The federal courts issued numerous ERISA-related decisions over the last week, but none stood out, so we are not highlighting a particular ruling. The cases ran the gamut, however, so you will definitely find something that tickles your fancy below.

For example, read on to learn about (1) the (almost) end of the ten-year-old McCutcheon v. Colgate-Palmolive case, in which the court awarded class counsel $96.28 million (!) in attorney’s fees; (2) another fruitless effort by a health care provider to enforce arbitration awards under the No Surprises Act (SpecialtyCare v. Cigna, SpecialtyCare v. UMR); (3) a Texas court allowing a challenge to the tobacco surcharge in 7-Eleven’s employee health plan (Baker v. 7-Eleven); (4) whether prevailing defendants in unpaid contribution cases can be awarded attorney’s fees (Johnson v. Crane Nuclear); and (5) a published decision from the Second Circuit addressing how to calculate withdrawal liability when employees switch unions and join a new plan (Mar-Can v. Local 854). 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

McCutcheon v. Colgate-Palmolive Co., No. 16-CV-4170 (LGS), 2026 WL 444748 (S.D.N.Y. Feb. 17, 2026) (Judge Lorna G. Schofield). This massive hard-fought ten-year-old class action is finally nearing completion. It has been up to the Second Circuit twice, where the class plaintiffs were victorious both times. At issue in the case was the calculation of benefits under Colgate-Palmolive Company’s retirement plan. (For more details on the complicated math involved, see our coverage of the 2023 and 2025 appellate rulings.) The case has now settled, and before the court here was class counsel’s motion for attorneys’ fees and expenses, settlement administration costs, and a service award for the class representative. The court noted that there were no objections from any class members to the requests. The petition sought $96.28 million in attorneys’ fees, which was 29% of the $332 million common fund, $2.9 million in litigation expenses, $150,000 in settlement administration costs, and a $10,000 service award for plaintiff Rebecca M. McCutcheon. The court first established a baseline fee amount by examining “other ERISA cases that generated very large common funds (in the $200-$350 million range) and that were litigated to judgment and defended on appeal or were otherwise of comparable magnitude, duration, and complexity,” and determined that the 29% requested here was reasonable in comparison. The court then subjected the request to the Second Circuit’s Goldberger factors, examining “(1) the time and labor expended by counsel; (2) the magnitude and complexities of the litigation; (3) the risk of the litigation; (4) the quality of representation; (5) the requested fee in relation to the settlement; and (6) public policy considerations.” The court noted that class counsel litigated the case for over a decade, defending the judgment twice on appeal and opposing a petition for certiorari in the Supreme Court. The litigation involved significant work and investment, with over 27,000 hours spent by class counsel. The case was challenging due to an IRS letter supporting Colgate and the “substantial number of defenses” asserted by Colgate. The court stressed that the settlement represented nearly 98% of the total residual annuities claimed by the class, reflecting high-quality representation. The court also emphasized the importance of setting fees that encourage counsel to undertake future risks for the public good. The court then conducted a lodestar cross-check to ensure the percentage fee was reasonable. The court found that the attorneys’ hours and rates were supported, approving rates that “range from $900 to $1,150 per hour for partners, $700 to $800 per hour for senior associates and $250 per hour for senior paralegals.” The result was “an overall lodestar of approximately $19.5 million and an effective lodestar multiplier of 4.92,” which the court deemed reasonable. Finally, the court found the litigation expense reimbursement request of $2.9 million and the $150,000 in settlement administration costs reasonable and adequately documented, and approved a $10,000 service award for McCutcheon.

Sixth Circuit

Johnson v. Crane Nuclear PFT Corp., No. 3:23-CV-00273, 2026 WL 474865 (M.D. Tenn. Feb. 19, 2026) (Judge Aleta A. Trauger). Here at Your ERISA Watch we typically give only light coverage to unpaid contribution and withdrawal liability cases. However, sometimes unusual issues pop up that are worth discussing, and this case involved one of them: when is a prevailing defendant in an unpaid contributions case (under 29 U.S.C. § 1145) allowed to recover its attorney’s fees? Here defendants Crane Nuclear Corporation and Chris Mitchell prevailed when the Plumbers & Steamfitters Local No. 43 benefit funds sued them; on summary judgment the court ruled that the defendants were not contractually obligated to contribute to the funds. Defendants filed a motion for attorney’s fees, requesting $196,632.10. The funds opposed, making four arguments: (1) defendants cannot recover attorney’s fees under Section 1145; (2) the court should exercise its discretion to deny fees; (3) the requested fees were excessive; and (4) the court should “offset any award against the amount the defendants owe plaintiffs.” The funds acknowledged the lack of case law in support of their Section 1145 argument, “candidly conced[ing] that they are aware of only two cases – both district court cases – even considering the question of a whether a prevailing defendant in an action under 29 U.S.C. § 1145 may be awarded attorney’s fees. But they also argue that they are aware of no cases, in the Sixth Circuit or elsewhere, that have awarded attorney’s fees to a prevailing defendant in a § 1145 case.” The court examined Section 1145 and Section 1132(g)(1), which both discuss fee awards, and ruled that “the plain language of [Section 1132(g)] clearly authorizes a prevailing defendant in a § 1145 action to seek attorney’s fees. Subsection (g)(1) authorizes the court to award attorney’s fees to either party ‘[i]n any action under this subchapter,’ ‘other than [in] an action described in paragraph (2).’” Paragraph 2 does refer to Section 1145 cases, but only those brought by a fiduciary; in such cases fee awards are mandatory to a prevailing plan. However, “subsection (g)(2) says nothing about § 1145 enforcement actions in which judgment is not awarded in favor of the plan.” Thus, Section 1132(g) was the operative statute and allowed fees to be awarded to either side, including defendants. Thus, the court turned next to whether it should exercise its discretion to award fees, using the Sixth Circuit’s King factors. The court found no evidence of bad faith or culpable conduct by the funds and noted that awarding fees would be detrimental to plan beneficiaries. The court also determined that further deterrence was unnecessary, as a similar case had been dismissed following the summary judgment ruling in this case. In any event, the deterrence factor “always weighs strongly against awarding fees against an ERISA fund, because ‘[a]warding fees in such a case would likely deter beneficiaries and trustees from bringing suits in good faith for fear that they would be saddled with their adversary’s fees in addition to their own in the event that they failed to prevail.’” As a result, the court concluded that “[t]he fact that the defendants prevailed…is not sufficient to overcome the weight of the other factors against it,” and thus exercised its discretion to deny defendants’ fee motion.

Breach of Fiduciary Duty

First Circuit

Steer v. The Charles Stark Draper Laboratory, Inc., No. 24-CV-13105-AK, 2026 WL 444637 (D. Mass. Feb. 17, 2026) (Judge Angel Kelley). Barry Steer is a former employee of The Charles Stark Draper Laboratory, Inc., a government contractor and research firm. He brought this putative class action against Draper and the committee at Draper responsible for overseeing Draper’s two retirement plans, the Charles Stark Draper, Inc. Retirement Plan for Draper Employees (the Retirement Plan) and the Charles Stark Draper, Inc. Supplemental Retirement Annuity Plan (the SRAP). Steer contends that the investment options in both plans “underperformed and charged unreasonably high fees, and that Defendants breached their fiduciary duty by failing to monitor the Plans’ investments and permitting underperforming investments and high fees.” Steer also contends that TIAA, the plans’ recordkeeper, charged unreasonable fees and engaged in prohibited transactions under ERISA, which the defendants failed to monitor. Defendants filed a motion to dismiss, challenging Steer’s constitutional and statutory standing, focusing on the fact that Steer was not a participant in the SRAP. Defendants also moved for a more definite statement as to the prohibited transactions at issue. Addressing constitutional standing first, the court ruled that “plaintiff has sufficient personal stake in the adjudication of the class members’ claims” because he alleged that “Defendants treated Plaintiff and other Class members consistently and managed the Plans jointly and uniformly as to all Participants.” Because “Plaintiff alleges that Defendants engage in uniform practices across the Plans that violate ERISA,” he “has standing to challenge these uniform practices, even though he was not a participant in the SRAP.” As for statutory standing, the court ruled that Steer “fall[s] ‘within the class of plaintiffs whom Congress has authorized to sue’” because he was a participant in one of the plans, and ERISA Sections § 1132(a)(2) and (3) both permit “participant[s]” to bring civil actions. Again, the fact that Steer was not an SRAP participant was irrelevant; “Requiring a named plaintiff to have identical claims as other class members ‘would render superfluous the Rule 23 commonality and predominance requirements.’” Finally, the court denied defendants’ request for a more definite statement, noting that Steer had identified “‘contract[s] for services, like recordkeeping and the provisions of investments, from service providers like TIAA’ as prohibited transactions for which Defendants are responsible.” The court concluded that Steer had not engaged in “shotgun pleading” by alluding to other transactions, and that he “need not plead with greater specificity under ERISA.” As a result, the court denied defendants’ motion in its entirety.

Fourth Circuit

Enstrom v. SAS Institute Inc., No. 5:24-CV-105-D, 2026 WL 459258 (E.D.N.C. Feb. 12, 2026) (Judge James C. Dever III). The plaintiffs in this case are former employees of SAS Institute Inc., a data services company based in North Carolina. In 2024 they filed this action alleging that SAS and related defendants violated ERISA in their management of the company’s defined contribution retirement plan. In their first complaint, plaintiffs took aim at the plan’s investment decisions, arguing that defendants breached their fiduciary duty of prudence by selecting and continuing to offer underperforming funds in the plan. The court granted defendants’ motion to dismiss, ruling that plaintiffs’ claims were not plausible as to the plan’s investment in the JPMorgan Chase Bank (JPM) Target Date Funds, and that plaintiffs lacked standing to challenge the plan’s investment in another fund. (Your ERISA Watch covered this order in our March 12, 2025 edition.) Plaintiffs retrenched and filed a new complaint. In their updated allegations, plaintiffs once again challenged the plan’s investment in the JPM funds, and added a new claim attacking SAS’ use of forfeitures to reduce its contributions to the plan rather than reduce plan expenses. Defendants once again filed a motion to dismiss. The court addressed plaintiffs’ claim regarding the JPM funds first. Plaintiffs alleged that the JPM funds underperformed compared to other similar target date funds, the S&P Target Date Index, and a composite benchmark. Plaintiffs also claimed that defendants violated the plan’s investment policy statement (IPS) by retaining the JPM funds because the funds did not meet performance objectives. However, the court ruled that plaintiffs’ comparator funds were not meaningful benchmarks because the JPM funds followed a “to” retirement glidepath, while the comparators followed a “through” glidepath, and thus the plans minimized risk at different times and were too dissimilar. Furthermore, even if plaintiffs’ funds were comparable, the JPM funds were “within one-to-two percentage points,” and “[u]nderperformance of this magnitude does not plausibly suggest a duty of prudence violation.” In response, plaintiffs relied on the IPS, but the court rejected this argument for the same reason it rejected it in its ruling on the first motion to dismiss; plaintiffs “cite no IPS provision that any defendant violated by adding the JPM funds to the plan.” Turning to plaintiffs’ claim that defendants breached their duty of loyalty in handling forfeitures, the court “agrees with the weight of authority,” citing numerous recent cases holding that “[w]hen (1) a plan document gives a plan fiduciary discretion in how to use forfeitures and (2) participants otherwise receive everything guaranteed by the plan’s terms, plan fiduciaries do not violate their duty of loyalty merely by declining to use forfeitures to cover administrative expenses.” Put simply, “Plaintiffs do not allege that they received less than what the Plan promised. The duty of loyalty does not require that defendants offer more than that.” For similar reasons, the court held that using forfeitures to reduce future contributions did not violate ERISA’s anti-inurement provision because “[u]sing forfeitures to pay Plan participants benefits participants.” Furthermore, “plaintiffs do not allege that defendants ever contributed less than the Plan required.” Finally, the court dismissed the failure to monitor claim because it was dependent on the success of the other claims, which the court had dismissed. The court thus granted defendants’ motion to dismiss, this time with prejudice.

Fifth Circuit

Baker v. 7-Eleven Inc., No. 3:25-CV-01609-X, 2026 WL 473252 (N.D. Tex. Feb. 19, 2026) (Judge Brantley Starr). Barbara Baker filed this putative class action against her former employer, 7-Eleven Inc., contending that the company’s health insurance plan violates ERISA. Specifically, she challenges the plan’s Tobacco-Free Wellness Program. The program “provided a reward of reduced medical plan premiums to participants who self-reported to not use tobacco products. Participants who reported tobacco use were offered an alternative means to qualify for the same reward.” The alternative varied, requiring participants to either state they would try to quit tobacco or complete a tobacco-cessation course. Baker did not participate in the alternative program and did not receive the lower medical premium reward. 7-Eleven filed a motion to dismiss, arguing that Baker did not have standing and she failed to state a claim. 7-Eleven contended that Baker had no standing because she did not participate in the Wellness Program, but the court found this argument “misses the point. Participation in the Program is irrelevant – neither ERISA nor Article III requires a plaintiff to enroll in an unlawful program to establish standing.” The court found that 7-Eleven’s deduction of a $27.70 premium from each of her paychecks was “a concrete, traceable monetary injury caused by 7-Eleven’s allegedly uncompliant Program which is redressable by the Court.” The court also rejected 7-Eleven’s argument that her injury was “informational” only. “ERISA disclosure violations can support standing when the omission interferes with a participant’s ability to understand and exercise plan rights, and standing is denied only where no actual loss was shown.” The court found that the “allegedly deficient notice is directly connected to Baker’s monetary loss.” The court also ruled that Baker had standing even though she was no longer an employee, reserving “any questions regarding the ultimate scope of relief” for the class-certification stage. Next, the court addressed the plan itself, and ruled that Baker had plausibly alleged that it was not compliant with ERISA. The court acknowledged that “federal courts have reached differing conclusions” on other tobacco wellness programs, but concluded that (a) a tobacco-use surcharge constitutes health-factor discrimination under ERISA, (b) Baker properly alleged that the program “failed to comply with the statutory requirement of offering the full reward to all similarly-situated participants,” and (c) Baker plausibly pled that the program “failed to comply with the statutory requirement of disclosing the reasonable alternative standard in all plan materials.” The court interpreted 29 U.S.C. § 1182 as including tobacco use as a “health status-related factor,” and thus “[c]harging higher premiums to tobacco users is therefore facial health-factor discrimination.” The court further agreed with Baker that “7-Eleven’s Program does not offer the full reward because it limits the retroactive relief available to some participants.” Instead, in some scenarios the program only allowed for prospective relief, depending on the timing of when a participant satisfied the alternative. The court further agreed that Baker could plead that 7-Eleven violated notification requirements because it omitted from its summary plan descriptions a statement that the recommendations of a participant’s physician would be accommodated. The court then turned to Baker’s claims under ERISA Sections 1104 and 1106. The court again ruled in Baker’s favor, ruling that she sufficiently alleged that 7-Eleven acted as a fiduciary and engaged in prohibited transactions by “collecting tobacco surcharges and refusing to retroactively reimburse participants who completed the Tobacco Cessation courses after the March 31st deadline.” As a result, the court denied 7-Eleven’s motion to dismiss in its entirety.

Class Actions

Fourth Circuit

Fisher v. GardaWorld Cash Service, Inc., No. 3:24-CV-00837-KDB-DCK, 2026 WL 482960 (W.D.N.C. Feb. 20, 2026) (Judge Kenneth D. Bell). Plaintiffs Jonathan Fisher and Blair Artis brought this putative class action against GardaWorld Cash Service Inc. seeking to represent current or former employees of GardaWorld who participated in GardaWorld’s ERISA-governed employee health plan. Plaintiffs contended that the plan “imposed monthly surcharges on employees who used tobacco or were not vaccinated against COVID-19,” and that the plan violated ERISA because it “did not disclose a ‘reasonable alternative standard’ or state that physician recommendations would be accommodated, as required by ERISA’s wellness-program regulations. Plaintiffs also allege the Plan unlawfully failed to offer retroactive refunds for employees who satisfied requirements after the cutoff date but before the end of the Plan year, thereby denying participants the ‘full reward’ contemplated by regulation.” GardaWorld filed a motion to dismiss, which the court granted in part, rejecting plaintiffs’ breach of fiduciary duty claims. (Your ERISA Watch covered this ruling in our September 3, 2025 edition.) The parties then began discovery, and unfortunately for plaintiffs, GardaWorld quickly discovered that neither Fisher nor Artis were participants in the plan during the relevant time period. As a result, plaintiffs filed a motion to amend their complaint to substitute three new representative plaintiffs who had participated in the plan. GardaWorld opposed and filed a motion to dismiss for lack of jurisdiction. In this order the court denied plaintiffs’ motion and granted GardaWorld’s. The court emphasized that without jurisdiction it could not proceed with the case, and that jurisdiction “must exist from the moment the complaint is filed.” In class actions, the standing inquiry focuses on the class representatives, who must allege an injury in fact that is concrete, particularized, and actual or imminent. Thus, “the Fourth Circuit has long held that a representative plaintiff must be a member of the proposed class and must have suffered the injury alleged.” Here, plaintiffs’ motion “confirms that neither class representative participated in the Plan at the center of this litigation and never suffered the injury alleged.” As a result, “they could not have suffered an ERISA injury under the facts alleged, and they therefore lacked III standing from the moment the action was filed. When standing is absent at the outset, federal jurisdiction never attaches.” The court acknowledged it was “mindful of the efficiencies that might be gained by permitting amendment.” However, “it is equally compelled to consider the constitutional consequences of allowing plaintiffs to cure a jurisdictional defect through substitution. Accepting such a theory would erode Article III’s limits by enabling litigants to initiate putative class actions with individuals who suffer no injury, secure the Court’s involvement, and then – after the absence of standing is exposed – find and substitute a plaintiff with an actual stake in the controversy. Constitutional jurisdiction cannot be manufactured in this manner.” Thus, the court granted GardaWorld’s motion to dismiss for lack of jurisdiction, denied plaintiffs’ motion to amend as moot, and closed the case.

