requiring that most employees may use at least three days (24 hours) of paid sick leave...more

5/18/2016 - Corporate Counsel Local Ordinance Paid Sick Leave Act PTO Sick Leave Wage and Hour

Two Adverse Decisions against Church Plans Reached at Appellate Court Level

In Depth - Since 2013, there have been more than 10 lawsuits filed against various health care systems across the country that maintain and operate defined benefit pension church plans. These suits allege that the...more

4/18/2016 - Churches Defined Benefit Plans ERISA Healthcare Pension Plan Amendments

Supreme Court Emphasizes Heightened Pleading Standard for Stock Drop Cases

On January 25, 2016, the Supreme Court of the United States issued a per curiam opinion in Amgen Inc. v. Harris, holding that the Amgen, Inc. employees who filed suit after the value of the employer stock in which they had...more

3/7/2016 - Amgen v Harris Breach of Duty Duty of Prudence ERISA ESOP FIfth Third Bancorp v Dudenhoeffer Pleading Standards Retirement Plan SCOTUS Stock Drop Litigation

Supreme Court Issues Further Clarification on Equitable Relief Remedies Available Under ERISA

ERISA Section 502(a)(3) empowers plan fiduciaries to file suit “to obtain … appropriate equitable relief … to enforce … the terms of the plan.” In 1993, the Supreme Court of the United States interpreted this ERISA provision...more

1/28/2016 - Employee Benefits Equitable Relief ERISA Medical Expenses Medical Liens Montanile v Board of Trustees Reimbursements SCOTUS Settlement Subrogation

Flambeau Inc. Wellness Program Testing Falls Within ADA Safe Harbor

On December 30, 2015, a federal judge in the Western District of Wisconsin ruled in favor of Flambeau, Inc. (Flambeau) and against the Equal Employment Opportunity Commission (EEOC) in holding that Flambeau’s medical exams as...more

1/8/2016 - ADA EEOC Employer Group Health Plans Medical Examinations Safe Harbors Wellness Programs

DOL’s New Disability Claim Rules Add to a Plan Administrator’s Duties under Welfare and Retirement Benefit Plans

Now, faced with an aging baby-boomer generation and increased costs related to disability litigation, the U.S. Department of Labor’s Employee Benefit Security Administration (DOL) has proposed new rules that would revise and...more

12/1/2015 - Corporate Counsel Disability Benefits DOL ERISA Plan Administrators Proposed Regulation Retirement Plan

Seventh Circuit Finds that State Insurance Law Applies, Resulting in De Novo Review of Benefit Claim

On September 4, 2015, the U.S. Court of Appeals for the Seventh Circuit ruled in Fontaine v. Metropolitan Life Insurance Company that the Employee Retirement Income Security Act of 1974, as amended (ERISA), does not preempt...more

9/16/2015 - Arbitrary and Capricious De Novo Standard of Review Denial of Benefits Disability Insurance ERISA Health Insurance MetLife Plan Administrators Preemption Standard of Review

California Amends Its Healthy Workplaces, Health Families Law

As previously reported, California’s Healthy Workplaces, Health Families Act of 2014 (California’s Sick Leave Law) took full effect on July 1, 2015, although some provisions were effective as of January 1, 2015. The new law...more

7/30/2015 - Accrual Method Earned Sick Time Healthy Families Act Healthy Workplace Act Paid Sick Leave Act PTO Recordkeeping Requirements Sick Leave Sick Pay

Supreme Court Rejects Latest Challenge to Affordable Care Act: What Are Employers' Obligations Going Forward?

On June 25, 2015, the Supreme Court of the United States upheld one of the main pillars of the Affordable Care Act (ACA): the tax credits that allow millions of Americans to afford health care insurance on the public...more

6/29/2015 - Affordable Care Act Corporate Counsel Employer Group Health Plans Employer Mandates Health Insurance Health Insurance Exchanges King v Burwell Public Health Insurance Marketplace State Health Insurance Exchanges Subsidies Tax Credits

Supreme Court Acknowledges Fiduciaries Have Continuous Duty to Monitor Plan Investments, Remove Imprudent Investments

On May 18, 2015, the Supreme Court of the United States issued its opinion in the Tibble v. Edison Int’l, 575 U.S. ___ (2015) case, finding that the U.S. Court of Appeals for the Ninth Circuit erred in applying the six-year...more

5/20/2015 - 401k ERISA Fiduciary Duty Plan Administrators SCOTUS Statute of Limitations Tibble v Edison Int

View From McDermott: 2014 ERISA Litigation Review–Decisions From the Supreme Court and Beyond

Recently, the U.S. Supreme Court issued a number of significant ERISA cases. In its 2013-14 term, the Supreme Court decided two ERISA-based appeals – Fifth Third Bancorp. v. Dudenhoeffer and Heimeshoff v. Hartford Life & Acc....more

4/8/2015 - Benefit Plan Sponsors Equitable Surcharge ERISA FIfth Third Bancorp v Dudenhoeffer Heimeshoff v. Hartford Life & Accident Insurance Co. M&G Polymers v Tackett Reformation SCOTUS Tibble v Edison Int Venue

Sixth Circuit Rejects Claim that Disgorgement of Profits Is Appropriate Remedy in ERISA Benefit Denial Action

On March 5, 2015, the U.S. Court of Appeals for the Sixth Circuit, sitting en banc in the matter of Rochow v. Life Insurance Company of North America, 2015 WL 925794 (6th Cir. Mar. 5, 2015), reversed the finding of a prior...more

