Justia ERISA Opinion Summaries

Javery began working for Lucent as a software engineer in 1998 and participated in Lucent’s Employee Retirement Income Security Act, 29 U.S.C. 1001, qualified disability plan, administered by CIGNA. In November 2002, he reported back pain. His family doctor, Dr. Dorado, prescribed medicine and testing, and recommended some time off work. In January 2003, after Lucent transferred him from Ohio to Illinois, Javery sought treatment from another physician, Seymour. The pain worsened. In May 2005, Javery stopped working on Dr. Seymour’s advice. Lucent approved and paid short term disability benefits from until those benefits expired in November 2005. Lucent notified CIGNA that it believed Javery might be eligible for long term benefits. Javery applied, submitting extensive medical evidence of his pain and resulting cognitive impairment and of his successful application for Social Security disability benefits, but the claim was denied. In addition to claiming that Javery had not shown that he was “disabled” as that term is defined in the Plan, CIGNA claimed that Javery should be judicially estopped from pursuing his ERISA claim because Javery failed to disclose the claim in his Chapter 13 personal bankruptcy action. The district court upheld the denial. The Sixth Circuit reversed. View "Javery v. Lucent Tech., Inc. Long-Term Disability Plan" on Justia Law

The Railroad owns the Corwith Rail Yard in Chicago and, until 2010, used an independent contractor, RTS, to operate Corwith. Teamsters Local Union 705 represented RTS employees, who were covered by the union’s health-and-pension plan. The Railroad contributed to the plan, as required by its contract with RTS. In 2010 the Railroad obtained wage-and-benefits concessions from Local 705. But when the Railroad ended its relationship with RTS and moved the Corwith work in-house, it entered into a bargaining agreement with a different union, TCIU. RTS terminated the employment of its Corwith employees. The employees could reapply with the Railroad, but its compensation package with TCIU was not as generous. Local 705 and employees filed a proposed class action, alleging violation of the Employee Retirement Income Security Act, 29 U.S.C. 1001 and conspiracy to violate ERISA. The district court dismissed. On appeal, the plaintiffs alleged unlawful interference with the attainment of retirement benefits in violation of ERISA and a related conspiracy claim. The Seventh Circuit affirmed. The plaintiffs alleged only an unlawful “discharge,” which presupposes an employment relationship. Only RTS was in an employment relationship with the membersof Local 705. The complaint alleged that RTS discharged the employees because it lost its contract, not for the purpose of interfering with their attainment of pension benefits. ERISA does not provide a cause of action for conspiracy. View "Teamsters Local Union No. 705l v. Burlington Northern Santa Fe, LLC" on Justia Law

As an assembler with Eaton Corporation, McClain purchased the highest level of long-term disability insurance, which was “designed to replace ... 70 percent of [her] monthly base pay.” She stopped working in January 2008, due to a back injury she suffered on the job in June 2007. She received benefits during the first 24 months under the First Tier of the Plan’s coverage, which defined disability as being “totally and continuously unable to perform the essential duties of your regular position with the Company, or the duties of any suitable alternative position with the Company.” After 24 months, the Plan to an “any occupation” standard, providing Second Tier coverage if “you are totally and continuously unable to engage in any occupation or perform any work for compensation or profit for which you are, or may become, reasonably well fit by reason of education, training or experience--at Eaton or elsewhere.” The Plan denied her claim for benefits because her treating physician opined McClain could work part-time, and a market study identified various part-time positions in the area for which she was qualified. The district court rejected her suit under the Employee Retirement Income Security Act, 29 U.S.C. 1001. The Seventh Circuit affirmed, finding that the determination was not arbitrary.View "McClain v. Eaton Corp. Disability Plan" on Justia Law

Plaintiff, the surviving spouse of an Acxiom employee, filed suit for accidental death benefits under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq. On appeal, Unicare appealed the district court's grant of summary judgment in favor of plaintiff. The court held that the district court correctly applied an abuse-of-discretion standard of review; the district court correctly found that UniCare erred in denying coverage for accidental death benefits where all of the evidence indicated that the spouse's death was the unexpected result of ingested prescribed medications; the district court correctly found that UniCare had not proven that the exclusion should be used to deny coverage; and the fee award was reasonable. Accordingly, the court affirmed the judgment of the district court. View "Nichols v. Acxiom Corp." on Justia Law

At the time of his divorce from Wife, Husband was a participant in a pension fund (Fund). To enforce the interest awarded to her under the decree, Wife needed to serve a domestic relations order (DRO) on the Fund and its administrators (collectively, the Plan) for qualification. Before Wife served any DRO on the Plan, Husband remarried. At the time of Husband's retirement, he made a survivor annuity payable to his current spouse upon his death. Wife eventually served a DRO on the Plan in 2005, but the Plan refused to qualify the DRO. After Husband died, Wife brought a motion to enforce the 2005 DRO. The district court ruled in favor of Wife, concluding (1) surviving spouse benefits do not vest in a plan participant's current spouse at the time of the plan participant's retirement; and (2) therefore, the 2005 DRO served on the Plan was a qualified domestic relations order. The court of appeals reversed. The Supreme Court affirmed, holding (1) under ERISA, surviving spouse benefits vest in a plan participant's current spouse at the time of the plan participant's retirement; and (2) accordingly, the 2005 DRO in this case could not be qualified.View "Langston v. Wilson McShane Corp." on Justia Law