Disability Benefit Claims

Second Circuit

Weiss v. Lincoln Nat’l Life Ins. Co., No. 2:24-CV-00591-CR, 2026 WL 483280 (D. Vt. Feb. 20, 2026) (Judge Christina Reiss). In a rare ERISA case out of your editor’s home state, the court considered whether Carl Weiss qualified for short-term disability (STD) and long-term disability (LTD) benefits under an ERISA-governed employee benefit plan. Weiss was hired by Verista, Inc. in August of 2021 as a software engineer, working remotely from home. Weiss’ medical history included treatment for anxiety, depression, attention deficit disorder (ADD), and other conditions, as well as regular cannabis use. He also received the COVID vaccine. During his employment, Weiss reported improvements in his condition and was functioning well at his job. He was terminated in February of 2022 because “his engagement ended with his client.” However, just prior to his termination he visited his doctor, complaining of fatigue, and after his termination he sought medical attention for various symptoms, including fatigue, brain fog, and photophobia, which he attributed to long COVID. During this time Weiss was approved for Social Security disability benefits. Weiss filed a claim for STD and LTD benefits, but Verista denied his STD claim, stating that his date of disability was after his termination date, and he did not provide sufficient evidence to support his claim. Lincoln also denied his LTD claim, citing insufficient medical evidence to substantiate disability prior to his termination date and throughout the elimination period. Weiss’ appeals were ineffective, and thus he brought this action against both Verista and Lincoln. In this order the court ruled on the parties’ cross-motions for judgment, applying two different standards of review. The court noted that the STD plan did not contain a discretionary clause granting Verista authority to interpret the STD plan, which would ordinarily result in de novo review. However, Verista argued that the administrative services agreement (ASA) between it and Lincoln conveyed discretionary authority. The court questioned this argument, noting the “consensus” of district courts, which was that “an ASA is not an ERISA plan document and, therefore, a [p]lan beneficiary is not bound by its terms.” However, it chose not to rule on this issue, and used the default de novo standard, because “Plaintiff’s claim does not survive the ‘even the broader de novo review[.]’” As for the LTD claim, the court used the arbitrary and capricious standard of review because the LTD plan contained a discretionary clause, and Indiana law, which governed the plan, did not prohibit such clauses. The court also considered whether it could consider new reasons for denial in litigation, and concluded that under Second Circuit precedent it could do so with respect to the STD claim because the standard of review was de novo, but not with respect to the LTD claim under the arbitrary and capricious standard. Finally, the court tackled the merits. It noted that credibility is important in assessing self-reported symptoms and found that due to inconsistencies in his reports and lack of medical support, Weiss was not particularly credible. “Although the court finds no evidence that Plaintiff was intentionally deceitful, it finds he is not a reliable source of information due to his conflicting statements, self-described poor memory, psychiatric symptoms, and extensive marijuana use.” The court also discounted the Social Security award because its findings (such as no substance abuse) were contradicted by Weiss’ medical records (which showed heavy use of marijuana). Ultimately, the court found that Weiss was not disabled for STD purposes because there was no evidence he was unable to perform the responsibilities of his job. He did not complain of COVID or long COVID before his termination date, seemed to be in good health, was able to work without missing any days up until his termination, and did not report any illness to Verista. The court ruled in Lincoln’s favor on Weiss’ LTD claim for similar reasons. There was no evidence, other than self-reports, of a COVID infection, and Weiss’ medical records provided little support, evidencing limited examinations, normal test results, and no sign of cognitive impairment. The court acknowledged that Lincoln had a structural conflict of interest as both claim administrator and payor, but “[b]ecause Lincoln took steps to reduce potential bias and promote accuracy in rendering its decision on Plaintiff’s LTD claim, because this is not a close call, and because Plaintiff has not shown that Lincoln’s structural conflict of interest affected its decision, Lincoln’s conflict is accorded no weight.” As a result, the court granted Verista’s and Lincoln’s motions for judgment, and denied Weiss’.

Seventh Circuit

Lehnen v. Unum Life Ins. Co., No. 23-CV-192-WMC, 2026 WL 444692 (W.D. Wis. Feb. 17, 2026) (Judge William M. Conley). Kent A. Lehnen was a senior account executive for Beacon Health Options, a job which required extensive computer use and high cognitive function. In 2015 he took a leave of absence due to persistent postural perceptual dizziness (PPPD), anxiety, depression, and attention deficit disorder (ADD). Lehnen was able to return to work with accommodations, but in 2019 his health deteriorated again, when he suffered from “bouts of dizziness, sleeping difficulties, neck pain, hand pain, and anxiety about his job performance.” Lehnen reduced his hours, then returned to full-time work, and then had to stop entirely in 2020. Lehnen submitted a claim for benefits to Unum Life Insurance Company of America, the insurer of Beacon’s long-term disability employee benefit plan. Unum approved benefits from July 2020 through February 2022, but denied further benefits on the ground that medical records no longer supported his disability. Lehnen appealed, providing additional evidence of his disability, including PPPD, cognitive impairment, sleep disorders, degenerative joint disease, and carpal tunnel syndrome. Unum relented slightly, extending benefits to July 2022, but no further, because the plan has a “lifetime cumulative maximum benefit period” of 24 months “for all disabilities due to mental illness and disabilities based primarily on self-reported symptoms.” Unum would not pay past that date because “his residual functional capacity did not exceed the physical demands of his regular occupation.” Lehnen filed this action challenging Unum’s denial. Unum responded with a counterclaim to recover an overpayment of benefits due to Lehnen’s receipt of Social Security Disability Insurance (SSDI) benefits retroactive to April 2020. In its decision, the Social Security Administration ruled that Lehnen was “primarily disabled due to ‘Disorders of the Skeletal Spine’ and that his mental disorders were secondary.” The parties filed cross-motions for judgment which the court adjudicated in this order. The court employed the de novo standard of review because the plan did not give Unum discretionary authority to determine benefit eligibility. The court ruled in Lehnen’s favor on his disability claim, finding that the medical evidence supported his claims of physical disability, which were consistent with his symptoms corroborated by diagnostic and clinical testing. The court found that Lehnen’s physical impairments, including PPPD, cognitive inefficiency, hand pain, neck pain, and sleep disorders, collectively contributed to his inability to perform job-related duties. The court was further persuaded by Lehnen’s SSDI award, as it was bolstered by additional evidence presented by Lehnen, including an occupational therapy assessment and letters from treating physicians. As a result, the court ruled that Lehnen remained disabled under the plan and was entitled to judgment in his favor and payment of benefits, at a prejudgment interest rate of 7.47%, retroactive to July 2022. It was not a total win for Lehnen, however, because the court also ruled that he was required to repay Unum under his reimbursement agreement because of his SSDI award. Lehnen argued that Unum was not entitled to an equitable lien under ERISA Section 502(a)(3) because “it cannot prove that the funds remain in his possession and cannot, therefore, attach a lien.” However, the court ruled that the agreement granted Unum the right to impose a lien on any real or personal property, and thus it was entitled to “set off or withhold” benefits to recover the overpayment. The court ordered Lehnen to provide an accounting within 30 days to determine the appropriate offset, after which Unum will file a motion regarding the precise amount owed. The court reserved ruling on attorneys’ fees and costs for both sides until a later date.

Eighth Circuit

Hudson v. Principal Life Ins. Co., No. 24-1308 (JRT/ECW), 2026 WL 496683 (D. Minn. Feb. 23, 2026) (Judge John R. Tunheim). Kim Hudson was hired by Consumer Cellular, Inc. on June 6, 2022 as a customer service representative. She stopped working on October 14, 2022, contending in this action that she was disabled due to symptoms of coccydynia (chronic pain in the coccyx, or tailbone). Hudson applied for benefits under Consumer Cellular’s employee long-term disability benefit plan, which was insured by Principal Life Insurance Company, claiming her disability arose from a motor vehicle accident in May of 2021. Hudson’s physician, Dr. Jonathan Landsman, submitted an attending physician statement which asserted that Hudson was unable to work due to “low back pain.” Principal denied Hudson’s claim, citing a pre-existing condition exclusion in the governing insurance policy. Principal also denied her appeal, and this action ensued. The parties filed cross-motions for summary judgment which were decided in this order. The court began with the standard of review. The court acknowledged that the Principal policy contained a delegation of discretionary authority to Principal, but agreed with Hudson that the policy was governed by Oregon law which prohibits such delegations. As a result, de novo review was the correct standard. The court then addressed the merits, identifying two issues: “The first is whether Hudson was treated for her disabling condition during the lookback period such that the pre-existing condition exclusion bars LTD coverage. The second is whether Hudson is disabled under the terms of the policy.” The court did not reach the second issue because it ruled that the pre-existing condition exclusion applied. The policy defined “pre-existing condition” as “any sickness or injury…for which a Member: a. received medical treatment, consultation, care, or services; or b. was prescribed or took prescription medications; in the three month period before he or she became insured under the Group Policy.” The court identified the relevant three-month lookback period as May 9, 2022 through August 8, 2022, because although Hudson first became eligible for coverage as a new hire on August 1, 2022, she was out of work from August 1-8, 2022, and thus coverage was delayed until August 9, 2022. The court found that during this lookback period Hudson received treatment for chronic right-sided low back pain with right-sided sciatica, which was documented in a telehealth visit on May 18, 2022, and a lumbar spine MRI on July 11, 2022. Hudson contended that neither of these events referred to the coccyx or sacral region of the spine and thus her condition was not preexisting. Principal responded that this was irrelevant because “these documents show that she was treated for ‘low back pain’ – the same condition Dr. Landsman found to be disabling.” The court agreed with Principal: “Because Hudson’s disability was based on her low back pain and she was treated for low back pain during the lookback period, the pre-existing condition exclusion squarely applies.” The court further noted that when Principal spoke with Hudson in May of 2023 she “confirmed that she was ‘out of work due to low back pain.’” Finally, the court ruled that Hudson was not entitled to a waiver of premium on her life insurance coverage with Principal due to her disability because she was over 60 years old at the time of her disability, which was beyond the maximum age in the policy. (Hudson did not challenge this decision on appeal or in litigation.) As a result, the court denied Hudson’s motion for summary judgment and granted Principal’s motion for summary judgment.

Life Insurance & AD&D Benefit Claims

Ninth Circuit

Aloff v. The Prudential Ins. Co. of Am., No. 3:25-CV-05834-DGE, 2026 WL 445565 (W.D. Wash. Feb. 17, 2026) (Judge David G. Estudillo). This case arises from a tragic plane crash in 2024 in which the pilot and co-pilot, both employees of Clay Lacy Aviation, Inc. died. The pilots’ widows, Cheryl Aloff and Kimberly Pulido, filed this action after their claims for benefits under Clay Lacy’s accidental death and dismemberment employee benefit plan were denied by the plan’s insurer, The Prudential Insurance Company of America. Prudential denied the claims based on an “aviation exclusion” in the benefit plan. Plaintiffs brought various claims against both Clay Lacy and Prudential, including recovery of plan benefits under ERISA, breach of fiduciary duties and equitable relief under ERISA, and violations of California’s Unfair Competition Law (UCL) and Washington’s Consumer Protection Act (WCPA). Defendants filed a motion to dismiss. The court first addressed plaintiffs’ claim for benefits under 29 U.S.C. § 1132(a)(1)(B). Prudential argued that plaintiffs had not identified any plan term that entitled them to benefits, while plaintiffs argued that “the aviation exclusion ‘does not apply,’ and if it ‘could apply, it should be stricken and the life insurance policy construed in favor of coverage on multiple legal grounds.’” The court agreed with Prudential, noting that plaintiffs did not “actually allege AD&D benefits ‘were covered under the terms of the relevant plans or describe the plan terms that would support such coverage.’” Thus, the court ruled that plaintiffs failed to state a claim. As for Clay Lacy, the court ruled that it was not a proper defendant on this claim because it had no authority to resolve benefit claims or responsibility to pay them under its agreement with Prudential. Turning to the breach of fiduciary duties claims, the court concluded that while plaintiffs plausibly alleged that Prudential was a fiduciary under the plan, this was not true for Clay Lacy because it made no benefit decisions and was not liable for benefits. However, the court ruled that plaintiffs had not established their breach of fiduciary duty claim against Prudential. Plaintiffs alleged that Prudential breached its duties “by not acting in accordance with the life insurance policy plan and failing to pay AD&D benefits.” However, because the court had already ruled that plaintiffs could not bring their benefits claim as currently formulated, “Plaintiffs’ theory that Defendants breached their fiduciary duties by failing to pay such benefits must also be dismissed for failure to state a claim.” Finally, the court dismissed the state law claims under the UCL and WCPA, finding them preempted by ERISA because they were based on the existence of an employee benefit plan and sought recovery for the loss of benefits under that plan. The court thus granted defendants’ motion to dismiss, although it granted plaintiffs leave to amend to address the identified deficiencies.

Medical Benefit Claims

Third Circuit

Shmaruk v. Liberty Mut. Ins. Co., No. 23-CV-22609 (MEF)(JRA), 2026 WL 446329 (D.N.J. Feb. 17, 2026) (Judge Michael E. Farbiarz). Boris Shmaruk brought this action individually and as guardian ad litem for a child identified as J.S. The dispute centers around a denied insurance claim for growth hormone medication prescribed to J.S. by an advanced practice nurse. The denial was based on guidelines used by the plan to assess claims for growth hormone medication. These guidelines contain a structured set of eligibility criteria to determine medical necessity, which are followed in a prescribed order. The claim was denied pursuant to “question 119,” which asks, “Does the patient have a pretreatment 1-year height velocity of greater than 2 standard deviations (SD) below the mean for age and gender?” The answer to this question was “no,” leading to the denial of coverage. Shmaruk filed suit against Liberty Mutual Insurance Company and CVS Caremark, alleging that the denial violated ERISA. Defendants moved for summary judgment, arguing that the denial was appropriate. Shmaruk opposed, arguing that the answer to question 119 should have been “yes,” which would have resulted in approval of the claim. The crux of the dispute was the term “pretreatment 1-year height velocity” and when to start measuring it. Shmaruk offered a February 2022 medical record showing that J.S. met the requirement over the previous twelve months. However, defendants argued that the one-year pretreatment period could not be measured at any time, but only during the time just prior to starting growth hormone treatment, which was in October of 2022. The court started by stating, “Out of the gate, the Plaintiff seems to have the better of this back-and-forth… [Q]uestion 119 says only that the 1-year period needs to be before treatment got started – it says nothing else about when, in particular, the 1-year period needs to fall.” The court faulted the parties somewhat, noting that “none of the relevant linguistic issues have been meaningfully taken up by the parties to this point,” but also admitted that “grammar is no be-all-and-end-all.” Furthermore, the court noted that the plan gave the administrator discretionary authority to interpret the plan’s terms, which meant that “the question is not whether the administrator’s reading of the plan is the best one, but rather whether it is a reasonable one.” In the end, the court threw up its hands: “there are gaps in the parties’ briefing that make it difficult to reliably decide the pending motion. Basic factual matters…are hard to follow, and key legal arguments (as to language, but also beyond that) are gestured at or assumed, but not meaningfully developed.” As a result, “the Court will require additional briefing from the parties that specifically zeroes in on the issues that have been laid out in this Opinion and Order. A schedule for this briefing will be set by the United States Magistrate Judge.” The court addressed one final issue, which was Shmaruk’s contention that “the guidelines are, themselves, arbitrary and capricious.” The court noted that the benefit plan at issue had delegated to the administrator the power to develop and maintain clinical policies to interpret the plan, and thus the issue was whether the treatment at issue was covered by those guidelines, not whether the guidelines were wise or the best policy. “‘The statutory language speaks of enforcing the terms of the plan, not of changing them’ or assessing their substance.” Thus, “the Plaintiff can argue that the Defendants failed to do what the plan promised they would…[b]ut the Plaintiff cannot win on the theory that the claims administrator-Defendant should have used different eligibility criteria in the first place.”

Seventh Circuit

Allison B. v. BlueCross BlueShield of Illinois, No. 24-CV-06162, 2026 WL 497246 (N.D. Ill. Feb. 20, 2026) (Judge John Robert Blakey). Allison B. was a participant in the Accenture LLP Medical Benefits Plan, and M.B. was a beneficiary; claims under the plan were administered by BlueCross BlueShield of Illinois (BCBSIL). M.B. received treatment at Open Sky Wilderness Therapy and Maple Lake Academy, both licensed mental health treatment facilities in Utah. BCBSIL denied claims for M.B.’s treatment at Open Sky under the plan’s “wilderness program” exclusion and denied claims for M.B.’s treatment at Maple Lake on the ground that Maple Lake “did not meet the minimum BCBSIL requirements of a residential treatment center due to the lack of 24-hour nursing staff.” Allison B.’s appeals were unsuccessful, so she brought this action against the plan and BCBSIL, alleging two claims for relief: one for recovery of benefits under 29 U.S.C. § 1132(a)(1)(B), and one under 29 U.S.C. § 1132(a)(3) for violation of the Mental Health Parity and Addiction Equity Act of 2008. Defendants moved to dismiss for failure to state a claim. The court started with the Parity Act claim against Maple Lake. Plaintiff presented two arguments in support of this claim: (1) the 24-hour onsite nursing requirement is more restrictive than the criteria the plan uses for analogous intermediate levels of medical/surgical services; and (2) the requirement “exceeds the generally accepted standard of care (‘GASC’)…when the Plan does not impose requirements above the GASC for analogous intermediate levels of medical/surgical services.” The court found the first claim sufficient. Defendants argued that analogous skilled nursing facilities (SNFs) also had a 24-hour nursing requirement, but the court found that this requirement was not explicitly in the plan, which only required SNFs to be “duly licensed.” Furthermore, applicable law governing SNFs contained exceptions not present in the plan. The second claim did not pass muster, however, because the American Academy of Child & Adolescent Psychiatry’s “Principles of Care for Treatment of Children and Adolescents with Mental Illnesses in Residential Treatment Centers” contained a 24-hour nursing requirement. Because plaintiff’s Parity Act claim as to Maple Lake survived, her claim for benefits survived as well. As for Open Sky, the court’s findings were similar. The court ruled that plaintiff had properly pled that the plan expressly excluded from coverage “wilderness programs,” but the plan contained no similar exclusion for analogous intermediate-level medical/surgical facilities. Thus, plaintiff had properly pled not just a Parity Act claim, but a claim for benefits as well regarding the Open Sky treatment. As a result, the Court denied defendants’ motion to dismiss in its entirety.

Pension Benefit Claims

Seventh Circuit

Soni v. Paul M. Angell Family Foundation, No. 25 CV 4863, 2026 WL 457332 (N.D. Ill. Feb. 18, 2026) (Judge Sunil R. Harjani). Rupal Soni worked for the Paul M. Angell Family Foundation for seven years and alleges in this action that she was discriminated and retaliated against and eventually terminated based on her race. The focus of this order, however, was on Soni’s claim for breach of fiduciary duties under ERISA. Soni contends that the Foundation and its ERISA-governed 403(b) pension plan failed to properly manage her retirement contributions, which were supposed to be invested but were left unallocated. She contends that she asked both her employer and Charles Schwab, which managed ongoing contributions, how to invest, indicating that she wanted to invest in a target-date fund because it was “set and forget,” but ultimately her contributions were never invested. Soni also contends that she never received annual notices or other required plan disclosures, or any individual account balance statements. Defendants filed a motion to dismiss Soni’s ERISA claim, arguing that she failed to exhaust administrative remedies and did not sufficiently allege a breach of fiduciary duty. Addressing exhaustion first, the court ruled that Soni was not required to exhaust appeals with the plan before filing suit. The court noted that the plan’s “claim procedure applies to claims for, and denials of, benefits, without any reference to claims for breach of fiduciary duties, which is what Plaintiff alleged here. Taking this allegation as true, this shows a lack of access to a review procedure because there was no available process for her to raise her breach of fiduciary duty claim.” Furthermore, the court noted that Soni had inquired with the Foundation before filing suit, and had been told, “We consider the matter closed,” which indicated that “she lacked meaningful access to review procedures.” As for the merits of her claim, defendants tried to “frame Plaintiff’s allegations as a clerical mistake by a Charles Schwab employee in 2016.” However, the court noted that the plan stated, “If you do not make an investment election your account balances will be placed in investments selected by the Plan Administrator.” The court stated that “this language…creates an unusual obligation for the Plan Administrator,” but it was enforceable, and thus Soni’s “allegation that the plan documents place an obligation on Defendants to invest the unelected funds is plausible based on the plain text of the plan.” Finally, the court addressed the remainder of defendants’ arguments, which it characterized as “scatter-shot” and “perfunctory” and therefore were waived. Regardless, the court ruled that (a) Soni’s claims were within the statute of limitations because she filed her claim in 2025, which was within six years of her termination in 2023, (b) defendants could not “pass the buck” to Charles Schwab because “the Foundation has a duty to monitor those it appoints to administer the plan,” and (c) Soni plausibly alleged that she was entitled to equitable relief under ERISA Section 502(a)(3) even if such relief was unavailable on an individual basis under Section 502(a)(2). As a result, the court denied defendants’ motion in full.