3/17/2015 - Breach of Duty Denial of Benefits Disability Benefits Disgorgement Equitable Relief ERISA Fiduciary Duty Section 502

Supreme Court Rejects Sixth Circuit’s Yard-Man Inferences in M&G Polymers USA, LLC v. Tackett

In M&G Polymers USA, LLC v. Tackett, 135 S. Ct. 935 (2015), the Supreme Court of the United States addressed the interpretation of collective bargaining agreements (CBAs) that include post-retirement welfare benefits, such as...more

2/19/2015 - CBAs Employer Group Health Plans Employer Healthcare Costs Health Insurance M&G Polymers v Tackett Retirement SCOTUS Vested Benefits Yard Man

ERISA Section 4062(e) Significantly Reformed Effective December 16, 2014

On December 16, 2014, President Obama signed into law the Consolidated and Further Continuing Appropriations Act, which contains provisions that significantly reform ERISA Section 4062(e). The new law is meant to ensure that...more

1/27/2015 - Defined Benefit Plans Defined Contribution Plans Employer Liability Issues ERISA Involuntary Reduction in Force New Legislation PBGC

View From McDermott: A New Type of ERISA-Based Hold-Up—The Rise of Out-of-Network Provider Suits Against Self-Funded Health Care...

Over the past decade, there has been a significant increase in the number of physicians who have dropped out of Preferred Provider Organization (‘‘PPO’’) and Health Maintenance Organization (‘‘HMO’’) networks and attempted to...more

12/4/2014 - ERISA Health Insurance HMOs Physicians PPOs Self-Funded Health Plans

California Imposes Mandatory Sick Leave Law

On September 10, 2014, California’s Healthy Workplaces, Healthy Families Act of 2014 (California’s sick leave law) became law. The new law requires most employers to allow employees to accrue up to three days of paid sick...more

12/3/2014 - Employee Rights Paid Leave Recordkeeping Requirements Sick Leave

Supreme Court to Review Application of ERISA’s Six-Year Statute of Limitations in Tibble v. Edison Int’l.

On October 2, 2014, the Supreme Court of the United States granted the plaintiffs’ petition for a writ of certiorari in Tibble v. Edison International to answer “Whether a claim that [Employee Retirement Income Security Act]...more

10/8/2014 - Certiorari Corporate Counsel ERISA Fiduciary Duty Mutual Funds Popular SCOTUS Statute of Limitations

Senate Unanimously Approves Bill Modifying ERISA Section 4062(e)

On September 16, 2014, the United States Senate unanimously approved Senate Bill 2511, which would amend Section 4062(e) of the Employee Retirement Income Security Act of 1974, as amended (ERISA), to clarify the definition of...more

10/1/2014 - Amended Legislation Benefit Plan Sponsors Employer Liability Issues ERISA Pending Legislation

PBGC Announces 2014 Moratorium on ERISA Section 4062(e) Enforcement Actions

On July 8, 2014, the Pension Benefit Guaranty Corporation (PBGC) issued a press release announcing a moratorium on its enforcement of Employee Retirement Income Security Act of 1974(ERISA) Section 4062(e) through the end of...more

7/11/2014 - Enforcement ERISA Moratorium PBGC

Sixth Circuit to Revisit Unprecedented Expansion of ERISA Wrongful Denial of Benefits Remedies

On December 6, 2013, in Rochow v. Life Insurance Company of North America, 737 F.3d 415 (6th Cir. 2013), the Sixth Circuit affirmed a district court ruling that an insurance company that improperly denied ERISA disability...more

3/7/2014 - Denial of Benefits Disability Disability Benefits ERISA

View From McDermott: Conflicting Review Standards in Executive Retirement Plan Benefit Claims—Is There Really a Difference?

Under the Employee Retirement Income Security Act, retirement plans generally come in two flavors – (i) retirement plans qualified under Section 401 of the Internal Revenue Code (the Code) and (ii) executive retirement plans,...more

2/27/2014 - ERISA Executive Compensation Retirement Plan Standard of Review

Supreme Court Upholds ERISA Plan’s Three-Year Deadline to File a Lawsuit

The Supreme Court of the United States ruled that an ERISA plan may properly impose a reasonable time limit on filing a lawsuit to recover benefits. Such time may start to run even before completion of the required...more

12/17/2013 - Claim Procedures Disability Benefits ERISA Hartford Life and Accident Insurance Company Heimeshoff v. Hartford Life & Accident Insurance Co. Proof of Loss SCOTUS Statute of Limitations

Multiple Class Action Complaints Challenge Church Plan Status of Hospital Pension Plans

Recent complaints challenging the “church plan” status of certain pension plans maintained by church-sponsored hospital systems may signal the beginning of a new wave of lawsuits challenging underfunded church pension plans. ...more

7/1/2013 - Catholic Church Churches Class Action ERISA Hospitals IRS Pensions

Second Circuit Narrows ERISA Exhaustion Requirement When Plan Document Is Ambiguous on Need to Follow Claims Procedures

The U.S. Court of Appeals for the Second Circuit’s holding in Kirkendall v. Halliburton, Inc. reaffirms that a benefit plan’s claims procedures must be drafted clearly and in language to be understood by a reasonable...more

2/7/2013 - Ambiguous Claim Procedures ERISA Patent Exhaustion Retirement Plan

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