Last week was a busy one in the federal courts with an unusual assortment of ERISA issues in the mix. There were no appellate decisions (in contrast to five last week), but the district court cases included (1) no fewer than three tobacco surcharge class actions, all of which took hits at the pleading stage (Spencer v. Campbell Soup, Mueller v. United Surgical Partners, Williams v. Target), (2) the demise of yet another case challenging a pension risk transfer to Athene Annuity and Life Assurance Company (Schoen v. ATI), (3) a ruling that the state law claims of seventeen people from Kosovo who worked in Afghanistan for an American military contractor, and are seeking long-term disability benefits, are preempted by ERISA (Ajeti v. LINA), (4) a setback for pharmacy benefit managers in their effort to invalidate a new California law imposing fiduciary duties on them (PCMA v. Bonta), and last, but certainly not least, (5) a ruling that makes the Democratic Socialists of America $5.2 million richer (Hecht v. NYU). Perfect timing ahead of the mid-term elections! We’ll see you next week.

Below is a summary of this past week’s notable ERISA decisions by subject matter and jurisdiction.

Attorneys’ Fees

Second Circuit

Emsurgcare v. Hager, No. 24-CV-6181 (JPO), 2026 WL 2123269 (S.D.N.Y. July 23, 2026) (Judge J. Paul Oetken). This is an action by a medical provider against one of its patients and the patient’s insurer, Oxford Health Plans (NY), Inc. and Oxford Health Insurance, to recover an unpaid balance for treatment provided to the patient. The case has a complicated history; as the court noted, “this action has proceeded in no fewer than five venues: It was filed initially in California state court before the case’s removal to the Central District of California and subsequent transfer to this Court and was appealed to both the Second and Ninth Circuits.” The case ended up in the Southern District of New York, where the court ruled in favor of defendants. Plaintiffs appealed, but the Second Circuit affirmed in May of this year. (For more information about the case, check out our summaries of the district court’s and Second Circuit’s rulings in our June 18, 2025 and May 20, 2026 editions.) Oxford would now like some attorney’s fees under ERISA § 502(g)(1) for all its hard work, and it has filed a motion to extend its time to seek those fees. In this order the court granted Oxford’s motion in part and denied it in part. The court noted that Oxford was seeking fees for both its trial court work and its appellate work, and that different standards applied to each. Federal Rule of Civil Procedure 54, which requires motions to be filed within fourteen days of entry of judgment, applies to district courts, while appellate fees should be requested “within a reasonable period of time after the circuit’s entry of final judgment.” The court ruled that Oxford’s motion for appellate fees was timely because it filed its request just over a month after the Second Circuit’s decision and within a week of the court receiving the mandate. The court thus granted Oxford an extension until July 30 to file its motion regarding its appellate fees. Oxford was not so fortunate with its trial court fees. Oxford contended that the complex procedural history of the case “created ‘legitimate uncertainty’ as to which court would exercise jurisdiction,” and thus “the excusable neglect standard both favors granting Oxford an extension and is premature on the existing letter-briefing.” However, the court emphasized that Oxford missed its Rule 54 deadline by nearly a year, and thus, despite its arguments, the “excusable neglect” standard applied. The court ruled that Oxford did not “make the formidable showing necessary to excuse its failure[.]” The court stated that despite the procedural history it was clear where the judgment was entered and where the fee motion should have been filed. Nor did Oxford explain why its failure “was forgivable ‘inadvertence, miscalculation, or negligence’ rather than simply ‘flout[ing] a deadline.’” The court noted that Oxford’s “prolonged delay” was prejudicial to plaintiffs “and bears little resemblance to the minimal delays courts have deemed excusable neglect.” Furthermore, a desire “to present one convenient, unified fee motion,” even if in good faith, “d[oes] not relieve [a party] of [its] obligation to comply with clear procedural rules, and does not constitute a valid explanation for [its] neglect.” As a result, Oxford will be allowed to pursue its appellate fees but not its trial court fees.

Breach of Fiduciary Duty

Second Circuit

Sonderling v. NuAxess 2, Inc., No. 2:26-CV-03391 (NJC) (AYS), 2026 WL 2098126, 2026 WL 2098127 (E.D.N.Y. July 9, 2026) (Judge Nusrat J. Choudhury). The Acting Secretary of Labor, Keith E. Sonderling, is the plaintiff in this action, and the defendants are NuAxess 2, Inc. and Quad M Solutions, Inc., which administered multiple employer welfare arrangements (MEWAs), and their agents, Joseph Frontiere and Robert J. Rossiter. The action alleges breaches of fiduciary duty under ERISA in which defendants “operated a scheme whereby they convinced dozens of employers…to contribute to a self-funded [MEWA] by promising to provide affordable employer-sponsored health benefits.” However, defendants did so “without conducting any actuarial analysis,” and “used Plan assets to pay third parties for services unrelated to the provision of benefits.” This resulted in the MEWA “los[ing] the ability to pay approved claims by approximately May 2022” and “collaps[ing] entirely by December 2022, leaving participants and beneficiaries ‘with millions of dollars in unpaid medical, dental, and prescription drug bills.’” Less than a month after the complaint was filed, the parties filed a joint letter motion to approve two proposed consent judgments. If approved, the agreement would (1) permanently enjoin defendants from engaging in further action in violation of ERISA, (2) appoint AMI Benefit Plan Administrators, Inc. as an independent fiduciary to manage the plans at issue and resolve unpaid claims, (3) hold the NuAxess defendants jointly and severally liable to the plans in the amount of $500,000, plus a penalty, and put them on a payment schedule, (4) permanently enjoin the NuAxess defendants from serving or acting as fiduciaries or service providers to any ERISA plan, (5) require Rossiter to pay $61,666.66, plus a penalty, to the independent fiduciary in accordance with a payment schedule, and (6) enjoin Rossiter from serving as a fiduciary to any ERISA plan for ten years. The court stated that the proposed judgments were “clear on their terms and the mechanism for enforcing their requirements.” The judgments resolved the claims in the complaint, provided injunctive and monetary relief to resolve unpaid claims pursuant to instructions to the independent fiduciary, were not the product of improper collusion or corruption, and served the public interest. As a result, the court approved the consent judgments, finding them “fair and reasonable.”