Plan Status

Seventh Circuit

Waites v. Rosalind Franklin Univ. of Medicine & Science, No. 1:25-CV-12526, 2026 WL 482187 (N.D. Ill. Feb. 20, 2026) (Judge Sharon Johnson Coleman). James Waites filed a complaint against United of Omaha Life Insurance Company (UOL) in 2024 regarding its denial of his claim for supplemental life insurance benefits. Waites settled with UOL and the action was dismissed in September of 2025. While settlement negotiations were ongoing, in August of 2025, Waites filed this action against Rosalind Franklin University (RFU) in which he alleged that RFU was negligent in the denial of his claim. Specifically, Waites contended that RFU failed to submit evidence of insurability for the decedent to UOL, which was required under the terms of the UOL policy. RFU removed the case to federal court, arguing that the life insurance benefits were part of an employee welfare benefit plan and thus Waites’ claims were preempted by ERISA. Waites disagreed and filed a motion to remand. He contended that the policy fell within ERISA’s “safe harbor” provision, which excludes certain group insurance programs from ERISA coverage if four specific criteria are met. Those criteria are: (1) no contributions are made by the employer; (2) participation is completely voluntary; (3) the employer does not endorse the program and its function is solely “to permit the insurer to publicize the program to employees or members, to collect premiums through payroll deductions or dues checkoffs and to remit them to the insurer”; and (4) the employer receives no consideration other than reasonable compensation for administrative services rendered in connection with payroll deductions. The court emphasized that ERISA “reach[es] virtually all employee benefit plans,” and construed the safe harbor provision “narrowly; only a minimal level of employer involvement is necessary to trigger ERISA.” It ultimately ruled in RFU’s favor because Waites could not establish two of the four factors. On the first factor, RFU admitted that the decedent paid all premiums for the life insurance at issue, but argued that it contributed to the employee benefit plan of which the life insurance was a part, which was enough to escape the safe harbor provision. Relying on Seventh Circuit authority, the court agreed, holding that “when a policy is part of a broader benefits package where ‘many aspects’ of the plan are funded by the employer, in whole or in part, it does not fit within the safe harbor.” On the third factor, RFU contended that it “endorsed” the insurance by performing administrative functions to ensure its operation. The court agreed, noting that Waites’ own complaint refuted his assertion that RFU only performed limited administrative duties: “Waites’ own allegations concede that RFU was responsible for obtaining and submitting evidence of insurability to UOL.” As a result, the safe harbor provision was not met, the plan was governed by ERISA, and thus the court denied Waites’ motion to remand.

Pleading Issues & Procedure

Third Circuit

Board of Trustees of the Greater Pa. Carpenters’ Medical Plan v. QCC Ins. Co., No. 2:24-CV-01047-MJH, 2026 WL 444743 (W.D. Pa. Feb. 17, 2026) (Judge Marilyn J. Horan). This action revolves around Carl Young, a former member of the Greater Pennsylvania Carpenters’ Medical Plan. QCC Insurance Company was the third-party insurer and administrator of claims under the plan, while Union Labor Life Insurance Company (ULLICO) provided stop-loss insurance. In 2021 and 2022 Young incurred extensive medical bills. In 2021 his treatment totaled $242,588.34, and in 2022 it was a whopping $2,587,608.94. As it turns out, Young’s coverage under the plan expired at the end of 2021. Nonetheless, Young’s 2022 bills were paid by QCC and charged to the plan. ULLICO, however, denied reimbursement under the stop-loss policy on the ground that the 2022 services were not covered. Left holding the bag, the plan brought this action naming QCC and ULLICO as defendants, alleging against ULLICO one claim for equitable relief under ERISA Section 502(a)(3) and one for breach of contract. ULLICO filed a motion to dismiss. ULLICO argued that the plan’s ERISA claim failed because ULLICO was not a plan fiduciary and because the plan “seeks legal relief which is not cognizable under ERISA.” The court first ruled that ULLICO’s status was irrelevant; the plan was not required to allege ULLICO’s fiduciary status to plead a claim under ERISA § 502(a)(3). In doing so, the court quoted the Supreme Court’s decision in Harris Trust and Sav. Bank v. Salomon Smith Barney, Inc., in which “the Supreme Court held that while Section 502(a)(3) describes ‘the universe of plaintiffs who may bring certain civil actions,’ it ‘admits of no limit…on the universe of possible defendants’ subject to Section 502(a)(3) liability.” However, regardless of ULLICO’s status, the court agreed that the relief sought by the plan was improper. In its briefing, the plan conceded that “the basis of its claim against ULLICO is contractual and not equitable in nature,” and thus the court ruled that “ERISA Section 502(a)(3) is not the appropriate vehicle against this defendant.” The plan attempted to characterize its ERISA claim as one for “specific performance,” which is an equitable remedy, but “the Amended Complaint clearly seeks reimbursement under the Plan’s contractual terms with ULLICO. Such an action is legal in nature and would not require to the Court to exercise any equitable powers. Therefore, the Plan cannot maintain an action for equitable relief under ERISA § 502(a)(3).” Finally, the court examined the plan’s breach of contract claim and dismissed that as well. The court found that the stop-loss policy only allowed compensation for plan expenses that were “covered and payable,” and here it was clear that Young’s eligibility for benefits terminated at the end of 2021. As a result, the 2022 medical treatment was not covered and the stop-loss protection could not be invoked. The court thus granted ULLICO’s motion to dismiss in its entirety.

Provider Claims

Third Circuit

SpecialtyCare, Inc. v, Cigna Healthcare, Inc., No. CV 24-1378-RGA, 2026 WL 483259 (D. Del. Feb. 20, 2026); SpecialtyCare, Inc. v. UMR, Inc., No. CV 24-1396-RGA, 2026 WL 483233 (D. Del. Feb. 20, 2026) (Magistrate Judge Eleanor G. Tennyson). These two actions were brought by health care provider SpecialtyCare, Inc. against benefit administration giants Cigna Healthcare, Inc. and UMR, Inc. seeking reimbursement for out-of-network services SpecialtyCare provided to patients who were covered by self-funded plans administered by Cigna and UMR. SpecialtyCare alleges that it billed Cigna and UMR for its services, but Cigna and UMR failed to pay or paid less than the full billed amount. SpecialtyCare initiated Independent Dispute Resolution (IDR) proceedings with both under the No Surprises Act. It contends that against Cigna it “obtained 789 IDR determinations in its favor, amounting to a combined $1,360,403 in unpaid fees,” and that against UMR it “obtained 300 IDR determinations in its favor, amounting to $256,427 in unpaid fees[.]” Nevertheless, neither Cigna nor UMR complied with these determinations, “[d]espite the statutory mandate that the IDR determinations ‘shall be binding’ and that payment ‘shall be made’ to the healthcare provider within thirty days.” SpecialtyCare thus brought this action, asserting claims for confirmation of arbitration awards, non-payment of arbitration awards, improper denial of benefits, open account, bad faith, and unjust enrichment. Cigna and UMR filed motions to dismiss, which the assigned magistrate judge reviewed in this order. The defendants argued that the IDR awards were not judicially enforceable and that SpecialtyCare lacked standing to bring its ERISA claim. They also argued that the state law claims were preempted by the No Surprises Act and failed to state a claim. SpecialtyCare contended that it was entitled under the Federal Arbitration Act (FAA) to seek a court order enforcing the IDR determinations, so the court examined whether the No Surprises Act permits such relief. The court concluded that the Act does not because it “expressly prohibits judicial review of IDR determinations except where vacatur is sought under Section 10 of the FAA” – which was not the case here. Agreeing with the Fifth Circuit’s 2025 opinion in Guardian Flight, LLC v. Health Care Serv. Corp. (discussed in our June 18, 2025 edition), and numerous other district court decisions, the magistrate found that Congress deliberately omitted FAA Section 9 relief from the No Surprises Act, indicating no private right of action for enforcement. The court further ruled that the No Surprises Act itself did not create its own private right of action. There was no express right in the statute, and the court refused to imply one because “the ‘robust system of administrative enforcement’ provided by the No Surprises Act creates a ‘strong presumption’ that Congress did not intend to create a personal remedy for SpecialtyCare.” Again, the court agreed with Guardian Flight’s discussion of this issue in ruling that “Congress empowered the Department of Health and Human Services (‘HHS’) – not the courts – to ‘assess penalties against insurers for failure to comply’ with the statute.” As for SpecialtyCare’s ERISA claims, the court ruled that SpecialtyCare “lacks standing to sue under ERISA for failure to pay the amounts due under the IDR determinations” because the plan beneficiaries who assigned their claims to SpecialtyCare did not suffer any concrete injury. The court reasoned that disputes under the No Surprises Act are between providers and insurers; “[b]y design, the No Surprises Act shields plan participants from the out-of-network costs that are the subject of this lawsuit[.]” As a result, “the outcome of this dispute will not affect the plan participants in any way.” Because the patients had no standing, their assignments to SpecialtyCare could not confer it. Finally, the court recommended dismissing SpecialtyCare’s state law claims because the federal claims were non-starters and there was no justification for exercising supplemental jurisdiction over the claims that were left. In short, the magistrate judge recommended granting Cigna’s and UMR’s motions to dismiss all counts of SpecialtyCare’s complaint.

Retaliation Claims

Tenth Circuit

Jewkes v. Orangeville City, No. 4:24-CV-00102-DN, 2026 WL 483333 (D. Utah Feb. 20, 2026) (Judge David Nuffer). Tasha M. Jewkes is a former employee of Orangeville City, Utah who brought this action against the City and its treasurer, Brittney Alger, alleging numerous claims including gender discrimination, retaliation, hostile work environment, wrongful termination, interference with ERISA rights, and defamation. The basis for Jewkes’ ERISA claim was that Orangeville allegedly refused to supply Jewkes with a health insurance stipend. Defendants filed a motion to dismiss, which the court converted into a motion for summary judgment. The court ruled that (a) the undisputed facts showed that Orangeville employed fewer than fifteen employees at the time in question, and thus she could not bring a claim under Title VII; (b) Jewkes could not bring a claim under Utah’s Anti-Discrimination Act because it does not allow a private right of action; and (c) Jewkes failed to provide notice of her claims as required under the Utah Governmental Immunity Act. As for Jewkes’ ERISA claim, Jewkes contended that, “By refusing to supply to Plaintiff the health insurance stipend, and by paying a stipend less than similarly situated employees…Defendant Orangeville interfered with Plaintiff’s protected rights as set forth in 29 U.S.C.A. § 1140.” However, the court found that Jewkes did not “provide any evidence of specific intent to violate ERISA… The undisputed facts demonstrate that Orangeville’s intent was to comply with [Utah law] requiring that these changes be made by ordinance or resolution.” Furthermore, the court relied on Tenth Circuit “de minimis” precedent which holds that “‘Proof of incidental loss of benefits as a result of a termination will not constitute a violation of § 510.’ Here, a $300 discrepancy, absent evidence of interference (termination) to prevent Ms. Jewkes’ from attaining her health insurance stipend, is an incidental loss and not a motivating factor.” As a result, the court converted defendants’ motion to dismiss into a motion for summary judgment and granted it in full.

Statute of Limitations

Second Circuit

Senderowitz v. Hebrew Acad. For Special Child., Therapeutic Servs., Inc., No. 24-CV-00797 (RER) (PCG), 2026 WL 440526 (E.D.N.Y. Feb. 17, 2026) (Judge Ramón E. Reyes, Jr.). Jennifer Senderowitz worked at the Hebrew Academy for Special Children from 2013 to 2021, and in this action asserts numerous claims based on her alleged mistreatment there. In her complaint she alleges discrimination based on religion, gender, and sexuality, as well as misclassification of her employment status, which deprived her of overtime pay and other benefits. She has brought claims against the school and her former supervisor under Title VII of the Civil Rights Act, the New York State Human Rights Law (NYSHRL), the New York City Human Rights Law (NYCHRL), the Fair Labor Standards Act (FLSA), New York Labor Law (NYLL), and ERISA. Defendants moved to dismiss all claims. The court granted the motion in part and denied it in part. The court dismissed Senderowitz’s FLSA misclassification claim because there is “no independent FLSA claim for ‘misclassification’ separate from a claim for violation of the other benefits FLSA provides – e.g., compensated overtime pay.” Senderowitz did not allege such a loss and thus the claim was a non-starter. The court dismissed Senderowitz’s NYLL claim for lack of standing, ruling that “she neither specifies [a material] harm nor makes a causal connection between a lack of accurate wage statements and any concrete injury in the form of unpaid wages or otherwise.” However, the court allowed Senderowitz’s discrimination and retaliation claims under Title VII, NYSHRL, and NYCHRL to proceed. The court found that she adequately pleaded that she was an employee, her claims were not time-barred, she alleged an adverse employment action in the form of a constructive discharge, and her allegations were sufficient to suggest discriminatory motivation based on Senderowitz’s sexual orientation, gender, and religion. As for ERISA, the court dismissed her claim under that statute as untimely. Senderowitz contended that due to defendants’ “intentional misclassification” of her as an independent contractor, she was denied participation in “retirement plans and other benefits comprised by ERISA that were offered to employees who were not misclassified as independent contractors.” The court construed this as a claim for benefits under ERISA section 502(a)(1)(B), which in New York has a statute of limitation of six years, accruing “upon a clear repudiation by the plan that is known, or should be known, to the plaintiff.” The court examined the contracts between Senderowitz and defendants and ruled that Senderowitz “knew or should have known that she would be denied participation in ERISA retirement or other benefits plans based on the terms of the employment contracts she signed.” Because she signed the contracts in 2013, her claims expired in 2019. Thus, her 2024 ERISA claims were time-barred and the court dismissed them.

Subrogation/Reimbursement Claims

Fourth Circuit

Beacon Sales Acquisition, Inc. v. Rodek, No. 1:26-CV-436 (RDA/LRV), 2026 WL 483601 (E.D. Va. Feb. 20, 2026) (Judge Rossie D. Alson, Jr.). Jeanne A. Rodek is insured under Beacon Sales Acquisition, Inc.’s employee health benefit plan. In 2023 she sustained personal injuries in an automobile accident, which resulted in the plan paying $220,194.09 in medical benefits. Rodek retained a law firm and ultimately obtained a settlement of $2.1 million in her tort case. The plan notified Rodek that it was entitled to reimbursement under the plan, but according to Beacon’s complaint in this matter, Rodek “failed to reimburse the Beacon Plan from the proceeds of the settlement and has thereby breached the terms of the Plan and ERISA.” Beacon alleges that Rodek instructed her lawyers “to disburse the remaining settlement funds directly to her in disregard of the plan’s equitable lien against the proceeds of the settlement.” When Beacon contacted the lawyers’ representative, it was told, “I just spoke with our client, and they have advised they will be disbursing all funds to the client, and you are welcome to sue their 75-year old client.” Beacon took them up on the offer and sued Rodek under ERISA Section 502(a)(3), seeking equitable relief. At issue here was Beacon’s motion for a temporary restraining order (TRO) “to maintain the status quo so that Defendant does not dissipate the identifiable settlement funds while this matter is proceeding.” The court considered the relevant TRO factors – whether the plan had a likelihood of success on the merits, whether irreparable harm would occur without a TRO, the balance of equities, and the public interest – and concluded that a TRO was warranted. The court found that Beacon had a likelihood of success on the merits because the plan’s subrogation terms were express and unambiguous, and it sought to recover specifically identifiable funds within the possession of the beneficiary, as authorized by the Supreme Court in Sereboff v. Mid Atlantic Med. Servs., Inc. The court also determined that irreparable harm would occur if the settlement funds were spent, as the plan would lose its right to equitable relief, noting the dissipation concerns raised by the Supreme Court in Montanile v. Board of Trs. of the Nat’l Elevator Indus. Health Benefit Plan. Furthermore, the balance of equities favored the plan, as a TRO would prevent the dissipation of funds without depriving Rodek of the settlement proceeds, and the public interest supported enforcing reimbursement provisions to preserve plan assets for all participants and beneficiaries. Thus, the court granted the TRO and restrained Rodek “from dispersing, disposing, or otherwise dissipating settlement proceeds…so that less than $220,194.09 remain in trust until such time as the Court can hold a preliminary injunction hearing.” The court required Beacon to post a “nominal” $5,000 bond.

