Justia ERISA Opinion Summaries

Christina DeBenedetti and Morgan Ensburg were involved in a marital dissolution case where the trial court assigned four of Morgan’s ERISA-governed retirement accounts to Christina through Qualified Domestic Relations Orders (QDROs). This assignment was to satisfy an award made against Morgan after the court found he breached his fiduciary duty to Christina, resulting in a loss of community property. The total amount ordered for reimbursement and attorney fees exceeded $2 million.The Superior Court of San Diego County initially issued QDROs dividing the community property interests in Morgan’s retirement accounts. After a trial on reserved financial disputes, the court found Morgan had mismanaged community property and awarded Christina $1,831,250 for her share of the lost assets and $230,000 in attorney fees. Christina later sought to enforce this award through new QDROs, which the trial court granted, assigning her 100% of Morgan’s remaining interests in the retirement plans.The Court of Appeal, Fourth Appellate District, Division One, State of California, reviewed the case. Morgan argued that the QDROs did not relate to “marital property rights” and violated ERISA’s purpose of protecting retirement income. He also claimed the QDROs were invalid under California law and that the trial court did not value the retirement accounts. The appellate court rejected Morgan’s contentions, holding that the QDROs related to marital property rights, complied with ERISA, and that California laws cited by Morgan were either preempted by ERISA or did not invalidate the orders. The court also found that Morgan’s argument regarding the valuation of the retirement accounts was not raised in the trial court and could not be considered on appeal. The appellate court affirmed the trial court’s orders. View "In re Marriage of DeBenedetti" on Justia Law

Event Media Inc. and Pack Expo Services, LLC, were contributing employers to the Central States, Southeast and Southwest Areas Pension Fund. Both companies withdrew from the Fund and incurred withdrawal liability obligations. The dispute centers on how to calculate these obligations, specifically whether post-2014 contribution rate increases should be included in the calculation.The United States District Court for the Northern District of Illinois, Eastern Division, held that the employers' post-2014 contribution rate increases should be excluded from the calculation of their withdrawal liability payments. The court reasoned that these increases were required by a rehabilitation plan and thus should be disregarded under 29 U.S.C. § 1085(g)(3).The United States Court of Appeals for the Seventh Circuit reviewed the case and affirmed the district court's decision. The appellate court held that the post-2014 contribution rate increases were indeed required by the rehabilitation plan and should be excluded from the calculation of the employers' withdrawal liability payments. The court concluded that neither of the exceptions outlined in 29 U.S.C. § 1085(g)(3)(B) applied in this case, as the increases were not due to increased levels of work, employment, or periods for which compensation is provided, nor were they used to provide an increase in benefits permitted by subsection (f)(1)(B). Therefore, the Fund must use the 2014 contribution rate, not the higher 2019 rate, in calculating the employers' withdrawal liability payments. View "Central States, Southeast and Southwest Areas Pension Fund v. Event Media Inc." on Justia Law

Petitioners, representing a class of current and former Cornell University employees, participated in two defined-contribution retirement plans from 2010 to 2016. They sued Cornell and other plan fiduciaries in 2017, alleging that the plans engaged in prohibited transactions by paying excessive fees for recordkeeping services to Teachers Insurance and Annuity Association of America-College Retirement Equities Fund and Fidelity Investments Inc., in violation of the Employee Retirement Income Security Act of 1974 (ERISA) §1106(a)(1)(C).The District Court dismissed the prohibited-transaction claim, requiring plaintiffs to allege self-dealing or disloyal conduct. The Second Circuit affirmed the dismissal but on different grounds, holding that plaintiffs must plead that the transaction was unnecessary or involved unreasonable compensation, incorporating §1108(b)(2)(A) exemptions into §1106(a) claims.The Supreme Court of the United States reversed and remanded the case. The Court held that to state a claim under §1106(a)(1)(C), a plaintiff need only plausibly allege the elements contained in that provision itself, without addressing potential §1108 exemptions. The Court determined that §1108 sets out affirmative defenses, which must be pleaded and proved by defendants. The Court emphasized that the statutory text and structure do not impose additional pleading requirements for §1106(a)(1) claims and that the burden of proving exemptions rests on the defendants. View "Cunningham v. Cornell University" on Justia Law

