An Arkansas law regulating pharmacy benefit managers’ (PBMs) generic drug reimbursement rates, and affecting the cost of prescription drugs provided under ERISA-governed benefit plans and the administration of those plans, is not preempted by ERISA, the U.S. Supreme Court has held unanimously. Rutledge v. Pharmaceutical Care Management Association, No. 18-540, 2020 U.S. LEXIS 5988 (Dec. 10, 2020).
Articles Discussing ERISA.
Supreme Court to Consider Appealability of Railroad Retirement Board Decisions
The U.S. Supreme Court will hear the second of several ERISA disputes this term, the first issue we discussed as the term began, October 5, 2020. Monday, November 2, 2020, the Justices will consider whether the Railroad Retirement Board’s denial of a claimant’s request to open a prior benefits decision
U.S. Supreme Court to Hear ERISA Preemption Dispute
On October 6, 2020, the U.S. Supreme Court will hear argument on ERISA’s preemptive effect on a state law regulating pharmacy benefit managers’ (PBMs) generic drug reimbursement rates in Rutledge v. Pharmaceutical Care Management Association (No. 18-540).
U.S. Supreme Court to Hear the First of Several ERISA Disputes This Term
The Supreme Court, whose new term begins today, the first Monday in October, will consider a number of cases impacting employee benefits and benefits litigation. This is the first in a series analyzing these cases as they are heard by the Court. The first issue up concerns prescription drug benefit
Is Personal Information of Retirement Plan Participants an ERISA Plan Asset?
A little more than one year ago, we reported on a settlement (Cassell et al. v. Vanderbilt University, et al.) involving the alleged wrongful use of personal information belonging to retirement plan participants, claimed to be “plan assets.” This year, similar claims have been made against Shell Oil Company in connection
ERISA Pension Plan Liability? 10th Circuit Rules in Favor of Foreign Parent of U.S. Subsidiary
On paper, the rule is straightforward: if a company sponsors a defined benefit pension plan or participates in a union/multiemployer pension plan in the United States, all members of that company’s controlled group of corporations (e.g., parents, subsidiaries, and affiliates connected through a common equity ownership of 80 percent or
Supreme Court: Plaintiffs Who Suffered No Injury Lack Standing to Sue under ERISA
The plaintiffs’ expectations surely suffered a blow after reading the Supreme Court’s initial observation in their case: “If [the plaintiffs] were to lose this lawsuit, they would still receive the exact same monthly benefits that they are already slated to receive, not a penny less. If [the plaintiffs] were to win this lawsuit, they
Expanding the Safe Harbor for (Certain) Electronic Disclosures
We previously wrote about the Department of Labor’s proposed expansion of its safe harbor for electronic delivery of certain retirement plan disclosures required under ERISA. The wait is finally over, with publication of the final rule (the “New Rule”) helped along by the DOL’s desire to alleviate some of the
Eighth Circuit Rules on ERISA’s “Church Plan” Exemption
Background
On March 27, 2020, the Eighth Circuit in Sanzone v. Mercy Health, 2020 U.S. App. LEXIS 9537 (8th Cir. March 27, 2020), ruled on several key issues on the “church plan” exemption to ERISA. As background, beginning in 2013, plaintiff’s counsel filed ERISA class-action cases across the country challenging
CalSavers Not Preempted by ERISA
With an alarming number of American workers lacking adequate retirement savings, California and a handful of other states began implementing state-sponsored retirement savings programs. The CalSavers Retirement Savings Program (CalSavers) was first launched as a pilot program in 2018 and then expanded to all eligible employers in the state in
The Supreme Court Defines Actual Knowledge
In a closely watched decision, Intel Corporation Investment Policy Committee v. Sulyma, Slip Op. No. 18-1116 (U.S. S. Ct., Feb. 26, 2020), construing ERISA’s three-year statute of limitations, see ERISA § 413(2), 29 U.S.C. § 1113(2), the Supreme Court held unanimously (J. Alito) that “actual knowledge” means “. . . when a plaintiff actually is aware of the relevant facts, not when he should be.”
Second Circuit Rules ERISA Plan Can Be Reformed Absent Any Mistakes, Fraud or Other Inequitable Conduct
The Second Circuit recently considered for the first time whether the equitable remedy of reformation was available under the Employee Retirement Income Security Act (ERISA) where a court determined that the written terms of a retirement plan violated ERISA but no allegation of fraud, mistake, or inequitable conduct existed. In Laurent v. PricewaterhouseCoopers LLP, the court found that “terms violative of ERISA” may serve an independent basis justifying an award of a reformation remedy as to a plan, indicating that its decision is in line with a “hint” from the Supreme Court in its 2011 decision in CIGNA Corp. v. Amara1 (referred to as “Amara III”) that courts should broadly construe remedies in equity under ERISA § 502(a)(3).2
“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined
A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan.1 This is another in a growing line of cases finding a disconnect between the term “medically necessary” in a health plan and the guidelines that third-party administrators use to determine whether treatment is “medically necessary.”
North Carolina Court Awards $41 Thousand-Plus Penalty for Failure to Produce Documents Requested by Plan Participants
Section 104(b)(4) of ERISA provides that a plan administrator must respond to a written request for certain documents (including the plan documents and summary plan description) by a participant or beneficiary by providing the requested documents. Section 502(c)(1) of ERISA and Regulation § 2575.502(c)-1 provide that a plan administrator who fails to do so within thirty days is liable to such participant or beneficiary in an amount (as determined by the court in its discretion) of up to $110 per day.
Seventh Circuit Holds that a Deceleration of Withdrawal Liability is Unavailable Under ERISA’s Common Law
In Bauwnes v. Revcon Technology Group, Inc., the U.S. Court of Appeals for the Seventh Circuit held that the trustees of a multiemployer pension plan could not agree to an employer’s installment payment plan of its withdrawal liability after the trustees had demanded full payment following the employer’s default. This “no good deed goes unpunished” decision will likely make trustees much less likely to agree to subsequent payment plans after finding an employer in default.