Withdrawal Liability & Unpaid Contributions

Second Circuit

Mar-Can Transp. Co., Inc. v. Local 854 Pension Fund, No. 24-1431, __ F.4th __, 2026 WL 452565 (2d Cir. Feb. 18, 2026) (Before Circuit Judges Lohier, Carney, and Pérez). This dispute between an employer and a multiemployer benefit plan involves the interpretation of 29 U.S.C. § 1415, which addresses an employer’s withdrawal liability in the event of a change in the employees’ labor union. In 2020, employees of Mar-Can, a school bus company, voted to leave Teamsters Local 553 and join the Amalgamated Transit Workers (ATW). This meant that Mar-Can withdrew from the Teamsters-affiliated Local 854 Pension Fund (the Old Plan), and began contributing to an ATW-affiliated plan (the New Plan). This of course triggered withdrawal liability under ERISA under the Old Plan, and meant that the Old Plan had to transfer assets and liabilities regarding the departing employees to the New Plan. Finally, and most importantly for this case, ERISA required the Old Plan to “reduce Mar-Can’s withdrawal liability to account for the assets and liabilities transferred from the Old Plan to the New. Under Section 1415(c), the designated reduction was the amount by which the ‘value of the unfunded vested benefits’ transferred exceeded the ‘value of the assets transferred.’” Mar-Can argued that this calculation should have reduced its withdrawal liability by $1.8 million (“the difference between the $5.5 million in Mar-Can-related liabilities and $3.7 million in Mar-Can-related assets that were transferred from the Old Plan to the New”), while the Old Plan contended that no reduction at all was required. The district court sided with Mar-Can, and the Old Plan appealed. The Second Circuit evaluated the district court’s decision de novo because it involved an interpretation of law. It began with a lengthy and educational history lesson about the purpose of ERISA and its multiemployer amendments, and an explanation of how withdrawal liability works. The court noted that “[t]his case presents a novel legal question in this and other Circuits, despite the decades that have passed since the MPPAA’s enactment: to what extent should a plan reduce an employer’s withdrawal liability if the employer withdrew from the plan because its employees have changed their collective bargaining representative? Or, in statutory terms, what is the correct construction of the phrase ‘unfunded vested benefits’ as used in Section 1415(c)?” Mar-Can argued that this meant “the total amount of liabilities transferred by the Old Plan to the New Plan,” which was “fair, because by offloading to the New Plan more liabilities than assets, the Old Plan has effectively recouped the amount of withdrawal liability that it would otherwise be entitled to collect from Mar-Can.” The Old Plan disagreed, arguing that the term “unfunded vested benefits” did not include transferred assets, and thus it was required to subtract those assets a second time in calculating withdrawal liability. The Second Circuit ruled that the term “unfunded vested benefits” was ambiguous, but given the statute’s text, structure, and legislative purpose, Mar-Can had the better reading for two reasons. First, the Old Plan’s interpretation “would create a windfall for the Old Plan and unfairly penalize employers that withdrew from a plan involuntarily because of a change in bargaining representative.” Indeed, it “would have functioned simply to double – not merely account for – the Old Plan’s net gain from the transfers… Given the MPPAA’s overarching aim to ‘ensure[ ] that both plans are funded and avoid[ ] the possibility of double payments by the employer’…we find it implausible that Congress could have intended this outcome.” Furthermore, the court noted that the Old Plan’s interpretation “would treat employers that voluntarily withdraw from a plan more favorably than those that involuntarily withdraw because of a change of bargaining representative,” which was “even more implausible.” Second, Mar-Can’s interpretation was “more consistent with other parts of Section 1415,” while the Old Plan’s interpretation created incongruities with those parts and even “undermined” the part which set a “floor” for withdrawal liability. As a result, the Second Circuit adopted Mar-Can’s interpretation of the statute and affirmed the district court’s ruling.

Parrott v. International Bancshares Corp., No. 25-50367, __ F.4th __, 2026 WL 364324 (5th Cir. Feb. 10, 2026) (Before Circuit Judges Elrod, Smith, and Wilson)

The last few years have seen a flood of attacks by plan participants against benefit plans that contain arbitration provisions. The targets of these attacks are provisions that contain language prohibiting plan participants from pursuing plan-wide remedies, even though Section 1132(a)(2) of ERISA explicitly gives participants the right to pursue such remedies.

Multiple circuit courts of appeal have ruled that such provisions are unenforceable because arbitration is intended to be an alternate vehicle to vindicate the parties’ rights, but the provisions do not allow the “effective vindication” of those rights because they strip away a statutory remedy. (Your ERISA Watch has covered all of these rulings, from the Second, Third, Sixth, SeventhNinth, Tenth, and Eleventh Circuits.)

In this week’s notable decision the effective vindication doctrine was squarely presented to the Fifth Circuit. That court is a bold outlier in many ways. Would it forge its own path on this issue as well?

The plaintiff was Paul Parrott, a former employee and participant in International Bancshares Corporation’s (IBC) retirement savings plan. He brought this putative class action alleging that IBC and related defendants breached their fiduciary duties under ERISA by failing to prudently invest plan assets for the exclusive benefit of plan participants. Parrott brought claims under Section 1132(a)(2) on behalf of the plan and under Section 1132(a)(3) individually.

When Parrott filed his complaint, he was immediately hit with a motion to compel arbitration by IBC pursuant to the Federal Arbitration Act (FAA). IBC contended that arbitration was required pursuant to a 2024 amendment to the plan. Parrott responded with two arguments. First, he explained that he retired from IBC in 2021 and received his distribution under the plan prior to 2024, so the clause could not apply to him because he received no consideration for the change. Second, he argued that the arbitration amendment was invalid under the effective vindication doctrine because it prohibited the exercise of statutory rights under ERISA by barring plan-wide relief and claims brought in a representative capacity on behalf of the plan.

The district court agreed with Parrott’s first argument and thus did not reach the second. The court ruled “there was no consideration under Texas law for the Amended Arbitration agreement because this was not a situation where an at-will employee received notice of an employer’s arbitration policy and continued working with knowledge of the policy.” As a result, the court denied IBC’s motion to compel as to all of Parrott’s claims. (Your ERISA Watch covered this decision in our April 30, 2025 edition.)

IBC appealed this decision, making two additional arguments not ruled on by the district court: (1) the effective vindication doctrine does not apply, and (2) the plan “does not unlawfully ‘water down’ the standard of review for fiduciary actions.”

The Fifth Circuit addressed all three issues, starting with the district court’s ruling. IBC argued that the arbitration provision was valid and enforceable because the plan itself, not individual participants, is the consenting party for amendments. According to IBC, the plan consented to the arbitration agreement when IBC, as the plan sponsor, amended the plan, and thus Parrott’s individual concerns were irrelevant.

Parrott countered that neither he nor the plan consented to arbitration, arguing that under ERISA Section 1132(a)(2) the right to sue “is conferred on the litigant, not the Plan.” He also claimed that a plan cannot consent to arbitration through a unilateral amendment by the sponsor.

The Fifth Circuit agreed with IBC that the plan is the relevant party for claims under Section 1132(a)(2), which allows a private right of action on behalf of the plan for violations of fiduciary duty under Section 1109. Citing the Third Circuit’s decision in Berkelhammer v. ADP (the case of the week in our July 19, 2023 edition), the Fifth Circuit stated that “the entire thrust of § 1109 is the vindication of injuries to the plan,” and thus “[b]ecause ERISA puts the plan at the center of the relevant provisions, it points ‘to the plan, not the participants, as the relevant contracting party.’”

Furthermore, the Fifth Circuit ruled that the plan had consented to arbitration in this case through its unilateral amendment provision, which ceded broad authority to the sponsor to amend its terms. To rule otherwise, the court stated, “would be to find that ERISA has a per se ban on unilateral amendment of arbitration provisions by plan sponsors, something foreign to the text of the FAA and the caselaw.”

However, this only took care of Parrott’s Section 1132(a)(2) claims on behalf of the plan. Regarding his individual claims under Section 1132(a)(3), “it is undisputed that he did not consent to the arbitration agreement personally.” IBC did not specifically contend otherwise, and simply lumped Parrott’s individual claims in with its Section 1132(a)(2) argument. Thus, “to the extent that IBC sought to challenge the district court’s rejection of the motion to compel arbitration as to Parrott’s individual claims, it failed to brief such a position adequately and thus forfeited the issue. Even if it were not forfeited, the result is unchanged, as ‘arbitration is a matter of consent’ and Parrott provided no such consent.”

Next, the court addressed the effective vindication doctrine, noting, “we have not had occasion to address the doctrine directly,” and acknowledging that other circuit courts had adopted it in the ERISA context.

IBC tried to convince the Fifth Circuit to buck the trend, arguing that the doctrine should not apply to ERISA claims. IBC noted that the Supreme Court had not applied it in any case, and the Fifth Circuit has found ERISA claims arbitrable. Second, IBC argued that the doctrine should not apply because Parrott could receive “all of the relief available to him under ERISA through individual arbitration.” Finally, IBC argued that the arbitration clause was severable.

Parrott responded with the argument that has been successful in other circuits: the arbitration clause conflicts with ERISA by forbidding representative actions, which are essential for Section 1132(a)(2) claims. He contended that the provision limiting relief to individual damages violates the effective vindication doctrine by waiving statutory remedies. Furthermore, he argued that the arbitration clause was not severable.

The Fifth Circuit joined its sister courts and sided with Parrott. The arbitration provision stated that “[a]ll Covered Claims must be brought solely in the Arbitration Claimant’s individual capacity and not in a representative capacity or on a class, collective, or group basis.” The court ruled that this requirement “is facially at odds with the statutory text of § 1109 and the remedy it provides.”

Section 1109’s remedy, enforced through Section 1132(a)(2), “gives the Secretary, plan participant, beneficiary, or fiduciary the authority to seek relief for any losses to the plan.” This broad scope “means that the remedy provided for in this instance is that a § 1132(a)(2) plan participant can seek to recover all losses and reclaim all profits that resulted from the breach of fiduciary duties.” Suits under Section 1132(a)(2) are “brought on behalf of the plan and thus in a representative capacity.”

As a result, “[b]ecause § 1132(a)(2) suits, by definition, must be brought in a representative capacity and plan participants are entitled to bring suit to recover all losses and profits, the anti-representative-action clause and remedy limitation are violative of the effective vindication doctrine.” The Fifth Circuit explained that “[t]his reading is supported by multiple circuits” and was consistent with the Supreme Court’s interpretation of Section 1132(a)(2) in LaRue v. DeWolff, Boberg & Assocs. Inc.

As for severability, the Fifth Circuit applied Texas law because “there is no evidence, nor does either party allege, that the FAA preempts Texas law when it comes to interpreting the severability clause.” Under Texas law, the court found the clause ambiguous, and chose to remand the issue to the district court for resolution in the first instance because interpretation of ambiguous contractual provisions is a factual issue.

Finally, the court addressed whether the arbitration provision contained exculpatory provisions unlawful under ERISA Section 1110(a). That statute voids any provision in a plan “which purports to relieve a fiduciary from responsibility or liability for any responsibility, obligation, or duty” under ERISA.

Parrott argued that the representative-action waiver, remedy limitation, and standard-of-review provisions were unlawful under Section 1110(a). The court limited its discussion to the standard-of-review provision because it had already invalidated the other two provisions under the effective vindication doctrine.

The court ruled, “Given that IBC asserts that it does not believe the provision reaches breach-of-fiduciary-duty claims, and further given that Parrott correctly suggests that changing to a more deferential standard of review would, by definition, relieve the Plan’s fiduciaries of liability, the standard-of-review provision is void to the extent that it expands beyond the reach of denial-of-benefits claims.”

As a result, the court reversed the district court’s denial of IBC’s motion to compel arbitration as to Parrott’s Section 1132(a)(2) claim because the plan’s unilateral amendment was lawful and applied to Parrott, but affirmed as to Parrott’s individual claims under Section 1132(a)(3) because he did not give consent. Furthermore, the court voided the standard of review provision “to the extent it purports to reach breach-of-fiduciary-duty claims,” and remanded “for further proceedings on whether provisions that violate the effective vindication doctrine can be severed.”

In short, even the Fifth Circuit is not immune to peer pressure. The effective vindication doctrine’s winning streak continues.

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

Class Actions

Ninth Circuit

Chea v. Lite Star ESOP Committee, No. 1:23-CV-00647-SAB, 2026 WL 383318 (E.D. Cal. Feb. 11, 2026) (Magistrate Judge Stanley A. Boone). Linna Chea is a former employee of B-K Lighting, Inc. and a participant in the Lite Star Employee Stock Ownership Plan (ESOP). She filed this class action in 2024, alleging claims under ERISA for prohibited transactions, breach of fiduciary duties, failure to monitor, and co-fiduciary liability. Her allegations were based on a 2017 transaction in which B-K’s founder, Douglas W. Hagen, sold 100% of the company’s stock to the ESOP for $25.27 million, which was partially financed through a loan from Hagen to the ESOP. Chea alleged that this transaction exceeded the fair market value of the company and that the ESOP’s fiduciaries “failed to remedy the alleged fiduciary violations arising from the transaction, resulting in millions of dollars of losses to the ESOP and its participants.” After surviving a motion to dismiss, the parties negotiated a settlement. The court gave it preliminary approval in October of 2025, and in this order made it final. The court certified a class including all participants and beneficiaries of the ESOP from its inception until December 31, 2024, Chea was confirmed as the class representative, and law firms Feinberg, Jackson, Worthman & Wasow LLP and Cohen Milstein Sellers & Toll PLLC were confirmed as class counsel. The settlement provided $2.25 million in aggregate economic value to the ESOP and its participants, or about $11,000 per class member prior to deductions. This represented “approximately 45% of the estimated maximum damages.” The court found the settlement amount to be fair, reasonable, and adequate. The court noted that an independent fiduciary report had approved and authorized the settlement. The court further approved attorneys’ fees of $500,000, representing 22% of the common fund, which fell within “[t]he typical range of acceptable attorneys’ fees in the Ninth Circuit,” which is “20% to 33.3% of the total settlement value, with 25% considered a benchmark percentage.” Chea’s requested $5,000 service award was also approved. Finally, the court determined an appropriate cy pres recipient for any residual settlement funds. The parties both offered suggestions, and the court went with plaintiffs’ choice, the Pension Rights Center, “a nonprofit consumer organization dedicated to protecting and promoting the retirement security of workers and retirees.” The action was dismissed with prejudice, and the court retained jurisdiction for six months to oversee settlement administration.

Discovery

Second Circuit

Carfora v. TIAA, No. 21-08384 (KPF), 2026 WL 392039 (S.D.N.Y. Feb. 12, 2026) (Judge Katherine Polk Failla). We have reported on this five-year-old case several times. In fact, two rulings in it have been our case of the week: (1) the court’s September 28, 2022 grant of defendants’ motion to dismiss, and (2) the court’s May 31, 2024 order denying defendants’ motion to dismiss plaintiffs’ amended complaint. The plaintiffs are university professors and researchers of various institutions who are participants in benefit plans administered by Teachers Insurance and Annuity Association (TIAA). Generally, plaintiffs allege that TIAA violated ERISA by driving plan participants away from their investments and into TIAA-sponsored higher-fee proprietary offerings through “cross-selling.” Before the court here was a discovery dispute. Plaintiffs have issued subpoenas to various non-party institutions such as Harvard, CalTech, the University of Chicago, and Dartmouth to obtain “a representative cross-section of TIAA recordkept plans.” The subpoenas were designed “to determine what a diverse cross-section of institutional fiduciaries did and did not do in the face of TIAA’s alleged cross-selling to show what the fiduciary standard should be in this case.” The university respondents objected, contending that the discovery requests were overly burdensome. An agreement was reached on one request, but they could not agree on the second, which concerned “documents related to TIAA’s promotion and sale of its non-plan products and services to participants, followed by a list of documents that may be encompassed in that request.” The court sided with the respondents, stating that it “views the probative value of the information that may be produced…to be negligible, on both an individual and classwide basis. Conversely, Respondent Universities have shown that the burden on them would be steep… The Court does not believe it is appropriate, under Rule 26, to force the nonparty Universities to bear this burden for information of such limited relevance.” The court acknowledged that plaintiffs had suggested a narrowing of their request “to include only minutes and materials from fiduciary meetings where TIAA’s marketing and/or sale of non-plan products and services was discussed.” However, “the Court is unaware if this proposition was ever discussed with Respondent Universities. And by not raising it earlier, Plaintiffs have deprived Respondent Universities of the opportunity to respond to the Court on the issues of relevance and burden.” As a result, the court denied plaintiffs’ motion to compel, as it was “unpersuaded that the probative value of the materials would be proportionate to the burden of producing them.”

Third Circuit

Schaefer v. Unum Life Ins. Co. of America, No. 4:24-CV-00590, 2026 WL 396445 (M.D. Pa. Feb. 12, 2026) (Judge Matthew W. Brann). Barbara Schaefer filed this action against Unum Life Insurance Company of America, alleging that it improperly terminated her disability benefits. She brought six claims for relief, including “breach of contract, bad faith insurance practice, improper denial of benefits, and breach of fiduciary duties under ERISA.” Now the parties are embroiled in a discovery dispute. Schaefer served interrogatories and requests for production of documents on Unum, seeking information on topics such as employment information for claims adjusters, supervision of claims adjusters, compensation to medical reviewing company Dane Street, and governmental investigations into Unum. Unum objected, relying on a list of “general objections” in which it claimed that the requests were beyond the scope of the Federal Rules of Civil Procedure, overly broad, unduly burdensome, and protected by privilege, among others. Schaefer filed a motion to compel and for leave to serve additional interrogatories above and beyond the limit in the Federal Rules of Civil Procedure. The court deemed Unum’s general objections to be waived because they were “boilerplate” and attempted to “shift the burden of determining whether each and every interrogatory or request for production could be objectionable to this Court by invoking the entire realm of possible objections, even where certain objections are clearly inapplicable to specific interrogatories or requests for production of documents.” The court then addressed Schaefer’s specific requests. The court required Unum to provide information related to incentives, bonuses, or reward programs for employees involved in reviewing Schaefer’s disability claims, but not general compensation documents. The court denied Schaefer’s request for “batting average” information – i.e., the percentage of claims approved by Unum – as it was deemed to have minimal probative value and would impose an unacceptable burden on Unum. The court allowed discovery of Unum’s internal review procedures and supervisory structure, as they were relevant to Schaefer’s bad faith claim. However, the court limited the scope to procedures related to Schaefer’s claim denial; “Defendant need not produce documents or information surrounding policies that are far afield from the issue at hand.” Regarding medical reviewer Dane Street, the court allowed discovery of relevant information related to its compensation for, and role in, Schaefer’s claim denial, but denied the requests for all communications between Unum and Dane Street, as well as batting average information, as these requests were unduly burdensome. The court also denied Schaefer’s request for documentation of communications with state or federal agencies investigating Unum, as “it is clear that this request is too broad; indeed, it is vague, ambiguous, and overbroad in scope. As a large insurance company, Defendant will certainly have been the subject of agency investigations within the last ten years. Such a request would portend an immense obligation for Defendant, a burden that far outweighs the slight probative value.” Finally, the court denied Schaefer’s request for leave to serve additional interrogatories, as some of her requests had been rejected by the court, and thus she was still under the limit imposed by the Federal Rules.

Life Insurance & AD&D Benefit Claims

Fifth Circuit

Camardelle v. Metropolitan Life Ins. Co., No. CV 25-1382, 2026 WL 397166 (E.D. La. Feb. 12, 2026) (Judge Eldon E. Fallon). In our December 24, 2025 edition, we reported on the court’s ruling in this case granting Metropolitan Life Insurance Company’s motion to dismiss Ryan Camardelle’s complaint in which he sought ERISA-governed accident insurance benefits for the loss of vision in his right eye. Camardelle alleged that his vision loss was attributable to an injury in September of 2019, but that he did not become blind until 2023. In its ruling, the court determined that even if the 2019 incident constituted an “accident” under the plan, the loss of eyesight in October 2023 did not meet the plan’s requirements because the plan requires an insured’s physical loss to occur within 365 days of the accident. Here, the gap was more than four years. Camardelle filed a motion to vacate the dismissal, which the court denied in this order. Camardelle argued that the court “committed a manifest error of fact” because his physical loss “did occur within 365 days of the covered accident because he had three unsuccessful corneal transplants within 365 days of the accident.” The court stated that Camardelle “has not identified an intervening change in controlling law,” and “did not present any new evidence that was not previously available. Instead, Plaintiff points the Court to facts that it already considered in its original order and reasons. Thus, Plaintiff’s motion for reconsideration asks the Court to rehash arguments and evidence that it previously considered – an impermissible task under a Rule 59(e) analysis.” As a result, the court denied Camardelle’s motion.