Third Circuit

Schoen v. ATI Inc., No. 2:24-CV-1109, 2026 WL 2146921 (W.D. Pa. July 27, 2026) (Judge J. Nicholas Ranjan). This is a putative class action by former employees of Allegheny Technologies Incorporated (ATI), who allege that ATI and related entities violated ERISA by engaging in a “pension risk transfer” (PRT) which moved the benefits in ATI’s ERISA-governed pension plan to Athene Annuity and Life Assurance Company, a private equity insurance firm. Plaintiffs contend that this transfer “caused the following harms: (1) a reduction in the present value of their rights to receive retirement payments; (2) a violation of their quasi-contractual rights to receive the “safest annuity available”…(3) the loss of their pensions’ ERISA-mandated protections; (4) a breach of fiduciary duty under the common law of trusts; and (5) the creation of a substantial risk of future harm – if Athene were to go under and thereby reduce their pension payments.” ATI moved to dismiss for lack of Article III standing, arguing that the harms alleged were neither actual nor imminent. Magistrate Judge Kezia O.L. Taylor issued a report and recommendation (R&R) in favor of ATI. Plaintiffs objected to the R&R, and the district court conducted this de novo review of their objections. The court agreed with the magistrate that the first four types of harm alleged by plaintiffs were precluded by the Supreme Court’s 2020 decision in Thole v. U.S. Bank N.A., which clarified that the only cognizable interest of defined benefit plan participants is in receiving their monthly benefits, which “have been unaffected by the PRTs – and will remain unaffected ‘regardless of how well or poorly’ Athene’s assets are managed.” The court repeated Thole’s admonition, “There is no ERISA exception to Article III.” Regarding the fifth type of harm – the risk of Athene failing financially – the court acknowledged cases allowing similar claims to proceed and admitted, “It’s a close call,” but ultimately agreed with ATI and the magistrate. The court acknowledged that Thole did not preclude plaintiffs’ alleged standing regarding this harm, but determined that their allegations were insufficient to create a cognizable injury that supported Article III standing. The court found that plaintiffs’ evidence, which included Athene’s high concentration of risky assets, a low claim-paying rating, and parallels to the financial profiles of other failed insurers, “don’t create the necessary ‘‘substantial risk’ that the harm’ at issue – losing pension benefits – ‘will occur.’” The court stated that “the closest Plaintiffs come to a projection that there’s a substantial risk that Athene will default on their pension payments is by referencing a study showing the economic loss to beneficiaries of a company choosing Athene as 14% and the price of Athene bonds’ risks as 21% higher than U.S. treasuries.” This was insufficient: “Plaintiffs haven’t shown anything more than an ‘objectively reasonable likelihood’ that Athene will fail.” The court also found that plaintiffs relied on “a highly attenuated chain of possibilities,” which included several hypothetical events that would need to occur for their benefits to fail. In short, “Plaintiffs haven’t plausibly alleged that there is a significant likelihood Athene would default to a degree that their pensions would be affected.” The court thus adopted the R&R and granted ATI’s motion to dismiss.

Spencer v. Campbell Soup Co., No. CV 24-9882 (RMB/SAK), 2026 WL 2111153 (D.N.J. July 22, 2026) (Judge Renée Marie Bumb). Jamar Spencer worked for Campbell Soup Company’s snack food subsidiary, Snyders-Lance, Inc., and paid a weekly tobacco surcharge as part of his participation in Campbell’s ERISA-governed employee health plan. ERISA prohibits discrimination based on health status-related factors like nicotine dependency. However, ERISA also allows for wellness programs that incentivize health promotion through premium discounts, provided they meet certain requirements such as providing a “full reward” to program participants. Campbell employees could avoid a surcharge by participating in the company’s wellness program, which included the Quit for Life tobacco-cessation course. Spencer brought this putative class action, alleging that Campbell’s wellness program was not compliant with ERISA. Specifically, Spencer contended that (1) the tobacco surcharge was illegal because the wellness program did not provide the “full reward,” i.e., retroactive reimbursement for previously paid surcharges upon completion of Quit for Life, (2) the plan failed to provide proper notice of a compliant wellness program and the accommodation of personal physician recommendations, and (3) Campbell breached its fiduciary duties under ERISA by administering a non-compliant plan. Campbell moved to dismiss the complaint for lack of standing and failure to state a claim. The court found that Spencer lacked Article III standing for Counts I and II. On Count I, the court determined that Spencer did not demonstrate an injury in fact because he did not even attempt to enroll in Quit for Life, nor did he allege that he would have enrolled if retroactive reimbursement were available. “This omission is fatal to Plaintiff’s standing because it breaks the causal chain required by Article III. Plaintiff’s alleged injury cannot be fairly traced to the program’s purported deficiencies because he neither alleges that he sought to avail himself of the course nor that the Plan’s terms deterred him from doing so.” As for Count II, the court found that Spencer’s claim was “a purely informational injury,” which is not cognizable under Article III, and that he failed to allege “specific downstream consequences of that injury,” such as being prevented from enrolling in Quit for Life. Turning to the merits, on Count I the court ruled that the statutory phrase “full reward” did not mandate retroactive reimbursement for tobacco surcharges. “Nowhere in the statutory text do the words ‘retroactive’ or ‘reimbursement’” appear.’” The court interpreted “full reward” to mean “parity in the ultimate reward… It does not speak to the reward’s nature, value, timing, or retroactive-versus-prospective operation.” The court further noted that the plan did provide a way for certain participants to avoid surcharges for the entire plan year. The court discounted Spencer’s reliance on a Department of Labor (DOL) preamble to the applicable regulation, stating that preambles “lack the force of law,” and in any event the DOL’s interpretation was not entitled to deference, regardless of where it was located. In so doing the court relied on the Supreme Court’s 2024 decision eliminating agency deference in Loper Bright Enterprises v. Raimondo. On Count II, the court held that ERISA did not require notice of retroactive reimbursement or accommodation of personal physician recommendations, as these were not supported by the statutory text. The court again rejected Spencer’s reliance on the DOL’s applicable regulation, finding that regulation “cannot easily be harmonized with the statutory text.” Finally, the court dismissed Count III, which alleged breach of fiduciary duty, because it was contingent on the first two claims. Thus, the court granted Campbell’s motion, but without prejudice.

Fifth Circuit

Mueller v. United Surgical Partners Int’l, Inc., No. 3:25-CV-2934-S, 2026 WL 2137816 (N.D. Tex. July 23, 2026) (Judge Karen Gren Scholer). In our second tobacco surcharge case of the week, plaintiffs Lisa Mueller and Dara Janosky are challenging the health insurance plan of their employer, United Surgical Partners International, Inc. USPI’s plan included a tobacco surcharge of approximately $50 per month for participants who used tobacco, which included plaintiffs. The plan offered a tobacco cessation program, and participants who completed it could have the surcharge removed prospectively. However, there was no provision for retroactive reimbursement of surcharges already paid during the plan year. As in Spencer, above, plaintiffs allege that this arrangement failed to provide the “full reward” required under ERISA. Additionally, plaintiffs contended that the surcharge was deducted pre-tax and treated as part of the plan’s contribution rate structure, with the funds being deposited into USPI’s general accounts rather than in the plan, thereby constituting a breach of fiduciary duty. Plaintiffs brought four claims: (1) failure to provide the full reward; (2) failure to provide the required notice in plan documents, (3) breach of fiduciary duty as to plaintiffs, and (4) breach of fiduciary duty as to their proposed class. USPI moved to dismiss all claims for lack of standing and for failure to state a claim. On standing, the court differed from Spencer by ruling that plaintiffs had standing to bring their claims. USPI contended that plaintiffs “never allege that they attempted to participate in the tobacco cessation program or that they saw or relied on any of the disclosures they allege are insufficient,” but this was unnecessary for the court. The court found that plaintiffs demonstrated a concrete injury traceable to USPI’s conduct because the tobacco surcharge was allegedly unlawful under ERISA’s antidiscrimination rules. The court further found that plaintiffs sufficiently alleged a loss to the plan supporting their fiduciary duty claim: “by depositing surcharges into its own operating account instead of depositing them into the Plan, Defendant manufactured a gain for itself.” However, the court agreed with USPI (“and Plaintiffs seemingly concede”) that plaintiffs’ claim for prospective relief was invalid because they were no longer employed by USPI. Turning to the merits, the court granted USPI’s motion to dismiss Count I. The court agreed with plaintiffs that tobacco use is a “health status-related factor” under ERISA, but USPI’s wellness program only needed to offer the “full reward” prospectively, not retroactively. The court declined to defer to the Department of Labor’s interpretation requiring retroactive reimbursement, applying the “anti-parroting canon” because the regulation mirrored the statutory language. (The “anti-parroting canon” provides that courts will not grant an agency deference when it interprets its own regulation if the regulation is essentially the same as the statute.) The court noted that cases had gone both ways on this issue, but “the Court agrees with those courts that have held that a wellness program need only offer the ‘full reward’ prospectively, not retroactively.” On Count II, the court denied USPI’s motion to dismiss. The court found that the benefits guide complied with ERISA’s disclosure requirements, but the plan’s summary plan description (SPD) did not. The court held that the SPD needed to describe the wellness program and include a compliant disclosure to be sufficiently accurate and comprehensive under ERISA. Finally, the court denied USPI’s motion to dismiss Counts III and IV, quickly ruling that plaintiffs could proceed with their fiduciary duty claims. The court rejected USPI’s argument that these claims were duplicative, and further stated that plaintiffs were allowed to bring claims in the alternative. Thus, USPI’s motion was only granted in part, and without prejudice.

