Plan Administrators

News & Analysis as of

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

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

November and December 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

New Affordable Care Act FAQs Provide Guidance on Preventive Services, Wellness Programs and Mental Health Parity

On October 23, 2015, the Departments of Labor, Health and Human Services and Treasury (the “Agencies”) jointly released their twenty-ninth (XXIX) set of Frequently Asked Questions (FAQs) about Affordable Care Act (ACA)...more

Employee Benefits & Executive Compensation: Do You Need to Send an Annual Notice to Plan Participants?

Plan sponsors of defined contribution qualified plans may need to issue one or more annual notices to participants before the end of each plan year. Failure to issue a required annual notice can have significant consequences....more

Michigan Court Dismisses Cross-Claim as Insurer Not Properly Subject to a Claim for Breach of Fiduciary Duty

In Van Loo v. Cajun Operating Co, No. 14-cv-10604 (E.D. Mich. Sept. 17, 2015), the Eastern District of Michigan, a Sixth Circuit district court, held that the requirement for evidence of insurability was triggered based on...more

The ERISA Litigation Newsletter - October 2015

Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

New Legislation Extends Future Form 5500 and 990 Deadlines, Affects Veterans Health Benefits and Extends Excess Pension Asset...

On July 31, 2015, President Obama signed the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015, temporarily extending the Highway Trust Fund to provide continued funding for federal transportation...more

Employee Benefits – Do Employers Owe a 401(k) Fiduciary Duty?

Back in July, we discussed how Jed Clampett of Mama’s Fried Pies caused his VP of marketing Elly May to suffer exorbitant taxes due to a deferred bonus that he offered.  This month, Jed finds himself again in the grease with...more

Avoid other Plan Providers who just want to sell you something

When I started my national single employer retirement plan practice, I learned that getting clients is something that was going to be dependent on me. Clients and referral sources don’t fall into your lap or grow on trees....more

Further Guidance on the ACA’s Cadillac Tax

The Affordable Care Act (ACA) added Code Section 4980I to the Internal Revenue Code. Effective for tax years beginning on or after January 1, 2018, an excise tax of 40 percent will be imposed on the cost of employer-sponsored...more

Participants in Top Hat Plans Must Exhaust Administrative Remedies

So-called “Top Hat” plans are nonqualified deferred compensation plans for a select group of management or highly compensated employees. These executive compensation arrangements are exempt from many ERISA provisions, but are...more

The ERISA Litigation Newsletter - September 2015

Editor's Overview - It has been a little more than one year since the U.S. Supreme Court altered the legal landscape for litigating ERISA breach of fiduciary duty claims relating to the investment in employer stock...more

Investment Adviser Settles SEC Charges After Data Breach

Last week, the Securities and Exchange Commission (SEC) settled charges against a registered investment adviser for failing to comply with Rule 30(a) of Regulation S-P (17 C.F.R. § 248.30(a)) (“Safeguards Rule”). The...more

A Summary Plan Description Can be a Plan Document

In a decision issued a couple of years ago, the United States Supreme Court held that a summary plan description that differed from the plan document could not be enforced as the plan document. The Court said that the summary...more

Court Finds That Plan Administrator Should Comply With Qualified Domestic Relations Order Issued After Retirement Plan...

A recent opinion from the Second Circuit puts retirement plan administrators on notice that adjustments to benefits may be necessary to account for retroactively effective qualified domestic relations orders (QDROs). In...more

Court of Appeals to Plan Administrators: Inform Claimants of Time Limits on Front End of Discussions

Recently, in Mirza v. Insurance Administrator of Am., Inc., __ F.3d__ (3d. Cir. 2015), the United States Court of Appeals for the Third Circuit was asked to determine whether plan administrators are required to include a...more

Plaintiffs’ Misdirected Demand for Documents Fails, and Their Claim for ERISA Civil Penalties Is Dismissed: Boyd v. Sysco...

A federal court dismissed the plaintiffs’ claim to recover civil penalties for failure to provide plan documents requested by the plaintiffs. Boyd v. Sysco Corporation, No. 4:13-cv-00599 (D. S. C. September 3, 2015), provides...more

Second Circuit Reinstates Mental Health Parity Case Against UnitedHealth

In late August the U.S. Court of Appeals for the Second Circuit reinstated a lawsuit by a physician association against a third-party plan administrator. The case against UnitedHealth Group and related entities (United) had...more

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

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