Medical Benefit Claims

Fourth Circuit

Healey v. United Healthcare Ins. Co., No. 5:24-CV-312-BO-RN, 2026 WL 377119 (E.D.N.C. Feb. 10, 2026) (Judge Terrence W. Boyle). Kempton Healey is a beneficiary under an ERISA-governed employee health plan, administered by United Healthcare, who was diagnosed with lipedema in 2021. Conservative treatment was unsuccessful, so Healey’s doctors recommended, and she underwent, a series of suction-assisted lipectomies. However, United denied her claims for these procedures, contending that it received insufficient information to make a medical necessity decision. Healey’s doctor participated in a peer-to-peer conversation with United’s reviewer, but United denied again on the same grounds. Healey then pursued an administrative appeal, during which United discovered that it was missing some portions of her submission. It contacted Healey’s provider and requested a resubmission, but it did not wait for a response and denied her appeal almost immediately thereafter. Healey requested an external review, but the denial was again upheld. Thus, Healey brought this action alleging wrongful denial of benefits under ERISA, and the parties filed cross-motions for summary judgment. The court employed the abuse of discretion standard of review because the benefit plan gave United discretionary authority to make benefit determinations. The court considered several factors from the Fourth Circuit’s Booth v. Wal-Mart test to determine whether United abused its discretion. First, the court found that, although “neither party was particularly diligent in their communications,” United “knowingly decided the appeal on an incomplete set of materials.” The court further found that these missing materials were material because they included “detailed provider letters, treatment history, and symptom documentation, all supporting Healey’s claim… United should have considered the whole appeal.” Next, the court examined the entire record and determined that Healey satisfactorily showed that she suffered from lipedema and that her treatment should have been covered: “The complete record is replete with evidence satisfying the criteria. More to the point, the complete record shows that the liposuction satisfied the plan’s definition of ‘medically necessary.’ It treated lipedema, was not cosmetic, and arose only as a substitute for failed conservative treatment.” Furthermore, the court questioned United’s decision-making process, particularly its assignment of Healey’s appeal to a doctor not licensed in North Carolina and its failure to consider additional materials submitted during the external review. Finally, the court addressed United’s dual role as both the claim administrator and insurer; the court found that while this created a potential conflict of interest, there was no evidence that this affected the decision. As for a remedy, the court awarded Healey the out-of-pocket cost of her procedures, totaling $88,060. United argued that she should only be able to recover the in-network cost of the procedures, but the court disagreed: “United’s blanket denial of benefits prevented her from exploring in-network alternatives.” The court also found an award of attorneys’ fees to Healey was appropriate given United’s “willful blindness to the omitted portions of the appeal and failure to reconsider denial after it gained access to the complete record.” The court thus granted Healey’s motion for summary judgment and denied United’s. It deferred ruling on the amount of Healey’s fees, and the amount of prejudgment interest, until it received further submissions from the parties.

Sixth Circuit

Patterson v. Swagelok Co., Nos. 1:20-CV-566, 1:21-cv-470, 2026 WL 375529 (N.D. Ohio Feb. 11, 2026) (Judge J. Philip Calabrese). This case is a consolidation of two long-running cases by husband and wife Eric and Laura Patterson; both cases have been up to the Sixth Circuit and back. The couple was involved in separate motor vehicle accidents and both received medical treatment paid for by insurer United Healthcare under an ERISA-governed benefit plan sponsored by the Swagelok Company. Eric and Laura both received compensation from the other drivers in the form of settlements. United pursued reimbursement against both pursuant to a provision in the summary plan description. United was successful with Eric, but not with Laura, because Laura was able to demonstrate that the controlling benefit plan document did not contain a reimbursement provision. Both Pattersons then filed suit against United and Swagelok to challenge the handling of their claims. After the Sixth Circuit’s most recent decision, the district court made several rulings in January paring down the couple’s claims. In short, the court ruled that Eric could pursue certain claims under ERISA while Laura could proceed with certain state law claims. The couple filed a motion for reconsideration, but found no relief from the court in this order. The court noted at the outset that their motion did not comply with the court’s civil standing order, which limits motions for reconsideration to two pages. Furthermore, the court found that they did not meet the high bar for reconsideration, which required “clear error of law, newly discovered evidence, or an intervening change in controlling law or to prevent manifest injustice.” The court offered three reasons in support. First, Laura lacked Article III standing to pursue her ERISA claims because her claims “do not turn on aspects of the ERISA Plan or its application, but on the primary conduct of Defendants in pursuing recovery – that is, malicious prosecution, abuse of process, and tortious interference. These claims arise from Defendants’ non-fiduciary conduct.” Second, the couple could not rely on the Supreme Court’s decision in Cigna Corp. v. Amara to argue that Laura suffered monetary harm that was cognizable under ERISA. “Mrs. Patterson’s monetary harm does not result from Defendants’ wrongful ERISA conduct. Indeed, the claims are not claims about Mrs. Patterson’s entitlement to benefits that ‘originate[] with the ‘terms and conditions’ of the Plan.’” Third, the couple could not pursue claims on behalf of the plan. The court noted that the Sixth Circuit had previously determined that Eric lacked standing to seek relief on behalf of the plan, and Laura’s arguments failed for the same reason. “[T]he current state of the record and the amended complaint suffers from the same flaws recognized by the Sixth Circuit decision with respect to Mr. Patterson’s claims on behalf of the plan. Therefore, without more, reconsideration of Mrs. Patterson’s standing for her ERISA claims is not appropriate.” With that, the court denied the Pattersons’ motion for reconsideration.

Seventh Circuit

Downey v. ATI Holdings, LLC, No. 25-CV-5785, 2026 WL 371127 (N.D. Ill. Feb. 10, 2026) (Judge April M. Perry). Suzanne Downey was injured by a third party and received medical treatment from ATI Physical Therapy. ATI was an in-network provider with United Healthcare Insurance Company of Illinois (UHC), and submitted bills to UHC for Downey’s treatment. UHC, through its affiliate, Optum, allegedly only issued partial payments, so ATI imposed a lien on Downey’s settlement with the third-party tortfeasor. Downey disagreed with this decision, contending that ATI’s contract with UHC “prohibited ATI Holdings from collecting payments from UHC insureds outside of applicable deductibles or copays, or imposing liens on insureds’ tort recoveries, even if ATI Holdings disputed the amount due.” Downey filed this action in state court, asserting numerous state law claims for relief against ATI and related defendants. Later, she amended her complaint to add an “alternative” claim under ERISA to enforce or clarify her rights to benefits under an ERISA plan. ATI seized on the amendment to remove the case to federal court based on ERISA preemption, and filed a motion to dismiss. Simultaneously, Downey filed a motion to remand. ATI contended that Downey failed to state a plausible ERISA claim because “it is not a suable entity under ERISA, which provides liability only for plans, plan administrators, and any entity that has the obligation to pay benefits under a plan.” Downey did not put up much of a fight. She “basically agrees,” and contended that “she was duped into adding the ERISA claim by Defendants[.]” The court did not argue. It noted that ERISA “does not define the proper defendants,” and “[t]he Court has not found, and the parties have not cited, any binding precedent addressing whether third-party medical providers are properly suable under ERISA.” However, in this case, it was clear ATI was not a proper defendant for Downey’s ERISA claim. The plan did not “confer any rights or obligations on Plaintiff with respect to her relationship with Defendants…the Plan provisions cited by Plaintiff…do not include any reference to the reimbursement rights of (or limitations on) medical providers. To the contrary, Plaintiff’s entire theory of liability rests on the separate contract between Optum and ATI Holdings.” As for Downey’s state law claims, the court declined to exercise supplemental jurisdiction over them. The court found that remanding the case to state court was preferable, considering factors such as judicial economy, convenience, fairness, and comity. The court noted that state law issues would predominate in the litigation, and both Downey and ATI were Illinois residents, indicating “more state interests than federal ones.” Furthermore, the claims were not preempted by ERISA. Finally, the court declined to award ATI attorney’s fees under ERISA after applying the Seventh Circuit’s five-factor test. The court determined that Downey did not act in bad faith and “thus no deterrence is necessary.” Furthermore, “the question as to [] whether a medical provider could ever be a proper defendant under 29 U.S.C. § 1132(a)(1)(B) has not been definitively resolved by either Illinois courts or in the Seventh Circuit,” and thus Downey’s claim “was not baseless.” In the end, the court dismissed Downey’s ERISA claim and gave her one week “to file a notice regarding whether or not she intends to file an amended complaint to attempt to state a plausible ERISA claim.” If not, the court will remand the case back to state court.

Plan Status

Fifth Circuit

Aikens v. Colonial Life & Accident Ins. Co., No. CV 24-0580, 2026 WL 373862 (W.D. La. Feb. 10, 2026) (Judge S. Maurice Hicks, Jr.). In our December 17, 2025 edition we introduced you to a business curiously named “Just What You Expect.” Colonial Life & Accident Insurance Company issued four individual term life insurance policies, each worth $250,000, to individuals allegedly associated with the company, including Daniel Dewayne Aikens and Keelien Lewis, each of whom allegedly had a 25% ownership in the business, which was named as the beneficiary. Two months after the policy was issued, in 2017, Lewis did not get what he expected. He died suspiciously; his death was eventually ruled a homicide. Colonial Life investigated and learned that Aikens had been charged with several unrelated federal crimes (he was convicted and sentenced to sixteen years in prison for two Louisiana bombings), and that news articles indicated he was a suspect in Lewis’ death. Uncertain as to whether it should pay any benefits, or to whom, Colonial Life filed this interpleader action. In December, over Aikens’ objections, the court granted Colonial Life’s motion to be dismissed from the case after depositing the insurance proceeds. In that ruling the court determined that Aikens could not assert claims under ERISA against Colonial Life because the insurance policy was not governed by ERISA. Instead, it “was for the benefit of the business, not for the benefit of Lewis as an employee,” and “if the business was owned equally by four individuals…then Lewis was not an employee for whom the employer established an ERISA plan[.]” Aikens filed a motion for reconsideration, which the court quickly denied in this order. “Although Aikens disagrees with the Court’s interpretation of ERISA law and interpleader doctrine, such disagreement does not constitute an obvious legal error or extraordinary circumstance warranting relief. The Motion identifies no newly discovered evidence, no fraud, no void judgment, and no exceptional circumstance justifying reopening the case. Instead, it reiterates arguments that were previously considered and rejected. Accordingly, Rule 60(b) relief is not appropriate.”

Pleading Issues & Procedure

Second Circuit

Moody v. Sedgwick Claims Mgmt. Servs., Inc., Nos. 25 Civ. 8671 (JHR), 25 Civ. 9787 (JHR), 25 CIV. 10720 (JHR), 2026 WL 370332 (S.D.N.Y. Feb. 10, 2026) (Judge Jennifer H. Rearden). You may remember Amari Moody from previous editions of Your ERISA Watch. As the court explained, Moody, “proceeding pro se, has brought seventeen actions in this District since October 2025, including the four before this Court concerning a sinus surgery and related benefits disputes.” These include cases against Sedgwick Claims Management Services, Inc., Unum Group, and Cigna Health and Life Insurance Company. In this order the court addressed the many “overlapping” motions filed by Moody in each case. First, the court denied Moody’s request to have the matters reassigned to a different judge. The court noted that it had promptly ruled on Moody’s emergency motions, and that dissatisfaction with a judge is not grounds for reassignment. Next, the court denied Moody’s emergency motions, which fell into three categories. First, Moody sought “preservation of records,” but the court noted that the defendants were already required to preserve records, and “[i]n any event, emergency relief or a preservation order are not ‘necessary’ at this stage.” Second, Moody sought to compel the production of documents on an emergency basis. The court ruled that this was improper; Moody could not “make an end run around the rules of discovery…by framing what is essentially a request to compel discovery as a motion for a temporary restraining order.” Third, Moody demanded relief on the merits of his benefit claims. The court ruled that Moody was not entitled to such a “drastic remedy” because he did “not demonstrate (1) likelihood of success on the merits or (2) sufficiently serious questions going to the merits to make them a fair ground for litigation and a balance of hardships tipping decidedly in h[is] favor.” Next, the court discussed Moody’s “other applications,” which included motions for “clarification,” “Article III supervisory intervention,” and a “motion for judicial notice of structural defects, retaliatory litigation conduct, and ADA Title II access violations.” The court found that its previous rulings covered most of these motions as well, and that Moody had consented to electronic service of documents and had not requested any Title II accommodations. Having addressed Moody’s sixteen pending motions, the court issued him a stern warning, informing him that his motions were “improper and delays the Court’s resolution of the case[s].” Thus, if Moody files any additional frivolous motions, “the Court will direct him to show cause why the Court should not bar him from filing any future submissions without leave of CourtPlaintiff is on notice that continued abuse of the judicial process could lead to sanctions” (emphasis in original).

Ninth Circuit

Saloojas, Inc. v. United States Dep’t of Health & Human Servs., No. 25-CV-04735-EMC, 2026 WL 406040 (N.D. Cal. Feb. 12, 2026) (Judge Edward M. Chen). Saloojas, Inc., is a medical testing business that contends “it is owed more than $18 million for tens of thousands of COVID-19 diagnostic tests that it provided to the public.” As readers of Your ERISA Watch know, in the last few years Saloojas has initiated multiple actions against health insurers to obtain reimbursement. The courts have generally thwarted these efforts, ruling that health care providers like Saloojas do not have a private right of action under the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), as incorporated into ERISA. Saloojas reportedly went bankrupt and is now trying to recoup from its patients, who are not happy. Saloojas also has a new legal strategy; instead of suing insurers, it has sued the federal government. In this action Saloojas seeks to compel the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury, along with their respective Secretaries, to enforce reimbursement provisions under the FFCRA and CARES Act. Saloojas argues that these agencies “unlawfully withheld or unreasonably delayed enforcement action under the Administrative Procedure Act (‘APA’)[.]” Saloojas also asserted a claim under the Mandamus Act and a Fifth Amendment takings claim. The government moved to dismiss. The court examined the FFCRA and CARES Act and noted that they authorize the Secretaries of HHS, Labor, and Treasury to implement these provisions through guidance or other means. The court further noted that under the APA, agency enforcement decisions are generally committed to agency discretion and are presumptively non-reviewable unless Congress “imposes meaningful standards constraining the agency’s discretion.” The court found that the FFCRA and CARES Act do not mandate specific enforcement actions by the Secretaries, thus leaving enforcement to agency discretion. Saloojas argued that the laws imposed “a mandatory, ministerial duty on the Secretaries to initiate enforcement actions wherever insurers allegedly fail to reimburse providers in accordance with the FFCRA,” but the court ruled that this interpretation “does not account for the statutory context.” The FFCRA and CARES “do[] not direct Secretaries to take any particular enforcement action.” Thus, the court ruled that it did not have jurisdiction over Saloojas’ APA claim. The court dismissed the Mandamus Act claim for the same reasons, as that act requires a “clear and certain” claim, a ministerial duty “so plainly prescribed as to be free from doubt,” and no other adequate remedy. The court found no ministerial duty because, again, enforcement authority was committed to agency discretion. Finally, the court dispensed with Saloojas’ Fifth Amendment takings claim. The court ruled that there was no vested entitlement to reimbursement enforceable against the federal government because “[t]he reimbursement obligations run from insurers to providers. The statutes do not obligate the federal government to pay providers in lieu of insurers, nor do they guarantee reimbursement in the event insurers fail to comply, as the statutes do not obligate the government to pay providers in lieu of insurers.” Furthermore, “only affirmative conduct by the government can give rise to a viable takings claim. A failure to act does not generally constitute a taking.” In the end, the court explained that it was “sympathetic to the frustration faced by Saloojas who responded to public need and provided services with a fair expectation of payment. But the law under the APA is clear. The Court is without power to review the Secretaries’ action or inaction with respect to federal enforcement of the statutes at issue.”

Retaliation Claims

Seventh Circuit

Horwitz v. Learjet, Inc., No. 24-CV-2709, 2026 WL 395632 (N.D. Ill. Feb. 12, 2026) (Judge John Robert Blakey). David Horwitz worked as a quality control inspector for Learjet, Inc. for thirteen years. He has unfortunately had two bouts with different cancers (lung and colorectal). In 2023, while at work, Horwitz felt extremely tired and uncomfortable, which he attributed to side effects from his cancer. He alleged that he “rested his head in his hand while he contemplated whether he should work through the pain, go to the hospital, or go home.” Later that day, Horwitz was terminated for sleeping on the job. Horwitz alleges that this occurred even though he explained to Learjet his “medical condition and the side effects.” Horwitz filed this action, alleging violations under the Age Discrimination in Employment Act (ADEA), the Americans with Disabilities Act (ADA), and ERISA. Learjet filed a motion to dismiss. On Horwitz’s ADEA and ADA claims, the court found that Horwitz “offers no factual connection between the adverse employment action and his membership in any protected class under either the ADEA or ADA.” The court noted that Horwitz admitted to resting his head on his desk, which was perceived as sleeping, and offered no evidence that his age or disability was the real cause, or even a factor, in his termination. Thus, the court dismissed these claims due to a lack of causation. As for Horwitz’s ERISA claim, he contended that his termination violated § 510 of ERISA by “‘abruptly’ terminating” his and his wife’s healthcare coverage. The court noted that to establish a prima facie case under § 510, a plaintiff must demonstrate a specific intent to interfere with benefit rights. However, Horwitz “offers nothing beyond his own conclusory assertions that he and his wife incurred high medical costs and his belief that the ‘sleeping on the job’ reason for his termination was ‘a pretext to fire Plaintiff.’” The court found that Horwitz had not offered any “evidence (direct or indirect) to show that Defendant’s decision to terminate him was motivated by the desire to cease paying Plaintiff’s medical bills.” The court acknowledged that while Horwitz was not required to “prove his claim” at the pleading stage, “he must assert some facts showing the specific intent § 510 requires.” Because he did not, the court dismissed this claim as well. As a result, the court granted Learjet’s motion to dismiss in its entirety, although it allowed Horwitz an opportunity to amend his complaint.