Eighth Circuit

Williams v. Target Corp., No. 24-CV-3748 (NEB/DJF), __ F. Supp. 3d __, 2026 WL 2111339 (D. Minn. July 22, 2026) (Judge Nancy E. Brasel). In our third (!) tobacco surcharge case of the week, Joseph Williams and Mark Bessey brought this putative class action against the Target Corporation and related defendants, contending that the surcharge imposed under Target’s employee health plan violated ERISA. Target’s wellness program allowed participants to avoid the surcharge by being tobacco-free or completing a tobacco cessation program. Plaintiffs contended that Target’s program was illegal because it (1) failed to provide the “full reward” to all eligible participants, and (2) did not provide notice that a participant’s physician recommendation would be accommodated, as supported by Department of Labor (DOL) regulations. Additionally, they alleged that Target breached its fiduciary duty by mismanaging proceeds from the tobacco surcharge. Target moved to dismiss, arguing that plaintiffs lacked Article III standing and failed to state a claim. Addressing standing first, the court differed from the Spencer case above, ruling consistently with Mueller that plaintiffs had standing to challenge the tobacco surcharge, even if they did not participate in the wellness program or procure a doctor’s note. Their injury was not merely procedural but stemmed from paying a fee they should not have been charged because the wellness program was noncompliant with ERISA. The injury was concrete and particularized, and redressable by a refund of the surcharge. However, plaintiffs lacked standing to pursue claims related to Target’s alleged self-dealing with surcharge proceeds. The court found this claim “murky at best,” and ruled that they failed to identify any concrete injury resulting from this conduct, especially since they “would not have benefitted from any reduced premiums.” On the merits, the court concluded that Target’s wellness program complied with ERISA’s requirement to provide the “full reward” to participants. Target provided its interpretation of the plan, which allowed for retroactive reimbursement of the surcharge for participants who met exemption criteria mid-year, and the court found this interpretation reasonable given Target’s discretionary authority in implementing the plan. Plaintiffs’ argument “stems from a contrasting read of that same language – not any concrete factual allegation,” and thus, “all that matters is whether Target’s interpretation is reasonable.” It was, so the court moved on to plaintiffs’ notice claims. The court ruled that ERISA did not require Target to provide notice that it would accommodate physicians’ recommendations. The statutory language did not impose such a requirement, and the court found no specific delegation of authority to the DOL to mandate this notice. The court declined to defer to the DOL regulation cited by plaintiffs, citing Loper Bright. Finally, the court rejected plaintiffs’ fiduciary duty claim, finding it derivative of their other claims. Target’s motion to dismiss was thus granted.

Discovery

Eighth Circuit

Krebsbach v. The Travelers Pension Plan, No. CV 24-257 (DWF/SGE), 2026 WL 2111001 (D. Minn. July 22, 2026) (Judge Donovan W. Frank). Judith M. Krebsbach, an employee of The Travelers Companies, Inc. and a participant in The Travelers Pension Plan, filed this action alleging that Travelers and the plan miscalculated her pension benefits and breached their fiduciary duty. As required by the plan, Krebsbach raised her concerns through the plan’s internal claims process by filing a claim and then an appeal. Both were denied. Throughout this process the law firm of Faegre Drinker Biddle & Reath LLP advised the plan on its legal obligations. Krebsbach then filed this action in which she served a subpoena on Faegre, requesting its “entire file for the services provided to Travelers[.]” Faegre objected and did not provide any responsive documents or a privilege log, contending that its documents “represented independent legal analysis and mental impressions and were therefore protected under the work product doctrine.” Krebsbach thus filed a “motion for an order to show cause why Faegre should not be held in contempt for failing to produce documents or privilege logs[.]” The motion was referred to the assigned magistrate judge (Shannon G. Elkins, who also authored the order in Gustafson below), who granted it, reasoning that “because Faegre advised Defendants on plan administration, Faegre’s internal documents would be relevant.” Faegre appealed that decision to the district court judge, who issued this order. The court noted that “[t]he main question before the Court is whether the fiduciary exception in ERISA cases applies to Faegre’s internal-only documents.” It was undisputed that “Faegre, as Defendants’ attorneys, were involved with Krebsbach’s claim for benefits and the subsequent appeal.” Thus, under the fiduciary exception, it was “clear that an attorney’s work can be relevant to litigation about benefits due. It therefore reasons, as the Magistrate Judge explained, it is possible that some of Faegre’s internal discussions about the claims would also be relevant because those internal discussions informed the communications between Faegre and Defendants.” The court pointed out that the purpose of the fiduciary exception “is to ensure any document that impacted decision-making is available to plaintiff.” The court also explained that “the Magistrate Judge already provided a method to avoid sharing information that should properly be withheld from discovery. The Magistrate Judge ordered Faegre to produce a privilege log. If the Magistrate Judge conducts an in-camera review of the documents and finds that they did not impact Krebsbach’s benefit claim, Faegre need not disclose them.” The court agreed with the magistrate that this method “balance[s] Plaintiff’s interest in disclosure and Faegre’s need for privacy.” The court observed that it was possible the documents would still end up protected from disclosure, but Faegre had to go through the process first: “Before the production of a privilege log, any objection on the basis that the documents are protected as work product is premature.” As a result, Faegre’s objections were overruled and the magistrate’s order was affirmed.

