Justia ERISA Opinion Summaries

After injuring her back in a car accident, plaintiff filed for and received long-term disability benefits from the insurance plan sponsored by her employer. Plaintiff brought suit pursuant to the Employee Retirement Income Security Act of 1974 (ERISA), 42 U.S. C. 29 U.S.C. 1001 et seq., against her employer and the administrators and underwriters of her employer-sponsored long-term benefit disability insurance policy after the claims administrator of that plan determined that she no longer qualified for benefits. At issue was whether the district court properly granted defendants' motion for summary judgment, finding no violation of law. The court held that because defendants acted reasonably, the court concluded that defendants' termination of plaintiff's benefits complied with federal law. The court found none of plaintiff's procedural claims persuasive and held that the district court did not err when it held that defendants did not violate plaintiff's right to a full and fair review of her adverse eligibility determination. The court also rejected plaintiff's argument that the district court violated local rule 7(h) where plaintiff failed to make this argument before the district court. Accordingly, the court affirmed the judgment of the district court. View "Pettaway v. Teachers Ins. and Annuity, et al." on Justia Law

The company closed paper mills and eliminated a health-care subsidy for retirees. The union filed suit in Ohio under the Labor Management Relations Act, 29 U.S.C. 185, and the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1132. The company filed a declaratory judgment suit in Wisconsin; the district court dismissed for lack of jurisdiction. The Seventh Circuit vacated and remanded. Although the suit does not seek equitable relief as described in Sect. 502 of ERISA, Sect. 2201 does authorize declaratory relief. The court further reasoned that the district court acknowledged its jurisdiction over the LMRA suit and that the union's suit came within the 502 grant of jurisdiction, so this mirror-image suit by the plan’s sponsor also is within federal subject-matter jurisdiction. In dismissing the Wisconsin litigation, the district judge assumed that the controversy would be resolved in Ohio. That is no longer true because the union mistakenly named a parent company that was not a party to the collective bargaining agreements; the case has been dismissed. View "NewPage Wis. Sys., Inc., v. United Steel, Paper & Forestry, Rubber, Mfg,. Energy Allied Indus. & Servs. Workers Int'l Union" on Justia Law

This case stemmed from the collective bargaining agreement (CBA) between Volvo Group North America, LLC (Volvo) and the union representing workers at Volvo's New River Valley assembly plant (NRV). At issue was whether the CBA permitted Volvo to make unilateral changes to the health benefits of retirees from its NRV assembly plant after the agreement expired. The court held that Volvo was not permitted to make unilateral modifications to the retirees' health benefits after the expiration of the CBA unless it followed the mechanism agreed to by both parties in that agreement. Therefore, the court affirmed the judgment of the district court where Volvo could not employ that mechanism in this case. View "Quesenberry, et al. v. Volvo Trucks North America Retiree Healthcare Benefit Plan, et al." on Justia Law

Plaintiff filed an action against defendants (collectively, the Plan) for refusing to pay certain long-term disability benefits. At issue was whether the district court erred in granting summary judgment for defendants and dismissed plaintiff's claims without prejudice due to his failure to exhaust available administrative remedies under the Plan. The court held that the district court adopted the Plan's reading of ERISA, 29 C.F.R. 250.503-1(i) without the benefit of the Secretary of Labor's interpretation of that provision. Therefore, deferring to the Secretary's plausible approach, the court held that where a claimant sought review of his or her disability claims, the quarterly meeting rule was restricted to multiemployer plans. Accordingly, the Plan was required to render a decision within 90 days of plaintiff's administrative appeal and failed to do so. Consequently, plaintiff's claims must be deemed exhausted and the judgment was reversed and remanded. View "Barboza v. CA Assoc. of Prof'l Firefighters, et al." on Justia Law

Plaintiff challenged the denial of his claims for long-term disability benefits by defendant, who served as both the administrator of claims and the payor of benefits in the long-term disability plan in which defendant participated. At issue was whether there was a conflict of interest where defendant was both administrator and payor of benefits of the plan governed by ERISA, 29 U.S.C. 1001-1461. The court found that defendant considered the medical information submitted by plaintiff's doctors and relied upon the advice of several independent medical professionals to conclude that plaintiff failed to make a sufficient showing of disability under the plan and, even where plaintiff's own doctors offered different medical opinions than defendant's independent doctors, the plan administrator could give different weight to those opinions without acting arbitrarily or capriciously. Therefore, the court held that a reasonable basis supported defendant's benefits decisions and that the conflict of interest did not render the decisions arbitrary or capricious. View "Blankenship v. Metropolitan Life Ins. Co." on Justia Law