Standard of Review

Ninth Circuit

Hildebrandt v. Unum Life Ins. Co. of Am., No. 8:23-CV-02297-ODW (JDEX), 2026 WL 413748 (C.D. Cal. Feb. 13, 2026) (Judge Otis D. Wright, II). Peter Hildebrandt was an employee of The Boston Consulting Group, Inc. (BCG) and a participant in BCG’s ERISA-governed long-term disability (LTD) plan, insured by Unum Life Insurance Company of America. Hildebrandt worked for BCG in California as a partner and is a current resident of that state. BCG employs thousands of employees across the United States and internationally, and is based in Boston, Massachusetts. The Unum group policy insuring the plan has a choice of law clause providing that Massachusetts law governs the agreement. The policy grants Unum discretionary authority to make all benefit determinations on LTD claims. After Unum denied Hildebrandt’s claim for LTD benefits, he initiated this action. At issue before the court in this order were the parties’ cross-motions regarding the applicable standard of review. Unum argued for the abuse of discretion standard of review because the policy granted it discretionary authority. Hildebrandt sought de novo review, arguing that California Insurance Code Section 10110.6, which prohibits discretionary clauses in disability insurance policies for California residents, invalidated the grant of discretionary authority. The court held that it “must start with the ‘threshold question’ of ‘what law applies to interpret the terms of an ERISA insurance policy.’” The court held that the answer to that question in this case was Massachusetts law because of the policy’s choice of law provision, and thus California’s ban on discretionary clauses did not apply. The court further stated that “federal choice of law rules require that, ‘[w]here a choice of law is made by an ERISA contract, it should be followed, if not unreasonable or fundamentally unfair.’” The court determined that the choice made here was not unfair because, “in light of BCG’s global reach, electing a uniform choice of law for the plan promotes Unum’s uniform administration regardless of the location of a particular participant.” The court stated that without this uniformity, “[t]he plan’s administrative costs and reserves for litigation expenses would necessarily have to account for greater risk and uncertainty [of a] plan [that is] subject to the choice of law doctrine of every state in which it might be sued, and whatever substantive law that doctrine might import.” Thus, according to the court, enforcing the choice of law provision ultimately helps beneficiaries (although Hildebrandt might disagree) by contributing to “the ‘soundness and stability of plans,’ an explicit statutory objective of ERISA.” The court acknowledged Hildebrandt’s arguments regarding the public policy benefits of enforcing California’s law, but ultimately concluded that the choice of law analysis took precedence. “The requisite choice of law analysis ‘requires the Court to first determine which state’s law should apply to a dispute, and only then to examine the substance of a state’s law.’” Because Massachusetts does not ban discretionary clauses, and its law controlled, “the proper standard of judicial review in this case is abuse of discretion.” The court thus granted Unum’s motion and denied Hildebrandt’s. (Disclosure: Kantor & Kantor LLP represents Mr. Hildebrandt in this action.)

Duke v. Luxottica U.S. Holdings Corp., No. 24-3207, __ F.4th __, 2026 WL 303549 (2d Cir. Feb. 5, 2026) (Before Circuit Judges Robinson, Nathan, and Kahn)

This week’s notable decision, a published opinion from the Second Circuit, addresses a number of issues that often pop up in challenges to the administration of employee benefit plans, so rather than list them all up front, let’s just dive into the facts and see if you can spot them, law-school style.

The plaintiff was Janet Duke, a retired regional manager for Luxottica U.S. Holdings Corporation. Duke worked for Luxottica for nearly 21 years and was a participant in the Luxottica Group Pension Plan, a defined benefit plan.

On retirement, Duke had a choice of benefits. She selected the default option for married participants, a joint and survivor annuity (JSA) that would pay a percentage of her monthly benefit to her surviving spouse.

Under ERISA, a JSA has to be “actuarially equivalent” to a hypothetical single life annuity (SLA) that a participant would otherwise receive. In order to calculate Duke’s JSA, the plan’s benefits committee used a 7% annual interest rate and life expectancy values published in 1971. Duke contends that these assumptions were outdated, resulted in a benefit that was not actuarially equivalent to an SLA, and decreased her monthly benefit by about $54.

Duke filed this putative class action against her employer and related defendants, asserting four claims: violation of ERISA’s JSA equivalence requirement, violation of ERISA’s equivalence requirement for accrued benefits, violation of ERISA’s rules prohibiting forfeiture of retirement benefits, and breach of ERISA’s fiduciary duty obligations.

As for remedies, Duke sought “both reformation of the Plan to update its actuarial assumptions used to convert SLAs into JSAs, as well as monetary restitution to the Plan in the form of loss restoration and disgorgement of profits.”

Defendants moved to compel arbitration pursuant to Duke’s employment agreement, or, in the alternative, for lack of standing and failure to state a claim. The district court agreed with defendants that Duke lacked standing to pursue relief on behalf of the plan under ERISA Section 502(a)(2), and ruled that she must arbitrate her individual claims under Section 502(a)(3). (Your ERISA Watch covered this ruling in our October 11, 2023 edition.)

This decision was short-lived, however. The case was transferred, and the new judge granted plaintiffs’ motion for reconsideration. The court concluded that Duke had standing to assert a claim under Section 502(a)(2) on behalf of the plan for both reformation and monetary payments, and further ruled that the “effective vindication” doctrine precluded mandatory individual arbitration of that claim. The district court also denied defendants’ request to stay litigation of the claims under Section 502(a)(2) pending arbitration of the claims under Section 502(a)(3). (Your ERISA Watch covered this decision in our December 4, 2024 edition.)

Defendants filed interlocutory appeals from both the motion to compel arbitration and the motion to stay.

The Second Circuit began by discussing its own appellate jurisdiction. The court noted that it has the power to review certain interlocutory orders, including a district court’s denial of motions to compel arbitration and to stay litigation under the Federal Arbitration Act (FAA). However, here defendants were asking the court to review whether Duke had standing under Section 502(a)(2), which was “a determination of the district court’s subject matter jurisdiction that is not ordinarily immediately appealable.”

The court was not concerned, however. It ruled that the scope of an appealable order under the FAA “includes a district court’s determination that it has subject matter jurisdiction over the controversy to be litigated rather than stayed or arbitrated – including a plaintiff’s Article III standing.” Even if the scope was not this expansive, the Second Circuit ruled that it would consider the issue regardless as a matter of its pendent jurisdiction because standing and jurisdiction were “inextricably intertwined” with appealable issues.

The Second Circuit then turned to Duke’s Article III standing under Section 502(a)(2). The court divided this issue into two parts: whether Duke had standing to seek plan reformation, and whether Duke had standing to seek monetary payments to the plan.

On the first issue, defendants agreed that Duke’s receipt of decreased benefits was a “classic pocketbook injury” cognizable under Article III. However, they contended that plan reformation was a remedy “categorically unavailable under Section 502(a)(2) – which authorizes relief only to a plan – and thus Duke’s injury is not redressable under that provision.”

The Second Circuit was unconvinced, noting that defendants’ argument “targets the merits of Duke’s claims, not her standing to pursue them.” Furthermore, Duke was careful to argue that the harm to the plan was not her “receipt of reduced benefits,” but instead “its use of allegedly outdated actuarial assumptions,” which “renders the Plan in constant noncompliance with ERISA and jeopardizes its favorable tax status as a result.” Thus, while correcting that noncompliance would benefit Duke, that was not her point: “the Plan’s alleged noncompliance is its own injury that Duke seeks to remedy with Section 502(a)(2), rather than her receipt of decreased benefits, which is sufficient for standing[.]”

The court stressed that it was not reaching the issue of “whether ERISA noncompliance and attendant tax consequences really do constitute ‘plan injuries’ within Section 502(a)(2)’s remedial scope[.]” This was “an undecided question properly reserved for the merits.” Instead, the court merely held that Duke had standing to advance her arguments on the issue.

The Second Circuit reached a different conclusion as to Duke’s standing regarding monetary payments. Duke sought repayment of losses and disgorgement of profits to the plan, but defendants contended that only the plan would benefit from those remedies, not Duke, and thus she had no standing. Relying on the Supreme Court’s decision in Thole v. U.S. Bank, N.A., the court agreed with defendants.

Duke attempted to distinguish Thole with two arguments. First, she pointed out that the plaintiffs in Thole, unlike her, had received all their benefits. However, the Second Circuit responded that this did not matter because both plans were defined benefit plans. Thus, the plaintiffs in both cases “possessed ‘no equitable or property interest’ in the plan’s assets, and so monetary repayment to the plan would not benefit the plaintiffs personally.” Furthermore, Duke’s benefits were not reduced because of “a lack of Plan funds, but because of the Plan’s use of outdated actuarial assumptions.”

Duke’s second argument was that “the forms of relief she seeks will ‘work in tandem’ by increasing Plan funding commensurate with the reformation she hopes to obtain.” However, the court found that this argument was “foreclosed by Thole.” The court explained that the employer was the backstop for the plan, and thus was both “on the hook for plan shortfalls” and the recipient of any surplus after benefit payments. Thus, “nothing suggests monetary payments to the Plan will be necessary to effectuate any eventual reformation.” Either way, Duke “will be made whole regardless of whether the Plan receives additional funds; and if Duke is unsuccessful in seeking reformation, she will not be made whole regardless of whether the Plan receives those funds.” As a result, this claim “fails Article III’s redressability requirement.”

Next, the court considered arbitration. Duke contended that the effective vindication doctrine “precludes mandatory individual arbitration of her Section 502(a)(2) claim,” and the Second Circuit agreed. The court noted that it had already recognized the doctrine in the ERISA context in Cedeno v. Sassoon, and saw no reason not to apply it here.

Defendants offered three arguments against this conclusion, but the court rejected them, ruling that (1) Duke had properly alleged standing to bring her claim, as explained above, (2) it made no difference that this case involved a defined benefit plan, rather than a defined contribution plan as in Cedeno, because either way “only a representative action can resolve the allegedly detrimental effects of widespread violations of federal law,” and (3) defendants’ authorities regarding the scope of the FAA did not apply because Duke was not pursuing a “representative procedure” seeking “a personal remedy under Section 502(a)(2),” but was instead seeking relief on behalf of the plan for “a single absent principal.”

Finally, the Second Circuit addressed the district court’s denial of defendants’ motion to stay the litigation of Duke’s Section 502(a)(2) claim while the arbitration of her Section 502(a)(3) claim progressed. Defendants contended that a stay was mandatory under Section 3 of the FAA, but the court noted that “Section 3 does not extend to claims not subject to arbitration; whether a district court stays those is ‘a matter of its discretion to control its docket.’” The court observed that “Duke’s requested relief under Section 502(a)(2) is much broader than, and therefore not derivative of, her request under Section 502(a)(3).” Thus, the district court was within its discretion to allow the Section 502(a)(2) claim to continue.

As a result, Duke’s claims will proceed on two tracks: her Section 502(a)(3) claims in arbitration, and her Section 502(a)(2) claims in federal court. Of course, we’ll keep you updated on any further developments.

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

Breach of Fiduciary Duty

First Circuit

Heet v. National Medical Care, Inc., No. CV 25-11644-WGY, __ F. Supp. 3d __, 2026 WL 353317 (D. Mass. Feb. 9, 2026) (Judge William G. Young). Plaintiffs Michelle Heet, Mike Bickle, Frank Luketich, and David Kitchell, participants in the Fresenius Medical Care North America 401(k) Savings Plan, brought this putative class action against National Medical Care, Inc. (d/b/a Fresenius Medical Care North America) and related defendants. Plaintiffs allege that defendants breached their fiduciary duties under ERISA by improperly applying forfeited matching contributions. According to the plan, these forfeited contributions should be used to reduce company contributions and offset administrative expenses. However, plaintiffs allege that from 2019 through 2024, the defendants applied these forfeitures only to reduce matching contributions and not to administrative expenses. Defendants moved to dismiss. The court noted, and readers of Your ERISA Watch are well aware, that this is a hot topic in ERISA litigation. The court explained, “There are two schools of thought here. On the one hand, fiduciaries typically argue that they are not required to maximize benefits, only to ensure that the benefits due plan participants are appropriately disbursed. Accordingly, the reallocation of forfeited benefits to other matching contributions due as opposed to paying off administrative expenses is appropriate. On the other hand, plan participants typically argue that fiduciaries are conflicted when presented with a choice about using forfeited contributions to pay down matching contributions due from the company and thereby benefit the coffers of the company, as opposed to paying down administrative expenses to plan beneficiaries.” The court characterized this as “a zero-sum game: using chargeable forfeited matching contributions to defray other contributions due from the company obviously benefits the company, while administrative expense defrayment benefits the plan participants.” The court noted there was no controlling ruling from the First Circuit on the issue, or a ruling by any Circuit for that matter. It observed that the majority of courts have ruled against plaintiffs, but “[h]ere, this Court follows persuasive authority adopting the minority position.” Addressing plaintiffs’ specific claims, the court ruled against plaintiffs on their first count for failure to follow plan terms. The court ruled that the plan was “unambiguous” in that it “requires forfeited matching contributions to be used to offset other matching contributions…and, once those are paid, the only other permissible, albeit discretionary, use under the Fresenius Plan expands to defrayment of administrative expenses[.]” However, this ruling did not compel the court to find for defendants on plaintiffs’ other claims because “ERISA’s statutorily imposed fiduciary duty of prudence ‘trumps the instructions of a plan document.’” On plaintiffs’ claims for breach of the duties of loyalty and prudence the court found that plaintiffs did not allege overbroadly that forfeitures must always be used to pay expenses. Instead, they alleged, sufficiently for the court, that defendants failed to act solely in the interest of plan participants in making their decisions and did not adequately investigate the best use of forfeited contributions. In this way the court distinguished its ruling from others, such as Hutchins v. HP, which had granted motions to dismiss. As for plaintiffs’ prohibited transactions claim, the court granted defendants’ motion, ruling that the reallocation of forfeitures did not qualify under the statute. Finally, the court denied defendants’ motion as to plaintiffs’ failure to monitor claim to the extent it was dependent on plaintiffs’ other claims that survived. As a result, the split deepens among the district courts on this issue.

Sixth Circuit

Sweeney v. Nationwide Mut. Ins. Co., No. 2:20-CV-1569, 2026 WL 352845 (S.D. Ohio Feb. 9, 2026) (Judge Sarah D. Morrison). This is a certified class action by former employees of Nationwide Mutual Insurance Company who were participants in the company’s 401(k) plan, the Nationwide Savings Plan. They claim that Nationwide Mutual, Nationwide Life Insurance Company, and members of the Plan’s Benefits Investment Committee (BIC) violated ERISA by maintaining the Guaranteed Fund (“a stable value investment vehicle backed by a Nationwide Life annuity contract”) as an investment option for plan participants. The Guaranteed Fund “is a heavily utilized investment option for Plan Participants. As of 2020, 86% of Plan Participants had some portion of their account invested in the Guaranteed Fund, accounting for $1.75 billion.” The plan also had several features that encouraged investment in the Fund, including a target date fund which included the Fund as a portfolio component, and an “easy enroll” option for new participants which automatically invested them in the Fund. Plaintiffs contend that the BIC’s mismanagement led to the plan overpaying for the Fund, benefiting Nationwide at the expense of plan participants. They alleged several claims under ERISA, including breach of fiduciary duty, prohibited transactions, self-dealing, and anti-inurement. Before the court here were several pre-trial matters, including cross-motions for summary judgment and expert-related motions. The court addressed the expert motions first, denying defendants’ motion to exclude because plaintiffs’ two experts were qualified and their opinions were helpful and relevant. The court granted plaintiffs’ motion to exclude in small part, ruling that defendants’ financial analyst could not testify as to legal conclusions (such as “whether the Annuity Contract is a prohibited transaction”). The court then turned to the summary judgment motions. Defendants asserted two “safe harbors” in its motion: ERISA Section 408(b)(5)’s exemption and the “transition policy” safe harbor. The court ruled that summary judgment was not appropriate on this issue because genuine disputes of material fact existed. Under Section 408(b)(5), there were questions as to whether the plan paid “no more than adequate consideration” and whether the process that led to the annuity contract price complied with defendants’ fiduciary duties. For similar reasons, the court found that defendants failed to establish that the annuity contract qualified as a transition policy. Turning to the merits of plaintiffs’ claims, the court found that there was a genuine dispute of material fact as to whether the BIC fulfilled its fiduciary duties in overseeing Fund expenses. The court also found that there were factual questions regarding whether the plan, investment policy statement, and annuity contract were monitored and followed. As for plaintiffs’ claims for prohibited transactions and self-dealing, the court ruled that genuine disputes of material fact prevented a finding that Section 408(b)(5) applied as a defense to these counts. The court also found that the statute of repose does not bar these claims to the extent they are based on rate setting within the six-year period before Plaintiffs filed suit. Under plaintiffs’ claim for self-inurement, the court granted defendants’ motion to the extent the claim was based on conduct outside the six-year period before plaintiffs filed suit. Finally, the court considered named plaintiff Bryan Marshall, whom defendants contend released any ERISA claims he had. However, the court found that Marshall’s release did not affect his ability to bring a claim on behalf of the plan, as such claims belong to the plan. As a result, most of the relief sought by both sides was denied, and this case will proceed to a bench trial.

Seventh Circuit

Russell v. Illinois Tool Works, Inc., No. 22 CV 02492, 2026 WL 332662 (N.D. Ill. Feb. 9, 2026) (Judge Sunil R. Harjani). Employees of Illinois Tool Works, Inc. (ITW) brought this action in 2022 alleging that ITW and related defendants violated ERISA by breaching their duties of prudence and monitoring in mismanaging the company’s retirement plan. Defendants filed a motion to dismiss which the court denied in 2024, ruling that plaintiffs’ allegations were similar enough to the allegations in Hughes v. Northwestern University, which the Seventh Circuit had deemed sufficient. In 2025, plaintiffs filed a motion to amend their complaint to add allegations regarding defendants’ use of plan forfeitures. In their new allegations plaintiffs contend that defendants allocated unvested benefits, which had been forfeited back to the plan, to reduce ITW’s contributions rather than plan expenses borne by participants. Defendants moved to dismiss. The court first addressed defendants’ statute of limitations argument. The court determined that plaintiffs’ new claims did not relate back to the original 2022 complaint because they were based on new factual allegations regarding the use of forfeitures, which were not included in the original complaint. As a result, any claims related to conduct before February 21, 2019, were barred by ERISA’s six-year statute of limitations. On the breach of fiduciary duty claim, the court ruled that plaintiffs sufficiently alleged that defendants acted as fiduciaries, and not as plan settlors, with regard to their use of the forfeitures. The court noted two potentially conflicting plan provisions and held that “[a] reasonable reading that gives effect to both provisions is that some forfeitures in a given year must be used to reduce employer contributions, but not necessarily all. Under this interpretation, Defendants would retain discretion to allocate the remainder to further reduce employer contributions or reduce Plan expenses.” As a result, it was “reasonable” for plaintiffs to allege that the plan granted defendants discretion, and thus reasonable to allege that defendants were acting in a fiduciary capacity. The court further held that plaintiffs’ claim survived because they did not allege a “per se ban on the use of forfeitures for reducing employer contributions.” Instead, “Plaintiffs assert that Defendants breached their duties by not considering whether specific forfeiture allocations benefited the Plan participants rather than just themselves and choosing the option that only benefited themselves.” For similar reasons, the court ruled that plaintiffs could pursue their duty of loyalty claim. The court reiterated that plaintiffs were not seeking a per se rule and “only allege liability for certain forfeiture use under the circumstances presented here.” Defendants argued that the plan and government regulations authorized them to allocate the forfeitures as they did, but “[t]he mere fact that Defendants can make these allocations under the Plan is not mutually exclusive with the allegation that they were motivated by selfish purposes that breached their duty of loyalty. Further, the Court cannot create a presumption of loyalty based on a plan’s allowance of an action because ERISA’s duties ‘trump[] the instructions of a plan document.’” The court further ruled that there was harm to the plan, because expenses paid by plaintiffs left the plan, and that plaintiffs plausibly pled an anti-inurement violation because the benefit to defendants was not “incidental,” but instead “a direct benefit that motivated their actions.” The court also upheld its earlier ruling that plaintiffs had adequately pled a breach of the duty of monitoring against ITW and its board. However, the court dismissed plaintiffs’ co-fiduciary liability claim against the plan’s investment committee because “Plaintiffs do not allege how a breach by the Committee enabled a breach by ITW or the Board.” As a result, defendants’ motion was granted in part, but denied on the issues that mattered most: “Plaintiffs have sufficiently alleged that Defendants acted as fiduciaries, used forfeitures to reduce employer contributions instead of Plan expenses in violation of ERISA’s fiduciary duty of loyalty and anti-inurement provision, and harmed Plaintiffs through a loss of benefits.”

