News & Analysis as of

Exhaustion Doctrine Employee Retirement Income Security Act (ERISA)

Manatt, Phelps & Phillips, LLP

Wit Redux—Again: Ninth Circuit Again Supersedes Its Prior Opinion in Landmark Mental Health Case

Editor’s Note: In the article below, Manatt discusses the Ninth Circuit’s new opinion in the ongoing Wit v. United Behavioral Health litigation and the changes from the now-vacated January 2023 Wit decision. ...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: Utah Court Rules ERISA Plan Was Wrong to Deny Coverage for Mental Health Care Received at...

In Raymond M. v. Beacon Health Options, Inc., 2020 U.S. Dist. LEXIS 94615 (D. Utah, May 29, 2020), a Utah district court held that an ERISA plan improperly applied acute-level criteria when denying benefits for a...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: ERISA Plaintiff Has Statutory Standing to Bring Action to Recover Spousal Healthcare...

Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: District Court Holds Breach of Contract Claims are Time-Barred

Plaintiff Gene Myers (“Plaintiff”), a physician, made a claim for individual disability insurance (IDI) benefits under an individual disability policy arising from low back injury caused by wearing a heavy leaded gown worn...more

Rivkin Radler LLP

Employee Benefit Plan Review – From the Courts

Rivkin Radler LLP on

Ninth Circuit Affirms Decision Rejecting Suit Seeking Early Retirement Benefits - The U.S. Court of Appeals for the Ninth Circuit has affirmed a district court’s decision rejecting a plaintiff’s lawsuit seeking to overturn...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: First Circuit Clarifies ERISA's Timing Requirements for Appealing Adverse Benefits Determination

In Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 (1st Cir. 2019) the U.S. Court of Appeals for the First Circuit clarified ERISA's timing requirements with respect to appealing an adverse benefits determination...more

King & Spalding

Federal District Court Rules United Unlawfully Denied Coverage for Mental Health and Substance Use Disorder Services Based on...

King & Spalding on

On March 5, 2019, Chief Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California ruled that United Behavioral Health (UBH), a subsidiary of UnitedHealth Group, violated its fiduciary...more

Proskauer - Employee Benefits & Executive...

ERISA Administrative Appeal Barred As Untimely

The First Circuit held that a plaintiff failed to timely exhaust her administrative remedies under a long-term disability plan because the plan’s 180-day time limit for submitting appeals commenced on the date the plaintiff...more

Faegre Drinker Biddle & Reath LLP

Defending Against Class Actions: Four Strategies for ERISA Litigation

They are the words in-house counsel dread to see in the caption of a new lawsuit: “on behalf of themselves and all others similarly situated.” ERISA class actions present special challenges and risks to plan sponsors and...more

McAfee & Taft

ERISA Plans: Part-time employee entitled to disability benefits

McAfee & Taft on

In Van Steen v. Life Insurance Company N.A., the Tenth Circuit Court of Appeals upheld the grant of long-term disability benefits to an employee working part-time....more

Proskauer - Employee Benefits & Executive...

Exhaustion of Plan Administrative Remedies: Important Considerations Following Hitchcock v. Cumberland

Recently, the Sixth Circuit ruled in Hitchcock v. Cumberland University 403(b) Plan that pension plan participants are not required to exhaust their plan’s administrative remedies before pursuing claims alleging statutory...more

Proskauer Rose LLP

ERISA Newsletter - First Quarter 2017

Proskauer Rose LLP on

After a brief hiatus, Proskauer's ERISA Newsletter is back with a brand new look. We hope you like it and find it is easier to navigate. In addition to implementing our new format, we have moved to a quarterly publication...more

Proskauer - Employee Benefits & Executive...

Sixth Circuit: ERISA Exhaustion Not Required in Plan Amendment Suit

The Sixth Circuit held that retirement plan participants were not required to exhaust their administrative remedies prior to bringing a claim alleging that a plan amendment violated ERISA....more

Fisher Phillips

Labor Department Boosts Disability Claimant Protections

Fisher Phillips on

The U.S. Department of Labor (USDOL) recently issued a final rule addressing disability benefit claims and appeals (see 81 FR 92316). The rule adds new procedural protections and safeguards meant to ensure disability...more

Seyfarth Shaw LLP

Judge Garland’s ERISA Jurisprudence Reflects His Methodical and Moderate Reputation

Seyfarth Shaw LLP on

With President Obama’s recent nomination of Judge Merrick B. Garland of the U.S. Court of Appeals for the D.C. Circuit to the U.S. Supreme Court, we thought our loyal readers would be interested to learn a little about Judge...more

Skadden, Arps, Slate, Meagher & Flom LLP

Inside the Courts: An Update From Skadden Securities Litigators - February 2016 / Volume 8 / Issue 1

We are pleased to present Inside the Courts (Volume 8, Issue 1), Skadden’s securities litigation newsletter. This quarter’s issue includes summaries and associated court opinions of selected cases principally decided between...more

K&L Gates LLP

ERISA’s Exhausting and Exasperating Exhaustion Requirement and the Exceptions Medical Providers Seeking Full Reimbursement From...

K&L Gates LLP on

The first Alert in this two-part series discussed three common issues facing out-of-network medical providers in asserting reimbursement claims against employee benefits plan administrators (whether an insurance company or...more

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