JONES DAY TALKS®: Consumer Protection Enforcement Changes Likely After SCOTUS AMG Decision
KT Sound Bytes Episode 1 | The Effects of the Supreme Court Decision in Liu v. SEC
Investment Management Roundtable Discussion – Regulatory and Enforcement Update
The Employee Retirement Income Security Act of 1974 (“ERISA”), as amended, regulates virtually every private employee benefit program in the United States. Among other things, ERISA contains its own civil enforcement section,...more
In an ERISA case for wrongful denial of health insurance benefits, the U.S. Court of Appeals for the Fourth Circuit addressed when a plaintiff may recover monetary relief under §§ 502(a)(1)(B) and (a)(3). The Fourth Circuit...more
The United States Court of Appeals recently shed light on when—and under what conditions—a plaintiff may seek a monetary recovery under § 502(a)(3) of the Employee Retirement Income Security Act (ERISA). Section 502(a)(3)...more
In Su v. Fensler, No. 22-cv-01030, 2023 WL 5152640 (N.D. Ill. Aug. 10, 2023), the court granted the Department of Labor’s motion for a preliminary injunction to replace with an independent fiduciary the trustees of the United...more
In Castillo v. Metro. Life Ins. Co., 2020 U.S. App. LEXIS 25985 (9th Cir. Aug. 17, 2020), the Ninth Circuit held that attorneys' fees incurred during the administrative review process cannot be recovered as "other equitable...more
In Julie L. v. Excellus Health Plan, Inc., 2020 U.S. Dist. LEXIS 47734 (W.D.N.Y. March 19, 2020), a New York district court rejected the plaintiff's claims that a health insurer improperly imposed stricter medical necessity...more
The Second Circuit Court of Appeals recently issued an opinion in Frommert v. Conkright, affirming a district court decision regarding appropriate equitable remedies under ERISA and the amount of prejudgment interest to be...more
Editor’s Overview - This month we review the U.S. Supreme Court’s decision in Montanile v. Board of Trustees of National Elevator Industries Health Benefit Plan where the Supreme Court considered the scope of...more
Most self-funded ERISA medical plans provide that participants who have been injured by other people (think car accidents) must reimburse the plan if the participant recovers from the other person for those injuries. In order...more
On January 20, the Supreme Court released its decision in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, concluding that although health plan fiduciaries can generally seek subrogation...more
Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan is the fourth decision by the U.S. Supreme Court addressing the subrogation rights of self-insured ERISA-covered health plans. Three...more
It’s a common scenario when dealing with a benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA): an employee participating in the plan is injured by a third-party, the plan pays covered medical...more
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
Over the years, the U.S. Supreme Court from time to time has explored the scope of equitable relief available under the Employee Retirement Income Security Act of 1974 (“ERISA”) in circumstances where an employee benefit plan...more
The U.S. Supreme Court has ruled that an ERISA plan has no right to recover benefits paid on behalf of a participant where the participant has already dissipated settlement funds received from a third party. In...more
“A” gets hit by a drunk driver and incurs $121,044 in medical expenses. The ERISA Plan agrees to pay the expenses if “A” contractually agrees to reimburse the Plan for any recovery obtained as the result of any legal action...more
On January 20, 2016, the Supreme Court handed down yet another case addressing health plan subrogation. From the Supreme Court’s earlier decision in Sereboff v. Mid Atlantic Medical Services, Inc. (547 U.S. 356) (2006),...more
In Montanile v. Bd. of Trs. of the Nat'l Elevator Indus. Health Benefit Plan, the U.S. Supreme Court on January 19 held that when an ERISA plan participant wholly dissipates a third-party settlement on nontraceable items, a...more
Welcome to the new, rejuvenated version of the Benefits Litigation Update, which we bring you jointly with the law firm of Epstein Becker Green. Our goal is to provide a concise and, we hope, insightful glimpse into recent...more
The Sixth Circuit Court of Appeals, sitting en banc, recently decided a closely-watched case regarding the scope of "other appropriate equitable relief" under ERISA Section 502(a)(3). In Rochow v. LINA, the court held that...more
The en banc Sixth Circuit reaffirmed what the Fourth and Eleventh Circuits knew all along. Ever since Cigna v.Amara, 131 S. Ct. 1866 (2011), in which the United States Supreme Court provided fresh theories (e.g.,...more
Yet again, the Court has been called upon to negotiate the juxtaposition between Varity and Amara. According to the Complaint in Biller v. Prudential Ins. Co. and Six Continents Hotels, Inc., 2014 U.S. Dist. Lexis 118577,...more
A federal court has ruled that, although a recent U. S. Supreme Court decision expanded the kinds of equitable remedies available to a plaintiff under ERISA § 502(a)(3), those remedies are still unavailable when the ERISA...more
In this issue: - Will Section 510 of ERISA Restrict Workforce Structuring under the Affordable Care Act? - A New Threat to Sponsors and Fiduciaries: Equitable Remedies After Amara - First ERISA Decision...more