ERISA Preemption

Third Circuit

Ajeti v. Life Ins. Co. of N. Am., No. CV 26-3249, 2026 WL 2150163 (E.D. Pa. July 27, 2026) (Judge Harvey Bartle III). The seventeen plaintiffs in this unusual case are citizens of the Republic of Kosovo who were employed in Afghanistan from 2011 to 2019 by the American infrastructure consulting firm AECOM to provide support services to the American military. They seek benefits under AECOM’s long-term disability employee benefit plan, which is insured by Life Insurance Company of North America. The complaint, originally filed in Pennsylvania state court, alleges breach of contract, fraud, conspiracy to commit fraud, negligent misrepresentation, breach of the duty of good faith and fair dealing, promissory estoppel and negligence. LINA removed the case to federal court and filed a motion to dismiss based on ERISA preemption. Plaintiffs responded by filing a motion to remand, in which they contended that ERISA did not apply because “their claims are extraterritorial due to the fact that plaintiffs are foreign nationals injured in a foreign country.” In evaluating the motions, the court applied the two steps outlined by the Supreme Court in Yegiazaryan v. Smagin (2023) to determine “whether a statute applies to injuries or conduct beyond the borders of the United States,” noting that “a presumption exists against extraterritoriality of statutes enacted by Congress.” The first step is “whether the statute gives a clear, affirmative indication that it applies extraterritorially,” and if not, the court “moves to the second step – ‘whether the case involves a domestic application of the statute, which is assessed by looking to the statute’s focus.’” The court stated that there was “no doubt” that AECOM established an employee benefit plan, and furthermore the plan covers more than 20,000 American citizens and thus does not fall within ERISA’s exception for plans “maintained outside of the United States primarily for the benefit of persons substantially all of whom are nonresident aliens.” The court rejected plaintiffs’ argument, which “ask[ed] the court not to focus on the plan itself but on the status of the individual employees in determining whether ERISA applies.” This approach, the court stated, “would defeat ERISA’s goal of uniformity.” Thus, “ERISA gives a clear affirmative indication that it applies to the plan in issue, including the benefits owed to its foreign beneficiaries.” The court then moved on to step two and found that it was satisfied as well because the plaintiffs had “asserted a domestic injury.” This was because LINA “investigated and denied plaintiffs their benefits in the United States and failed to pay them benefits allegedly due under the employee benefit plan established by AECOM, an American company, in the United States.” Plaintiffs argued that even if some of their claims were governed by ERISA, their claims for fraud, breach of the duty of good faith, and negligent misrepresentation fell outside ERISA’s ambit. These claims were “predicated on defendant’s denial letters falsely asserting untimeliness and June 2004 correspondence falsely asserting that foreign nationals were ineligible for benefits.” The court disagreed, noting ERISA’s broad preemptive force. The court found that “[t]he essence of plaintiffs’ complaint is the failure of defendant to pay plaintiffs the benefits they allege are due,” and thus ERISA provides their exclusive remedy. Plaintiffs could not therefore “duplicate, supplement or supplant” ERISA’s remedies “by pleading a wide assortment of state law claims.” The court thus moved on to LINA’s motion to dismiss, which it quickly granted for the reasons already stated. Because plaintiffs’ state law claims were preempted, they were non-viable as pled. Thus, the court dismissed the complaint without prejudice.

Parcells Plastic Surgery, LLC v. Oxford Health Plans, LLC, No. CV 25-11928 (ZNQ) (JTQ), 2026 WL 2111477 (D.N.J. July 22, 2026) (Judge Zahid N. Quraishi). This case involves reimbursement of out-of-network surgical services provided by Parcells Plastic Surgery, LLC to a patient diagnosed with breast cancer named E.S. E.S. was covered by an ERISA-governed medical benefit plan administered by Oxford Health Plans, LLC. Plaintiff sought a “gap exception” from Oxford, which would allow the surgeries to be covered as if they were in-network. Plaintiff contends that Oxford approved this request. However, after the surgeries were performed, plaintiff billed Oxford for $127,800 but only received $5,048.86. Plaintiff’s appeals were unsuccessful, so it brought this action asserting a single state law claim against Oxford for promissory estoppel. Oxford filed a motion to dismiss in which it made three arguments: “(1) Plaintiff is not a proper party to the purported promise; (2) Plaintiff’s claim is preempted by § 514(a) of [ERISA]; and (3) Plaintiff’s claim fails to state a claim upon which relief can be granted.” The court’s order began and ended with the second argument. The court explained that ERISA preempts state law when it “has a connection with or reference to [] a plan.” Here, plaintiff’s claim for promissory estoppel “related to” E.S.’s benefit plan and was therefore preempted. The court found that the approval letter on which plaintiff relied explicitly stated that coverage and payment were subject to the terms and limitations of E.S.’s benefit plan. The letter further stated that “‘this approval does not guarantee that the plan will pay for services,’ and could depend ‘on other plan rules, including coordination of benefits.’” Plaintiff argued that its claim involved an independent agreement separate from the plan, and that any reference to the plan would only require “a ‘cursory review’…to determine the negotiated rate, and is therefore not the ‘exacting, tedious, or duplicative inquiry’ that § 514(a) forbids.” However, the court disagreed, finding this argument to be “contradicted by the Approval Letter attached to the Complaint… As discussed above, the Approval Letter repeatedly directs E.S. to consult her ‘plan documents,’ expressly stating that coverage remained subject to the Benefit Plan’s terms and limitations.” As a result, the court determined that plaintiff’s promissory estoppel claim was preempted by ERISA, and granted Oxford’s motion to dismiss. The court took pains to “note[] that it is sensitive to the important issues raised in the Complaint. The patient in this case required medical treatment, and Plaintiff, in turn, performed the necessary operations.” However, “The Court is nonetheless obligated to follow the law and the preemption provision found in § 514(a).” The court granted plaintiff leave to amend its complaint to file a claim under ERISA.

Exhaustion of Administrative Remedies

Second Circuit

Garan v. New York-Presbyterian Hosp., No. 24-CV-06978 (JAV), 2026 WL 2137670 (S.D.N.Y. July 24, 2026) (Judge Jeannette A. Vargas). Regular readers of Your ERISA Watch are familiar with Jozef Garan, who has been representing himself pro se in an effort to obtain pension benefits he believes he is owed. Last month the Second Circuit affirmed a decision ruling that Garan could not seek pre-2020 benefits from his former union’s pension fund because Garan’s employer was not obligated to contribute to that fund until 2020. The appellate court suggested that Garan might have better luck with his former employer, New York-Presbyterian Hospital (NYPH). (Your ERISA Watch covered this ruling in our June 24, 2026 edition.) Sure enough, Garan was simultaneously pursuing this action against NYPH. In 2024, the court ruled that Garan’s claims arose under ERISA and denied his motion to remand the case to state court. (See our November 13, 2024 edition for more details.) NYPH has now moved for summary judgment, contending that Garan did not exhaust his appeals under the plan before filing suit. In this brief order, the court agreed. The court emphasized that under Second Circuit precedent plaintiffs must exhaust all administrative remedies before bringing an action for benefits under ERISA. Garan did not do so. He argued “only that, based upon his ‘history with the Hospital and their officials, pursuing available administrative remedies would have been futile.’” However, “nothing in the record suggests that pursuit of administrative remedies would have been futile such that Garan could be released from the requirement to exhaust administrative remedies.” Garan did not “point to any materials in the record to substantiate the alleged futility of such an attempt, besides his attestations as to the many meetings he had with officials from the Lawrence Hospital, Local 1199 representatives, and the Office of United States Representative Eliot Engel.” This was not enough: “[T]he fact that those individuals could not ‘provide [Plaintiff] with the information and explanations [he] sought’ has no bearing on whether it would have been futile to dispute his pension benefits before the Retirement Board – the one entity he was required to present these issues to and that was most likely to have the information he sought from others.” As a result, NYPH’s motion was granted and the case was closed.