At issue in this interlocutory appeal was whether the claims of an employee against his employer, both of whom were health care providers, alleging injuries arising out of inadequate training, supervision, risk-mitigation, and safety in a mental health facility, constituted health care liability claims (HCLCs) under the Texas Medical Liability Act (Act). Employer filed a motion to dismiss on the grounds that Employee's claims constituted HCLCs under the Act and that Employee had not served an expert report on Employer as required under the Act. The trial court denied Employer's motion. The trial court affirmed. The Supreme Court reversed, holding (1) Employee here was properly characterized as a "claimant" under the Act and his allegations against his nonsubscribing Employer were health care and safety claims under the Act's definition of HCLCs, requiring an expert report to maintain his lawsuit; and (2) the Act does not conflict with the Texas Workers' Compensation Act. Remanded.View "Tex. W. Oaks Hosp., LP v. Williams " on Justia Law

Appellee, as executrix of the estate of her father, and her sister, brought a breach of contract action in which they asserted that their father's second wife, appellant, contractually waived her right to retain the proceeds of their deceased father's employer-provided 401K plan and life insurance policy by entering a settlement agreement incorporated into an order of separate maintenance executed approximately a year prior to the father's death. At issue was whether the court of appeals erred in finding that decedent's children could maintain a state law action against the decedent's surviving spouse to recover proceeds distributed to the spouse as the beneficiary of the decedent's ERISA-governed benefits plans, 29 U.S.C. 1001 et seq., where the state law claims were based on a contention that the spouse waived her rights to such proceeds. The court answered in the negative, concluding that, in this case, since the proceeds of the ERISA-covered plans were paid out to appellant and were no longer in the control of the plan administrator, the trial court erred when it dismissed appellees' breach of contract claim against appellant.View "Appleton v. Alcorn, et al." on Justia Law

The parties to the appeal disagreed about whether an employer who self funded a health-benefit plan for its employees was an "insurer" under the Texas Insurance Code, and therefore should be treated as a reinsurer when purchasing stop-loss insurance. The court of appeals concluded that an employer's self-funded plan was clearly an insurer under the Code and that a plan's purchase of stop-loss insurance was also clearly reinsurance beyond the regulatory scope of the Texas Department of Insurance. The court accordingly reversed the trial court's judgment, which held that the agency's regulation of the stop-loss policies at issue as direct insurance. Because the regulatory agency did not clearly err in its regulation of these stop-loss policies, however, the court reversed the court of appeals' judgment and rendered judgment for the agency.View "TX Dept. of Ins., et al. v. American National Ins. Co., et al." on Justia Law

The issue before the Supreme Court in this case concerned whether Section 514(a) of the Employee Retirement Income Security Act of 1974 (ERISA), preempted the breach of contract claim asserted by Appellees Lawrence J. Barnett, Christine Cookenback, James M. Defeo, and Madlin Laurent against Appellant SKF USA, Inc. under Pennsylvania law. Appellees were salaried, non-unionized, employees of SKF, working in its Philadelphia plant. The Company also employed hourly unionized employees at the plant. In 1991, SKF announced its decision to shut down the plant and terminate all workers. Over the course of the next year, the effect of the closing on employee retirement rights and benefits became a matter of discussion between Appellees and their supervisors. Appellees' retirement and pension rights were set forth in the an ERISA plan which SKF maintained and administered. Appellees became aware that, as a result of collectively bargaining the effects of plant closing, SKF agreed that any union worker with 20 years of service and 45 years of age, as of March 10, 1993, the date on which the collective bargaining agreement then in effect expired, would be entitled to receive an immediate and full pension (the creep provision). Two years after their employment with SKF was terminated, and prior to the submission of pension applications, Appellees commenced a breach of contract action against SKF alleging that throughout the course of their employment with the Company, they were employed under the same or better terms and conditions, including "pension eligibility," as SKF’s union workers. Upon review of the trial court record, the Supreme Court found that Appellees' claim was preempted, and accordingly reversed the Superior Court's order that affirmed the trial court's denial of summary judgment in favor of SKF. View "Barnett v. SKF USA, Inc." on Justia Law

Respondent A&J Beverage Distribution, Inc. appealed decisions of the Department of Labor (DOL) brought under the Whistleblowers' Protection Act by Petitioner Kevin Perrier. Petitioner worked for A&J as a truck driver. When he first started working, Petitioner did not participate in the company health plan. When premiums increased, Petitioner opted out of the plan. In 2009, rates decreased, and Petitioner claimed he was not informed of the decrease. When he sought information on the plan at that time, the company refused to give it to him. Petitioner notified the company that he had contacted the federal Department of Labor to learn more about his rights under ERISA with regard to notification of the company health plan. A&J then gave Petitioner the requested information, but shortly thereafter, he was terminated. The New Hampshire DOL hearing officer ruled that Petitioner "sustained his burden of proof to show that he was discharged in retaliation for having exercised his legitimate rights under the law." On appeal, A&J asserted preemption: that the whistleblower claim was preempted by ERISA. Upon review, the Supreme Court vacated the DOL's decision: "while the petitioner correctly notes that state and federal courts have concurrent jurisdiction over actions... his whistleblower claim is not such an action. ... [the Court] reject[ed] the petitioner's argument that DOL had jurisdiction over the petitioner's ERISA claim." View "Appeal of A&J Beverage Distribution, Inc. " on Justia Law