The case involves the Central States, Southeast and Southwest Areas Pension Fund (the "Fund") seeking to collect withdrawal liability payments from several companies (the "Related Employers") that were commonly controlled with Borden Dairy Company of Ohio, LLC and Borden Transport Company of Ohio, LLC (the "Borden Ohio entities"). The Borden Ohio entities had previously withdrawn from the Fund and entered into a settlement agreement with the Fund during an arbitration process, which revised their withdrawal liability payments. The Borden Ohio entities later went bankrupt and ceased making payments, prompting the Fund to seek payment from the Related Employers.The United States District Court for the District of Delaware dismissed the Fund's suit under Federal Rule of Civil Procedure 12(b)(6), ruling that the Multiemployer Pension Plan Amendments Act (MPPAA) does not provide a statutory cause of action to enforce a private settlement agreement. The District Court also concluded that the Fund failed to meet the procedural requirements for notice and demand outlined in 29 U.S.C. § 1399(b)(2).The United States Court of Appeals for the Third Circuit reviewed the case and concluded that the settlement agreement is properly understood as a revision to the withdrawal liability assessment under the MPPAA. Since no employer began an arbitration with respect to the revised assessment, the Fund has a cause of action under 29 U.S.C. § 1401(b)(1). The Court also determined that the Fund met the procedural requirements for notice and demand under 29 U.S.C. § 1399(b)(1). Consequently, the Third Circuit reversed the District Court's order dismissing the Fund's suit and remanded the case for further proceedings. View "Central States Southeast & Southwest Areas Pension v. Laguna Dairy S.de R.L. de C.V." on Justia Law

Scott Cannon, individually and as the personal representative of the estate of Blaise Cannon, filed a wrongful death and punitive damages claim against Blue Cross and Blue Shield of Massachusetts (BCBS). Cannon alleged that BCBS's denial of coverage for a specific inhaler led to asthma-related complications that contributed to Blaise's death. Blaise was a beneficiary of his partner's BCBS health insurance policy, which was governed by the Employee Retirement Income Security Act of 1974 (ERISA).The United States District Court for the District of Massachusetts granted summary judgment to BCBS on the grounds of ERISA preemption. The court found that Cannon's wrongful death claim was preempted by ERISA because it related to an employee benefit plan and arose from the denial of benefits under that plan. The court also held that the claim conflicted with the remedial scheme established by ERISA, which provides specific civil enforcement mechanisms.The United States Court of Appeals for the First Circuit reviewed the case de novo and affirmed the district court's decision. The appellate court held that Cannon's claim was statutorily preempted under ERISA because it had a connection with the ERISA-regulated health insurance plan. The court also found that the claim was preempted under ERISA's civil enforcement provisions, as it sought remedies for the denial of benefits under the plan. The court rejected Cannon's argument that the Supreme Court's decision in Rutledge v. Pharmaceutical Care Management Association altered the preemption analysis, reaffirming that ERISA preempts state laws that relate to employee benefit plans. The court concluded that Cannon's wrongful death claim was derivative of Blaise's potential claim for benefits, which would have been preempted by ERISA. View "Cannon v. Blue Cross and Blue Shield of Massachusetts, Inc." on Justia Law

Barton Hankins was hired by Crain Automotive Holdings, LLC in 2019 as Chief Operating Officer and was offered a deferred compensation plan (DCP). After four years, Hankins resigned and sought compensation under the DCP, which Crain denied. Hankins then filed a lawsuit under the Employee Income Retirement Security Act of 1974 (ERISA) to claim his benefits. The DCP stipulated that Hankins could earn a percentage of Crain’s fair market value upon his exit, with full vesting at five years. Having served four years, Hankins was entitled to 80% of the benefits.The United States District Court for the Eastern District of Arkansas granted judgment in favor of Hankins, concluding that the DCP did not require the creation of an Employment Agreement or a Confidentiality, Noncompete, and Nonsolicitation Agreement for enforceability. The court found that Crain’s claims of misconduct by Hankins were unsubstantiated and awarded Hankins attorney’s fees, determining that Crain’s conduct was sufficiently culpable.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court affirmed the district court’s judgment, holding that Crain’s interpretation of the DCP was unreasonable. The court found that the DCP’s Article 4, which mentioned the Employment and Confidentiality Agreements, did not create a condition precedent but rather a condition subsequent. The court also upheld the award of attorney’s fees, noting that Crain’s actions lacked merit and were raised only after Hankins sought his vested compensation. The appellate court concluded that the district court did not abuse its discretion in its rulings. View "Hankins v. Crain Automotive Holdings, LLC" on Justia Law

Derek Kramer, the plaintiff, joined American Electric Power Service Corporation (AEP) in 2018 and later participated in the AEP Executive Severance Plan. In 2020, AEP terminated Kramer’s employment due to his executive assistant’s misuse of a company credit card and Kramer’s alleged interference with an investigation into his company-issued cell phone. Kramer applied for severance benefits under the Plan, but AEP denied his claim, citing termination for cause. Kramer appealed the decision, but the Plan’s appeal committee upheld the denial.Kramer then filed an ERISA action in the United States District Court for the Southern District of Ohio, seeking benefits and alleging interference. He also demanded a jury trial. The district court struck his jury demand, limited discovery to procedural claims, and denied his motion to compel the production of documents protected by attorney-client privilege. The court ultimately granted judgment in favor of AEP and the Plan, finding that the denial of benefits was not arbitrary and capricious.The United States Court of Appeals for the Sixth Circuit reviewed the case. The court affirmed the district court’s rulings, holding that the Plan was a top-hat plan exempt from ERISA’s fiduciary requirements, thus the fiduciary exception to attorney-client privilege did not apply. The court also upheld the district court’s decision to strike Kramer’s jury demand, citing precedent that ERISA denial-of-benefits claims are equitable in nature and not subject to jury trials. Finally, the court found that the district court correctly applied the arbitrary-and-capricious standard in reviewing the denial of benefits and that the decision was supported by substantial evidence. The Sixth Circuit affirmed the district court’s judgment in favor of AEP and the Plan. View "Kramer v. American Electric Power Service Corp. Executive Severance Plan" on Justia Law