Eighth Circuit

Plesha v. Ascension Health Alliance, No. 4:24-CV-01459-CMS, 2026 WL 279321 (E.D. Mo. Feb. 3, 2026) (Judge Cristian M. Stevens). In this putative class action Jennifer L. Plesha challenges the tobacco surcharge provision in the ERISA-governed health benefit plan administered by her employer, Ascension Health Alliance. Under the plan, “any member who used tobacco products in the past three years was required to identify himself as a tobacco user during enrollment for the next year… Tobacco users were surcharged an additional $750 per year, or about $30 per paycheck.” However, tobacco users could avoid this surcharge by participating in a wellness program, which qualifies as a “reasonable alternative standard” under ERISA. Plesha paid the surcharge, and now brings three claims for relief. First, she claims that the plan violates ERISA, specifically 29 U.S.C. § 1182(b), because it does not provide the “full reward” for participating in the wellness program. Specifically, she contends that the plan does not provide a refund for the entire year if a participant completes the program. Second, she claims that Ascension “failed to provide the required notice of a reasonable alternative standard that would allow participants to avoid paying the tobacco surcharge for the entire plan year, as required by applicable regulations.” Third, she contends that Ascension breached its fiduciary duty by assessing the surcharge. Ascension filed a motion to dismiss. On Plesha’s first count, Ascension contended that “full reward” in the statute meant only that it had to remove the surcharge prospectively, not retroactively, and the court agreed. “Nothing in the text…suggests that that particular reward must be given retroactively, and Congress knew how to mandate retroactive reimbursement when it enacted the PHSA.” The court also stated that Plesha’s interpretation would “frustrate Congress’ stated purpose in creating the wellness program scheme” because withholding retroactive reimbursement would incentivize insureds to participate in the plan sooner. Plesha asked the court to “defer to the regulatory definition of ‘full reward’ found in the 2013 preamble” to the Department of Labor’s interpreting regulations, but the court declined because the statute was unambiguous, could not be overridden by regulation, and the court was not obligated to show the preamble or the regulations any special deference. (For a contrary view, see last week’s edition in which we summarized the court’s decision in Wilson v. Whole Food Market, Inc. that “to make available the ‘full reward’ to ‘all similarly situated individuals,’ a wellness program must provide retroactive reimbursements of all tobacco surcharges paid that Plan year.”) As for Plesha’s second claim, the court ruled that Plesha lacked Article III standing. The court determined that Plesha’s alleged injuries – not receiving proper notification – were “purely informational” and did not satisfy the concreteness requirement for standing. Plesha also did not allege how her behavior would have changed if she had received proper notice: “Put another way, Plaintiff would be in the exact same place with or without the purported defects in the notice.” Plesha’s third count met the same fate as the first two. The court agreed with Ascension that it did not breach any fiduciary duty because the plan complied with ERISA. The court also found that Ascension acted as a settlor, not a fiduciary, in creating and administering the plan. As a result, the court granted Ascension’s motion to dismiss in its entirety and dismissed the case with prejudice.

Ninth Circuit

Wit v. United Behavioral Health, No. 14-CV-02346-JCS, 2026 WL 290352 (N.D. Cal. Feb. 3, 2026) (Magistrate Judge Joseph C. Spero). This class action, originally filed in 2014, has a long and tortured history, including numerous Ninth Circuit rulings. (We covered the Circuit’s published 2023 decision as our case of the week in our August 30, 2023 edition.) The Westlaw history map says it all:

The decisions above the dotted line are from the Ninth Circuit. In the course of issuing those decisions, the Ninth Circuit significantly scaled back the district court’s extensive rulings against United Behavioral Health in which the district court found that UBH breached its fiduciary duty to health plan participants in its misuse of mental health guidelines to deny patient claims. The Ninth Circuit’s rulings left several issues open, however, and the district court tried to sort it all out in an August 5, 2025 order, as we explained in our August 13, 2025 edition. In that order the court acknowledged that the Ninth Circuit had eliminated parts of the plaintiffs’ breach of fiduciary duty claim, but ruled that other parts survived: “the Court’s findings as to the breach of the duty of care and the duty of loyalty are not intertwined with the erroneous interpretation of the Plans identified by the [Ninth Circuit] Panel and therefore, the Court’s judgment on the breach of fiduciary duty claim survives to the extent that it is based on those theories.” The district court further ruled that the fiduciary duty claim was not subject to exhaustion requirements, and even if it were, exhaustion would be excused as futile because of UBH’s uniform application of its guidelines. The court ordered the parties to meet and confer, and after further submissions, it issued this judgment. The court declared that UBH acted as a fiduciary under ERISA when it developed level of care guidelines and coverage determination guidelines for making coverage determinations, which were not terms of the class members’ plans. Those plans required services to be consistent with generally accepted standards of care (GASC), and UBH’s guidelines were used to interpret this requirement. However, although the class members “had a right, under ERISA and their plans, to have UBH adopt Guidelines that were developed solely in the interests of the class members and with care, skill, prudence, and diligence,” they “were deprived of this right” because the guidelines were “tainted by UBH’s financial interests and its lack of due care.” Furthermore, “UBH’s misconduct in developing and adopting its Guidelines was willful and systematic,” “affected the class members across-the-board,” and violated ERISA’s statutorily imposed duties of loyalty and care. The court noted that UBH’s guidelines “purport to be based on generally accepted standards of care.” However, the court compared the guidelines to the standards that “are generally accepted in the field of mental health and substance use disorder treatment and patient placement,” and concluded that UBH’s guidelines in fact “do not accurately reflect generally accepted standards of care. They are instead significantly and pervasively more restrictive than those standards. This defect is a direct result of UBH’s self-interest and lack of due care[.]” Among other failures, the court noted that UBH’s guidelines inappropriately emphasized acuity and crisis stabilization over effective treatment of underlying conditions, failed to address co-occurring conditions, did not address the unique needs of children and adolescents, and did not err on the side of caution for higher levels of care. The court further found that “UBH affirmatively misled regulators about its Guidelines” and violated the laws of Connecticut, Illinois, Rhode Island, and Texas in applying its too-strict guidelines. As a result, the court ruled that UBH “breached its fiduciary duties to the class members, including its obligations under 29 U.S.C. §§ 1104(a)(1)(A), and (a)(1)(B), when it developed, revised, and adopted the Guidelines.” The court imposed injunctive relief, (1) permanently enjoining UBH from using the invalidated guidelines to implement the GASC requirement in ERISA-governed plans, and (2) ordering UBH, in adopting criteria to interpret ERISA-related plans, to ensure that its criteria “accurately reflect GASC” and comply with state law. The second requirement will be in effect for the next five years, during which the court will maintain jurisdiction. Will UBH once again appeal to the Ninth Circuit? Given the history of this case, it would be astonishing if it did not. Either way, we will let you know of any further developments.

Class Actions

Sixth Circuit

Best v. James, No. 3:20-CV-299-RGJ, 2026 WL 357964 (W.D. Ky. Feb. 9, 2026) (Judge Rebecca Grady Jennings). In a case with one of the shortest names we have had the pleasure of covering here at Your ERISA Watch, plaintiffs Nathan Best, Matthew Chmielewski, and Jay Hicks have sued defendants ISCO Industries, Inc., James Kirchdorfer, and Mark Kirchdorfer. Plaintiffs have alleged various ERISA claims against defendants, including fiduciary breach and engaging in a prohibited transaction in connection with ISCO’s Employee Stock Ownership Plan (“ESOP”). In 2022, the court granted defendants’ motion to compel arbitration, and in 2023 it denied plaintiffs’ motion for reconsideration, in which plaintiffs argued that the effective vindication doctrine invalidated the operative arbitration provision. However, in 2024 the Sixth Circuit decided Parker v. Tenneco, in which it applied the effective vindication doctrine to strike down an arbitration provision similar to the one in this case. Based on Parker, plaintiffs filed another motion for reconsideration, and in 2025 the court granted it, agreeing that Parker was a change in controlling law that required it to vacate its prior order. Plaintiffs then filed a motion for class certification, seeking to certify a class of all persons who were participants in the ISCO ESOP when it sold its shares in 2018. The motion was unopposed and granted by the court in this order. The court marched through the Federal Rule of Civil Procedure 23(a) requirements: numerosity, commonality, typicality, and adequacy of representation. The proposed class consisted of over 400 participants, satisfying the numerosity requirement. Commonality was met as the case involved common questions of law and fact, such as whether the defendants breached fiduciary duties under ERISA. Typicality was satisfied because the plaintiffs’ claims arose from the same conduct affecting all class members. Adequacy of representation was confirmed as the plaintiffs had common interests with the class and were represented by qualified counsel. The court also considered Rule 23(b) requirements, determining that certification was appropriate under Rule 23(b)(1)(B) because the case involved ERISA fiduciary duty claims, which typically require plan-wide relief. This subsection was deemed suitable because adjudications for individual class members could affect the interests of others not party to the adjudications. Finally, under Rule 23(g), the court appointed Kaplan Johnson Abate & Bird LLP as class counsel, finding them qualified based on their experience and the work done in the case.

Disability Benefit Claims

Eighth Circuit

Jackson v. The Hartford Financial Servs. Grp., Inc., No. 4:25-CV-01329-JAR, 2026 WL 352912 (E.D. Mo. Feb. 9, 2026) (Judge John A. Ross). Lynette Jackson, a former employee of American Water, asserts that she filed a claim for disability benefits with The Hartford Financial Services Group in 2019 due to unspecified health conditions. She brought this pro se complaint against Hartford accusing it of bad faith and fraudulent practices, including underpaying her short-term disability benefits and incorrectly asserting that she lacked long-term disability coverage. Jackson alleged that these actions led to her termination from American Water in 2020, resulting in severe financial hardship and emotional distress. She seeks $300 million(!) in compensatory and punitive damages. Jackson brought claims under several state and federal laws, including ERISA, the Americans with Disabilities Act (ADA), the Rehabilitation Act, and the Family and Medical Leave Act (FMLA). Jackson filed a motion for leave to proceed in forma pauperis, the appointment of counsel, leave to amend, and to compel a ruling. The court quickly dismissed Jackson’s state law claims, ruling that because they “arise directly from the administration of her employee health plan, they are preempted” by ERISA. As for Jackson’s ERISA claims, the court ruled that “Jackson does not identify a particular disability, impairment, or medical condition, nor does she allege any facts describing functional limitations that would bring her condition within the plan’s definition of disability… Jackson’s allegation that she became ‘medically unable to work’…is a ‘naked assertion’ devoid of ‘further factual enhancement.’” This was insufficient under federal pleading standards and thus the court dismissed her ERISA claims. The court also dismissed Jackson’s other claims, ruling that (1) under the ADA and Rehabilitation Act she did not sue her former employer, American Water, but rather Hartford, and did not allege that Hartford discriminated against her based on her disability, and (2) under the FMLA she again did not allege that Hartford was her employer, which was necessary to establish a violation under the FMLA. As for Jackson’s motion to amend, the court determined that her proposed amendment would be futile because it did not address the deficiencies in her original claims or establish a new cause of action against Hartford. As a result, the court granted Jackson’s motion to proceed in forma pauperis but dismissed the action without prejudice for failing to state a plausible claim for relief.

Medical Benefit Claims

Second Circuit

Savage v. Rabobank Med. Plan, No. 24-2759-CV, __ F. App’x __, 2026 WL 303600 (2d Cir. Feb. 5, 2026) (Before Circuit Judges Calabresi, Raggi, and Lee). The plaintiff in this case is Sheri Savage, who is the executor of the estate of Cindy Sieden. The case revolves around Sieden’s daughter, J.S., who suffered from a severe eating disorder and mental health conditions. J.S. had been receiving treatment for her eating disorder since she was eight years old, including residential treatment and partial hospitalization. In 2016 J.S. was admitted to Avalon Hills Adolescent Treatment Facility. Sieden submitted claims for J.S.’ treatment at Avalon to United Behavioral Health (UBH), the mental health claims administrator for the Rabobank Medical Plan, under which J.S. was a covered dependent. Initially, UBH approved her claims, but as of February 2017, UBH determined that J.S. no longer met the criteria for partial hospitalization or residential care and denied further coverage. Appeals were unsuccessful, and UBH did not respond to post-service claims from Avalon, so Savage brought this action. On cross-motions for summary judgment, the district court applied an arbitrary and capricious standard of review because the plan conferred discretion on UBH. The court affirmed UBH’s use of its level of care guidelines and held that Avalon’s post-service submission functioned as an additional appeal rather than a new claim requiring a merits determination, thus not altering the standard of review. The court ultimately ruled that UBH’s denials were not an abuse of discretion. (Your ERISA Watch covered this ruling in our October 9, 2024 edition.) Savage appealed to the Second Circuit, which issued this unpublished opinion. On appeal, Savage argued that (1) the district court was bound by findings made in Wit v. United Behavioral Health regarding UBH’s level of care guidelines (see above for the latest installment in the Wit case), (2) UBH’s denials were arbitrary and capricious, and (3) Avalon’s post-service claims were subject to de novo review and were supported by unrebutted medical evidence. The Second Circuit rejected all three arguments. First, the court ruled that the collateral estoppel argument regarding Wit was forfeited because it was not raised in the district court; instead, Savage had used the Wit ruling “more generally as persuasive authority.” Furthermore, the Second Circuit noted that the Ninth Circuit in Wit did not require UBH’s level of care guidelines to be coextensive with generally accepted standards of care. As for the denial of benefits, the court acknowledged there was evidence in support of both sides as to the medical necessity of J.S.’ treatment. However, “[g]iven the substantial deference afforded to ERISA administrators, the record here does not overcome the requisite standard to warrant overturning the denial of benefits.” Finally, the Second Circuit rejected Savage’s arguments regarding the post-service claim, noting that “voluntary appeals” are not subject to “ERISA safeguards” and thus the claim did not require de novo review. The court further stated that the “post-service submission appears to largely repackage claims for services that had already been denied with overlapping dates.” As a result, the court upheld the district court’s rulings on the post-service submission as well, and affirmed the judgment below. (Disclosure: Kantor & Kantor represented Ms. Savage in this action.)

Seventh Circuit

R.S. v. Quartz Health Benefit Plans Corp., No. 22-CV-418-WMC, 2026 WL 309629 (W.D. Wis. Feb. 5, 2026) (Judge William M. Conley). Plaintiff R.S. was a participant in an employee health benefit plan insured and administered by Quartz Health Benefit Plans, and his son, A.S., was a covered dependent under the same plan. A.S. has a history of behavioral and mental health difficulties from an early age, including diagnoses of attention deficit hyperactivity disorder and “extreme” oppositional defiant disorder. A.S. was failing his school classes, had suicidal thoughts, used drugs, and stole from his parents. “When confronted, A.S. also attacked his father, destroyed parts of his car, and threatened to have his friends kill him.” A.S.’ therapist recommended inpatient treatment, so A.S. was admitted to Triumph Youth Services, a residential mental health facility in Utah. Quartz initially covered A.S.’ treatment at Triumph for 34 days but later denied further coverage, stating that continued residential treatment was not medically necessary. Appeals were unsuccessful, so R.S. filed this action, alleging that Quartz violated ERISA by denying coverage for A.S.’ treatment, and violated the Mental Health Parity and Addiction Equity Act. The parties filed cross-motions for summary judgment. R.S. acknowledged that the benefit plan gave Quartz discretionary authority to make benefit determinations, but argued that because of Quartz’s procedural violations, it had forfeited any deference. The court decided it “need not resolve this dispute because, as discussed below, defendant’s decision denying benefits was arbitrary and capricious under even the more deferential standard.” The court found that Quartz did not provide a full and fair review because it did not give its medical review report to R.S. until litigation, even though ERISA’s claim procedure regulation required it to do so before denying the appeal. The court further ruled that Quartz erred by failing to consider A.S.’ severe substance abuse disorder. Quartz never addressed his substance abuse in any of its reports or denials, and “[g]iven its length and comorbidity, defendant’s failure to address plaintiff’s substance abuse disorder as powerful evidence supporting his need for ongoing, residential treatment was arbitrary and capricious.” The court rejected Quartz’s contentions that (1) A.S.’s substance abuse was not a focus of his treatment, finding that this was belied by the record, and (2) Quartz considered the substance abuse by implication even if it never directly discussed it. “[A] vague reference that all records were reviewed is not sufficient under the circumstances here, in which plaintiff asked specifically and repeatedly that defendant consider his substance abuse treatment needs on appeal, just as his primary care providers did at Triumph.” The court thus granted R.S.’ motion, and remanded the case to Quartz for further findings and explanations. R.S. had less luck with his Parity Act claim. R.S. contended that the plan violated the Parity Act because it required “acute” symptomatology for mental health coverage while the analogous skilled nursing plan provisions did not. The court seemed sympathetic to the argument; a comparison “appears to support plaintiff’s assertion.” However, the court ruled that the claim, as presented, was “poorly developed” and that R.S. did not address several of Quartz’s arguments in opposition. As a result, the court denied R.S.’ motion as to his Parity Act claim. However, the court stated that on remand Quartz “should consider whether its review of plaintiff’s claim satisfies the concerns raised by the court and plaintiff under the Parity Act, as the court’s decision is not intended to foreclose plaintiffs from raising a new as-applied challenge under the Parity Act to a new decision by defendant.”

