March 24, 2023

AGs Seek En Banc Review of Ninth Circuit Decision on ERISA Plan Insurers’ Obligations

Lori Kalani, Bernard Nash

Cozen O'Connor

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Cozen O'Connor

A group of 16 Democratic AGs filed an amicus brief supporting plaintiffs-appellees’ petition for rehearing en banc in Wit v. United Behavioral Health—a case before the U.S. Court of Appeals for the Ninth Circuit in which beneficiaries of health plans governed by the Employee Retirement Income Security Act of 1974 (“ERISA”) challenged denials of coverage for mental health and substance use disorder services.
In their brief, the amici urge the court to find that insurers regulated under ERISA cannot deny coverage for mental health and substance use disorder services under plan guidelines that are more restrictive than state law and generally accepted standards of care. They also argue that the panel’s decision exacerbates inadequate access to those services in the amici states.
The case is before the Ninth Circuit on petition for rehearing en banc after a Ninth Circuit panel overturned the trial court’s decision, in which the court had found that United Behavioral Health had wrongly denied coverage to plaintiffs-appellees.

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