Lane Powell PC - ERISA Law Blog

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ERISA: Sometimes A Government Employee’s Benefits Could Be Governed By ERISA?

You already know that employee benefit plans established by governmental entities are exempt from ERISA. But ERISA might apply if the employee benefit for the government employee is established through an association…more
| Education, Government Contracting, Insurance, Labor & Employment Law

ERISA – 9th Cir. Telephonic Beneficiary Designation Enforced — Beneficiary Designation Forms Are NOT Plan Documents

Can a participant designate a beneficiary merely with a phone call? You need to look at the plan documents. But are beneficiary designation forms ERISA “plan documents”? It depends, and it makes a difference…more
| Civil Procedure, Commercial Law & Contracts, Finance & Banking, Labor & Employment Law

ERISA-Disability: 1 in 3 Social Security Administration Disability Determinations Involve Mental Disorder Diagnosis

As you know, ERISA plan administrators must consider Social Security Administration (SSA) disability determinations when making the disability benefit decision. ERISA plan administrators are not bound by the SSA’s…more
| Labor & Employment Law, Insurance

ERISA: 8th Circuit: Choice-Of-Law Provision Trumps Insurance Regulation Banning Discretionary Review

You already know that when a claimant brings suit alleging wrongful denial of ERISA-governed disability benefits, the first issue the court looks at is: what standard of review applies. If the plan or policy includes…more
| Civil Procedure, Commercial Law & Contracts, Insurance

ERISA: 4th Circuit: When Is A Plan Administrator Obligated To Obtain Medical Records?

You already know that the primary responsibility for providing medical proof of disability undoubtedly rests with the claimant. But does the plan administrator sometimes have an obligation to obtain medical records and…more
| Labor & Employment Law, Insurance

ERISA (11th Cir.): Claim Barred by Statute of Limitations Even When Administrator Cannot Produce Denial Letter

What happens when a claim denial letter was issued, but the claimant denies ever receiving it, and the administrator can’t produce it? How does that affect the statute of limitations?…more
| Civil Procedure, Labor & Employment Law

Watch For A New Wave Of ERISA Stock Drop Cases

Plan fiduciaries may create a fiduciary duty in stock drop cases by incorporating filings with the Securities and Exchange Commission into the Summary Plan Description. We have been waiting for the Ninth Circuit to rule…more
| Civil Procedure, Labor & Employment Law, Finance & Banking, Business Torts, Securities Law

ERISA (6th Circuit): Venue Selection Clauses Enforceable Despite Secretary of Labor Opposition

Many ERISA plans have venue provisions. The Secretary of Labor has argued in litigation, however, that these provisions are “incompatible with ERISA.”…more
| Civil Procedure, Commercial Law & Contracts, Labor & Employment Law, Finance & Banking

ERISA: 11th Circuit Says “Show Me The Money” In Equitable Recovery Of Medical Expenses Even After Disbursement Or Commingling Of Funds

Can the Plan get reimbursed even when the beneficiary’s settlement funds have been disbursed or commingled? Yes in the 11th Circuit. But watch out in the 9th Circuit…more
| Labor & Employment Law, Finance & Banking, Insurance

ERISA: 2nd Circuit — Tough to Appeal District Court’s ERISA Remand Order

What happens when the district court orders a remand to the ERISA plan administrator? Can you appeal it? It depends on the circuit. FACTS: Mead sought ERISA-governed long term disability benefits, which were…more
| Civil Procedure, Labor & Employment Law, Finance & Banking

ERISA: Plaintiff’s Attorney Fees Denied — Filing Of Lawsuit Was Not Reason Why Benefits Were Granted

You already know that in ERISA cases a court may, in its discretion, award attorney fees if a party achieved “some degree of success on the merits.”…more
| Civil Procedure, Civil Remedies, Labor & Employment Law, Insurance

ERISA ATTORNEY FEES – 1st Circuit: Court Remand to Claims Administrator “because the record is insufficient for de novo review” is “sufficient success on the merits” to Award Attorney Fees?

You have seen this issue before: The court remands the ERISA-governed long term disability claim for further consideration by the claims administrator because the administrative record was insufficient for de novo review…more
| Administrative Law, Civil Procedure, Civil Remedies, Labor & Employment Law

ERISA: 6th Circuit — Benefit Denial Letters: Include The Time Limit For Judicial Review Or Lose Contractual Limitations Defense

Does your ERISA claim benefit denial letter preserve the contractual limitations defense? If your denial letter fails to expressly state the contractual limitations timeframe, it might not preserve that defense…more
| Civil Procedure, Commercial Law & Contracts, Labor & Employment Law

ERISA (8th Circuit): Over-The-Counter Vitamin Supplements Trigger Pre-Existing Condition Exclusion

What sort of “medical treatment” triggers the pre-existing condition exclusion in an ERISA-governed disability policy?…more
| Civil Procedure, Labor & Employment Law, Health, Insurance

More Disabled Employees But Fewer Employees Covered With Long Term Disability Coverage

Here is a recent news item showing the scope of the employee disability problem. In a nutshell..…more
| Labor & Employment Law
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