Jeremy Smith, a customer care technician for Cox Enterprises, Inc., received long-term disability benefits for seven years due to severe back pain and multiple surgeries. In 2019, Aetna, the plan administrator, terminated his benefits, concluding he could work under certain conditions. Smith appealed, providing additional medical evidence, including a consultative examination from Dr. Harris, which supported his disability claim. Aetna upheld the termination, leading Smith to file a lawsuit under the Employee Retirement Income Security Act (ERISA).The United States District Court for the Eastern District of Virginia granted summary judgment in favor of Cox Enterprises, Inc. Welfare Benefits Plan. The court found that Aetna's decision was supported by substantial evidence and that it was reasonable for Aetna to discount the opinions of Smith's primary care physician and the Social Security Administration's disability determination.The United States Court of Appeals for the Fourth Circuit reviewed the case. The court held that Aetna abused its discretion by failing to adequately discuss and consider conflicting evidence, particularly Dr. Harris's consultative examination and the Social Security Administration's disability determination. The court found that Aetna did not engage in a deliberate and principled reasoning process, as required by ERISA regulations. Consequently, the Fourth Circuit reversed the district court's decision and remanded the case for further proceedings, instructing the district court to remand the matter to Aetna for reconsideration of Smith's claim. View "Smith v. Cox Enterprises, Inc. Welfare Benefits Plan" on Justia Law

Michael Gifford, a beneficiary of the Operating Engineers 139 Health Benefit Fund, sought reimbursement for out-of-network medical expenses incurred during his treatment for a stroke and subsequent brain aneurysm surgery. The Fund denied the claim, stating the services were not provided in an emergency and were not medically necessary. Gifford's wife, Suzanne, appealed the decision, but the Fund upheld the denial after consulting two independent medical reviewers who concluded the surgery was not an emergency and not medically necessary.The United States District Court for the Eastern District of Wisconsin granted the Fund's motion for summary judgment, agreeing that the Fund's decision was not arbitrary and capricious. The court also granted the Fund's motion for a protective order, limiting discovery to the administrative record. The Estate of Michael Gifford, represented by Suzanne, appealed the decision, arguing that the Fund failed to conduct a full and fair review by not considering a surgical note from Dr. Ahuja, which was not included in the administrative record.The United States Court of Appeals for the Seventh Circuit affirmed the district court's decision. The appellate court held that the Fund's denial of benefits was not arbitrary and capricious, as the Fund reasonably relied on the independent medical reviewers' reports and the administrative record. The court also found that the Fund was not required to seek out additional information not provided by the claimant. Additionally, the court upheld the district court's grant of the protective order, finding no abuse of discretion in limiting discovery to the administrative record. The court concluded that the Fund provided a full and fair review of the claim, and the denial of benefits was reasonable. View "Estate of Gifford v Operating Engineers 139 Health Benefit Fund" on Justia Law

Ariel Torres, a former Starbucks employee, and Raphyr Lubin, the husband of another former Starbucks employee, filed a putative class action against Starbucks. They alleged that Starbucks sent them deficient health-insurance notices under the Employee Retirement Income Security Act (ERISA), as amended by the Consolidated Omnibus Budget Reconciliation Act (COBRA). Starbucks moved to compel arbitration based on employment agreements signed by Torres and Lubin’s wife. Torres agreed to arbitration, but Lubin opposed it, arguing he was not a party to his wife’s employment agreement.The United States District Court for the Middle District of Florida denied Starbucks’s motion to compel arbitration for Lubin. The court found that Lubin was not a party to his wife’s employment agreement and was not suing to enforce it. Instead, Lubin sought to enforce his own statutory right to an adequate COBRA notice. The court held that no equitable doctrine of Florida contract law required Lubin to arbitrate and that Starbucks waived its argument that Lubin’s rights were derivative of his wife’s rights.The United States Court of Appeals for the Eleventh Circuit reviewed the case and affirmed the district court’s decision. The court held that Lubin, not being a party to the arbitration agreement, could not be compelled to arbitrate. The court also found that the arbitration agreement’s delegation clause did not apply to Lubin, as he was not a party to the agreement. Additionally, the court rejected Starbucks’s arguments based on equitable estoppel, third-party beneficiary doctrine, and the derivative claim theory, concluding that none of these principles required Lubin to arbitrate his claim. The court affirmed the district court’s order denying Starbucks’s motion to compel arbitration. View "Lubin v. Starbucks Corporation" on Justia Law