Kurt R. Ward, Attorney at Law, LLC, appealed the district court's order denying its motion for judgment on the pleadings and granting the Plan Parties' (the Bert Bell/Pete Rozelle NFL Player Retirement Plan, the Retirement Board of the Plan, and the Bank of New York Mellon Corporation) cross-motion for judgment on the pleadings. Both parties' motions sought a declaration about whether the Plan Parties had to pay the disability benefits of two of the Ward Firm's retired NFL player clients into the firm's client trust account pursuant to state court jurisdiction for unpaid attorney's fees despite a provision in the Plan prohibiting any "benefit under the Plan" from being assigned or reached by creditors through legal process. The court held that its prior panel precedent held that bargained-for provisions barring assignments in ERISA welfare benefits were valid and enforceable and that the Ward Firm had not directed the court's attention to any such intervening en banc or Supreme Court decision. Accordingly, the court affirmed the judgment and held that the district court did not err in declaring that the spendthrift provision in the Plan prevented the Plan Parties from depositing the disability benefits owned by two retired NFL players into the Ward Firm's trust account. View "Ward v. The Retirement Board of Bert Bell, et al." on Justia Law

A 1998 amendment to the plan effectively penalized lump-sum distributees by voiding their future interest credits, in violation of ERISA, 29 U.S.C. 1054(c)(3). Participants who had received lump sum distributions filed suit in 2007. The district court held that the claims accrued when the plaintiffs received their distributions and that some claims were barred by the six-year state limitations period. The court ordered recalculation of the distributions for the other plaintiffs using a modified version of a method proposed by defendants. The Seventh Circuit reversed in part. The distributions were the final step of a clear repudiation of the participants’ entitlement to anything different and triggered the running of the limitations period; prior communications about the amendment were simply "hints." The plan fiduciaries were not entitled to deference with respect to the recalculation of benefits; the district court must determine how to calculate awards. View "Thompson v. Retirement Plan for SC Johnson" on Justia Law

The court agreed to hear this case en banc in order to reconsider its precedent as to which parties could be sued as defendants in actions for benefits under 29 U.S.C. 1132(a)(1)(B), part of ERISA. Some of the court's previous decisions had indicated that only a benefit plan itself or the plan administrator of a benefit plan covered under ERISA was a proper defendant in a lawsuit under that provision. The court concluded that the statute did not support that limitation, however, and that an entity other than the plan itself or the plan administrator could be sued under that statute in appropriate circumstances. Therefore, the court held that Reliance Standard Ins. Co. was a proper defendant in a lawsuit brought by plaintiff under ERISA and overruled its prior decisions to the contrary. To apply that decision and to resolve other issues raised in the appeal, the court transferred this case back to the three-judge panel to which the case was previously assigned. View "Cyr v. Reliance Standard Life Ins. Co." on Justia Law

The company filed a Chapter 11 bankruptcy petition and continued to make payments to pension plans, as required by collective bargaining agreements. When the company was sold and it no longer employed individuals covered by the plans, the pension fund filed a claim for $5,890,128 (withdrawal liability) and requested that the claim be classified as an administrative expense. The bankruptcy court classified the claim as unsecured debt. The district court reversed and remanded, holding that the portion of withdrawal liability attributable to the post-petition period was entitled to priority. The Third Circuit affirmed. If entire withdrawal liability were automatically classified as a general unsecured claim, it would undercut the purpose of the Multiemployer Pension Plan Amendments Act, 29 U.S.C. 1381, amendment to the Employee Retirement Income Security Act: to secure the finances of pension funds and prevent an employer's withdrawal from negatively affecting the plan and its employee beneficiaries. View "In Re: Marcal Paper Mills, Inc, " on Justia Law

The decedent, killed in a motorcycle accident in 2008, was covered by a life insurance policy, subject to the Employee Retirement Income Security Act, 29 U.S.C. 1101. The insurance company denied a claim by the decedent's widow, claiming that the decedent's anti-coagulant medications contributed to his death so that it fell within an exclusion for medical conditions. The district court concluded that the policy gave the company discretionary authority to determine eligibility and entered summary judgment in the company's favor. The Third Circuit reversed in part and remanded. Deferential review was not appropriate, given the language of the policy. The words "proof of loss satisfactory to Us," surrounded by procedural requirements, do not notify participants that the company has the power to re-define the entire concept of a covered loss on a case-by-case basis. The district court's interpretation of the medical exclusion, in favor of the company, was correct; the clause was not ambiguous. View "Viera v. Life Ins. Co. of N Am." on Justia Law