Life Insurance & AD&D Benefit Claims

Third Circuit

Fleming v. Minnesota Life Ins. Co., No. CV 23-2558, 2026 WL 2116960 (E.D. Pa. July 22, 2026) (Judge Kai N. Scott). Kim DiNicola was employed at Vanguard for 21 years and was covered under Vanguard’s ERISA-governed employee life insurance plan, which was insured by Minnesota Life Insurance Company. The plaintiffs – Kevin Fleming, Rebekah Fleming, Ryan Fleming, and Robert DiNicola – were named as Kim’s beneficiaries. In 2019, Kim became disabled and was approved for continued coverage without premium payments. In 2020, “though it is unclear why,” Minnesota Life sent Kim a form to convert her group coverage into individual coverage, which she completed. Kim resigned from Vanguard the same year due to her disability. Afterward, a series of confusing communications ensued in which Minnesota Life represented on several occasions that Kim’s group coverage was still in effect, including informing Kim that her waiver of premium was still active and requesting updated disability information. Kim died in 2021, and when plaintiffs filed a claim for benefits under the group policy, Minnesota Life denied it, claiming Kim was only covered under the individual conversion policy. It called its communications “clerical errors.” This action ensued in which plaintiffs alleged breach of fiduciary duty and estoppel against Minnesota Life and Securian (Minnesota Life’s parent company) on one hand, and against several Vanguard defendants on the other. The Vanguard defendants filed a motion to dismiss for failure to state a claim, arguing that “(i) Plaintiffs do not state a claim for breach of fiduciary duties against them; (ii) Plaintiffs fail to state a claim for equitable estoppel against them; and (iii) Plaintiffs should be denied leave to amend a third time.” The court “agrees on all three points.” On the breach of fiduciary duty claim, the court found that plaintiffs did not sufficiently plead any material misrepresentations by the Vanguard defendants. The allegations were vague and lacked critical details, and plaintiffs failed to demonstrate how any alleged misrepresentations were material or how they or Kim relied on them detrimentally. As for equitable estoppel, the court concluded that plaintiffs could not have reasonably relied on any alleged misrepresentations by Vanguard because Kim had signed the conversion form, indicating that she was aware she was converting her coverage to an individual policy. The court thus granted the Vanguard defendants’ motion to dismiss, without leave to amend.

Myers v. Creative Pultrusions Life Ins. Plan, No. 3:25-CV-317, 2026 WL 2110790 (W.D. Pa. July 22, 2026) (Circuit Judge D. Brooks Smith, sitting by designation). Matthew S. Myers was employed by Creative Pultrusions, Inc. (CP) (“a world renowned pultruder that specializes in pultruding large custom pultrusion profiles”) and thus was eligible to enroll in the company’s ERISA-governed life insurance benefit plan. Matthew originally waived coverage when he first became eligible in 2019. During the company’s open enrollment period in 2020, he allegedly signed up for $100,000 in coverage. However, CP “failed to run a competent enrollment/payroll/EOI process,” which led to inconsistencies in payroll deductions and a lack of timely communication. Matthew passed away in 2023, and his surviving spouse, Daphne Myers, attempted to obtain information from CP regarding how to file a claim. She contends that “for ‘nearly two years,’ Creative Pultrusions failed to supply [her] with the ‘claim instructions and plan documents’ she requested.” Eventually, she submitted a claim to the plan’s administrator, UnitedHealthcare Specialty Benefits, which denied it in 2025 on the ground that Matthew did not have coverage because he had waived it in 2019. Daphne did not appeal this decision and instead filed this pro se action against United, CP, and the plan administrator, alleging three claims for relief under ERISA: (1) failure to pay plan benefits under 29 U.S.C. § 1132(a)(1)(B) (against United and the plan), (2) breach of fiduciary duty under 29 U.S.C. § 1132(a)(3) (against CP), and (3) statutory penalties for failure to provide plan documents under 29 U.S.C. § 1132(c)(1) (against the plan administrator). United moved to dismiss Count I, while CP moved to dismiss Counts II and III. In its motion, United contended that Daphne failed to exhaust her administrative remedies under the plan before filing suit. In response, Daphne “admits that she did not exhaust her administrative remedies under the Plan[.]” As a result, she could only proceed if she “provide[s] a clear and positive showing of futility…or plausibly alleges that she ‘filed an administrative appeal…but [United] failed to timely decide it[.]’” The court ruled for United, finding that Daphne “has accomplished neither.” Daphne made two arguments. First, she contended that an appeal was futile because United “had already taken a firm position denying benefits based on an alleged waiver, and the same entity responsible for the denial would have adjudicated any appeal.” This was insufficient for the court, which ruled that “[n]othing in the record indicates that United stubbornly clung to adverse claims decisions when confronted with persuasive evidence of error,” or that United did not comply with its claim procedures. Second, Daphne contended that the appeal process “was the result of plan-side nondisclosure and delay, rendering exhaustion unavailable or excused at the pleading stage.” However, the court found that United “acted promptly” once it received her claim. In short, “speculative recalcitrance is not a clear and positive showing of futility,” and thus the court granted United’s motion. CP was not so fortunate on its motion. CP argued that Count II (breach of fiduciary duty) was duplicative of Daphne’s claim for benefits and sought relief “not typically available in equity.” However, the court found that the claim was not merely a repackaged denial of benefits claim but alleged separate fiduciary breaches by CP – “failing to consummate Matthew’s decision to opt in, thereby leaving him uncovered” – that were not compensable under § 1132(a)(1)(B). Thus, the court allowed Count II to proceed. As for Count III, CP “does not deny that it failed to timely furnish the requested documents. Instead, it [] argues that it had no obligation to furnish them because Matthew waived life insurance coverage, so Mrs. Myers was not a ‘beneficiary.’” However, the court found that this argument inverted the proper standard on a 12(b)(6) motion by assuming facts in CP’s favor. The court ruled that Daphne “has plausibly pled that Matthew opted into the group life insurance plan during the 2020 open enrollment period,” and thus she was plausibly a beneficiary and the plan administrator was required to provide her plan documents upon request. Count III thus survived as well.

