Seyfarth Synopsis: The Supreme Court unanimously upheld Act 900, an Arkansas law regulating Pharmacy Benefit Managers (PBMs). The opinion could be used as a framework for states to attempt to indirectly regulate ERISA plans...more
Seyfarth Synopsis: The Supreme Court dismissed, prior to any discovery, claims of ERISA fiduciary breach because the plan participant-plaintiffs failed to show that the alleged breaches caused them concrete injury. ...more
6/8/2020
/ Article III ,
Breach of Duty ,
Defined Benefit Plans ,
Duty of Loyalty ,
Duty of Prudence ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Injury-in-Fact ,
Investment Adviser ,
Mismanagement ,
Pensions ,
Plan Participants ,
Retirement Plan ,
SCOTUS ,
Standing ,
Thole v U.S. Bank
Seyfarth Synopsis: Reversing course and overruling previous precedent, the Court of Appeals for the Ninth Circuit now holds that ERISA plan mandatory arbitration and class action waiver provisions are enforceable, and can...more
10/16/2019
/ 401k ,
Arbitration ,
Arbitration Agreements ,
Breach of Duty ,
Charles Schwab ,
Class Action Arbitration Waivers ,
Contract Terms ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Putative Class Actions ,
Retirement Plan
Seyfarth synopsis: Arkansas has sought certiorari on the question of the ability of states under the ERISA preemption clause to regulate the rates charged by PBMs, and the Supreme Court has asked for the input of the...more
Seyfarth Synopsis: A provider that is not seeking benefits based upon an assignment of a patient’s claims under ERISA but instead is pursuing state law claims based solely on agreements and representations made directly by...more
In the growth of the gig economy, many employers are increasing the number of categories of their employees and associates. One challenge of the gig economy is determining when a worker qualifies as a full-time employee for...more
5/6/2019
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Employee Benefits ,
Employer Liability Issues ,
Full-Time Employees ,
Gig Economy ,
Health Insurance ,
Hiring & Firing ,
Look-Back Measurement Period ,
Safe Harbors ,
Wage and Hour
Seyfarth Synopsis: In an unpublished yet fascinating decision, the California Court of Appeal held that ERISA § 514 preempts state law causes of action premised on wrongful disclosure of protected private health information....more
Seyfarth synopsis: The Second Circuit reversed dismissal of an ERISA stock drop class action finding plaintiff alleged enough to plausibly show that disclosure of alleged corporate problems would not have done more harm than...more
12/19/2018
/ 401k ,
Breach of Duty ,
Class Action ,
Common Stock ,
Disclosure Requirements ,
Duty of Prudence ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ESOP ,
Fiduciary Duty ,
Retirement Plan ,
Stock Drop Litigation
Employers who are interested in designing different benefits packages for different categories of employees must comply with both the Internal Revenue Code and the Affordable Care Act. ...more
Seyfarth Synopsis: Claims for benefits at termination may proceed as a breach of contract claim in state court, and avoid ERISA preemption, where the calculations are individualized, straightforward and do not implicate an...more
Seyfarth Synopsis: The Fourth Circuit found that the medical necessity of a given service constitutes a material element of representations regarding submissions for payment, potentially providing payors with another legal...more
11/16/2017
/ Clinical Laboratories ,
Criminal Convictions ,
Drug & Alcohol Abuse ,
Drug Testing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
False Billing ,
Health Clinics ,
Health Insurance ,
Healthcare Fraud ,
Material Misrepresentation ,
Medical Necessity
Seyfarth Synopsis: The Ninth Circuit Court of Appeals recently confirmed that ERISA preempts state insurance law bans on discretionary clauses for self-funded ERISA plans....more
9/11/2017
/ Aetna ,
Denial of Benefits ,
Disability Benefits ,
Discretionary Clauses ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Insurance Industry ,
Popular ,
Preemption ,
Self-Funded Health Plans
Seyfarth Synopsis: The Texas Supreme Court held that the U.S. Supreme Court’s landmark marriage equality decision, Obergefell v. Hodges, did not dispositively address how far government employers must go in providing benefits...more
7/10/2017
/ Benefit Plan Sponsors ,
Employee Benefits ,
Equal Protection ,
First Amendment ,
Fourteenth Amendment ,
Free Exercise Clause ,
Free Speech ,
Freedom of Religion ,
Marriage Equality ,
Masterpiece Cakeshop Ltd v Colorado Civil Rights Commission ,
Obergefell v. Hodges ,
Public Accommodation ,
Same-Sex Marriage ,
SCOTUS ,
TX Supreme Court