Plan Administrators

News & Analysis as of

What Does the Supreme Court’s Spokeo Decision Mean in the ERISA Litigation Context?

ERISA practitioners should be aware of the extent to which the United States Supreme Court’s decision in Spokeo, Inc. v. Robins may touch on ERISA claims and defenses. In Spokeo, decided 6 to 2 last month, the Supreme Court...more

The Rosenbaum Law Firm Review - July 2016

The Future Is Now For 401(k) Plan Sponsors. The future is here. When I was the head ERISA attorney at a New York based third party administrator (TPA), I left because I saw the future of the retirement plan...more

For ERISA Section 502(c) Penalties — Must Plaintiff Prove “Actual Injury”? A Recent U.S. Supreme Court Decision Creates the...

These Section 502(c) penalty claims seem to be added to most every ERISA lawsuit... Does a claimant have to prove “actual injury” to win ERISA Section 502(c) penalty claims? MAYBE. Here’s why...more

401(k) Providers and their Plans

I love Clint Eastwood movies and one favorite is “In The Line of Fire’. John Malkovich is playing a wannabe Presidential assassin named Leary and Clint is playing Frank Horrigan, the Secret Service agent who is trying to...more

Spokeo—New Hope for Defending Against ERISA Claims?

Last month, the Supreme Court of the United States issued its decision in Spokeo, Inc. v. Robins, No. 13–1339 (May 16, 2016). Spokeo involved a lawsuit brought under the Fair Credit Reporting Act of 1970 (FCRA). ...more

Plan Sponsors are Seeking ERISA Fiduciary Services

When I was in law school at American University and we moved into a new building (20 years later, they are now in another new building) a few blocks away from the main campus. The computer sync site at the new building had a...more

Court Orders Cigna to Pay Out-of-Network Surgical Claims

On June 1, 2016, the United States District Court for the Southern District of Texas ordered Cigna to pay nearly $13.7 million to Humble Surgical Hospital, LLC (“Humble”). Of the nearly $13.7 million, almost $11.4 million...more

ERISA: Reviewing What Needs to Be Proved to Establish the Suicide Exclusion

For many reasons, some of the toughest cases to litigate involve the application of the suicide exclusion. There is a growing body of evidence challenging suicide exclusion determinations....more

The Bottom Line On What Retirement Plan Sponsors Need To Do

I worked for a third party administrator (TPA) for almost 5 years and one of my favorite things about the boss there was that he just wanted to cut to the chase. We had an actuary who developed a speech im- pediment when he...more

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

Department Of Labor Audits Are Focusing On Plan Procedures For Locating Missing Vested Participants

The U.S. Department of Labor (DOL) has increased its examinations of the procedures of defined benefit and defined contribution retirement plans for locating and paying out benefits to terminated vested participants whom the...more

Recent Lawsuit Demonstrates Continuing Need for Plan Fiduciaries to Document Decision-Making Process

Late last year, another lawsuit was brought on behalf of participants in a 401(k) plan alleging breaches of fiduciary duties resulting from allegedly high plan fees. This type of case is not novel; the law firm that brought...more

Seventh Circuit Does The Math and Sides with Plan Administrator in Pension Calculation Dispute

On Wednesday, March 16, the Seventh Circuit inspired a collective sigh of relief among actuaries and plan administrators everywhere. In Cocker v. Terminal Railroad Association of St. Louis Pension Plan for Nonschedule...more

Out with the Old, In with the New: What’s New with the Ontario Pension Regulator

FSCO reminds administrators about their roles and responsibilities On January 25, 2016, the Financial Services Commission of Ontario (“FSCO”) issued a new policy that describes the roles and responsibilities of administrators...more

Alert: Proposed Ontario Amendment Eliminating the 30-per-cent Rule for Pension Fund Investments

The Ontario government has announced a consultation? until April 29, 2016, relating to a proposed regulation change under the Pension Benefits Act (Ontario) that would permit a pension plan administrator to invest pension...more

Supreme Court Concludes That ERISA Preempts State Reporting Requirements

In a closely observed federalism battle over the scope of ERISA preemption, the Supreme Court came down on the side of Federal power. Specifically, in Gobeille v. Liberty Mutual Insurance Company, the Court, in a 6-2 ruling,...more

ERISA Preemption Made Easy? Supreme Court Sends Vermont All-Payer Database Back to the Drawing Board

On the first day of decisions since the unexpected passing of Justice Scalia, the Supreme Court of the United States ventured into the thorny area of preemption under the Employee Retirement Income Security Act (ERISA) and...more

HHS Fact Sheet on Your Employees’ and Clients’ Rights under HIPAA to Access their Health Information

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, contains extensive rules designed to limit access by non-health plan entities to certain individually identifiable health...more

BIG NEWS: ERISA Preempts Hodgepodge of State Insurance Reporting Regulations

You know there has been a court trend toward narrowing ERISA preemption. But…that trend was brushed back today by the U.S. Supreme Court. Here’s today’s case: Gobeille v. Liberty Mutual Insurance Com., __ U.S. __ (March 1,...more

ERISA (5th Circuit): Are There Exceptions to the Exhaustion of Administrative Remedies Requirement

You already know that claimants with a denied claim must submit an appeal and exhaust administrative remedies before filing suit. But are phone calls sufficient to trigger the appeal process?...more

The ERISA Litigation Newsletter - January 2016

Editor's Overview - Happy New Year! Because 401(k) plans play an increasingly prominent role as an employee's principal retirement investment vehicle, fiduciaries overseeing those plans face increased pressure to see...more

May Vermont Apply Its Health Care Database Law to the Third-Party Administrator for a Self-Insured ERISA Plan?

Vermont requires all public and private entities that pay for health care services provided to its residents to supply data to its "all-payer database." The requirements apply to insurers and third-party administrators, among...more

Will Your 401(k) Plan be Sued in the New Year?

Late last year, another lawsuit was brought on behalf of participants in a 401(k) plan alleging breaches of fiduciary duties resulting from allegedly high plan fees. This type of case is not novel; the law firm that brought...more

Fifth Circuit Upholds ERISA Disability and Life Benefit Denials

In two decisions issued last month, the Fifth Circuit upheld ERISA plan denials of disability and life benefits, confirming its deferential approach in most ERISA benefit cases....more

DOL Notice on Tips for Selecting and Monitoring an ERISA Plan Auditor Alarms Recipients – Fear Not!

If you have recently received a notice from the U.S. Department of Labor (DOL), titled “Tips for Selecting and Monitoring a Plan Auditor,” do not be alarmed. It does not mean that you are being audited by the DOL and it does...more

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