Ninth Circuit

Life Ins. Co. of N. Am. v. Zaidi, No. 5:24-CV-01576-SSS-DMKX, 2026 WL 2100853 (C.D. Cal. July 21, 2026) (Judge Sunshine S. Sykes). Javid Zaidi, who passed away in 2023, was insured under an ERISA-governed life insurance policy purchased by his employer, Matrix Service Company, and insured by Life Insurance Company of North America. The policy included both basic, company-provided coverage as well as voluntary life insurance. Javid designated Hanna Zaidi as the beneficiary for his voluntary life insurance (totaling $100,000), which LINA paid. However, Javid did not designate a beneficiary for his basic coverage, which, with interest, totaled $232,608.95. The policy provided that if no beneficiary was designated, benefits are “payable to the first surviving class of relatives in this order: spouse, children, parents, siblings, or the executors or administrators of the insured’s estate.” Hanna claimed entitlement to the basic coverage as Javid’s spouse, but confusingly, so did someone else: Shahper Khalid-Zaidi. In support of her claim, Shahper submitted a marriage certificate showing she was married to Javid in 2008. As a result, LINA denied Hanna’s claim. Hanna appealed, stating that she was probating Javid’s will and contending that Javid and Shahper divorced in 2016. At this point LINA threw up its hands and filed this interpleader action naming Hanna and Shahper as defendants. LINA deposited the benefits with the court and was dismissed from the action, taking $6,000 with it in reasonable costs and fees. Subsequently, in 2025, a California probate court ruled that Shahper was the legal wife and surviving spouse of Javid. The court in this case then held a one-day bench trial in January at which both claimants testified. The court subsequently ordered LINA to provide relevant documents, held another day of trial, and has now issued this ruling. The court first determined that the doctrine of collateral estoppel applied, which prevented Hanna from relitigating her spousal status. The issue of who the legal spouse was had already been decided in Shahper’s favor by the California probate court and the parties could not revisit it. As a result, under the policy, because no beneficiary was designated, benefits were required to be paid to Shahper as Javid’s legal spouse. The court “acknowledge[d]that some of the evidence Hanna Zaidi submitted suggests that she may have been personally closer to Javid Zaidi at the time of his death, and that he may have intended for the basic coverage benefits to go to her as well.” However, the court was bound by the terms of the plan. “[I]t is not the role of the Court to guess whose name the decedent would have designated had he known or remembered to do so. ERISA directs that benefits be paid in accordance with the plan documents as written, precisely to avoid this type of inquiry into a deceased participant’s subjective wishes.” The court noted that Javid’s listing of Hanna Zaidi as a “contact” in his employer’s database did not equate to a beneficiary designation, as the records for contacts and beneficiaries were maintained separately, and there was no dispute that Javid had not named a beneficiary for his basic coverage. As a result, the court directed the clerk to disburse the remaining interpleaded funds to Shahper.

Medical Benefit Claims

First Circuit

Stephen T. v. Blue Cross & Blue Shield of Mass., Inc., No. CV 24-12829-MJJ, 2026 WL 2123352 (D. Mass. July 20, 2026) (Judge Myong J. Joun). Plaintiffs Stephen T. and M.T. were participants in an ERISA-governed health benefit plan administered by Blue Cross and Blue Shield of Massachusetts, Inc. In 2021 M.T. received treatment for mental health conditions at Aspiro Adventure, LLC, an intermediate outdoor behavioral health facility in Utah. Plaintiffs did not request preauthorization for M.T.’s treatment at Aspiro. After M.T.’s discharge, plaintiffs submitted claims for the treatment to BCBSMA, which denied them for lack of preauthorization. This action followed in which plaintiffs challenged the denial under ERISA and the Mental Health Parity and Addiction Equity Act (Parity Act). They argued that the plan did not require preapproval for intermediate behavioral health facilities like Aspiro and that BCBSMA’s network inadequacies constituted a violation of the Parity Act. The case proceeded to cross-motions for judgment on which the court ruled in this order. The court applied the abuse of discretion standard of review because the plan gave BCBSMA discretionary authority to interpret the plan and determine benefits. Under this standard, the court found BCBSMA’s denial of benefits reasonable, as the plan required preauthorization for intermediate care facilities like Aspiro, which plaintiffs failed to obtain. Plaintiffs contended that the plan was ambiguous because its requirement pertained to “a hospital or other covered facility,” and an “intermediate, outdoor behavioral health facility is not explicitly included in the definition of ‘hospital and other covered facilities.’” However, the court found that this was insufficient to create an ambiguity because the rest of the plan confirmed that preapproval was required for the treatment M.T. received. “[T]he Plan unequivocally states that pre-approval is required before admittance into an inpatient program that provides intermediate care[.]” As for plaintiffs’ Parity Act claim, the court rejected it for two reasons. First, the court ruled that it was plaintiffs’ burden to provide evidence in support of their claim, and thus they could not contend that “Defendant did not provide evidence of its compliance with the Parity Act claim in response to Plaintiffs’ appeal letter[.]” Second, the court concluded that plaintiffs’ arguments about network inadequacies did not support a violation because they did “not show that the preapproval requirement, as applied, was not at parity with how that requirement would be applied to medical/surgical treatments.” As a result, BCBSMA prevailed and judgment was entered in its favor on both of plaintiffs’ claims.

Eleventh Circuit

Mosse v. Blue Cross & Blue Shield of Fla., Inc., No. 25-CV-22687, 2026 WL 2146950 (S.D. Fla. July 27, 2026) (Judge Roy K. Altman). Plaintiff Matias Mosse is the parent of a minor, A.M., who was diagnosed with growth hormone deficiency (GHD), as “evidenced by decreased velocity with height, short stature, delayed bone age[.]” A.M. also experienced skin issues due to his diagnosis which his physicians determined required Skytrofa, a once-weekly growth hormone injection. However, Blue Cross and Blue Shield of Florida, Inc. (Florida Blue), the insurer of the controlling ERISA-governed health plan, denied the request, contending that the medication “is not covered under your pharmacy plan.” Mosse’s appeal was unsuccessful and this action followed in which Mosse contended that the denial violated ERISA. Florida Blue responded with a motion for judgment on the pleadings, asserting that the plan at issue expressly excluded Skytrofa from coverage. Mosse “counters with several arguments,” but the court found it only needed to address one: “[t]he alleged exclusion of Skytrofa is not clear on the face of the complaint as alleged by Florida Blue nor as provided for in Florida Blue’s own documents.” Florida Blue relied on the plan’s benefit booklet, which included a Medications Not Covered List that listed Skytrofa. However, Mosse highlighted the plan’s Coverage Guidelines, which suggested that Skytrofa could be covered under certain circumstances when preferred brands were not suitable. The court acknowledged that Mosse “might well be misreading the Plan,” but also found that Florida Blue’s response was inadequate and did not give “a clear explanation as to why the Plaintiff cannot rely on the Coverage Guidelines.” The court further found that Mosse’s complaint contained enough facts to reasonably infer that A.M. might qualify for Skytrofa under the Coverage Guidelines. The complaint detailed medical reasons why Skytrofa was necessary, including the risk of skin irritation from daily injections of alternative medications. In the end, “The Defendant presents a persuasive argument for its view that the Plan excludes Skytrofa. But the Plaintiff counters by identifying a potential exception to that exclusion. And the Defendant neither challenges the authenticity of that exception nor clarifies why it doesn’t apply to the Plaintiff. We thus lack, on the record before us, enough information to grant a judgment on the pleadings.” Florida Blue’s motion was thus denied.

