Justia ERISA Opinion Summaries

Articles Posted in US Court of Appeals for the Eighth Circuit

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MetLife and Ford appealed the district court's award of benefits, costs and attorney fees in an Employee Retirement Income Security Act (ERISA) action. In this case, while MetLife paid plaintiff her husband's basic life insurance benefit, it denied payment of an optional life insurance (OLI) benefit. The Eighth Circuit affirmed in part and reversed in part, holding that the district court erred in finding that there was no substantial evidence supporting MetLife's denial of OLI benefits, because substantial evidence supported MetLife's assertion that the husband answered an online questionnaire averring that he had not been treated for high blood pressure, when in fact he had. The court also held that there was substantial evidence in the record to support MetLife's reliance upon the plan administrator's representations that the husband would not have been automatically enrolled in the OLI program if he had truthfully answered the high blood pressure question in the screening questionnaire; the OLI benefits could not have been awarded on an equitable estoppel theory; the district court did not abuse its discretion by denying statutory penalties for the delay in providing documents; and attorney fees and costs must be reversed and remanded. View "Sepulveda-Rodriguez v. Metropolitan Life Insurance Co." on Justia Law

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The Eighth Circuit affirmed the district court's dismissal of Air Evac's claims in an action alleging that Arkansas Blue inadequately reimbursed Air Evac for ambulance services that Air Evac provided Arkansas Blue plan members. The court held that Air Evac's assignment did not convey the right to sue for equitable relief under section 1132(a)(3) of the Employee Retirement Income Security Act (ERISA). Furthermore, the district court did not err by finding that Arkansas Blue's conduct was not actionable because it fell within the Arkansas Deceptive Practices Act's safe harbor for actions or transactions permitted under the laws administered by the insurance commissioner. Finally, the district court did not err by rejecting Air Evac's claims for breach of contract and unjust enrichment. View "Air Evac EMS, Inc. v. USAble Mutual Insurance Co." on Justia Law

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The Eighth Circuit affirmed the district court's grant of summary judgment to MBI in an action brought by MBI seeking reimbursement of the benefits it paid to defendant under a self-funded employee benefit plan sponsored and administered by MBI. The court held that the Employee Retirement Income Security Act allows a fiduciary such as MBI to bring an action for equitable relief to enforce the terms of an employee benefit plan. The court also held that MBI was entitled to reimbursement because the Summary Plan Description was the plan's written instrument and defendant did not dispute that its reimbursement provision required him to pay MBI if it was an enforceable part of the plan. The court rejected defendant's remaining claims. View "MBI Energy Services v. Hoch" on Justia Law

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Plaintiff, a former employee of Semi, filed a derivative lawsuit on behalf of a defined-contribution retirement savings plan and, in the alternative, as a putative class action on behalf of plan participants, claiming that Semi and others breached their fiduciary duties under the Employee Retirement Income Security Act (ERISA). The Eighth Circuit affirmed the district court's dismissal of the complaint for failure to state a claim and held that, under Fifth Third Bancorp v. Dudenhoeffer, 573 U.S. 409 (2014), plaintiff's allegations were insufficient to plausibly state a claim for breach of the duty of prudence. Finally, the court affirmed the denial of plaintiff's motion for leave to amend his complaint because he failed to submit a proposed amended complaint with his motion. View "Usenko v. MEMC LLC" on Justia Law

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Former employees of Honeywell, who retired before age 65 during the terms of Honeywell's 2007 and 2010 collective bargaining agreements (CBAs), filed a class action alleging that Honeywell's announced plan to terminate early retiree healthcare benefits at the end of 2017 breached the CBAs and violated the Employee Retirement Income Security Act of 1974 (ERISA), because those healthcare benefits vested when each class member retired. The Eighth Circuit agreed with the Sixth Circuit and held that the Supreme Court's decision in CNH Indus. N.V. v. Reese, 138 S. Ct. 761 (2018), was controlling in this case. Under Reese, the court held that plaintiffs' retiree healthcare benefits were not vested as a matter of law. Therefore, the court reversed and remanded for further proceedings. View "Pacheco v. Honeywell International Inc." on Justia Law

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The Eighth Circuit affirmed the district court's grant of ex-wife's motion to dismiss an action brought by ex-husband, alleging violations of the anti-alienation provisions of the Employee Retirement Income Security Act of 1974 (ERISA), that arose from payments he made to her for almost three decades. The court held that a prior state court judgment was entitled to res judicata effect where ex-husband had an opportunity to litigate the question of whether the state court had jurisdiction to address his violations of ERISA claims. View "Schwartz v. Bogen" on Justia Law

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In these consolidated cases, out-of-network medical providers who United intentionally failed to fully pay for services rendered to United plan beneficiaries in order to offset overpayments to the same providers from other United administered plans filed a class action under the Employee Retirement Income Security Act (ERISA) on behalf of their patients, the plan beneficiaries. Providers claimed that the relevant claim plan documents did not authorize United to engage in cross-plan offsetting. The Eighth Circuit affirmed the district court's grant of partial summary judgment to providers on the issue of liability and held that nothing in the plan documents even comes close to authorizing cross-plan offsetting. Furthermore, the practice of cross-plan offsetting was in some tension with the requirements of ERISA. While the court need not decide whether cross-plan offsetting necessarily violated ERISA, the court held that United's interpretation of the documents was not reasonable. View "Louis J. Peterson, D.C. v. UnitedHealth Group Inc." on Justia Law

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The Eighth Circuit affirmed the district court's grant of summary judgment for Proctor and Gamble in an action brought by an employee under the Employee Retirement Income Security Act (ERISA) after his disability benefits were terminated. The court held that plaintiff possessed the information necessary to litigate his claim and was thus not prejudiced by any procedural irregularities; the company did not abuse its discretion in denying plaintiff's claim for benefits where the denial letter adequately stated the reasons for supporting its decision; and the company's interpretation of the plan was reasonable and there was substantial evidence to support its decision. The court held that plaintiff's remaining claims were unavailing and the district court did not abuse its discretion by denying plaintiff's request for statutory penalties. View "Leirer v. Procter & Gamble Disability Benefit Plan" on Justia Law

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The Eighth Circuit reversed the district court's judgment against Liberty Life in an action filed by plaintiff under the Employee Retirement Income Security Act (ERISA), alleging that the company's denial of long-term disability benefits under his employer's welfare plan was an abuse of discretion. The court held that Liberty Life's decision was not an abuse of discretion because the medical opinions the district court rejected were supported by medical evidence and were sufficiently reliable to provide a reasonable basis for defendant to deny the claim. The court also vacated the award of attorney's fees. View "Zaeske v. Liberty Life Assurance Company of Boston" on Justia Law

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Plaintiffs filed suit against Anderson Excavating under 29 U.S.C. 185(a), 29 U.S.C. 1132, and 29 U.S.C. 1145, requesting that the district court order Anderson Excavating to pay the contributions it allegedly owed to the Welfare Plan and Pension Plan, along with interest, liquidated damages, and attorneys' fees and costs. The Eighth Circuit held that the district court erred in determining damages for unpaid contributions, prejudgment interest, liquidated damages, and attorneys' fees; the district court legally erred in applying the alter ego doctrine to justify an award of unpaid contributions for an alleged employee's work; and thus the court reversed the judgment of the district court and remanded for further proceedings. View "Marshall v. Anderson Excavating & Wrecking" on Justia Law