Pension Benefit Claims

Second Circuit

Hecht v. New York Univ., No. 25 CIV. 3042 (PAE), 2026 WL 2151163 (S.D.N.Y. July 27, 2026) (Judge Paul A. Engelmayer). This case revolves around David Greenberg, who was a professor of sociology at New York University and known for his work in Marxist and radical criminology. As a NYU employee, he was a participant in the university’s ERISA-governed faculty pension plan. He originally named his parents as the primary beneficiaries of his account and the New American Movement (NAM) as the sole contingent beneficiary, but later changed the contingent designation to NAM “or any successor thereof,” and, failing that, his executors or administrators. In 2024 Greenberg died unmarried and intestate with an account valued at $5,283,120.65. His immediate family had predeceased him, including his parents. Meanwhile, NAM had gone defunct, dissolving in a 1982 merger with another political organization which resulted in the Democratic Socialists of America (“DSA”). Greenberg had been a dues-paying DSA member since at least 1992. After Greenberg’s death, NYU sought merger documentation from DSA while Martin Hecht, the administrator of Greenberg’s estate, objected to any distribution. NYU directed a hold on the assets during its investigation. Hecht submitted a written claim, but NYU did not respond within ERISA’s regulatory deadline and then claimed it needed more time. Hecht thus filed this action against NYU and DSA in which he made the following claims under ERISA: (1) a declaration that DSA is not NAM’s successor; (2) benefits from NYU; (3) breach of fiduciary duty by NYU for failing to confirm Greenberg’s designation remained current; and (4) alternatively, “equitable relief at common law” in the form of benefit payment. DSA counterclaimed for a declaration that it is the proper beneficiary and cross-claimed against NYU for an order of distribution. The parties filed cross-motions for summary judgment, and the court decided them under a de novo standard of review because NYU had forfeited any discretionary authority by missing its response deadline. The court quickly disposed of any issues regarding exhaustion because all parties “agree that Hecht adequately exhausted his administrative remedies before filing this lawsuit” by filing a claim that NYU did not resolve in a timely fashion. The court then turned to the central issue of the case, i.e., “Whether DSA Is NAM’s ‘Successor’ Within the Meaning of Greenberg’s Contingent Beneficiary Designation.” The court interpreted the word “successor” according to its “plain meaning” as “a person or thing that succeeds another,” and rejected Hecht’s argument that the term had a more specialized meaning that “import[ed] corporate law formalities.” Under the more general definition, the court found that the answer to the question of whether DSA “succeeded” NAM was “emphatically yes. The assembled record overwhelmingly reflects that, in every ordinary and functional sense, DSA is NAM’s successor.” The court cited evidence in the record which showed years of publicized negotiations, a merger vote, a merger agreement, a ratifying membership referendum, dissolution of the predecessor organizations at a 1982 convention, and the combination of the organizations’ assets and debts. This evidence “conclusively establishes that DSA is NAM’s ‘successor,’ within the meaning of Greenberg’s contingent beneficiary designation,” and thus “DSA is entitled to the disputed retirement account.” As for Hecht’s claims against NYU, the court ruled that NYU had no duty to “prompt Greenberg to revisit his designations,” and even if it did, Hecht did not prove that NYU had never done so. The court noted that ERISA was designed to ease plan administration, and thus “NYU’s fiduciary duties to Greenberg or his beneficiaries did not compel it to second-guess, or prompt Greenberg to revisit, his stated beneficiary designations as to the retirement account.” Furthermore, any delay by NYU in deciding Hecht’s claim did not amount to a breach because (a) the benefits were not payable to the estate, and (b) in any event NYU acted consistently with its duty by “attempting to access sufficient historical documents as to NAM and DSA to enable it to reach a reliable conclusion as to the identity of NAM’s successor,” and by keeping Hecht up to date on its research. As a result, the benefits were awarded to DSA, Hecht was denied any relief, and NYU escaped liability.

Pleading Issues & Procedure

Sixth Circuit

Smith v. Humana, Inc., No. 3:25-CV-00727-GNS, 2026 WL 2103411 (W.D. Ky. July 21, 2026) (Judge Greg N. Stivers). This is a putative class action regarding forfeitures by participants in Humana, Inc.’s ERISA-governed defined contribution Retirement Savings Plan. Like many plans, the Humana plan is funded by contributions from employees and matching contributions from the employer. The contributions of participants are immediately vested, but Humana’s matching contributions do not immediately vest. As a result, if employees leave before the vesting period ends, they forfeit Humana’s matching contributions, which become assets of the plan. The Humana plan allows administrators to use forfeited funds to offset the employer’s future contributions, administrative expenses, or both. However, Kathleen Smith alleges that during the relevant period, plan administrators “improperly allocated forfeited Plan funds to offset Humana’s contributions to the Plan instead of to defray administrative costs… Smith alleges that these allocations constitute a breach of Defendants’ fiduciary duties under ERISA, violations of ERISA’s anti-inurement provision, and self-dealing prohibited by ERISA.” Defendants moved to dismiss, but the motion hit a roadblock. The court noted that “[a]ll parties agree on the importance of a sister court’s decision in Donelson v. Meijer, Inc…. Donelson involved nearly identical claims about forfeited contributions to a grocery chain’s retirement plan.” (For more on Donelson, check out Your ERISA Watch’s coverage of the ruling in our December 31, 2025 edition.) The district court ruled in the employer’s favor in Donelson, but the plaintiffs in that case have taken the case up to the Sixth Circuit. The court in this case seemed sympathetic to the reasoning in Donelson: “This Court…sees no reason to disagree with a sister court, especially since its holding aligns with the ‘significant majority’ of courts in other circuits that have considered similar claims.” However, the court determined that discretion was the better part of valor: “Any opinion issued by the Sixth Circuit in Donelson will surely influence – if not determine – the outcome of Smith’s claims in this matter… Accordingly, Defendants’ motion to dismiss will be administratively remanded until the Sixth Circuit has issued a ruling on the appeal pending in Donelson.” Thus, the case will remain inactive until a party files a motion to reopen it after Donelson is decided.

Ninth Circuit

Pharmaceutical Care Mgmt. Ass’n v. Bonta, No. 2:26-CV-00012-ODW (MBKX), 2026 WL 2138551 (C.D. Cal. July 24, 2026) (Judge Otis D. Wright, II). California Senate Bill 41, which became effective January 1, 2026, amended Section 4441(c)(2) of the California Business and Professions Code to impose fiduciary duties on pharmacy benefit managers (PBMs) for self-insured employer plans. (PBMs “administer prescription-drug benefits for plans covering over 230 million individuals nationwide and contract with self-insured ERISA plans operating in California.”) Among the duties imposed by the new law is the duty “to be fair and truthful toward the client, to act in the client’s best interests, to avoid conflicts of interest, and to perform its duties with care, skill, prudence, and diligence.” Pharmaceutical Care Management Association (PCMA), a national trade association representing PBMs, is not happy with this new law and brought this suit against the State of California asserting “one cause of action for ERISA preemption… It seeks a declaration that Section 4441(c)(2) is preempted by ERISA as applied to ERISA-covered plans, and an injunction prohibiting the State from enforcing Section 4441(c)(2) in that context.” California responded with a motion to dismiss for lack of Article III standing and for failure to state a claim. Meanwhile, PCMA filed a motion for summary judgment. In this order the court did not get past the standing issue. California made “a facial standing challenge and argues that PCMA lacks Article III standing because it fails to allege facts showing one or more of its members would otherwise have standing to sue in their own right.” The court thought that PCMA’s response, “[a]s an initial matter…advances a cognizable theory of injury.” PCMA argued that the new law “requires PBMs to alter their business practices and incur compliance-related costs,” which “if adequately supported, can establish an injury in fact, as regulated entities may suffer concrete harm when a statute compels them to alter their conduct or incur compliance costs.” However, the court found that “PCMA’s allegations do not move past this abstract theory.” PCMA offered “only generalized assertions that PBMs ‘will have to revise their business practices,’ without explaining how the statute requires those changes.” PCMA did not identify any contractual provisions that would have to be changed, and “fails to describe how the statute’s imposition of fiduciary duties translates into concrete operational changes to PBM services.” PCMA attempted to buttress its standing argument by referring to declarations it submitted in support of its motion for summary judgment, but the court rejected this because the declarations were outside the pleadings. As a result, “although PCMA articulates a viable theory of injury, it fails to allege sufficient facts to show its members have suffered that injury. Specifically, PCMA fails to allege sufficient facts showing that Section 4441(c)(2) requires PBMs to alter their business practices and imposes concrete, non-speculative compliance burdens on PBMs.” California’s motion to dismiss for lack of subject matter jurisdiction was thus granted, but PCMA was given leave to amend.

Retaliation Claims

Second Circuit

Chui v. Publicis Groupe S.A., No. 24 CIV. 6767 (AT), 2026 WL 2124841 (S.D.N.Y. July 23, 2026) (Judge Analisa Torres). Wai Lun Chui was an employee of Publicis Groupe S.A. and its subsidiaries from 2016 to 2021. In 2024, he brought this action in which he asserted numerous claims of discrimination and retaliation. His original complaint included claims of discrimination under the Age Discrimination in Employment Act, discrimination based on race, national origin, and religion under Title VII of the Civil Rights Act of 1964, and retaliation claims under Title VII, the Sarbanes-Oxley Act (SOX), and the Dodd-Frank Act. In 2025 the court dismissed Chui’s complaint for failure to exhaust administrative remedies and for failure to state a claim. Now plaintiff has moved for leave to amend his complaint, adding factual allegations to support his old claims and adding claims for retaliatory interference under ERISA, new claims under the New York State Human Rights Law (NYSHRL) and New York City Human Rights Law (NYCHRL), and a common law claim for constructive fraud/negligent misrepresentation. The court ruled that plaintiffs’ proposed complaint “does not remedy the deficiencies identified in the Court’s prior order and does not set forth any facts rendering Plaintiff’s new proposed claims plausible. The Court, therefore, concludes that amendment would be futile and denies leave to amend.” Specifically, the court found that (1) the SOX claim had been removed and was thus deemed abandoned, (2) plaintiff did not provide additional facts to support a minimal inference of discriminatory motivation, pleading no facts regarding comparative unfavorable treatment or protected activity, (3) plaintiff did not specify whether he reported securities violations to the SEC, a requirement for Dodd-Frank whistleblower protections, (4) plaintiff did not plead that he was treated less well than other employees due to a protected characteristic under the NYSHRL and NYCHRL, and (5) plaintiff did not establish a fiduciary or special relationship that would give rise to a constructive fraud/negligent misrepresentation claim, and the incorrect or misleading communications he alleged were made to third parties, not him. As for plaintiff’s ERISA retaliation claim, his “sole allegation is that ‘Defendants withheld COBRA subsidy to punish Plaintiff’s legal complaints. [Employee Benefits Security Administration (“EBSA”) found violation.” This was insufficient because “[t]his conclusory allegation is not supported by any facts…which suggest that Plaintiff ‘exercise[d]’ any right under an employee benefit plan, or that Defendants discriminated against him because of exercising that right.” As a result, plaintiff failed to state a claim. Defendants’ motion was thus granted in full, with prejudice.

Eighth Circuit

Gustafson v. TransPerfect Global, Inc., No. 26-CV-1687(JWB/SGE), 2026 WL 2139017 (D. Minn. July 24, 2026) (Magistrate Judge Shannon G. Elkins). Kari Gustafson was an account manager with TransPerfect Global, Inc. She alleges in this action that she was terminated by TransPerfect because it wanted to avoid covering a high-cost medical procedure she was planning to undergo. Specifically, she intended to seek treatment for migraines through Reed Migraine Centers, which involved the implantation of a spinal cord stimulator (SCS). The process for securing coverage for the SCS began in May of 2025 and the authorization period for the procedure was effective June 30, 2025. TransPerfect terminated her on July 7, 2025, which she alleges prevented her from undergoing the procedure while still insured. In her first amended complaint, Gustafson alleged discrimination and retaliation in violation of the Americans with Disabilities Act and the Minnesota Human Rights Act, benefit interference under ERISA, and interference and retaliation under the Family Medical Leave Act. Defendants responded with two motions: one to transfer venue and one to dismiss the ERISA claim, arguing that Gustafson failed to plausibly allege the requisite intent to interfere with her benefits. In response, Gustafson filed a motion for leave to amend her complaint to buttress her ERISA interference allegations. Gustafson’s motion was referred to Magistrate Judge Elkins, who granted it in this order. Defendants argued that the motion should be denied because amendment would be “futile and prejudicial,” but the court disagreed. The court found that the amendment was not futile because Gustafson “has set forth numerous facts which, if proven, could support a claim for benefits interference under ERISA.” Among these facts were that TransPerfect was financially responsible for paying benefits, it was aware of her medical procedure plans, it had the ability to track her authorization process, and the close timing of the events in question. The court was unpersuaded by TransPerfect’s arguments that Gustafson merely alleged company knowledge without linking her termination to a specific person with knowledge of the authorization process. The allegations that her supervisor knew and that the company could track her authorization were sufficient. The court also disagreed with TransPerfect’s claim of prejudice, noting that its ERISA arguments were just one part of the company’s broader motion to transfer or dismiss, and TransPerfect had already briefed the matter for the current motion. As a result, Gustafson’s motion was granted and she was permitted to file a second amended complaint.

Venue

Ninth Circuit

Kvek v. Cushman & Wakefield, U.S., Inc., No. 2:26-CV-00736-JHC, 2026 WL 2123023 (W.D. Wash. July 23, 2026) (Judge John H. Chun). Renee Kvek, a former employee of Cushman & Wakefield, participated in the company’s ERISA-governed 401(k) plan and alleges in this putative class action that she “suffered a financial injury through Defendants’ investment decisions concerning that plan.” Defendants, which include the company and its investment committee, are headquartered in Chicago, and thus they filed a motion requesting that the court transfer the case to the Northern District of Illinois. The court observed that venue was proper in that district under ERISA, and thus used the Ninth Circuit’s nine-factor test to determine if venue should be transferred pursuant to 28 U.S.C. § 1404(a), which allows transfer “[f]or the convenience of parties and witnesses [and] in the interest of justice[.]” The court found that transfer was favored because the plan was administered from Illinois, not Washington, there were stronger ties to Illinois, where the investment decisions were made, most potential class members did not reside in Washington, more nonparty witnesses were located within the subpoena range of the Northern District of Illinois, and Illinois had an interest in in having localized controversies decided at home. Neutral factors included litigation costs and the fact that both Washington and Illinois courts were equally capable of applying ERISA. Transfer was disfavored because plaintiff had chosen Washington (although this choice was entitled to less weight because she sought to represent a class) and “electronic documents may easily be transported.” Thus, on balance, the factors favored transfer. Plaintiff argued there was a “greater level of court congestion in the Northern District of Illinois,” but the court stated that even if that were conceded, it “does not override the other substantive connections that Defendants have to Illinois.” As a result, defendants’ motion was granted and the case was transferred to the Northern District of Illinois.