Pension Benefit Claims

Second Circuit

Dimps-Hall v. Employee Benefit Plan Administration Committee HSBC-North America, No. 25-CV-00421 (LJL), 2026 WL 305485 (S.D.N.Y. Feb. 5, 2026) (Judge Lewis J. Liman). In this action Shirley A. Dimps-Hall seeks benefits under the Manhattan Savings Bank (MSB) pension plan. She alleges that a temporary agency placed her at MSB in 1982, but she was hired as a full-time employee by MSB in 1983, and was a permanent employee of MSB from that year until April of 1991, when she retired as Senior Bookkeeper. Before she retired, MSB was taken over by Republic National Bank of New York. Republic was, in turn, acquired by HSBC in 1999. In 2023, Dimps-Hall submitted a claim contending she was entitled to pension benefits beginning in 2019, when she turned 65, pursuant to her employment at MSB and Republic. HSBC denied her claim. HSBC stated that under the Republic pension plan, which was in effect at the time of Dimps-Hall’s retirement, participants were eligible for benefits if they had “completed at least 5 RNB Years of Service.” Active participants in the MSB plan when MSB was taken over by Republic were given credit for their employment at MSB. However, “HSBC’s records, including IRS Employee Census Reports for the Retirement Plan of the Manhattan Savings Bank…from 1988, 1989 and 1990, reflect that you were first hired by MSB on July 20, 1987.” As a result, HSBC told Dimps-Hall that she did not have five years of vesting service when she retired in 1991, and was not eligible for benefits. Dimps-Hall unsuccessfully appealed this decision and then filed this pro se action against HSBC. HSBC moved to dismiss. The court noted that the plan gave HSBC discretionary authority to determine eligibility for benefits, and thus the arbitrary and capricious standard of review applied. The court agreed with HSBC that it was appropriate for HSBC to rely on its records in denying Dimps-Hall’s claim because such reliance “promotes uniformity, predictability, and efficiency. Those features, in turn, protect all participants as a group. They help ensure that benefits are calculated according to the same rules for everyone, that the Plan can be funded and administered at a reasonable cost, and that assets are reserved for the benefits promised under the Plan rather than spent on repeated reconstruction of decades-old employment histories whenever a dispute arises.” Thus, “It is not enough to allege that other records might exist somewhere, or that further searching might yield a different picture.” As a result, the court ruled that Dimps-Hall had not plausibly pled that HSBC abused its discretion. HSBC had relied on its records in making the decision, and “[t]he fact that Plaintiff believes those records to be incomplete, or believes that other documents might exist that would support her view of her employment history, does not by itself render the Committee’s decision arbitrary and capricious, particularly where the Plan expressly permits the Committee to ‘conclusively rely’ on those records.” The court further rejected Dimps-Hall’s contention that she should be allowed to conduct discovery to find supporting evidence of her employment, noting that discovery beyond the administrative record is typically not allowed. Furthermore, because the plan allowed HSBC to “conclusively rely” on its records, “even if there existed documents in the bowels of the bank that would tend to show that Plaintiff was a full-time, salaried employee prior to 1987, that would not make the Committee’s decision arbitrary and capricious.” The court then quickly disposed of Dimps-Hall’s remaining claims, ruling that (1) she was not a plan participant and thus could not sue for statutory penalties, and in any event HSBC responded appropriately to her inquiries, (2) her breach of fiduciary duty claim was duplicative of her claim for benefits, and (3) she did not have a private right of action to sue for violations of Department of Labor regulations. The court further struck her jury demand as there is no right to a jury trial in ERISA benefit actions. The court thus granted HSBC’s motion in full, and dismissed Dimps-Hall’s complaint with prejudice, ruling that it would be futile to allow her to amend.

Sixth Circuit

Alliance Coal, LLC v. Smith, No. 0:26-CV-10-REW-EBA, 2026 WL 353029 (E.D. Ky. Feb. 9, 2026) (Judge Robert E. Wier). This is an interpleader action initiated by Alliance Coal, LLC, concerning the distribution of retirement plan benefits following the death of Constance Smith, a long-time employee of Excel Mining, LLC, a subsidiary of Alliance Coal. In 2007 Constance designated Dusty L. McCoy, her second cousin, as the primary beneficiary of her account in Alliance Coal’s 401(k) retirement plan, which was managed by INTRUST Bank. After Constance’s death in December 2024, her brother, Larry Smith, contested this designation, presenting a beneficiary form dated February 21, 2024, which allegedly named him as the sole beneficiary. Larry claimed that Constance did not file this form due to misrepresentations by INTRUST Bank representatives, who allegedly told her that she did not need to update her beneficiary designation. Alliance Coal thus filed this action to allow the court to determine who was the proper beneficiary. Larry responded by filing counterclaims against Alliance Coal and McCoy, alleging breach of fiduciary duty, equitable estoppel, reformation of plan documents, and breach of plan requirements under ERISA. McCoy and Alliance Coal filed motions to dismiss. Addressing the Alliance Coal motion first, the court held that Larry could not obtain individual relief under ERISA § 502(a)(2) because his claims did not benefit the plan as a whole. Additionally, his claims under ERISA § 502(a)(3) failed because he did not adequately allege that Alliance Coal made any misrepresentations, or that INTRUST Bank’s actions could be attributed to Alliance Coal. (The court noted that INTRUST Bank, although named by Larry as a counter-defendant, had not appeared in the case and Larry conceded that INTRUST Bank was not a target of his claims.) Furthermore, Larry could not bring a breach of plan requirements claim under ERISA § 502(a)(1)(B) because he “does not identify a plan provision entitling him to the disputed benefits… Rather, he argues that he should be entitled to the disputed benefits on account of Ms. Smith’s intent and the communications history… He fails to highlight any plan provision that Alliance Coal itself has broken[.]” The court further ruled that Larry could not pursue a surcharge remedy because of Sixth Circuit precedent, and was not entitled to a jury trial. Thus, the court granted Alliance Coal’s motion in its entirety, with prejudice. This ruling rendered McCoy’s motion to dismiss moot, so the court did not discuss it in any detail, other than to note that Larry’s counterclaims did not allege any facts supporting a claim against her, and were primarily directed at Alliance Coal. The dismissal was with prejudice.

Pleading Issues & Procedure

Second Circuit

Sacerdote v. Cammack Larhette Advisors, LLC, No. 17-CV-8834 (AT) (VF), 2026 WL 350842 (S.D.N.Y. Feb. 9, 2026) (Magistrate Judge Valerie Figueredo). This is a long-running action in which employees of New York University allege that Cammack Larhette Advisors, LLC, the investment advisor to the plans, breached its fiduciary duty by providing imprudent advice, resulting in substantial losses to the plans. (The Second Circuit’s ruling reviving this case was the notable decision in our October 8, 2019 edition.) Before the court here was plaintiffs’ motion to join CapFinancial Group, LLC as a party under Federal Rule of Civil Procedure 25(c). “Plaintiffs contend that Cammack transferred its assets, operations, and personnel to CapTrust following an acquisition that occurred in February 2021… More specifically, Plaintiffs argue that CapTrust is the successor-in-interest to Cammack because it substantially continued Cammack’s business operations, personnel, and client relationships, and CapTrust had actual or constructive notice of Plaintiffs’ claims against Cammack at the time of the acquisition.” CapTrust opposed plaintiffs’ motion, arguing it was untimely under the court’s scheduling order, and thus plaintiffs had to show “good cause” to amend under Federal Rule of Civil Procedure 16. CapTrust also argued that ERISA forecloses successor liability for breaches of fiduciary duty. The court concluded that plaintiffs did not have to show good cause under Rule 16 because that requirement did not apply to Rule 25(c) motions. The court noted that substitution under Rule 25(c), unlike under Rule 16, “does not alter the claims and ‘[t]he merits of the case and the disposition of the property are still determined with respect to the original parties.’” In short, “Imposing a good-cause requirement on Rule 25(c) motions is nonsensical given the purpose served by the rule. Substitution is not mandatory and, even if a party does not seek substitution, the judgment will be binding on a successor-in-interest. The Rule simply serves as a mechanism to simplify the action and expedite the ultimate resolution.” The court further ruled that even if Rule 16 applied, it would not bar plaintiffs’ motion because CapTrust did not demonstrate that it would be prejudiced by the substitution (although the court noted that plaintiffs “unduly delayed” filing their motion to add CapTrust as a party). Finally, the court addressed whether ERISA bars successor liability for claims of breach of fiduciary duty. CapTrust argued that Section 409(b) of ERISA precludes successor liability, but the court noted that courts have applied successor liability in the ERISA context, particularly for withdrawal liability and delinquent contributions. The court found that ERISA’s purpose supports applying successor liability to breaches of fiduciary duty, as it aligns with the statute’s goals of protecting employee interests. The court directed CapTrust to submit a letter identifying specific factual allegations that it contends are disputed, and for which an evidentiary hearing regarding successor liability might be necessary, by March 2, 2026.

Eighth Circuit

Meilstrup v. Standing Rock Sioux Tribe, No. 1:25-CV-162, 2026 WL 352690 (D.N.D. Feb. 9, 2026) (Judge Daniel L. Hovland). Daniel Meilstrup worked at Prairie Knights Casino in North Dakota as the Chief Executive Officer and General Manager. The casino is owned and operated by the Standing Rock Sioux Tribe. Meilstrup initiated this action to challenge the casino’s actions in mishandling his termination, which caused delays and disruptions to his wife’s medical care. He has alleged claims under ERISA and common law against the Standing Rock Sioux Tribe and related defendants. In our October 15, 2025 edition, we covered the court’s order denying defendants’ motion to dismiss as to Meilstrup’s ERISA claim, which ruled that (1) Meilstrup’s claim was properly pled, (2) defendants’ operation of a non-governmental plan waived their sovereign immunity as to the claim, and (3) the tribal court did not have jurisdiction over the claim. Now the Tribe has brought a motion to stay the proceedings while the tribal court handles non-ERISA issues relating to Meilstrup’s termination, contending that a stay is warranted under federal abstention doctrine. “Abstention is a judge-made doctrine that allows a federal court to abstain from exercising its jurisdiction when parallel state court proceedings are pending and doing so would result in the conservation of judicial resources.” The court made short work of the motion. The court noted that “a federal district court must exercise its jurisdiction over claims unless there are ‘exceptional circumstances’ for not doing so,” and “[w]here jurisdiction to hear a case exists, a federal court’s ‘obligation’ to hear and decide a case is ‘virtually unflagging.’” The court ruled that defendants could not overcome this high bar: “no exceptional circumstances in this case that warrant a stay.” The court acknowledged that defendants disagreed with its prior ruling on their motion to dismiss, but “[t]he Defendants cannot evade the Court’s prior order finding that tribal courts lack jurisdiction over ERISA claims. Any ERISA claim purportedly raised in the Tribal Court litigation does not deprive this Court of its jurisdiction, nor does it provide reason for this Court to abstain from exercising its jurisdiction while a court that lacks jurisdiction rules on the issue. A stay would be futile because the Tribal Court plainly lacks jurisdiction over Meilstrup’s ERISA claim. Any rulings from the Tribal Court pertaining to Meilstrup’s ERISA claim have no effect on this case.” Furthermore, staying the case “would cause unnecessary delay and would prejudice the Plaintiff.” As a result, the court denied defendants’ motion to stay.

Provider Claims

First Circuit

Abira Medical Laboratories, LLC v. Blue Cross Blue Shield of R.I., No. 24-CV-475-MRD-PAS, 2026 WL 353339 (D.R.I. Feb. 9, 2026) (Judge Melissa R. DuBose). As Your ERISA Watch readers know, Abira Medical Laboratories, d/b/a Genesis Diagnostics, is a medical testing business that has filed dozens of actions across the country in the last few years alleging underpayment by health insurers. In this action Genesis has alleged that it performed various testing services for patients who were insured by Blue Cross Blue Shield of Rhode Island (BCBSRI). Genesis claims that these patients assigned their insurance benefits to it, creating a contractual obligation for BCBSRI to reimburse Genesis for the services rendered. However, BCBSRI allegedly failed to respond to claims, fabricated reasons to refuse payment, and underpaid other claims, resulting in a claimed debt approaching $1.8 million. Genesis filed a complaint against BCBSRI asserting claims under ERISA and state law. BCBSRI moved to dismiss, arguing that Genesis failed to identify any specific insurance contract or provision entitling it to reimbursement. BCBSRI also contended that Genesis’ claims were barred by anti-assignment provisions in the health plans and were time-barred. Addressing Genesis’ ERISA claim first, the court ruled that it was insufficiently pleaded because Genesis did not identify any specific ERISA plan or provisions entitling it to benefits. The court acknowledged that “some courts have been sympathetic to the concern raised by [Genesis], specifically its claim that they have no access to any health plans prior to filing their Complaint.” However, the court still found Genesis’ allegations far too vague. The court noted that the complaint lacked details about the ERISA plans, such as the intended benefits, class of beneficiaries, and procedures for receiving benefits. Furthermore, the court was unconvinced by Genesis’ argument that discovery was necessary in order to obtain more detailed plan information. The court noted that Genesis received assignments of benefits “which presumably includes the right to access the patients’ plan.” Furthermore, “this Court views [Genesis’] predicament as self-inflicted because it never sought to secure the Plans from their patients upon receiving the requisitions of laboratory testing, failed to plead any attempts to retrieve Plan documents directly from BCBSRI, and refused to engage in the process outlined by this Court – designed to have the Plans produced – after BCBSRI filed its initial motion to dismiss.” As a result, the court granted BCBSRI’s motion to dismiss Genesis’ ERISA claim. The court ruled against Genesis on its state law claims as well for various reasons, and thus granted BCBSRI’s motion to dismiss in its entirety and entered judgment in its favor.

Fourth Circuit

Abira Medical Laboratories, LLC v. Anthem Health Plans of Virginia, Inc., No. 3:25CV108 (RCY), 2026 WL 281172 (E.D. Va. Feb. 3, 2026) (Judge Roderick C. Young). In our second case involving Genesis this week, it sued Anthem Health Plans of Virginia, Inc. for services it provided based on requisitions that included an assignment of benefits provision. Genesis claims that Anthem failed to pay for these services, resulting in damages approaching $3 million. In its complaint Genesis alleged four counts: (1) violation of ERISA, (2) breach of contract, (3) breach of the implied covenant of good faith and fair dealing, and (4) actual and constructive fraud. Anthem filed a motion to dismiss, which the court ruled on in this order. The court denied the motion as to Genesis’ ERISA claim, ruling that Genesis sufficiently alleged standing through valid assignments of benefits from Anthem’s insureds. The court observed, “The Fourth Circuit has not defined what constitutes a ‘valid’ assignment for purposes of assessing derivative standing; the last time it appears to have even considered the concept was in 2008.” However, the court noted that “courts within the Fourth Circuit have held that Plaintiffs generally need not plead specific language of assignment for purposes of showing derivative standing.” Based on those cases, and decisions from other circuits, the court found that the following allegations by Genesis were sufficient: “medical service providers submitted requisitions for lab services to Plaintiff,” “those requisitions contained an assignment of benefits from Defendant’s insureds to Plaintiff,” “Defendant’s insureds executed the assignment(s),” and “the assignments… specifically assigned the right of payment and the right to pursue and collect such payments to Plaintiff.” The court noted that the alternative was a “tidal wave of piecemeal litigation which would bog down courts across this country and in no way benefit the ERISA plan participants.” The court also rejected Anthem’s arguments that Genesis’ claim was too thinly pled and that it failed to plead exhaustion. The court cited the Fourth Circuit’s “high-level” approach to pleading, which “recognize[s] plaintiffs’ difficulty obtaining plan documents at the early stages of litigation,” thus justifying some level of vagueness in referring to operative plan provisions. As for exhaustion, the court noted that the Fourth Circuit “has not ruled on whether administrative exhaustion is something that must be pleaded in the first instance, as Defendant argues, or an affirmative defense with the onus of proof on the Defendant, as Plaintiff argues.” However, the court sided with the latter, “in line with the positions of the Second, Third, and Fifth Circuits,” thus ruling that Genesis did not have to plead around the exhaustion defense, and leaving the issue for another day. The court then turned to Genesis’ state law claims. It denied Anthem’s motion as to the claims for breach of contract and breach of the implied covenant of good faith and fair dealing, ruling that Genesis plausibly alleged a legally enforceable obligation, a breach of that obligation, and resulting damages. (However, the court indicated that Genesis might not be able to pursue both claims if they were factually duplicative by the summary judgment stage.) The court granted Anthem’s motion as to Genesis’ fraud claim, finding that Genesis’ “general, conclusory, and anonymous allegations regarding its course of dealing with Defendant and/or Defendant’s ‘representatives’ are insufficient to state a claim for fraud under either Virginia law or [Federal Rule of Civil Procedure 9(b)].” Finally, Anthem argued in its motion that Genesis had improperly combined 2,170 claims for services rendered to over 1,000 patients into one action. The court “appreciate[d] Defendant’s concern for its case management capabilities,” but ruled that Genesis’ claims were proper under Federal Rule of Civil Procedure 18, which gives a plaintiff the “freedom to assert as many claims as the plaintiff chooses.” The court admitted that the number of claims was “certainly a large number,” but they were still “related” and thus Genesis, as “the master of the complaint,” could combine them. Plus, “Defendant does not acknowledge the alternative to permitting Plaintiff to bring all its claims together, i.e., that the Court would be inundated with duplicative, claim-by-claim litigation.” Thus, “the Court will not sever and dismiss the claims underlying Plaintiff’s Complaint simply because Defendant is daunted by the discovery process.” As a result, Anthem’s motion was largely unsuccessful, as it was only able to eliminate one of Genesis’ claims and failed to break up the lawsuit.

Retaliation Claims

Sixth Circuit

Tascarella v. Aptiv US General Services Partnership, No. 4:26-CV-0024, 2026 WL 294962 (N.D. Ohio Feb. 4, 2026) (Judge Benita Y. Pearson). In September of 2025 defendant Aptiv US General Services Partnership (the American subdivision of a Swiss automotive technology supplier), offered Daniel Tascarella a job as the plant manager of its Ohio facility. He began work on September 29, but only worked two days before stopping due to health issues and taking a medical leave of absence. From its conversations with Tascarella, which included Tascarella informing Aptiv that he was on a liver transplant recipient list, Aptiv concluded that his absence would be lengthy and chose to terminate him as of December 31, offering him a severance agreement. On the date of his termination, Tascarella filed this action in state court alleging six claims: ERISA interference, promissory estoppel, fraud in the inducement, unilateral contract, disability discrimination, and unlawful retaliation. Tascarella also sought a temporary restraining order (TRO) and a preliminary injunction seeking the continuance of his healthcare and employment benefits. The state court initially granted an ex parte TRO, after which Aptiv removed the case to federal court. In this order the court considered Tascarella’s motion for a preliminary injunction, addressing the four required elements: “(1) the movant has a strong likelihood of success on the merits; (2) the movant would suffer irreparable injury without injunctive relief; (3) granting injunctive relief would cause substantial harm to others; and (4) the public interest would be served by granting injunctive relief.” First, the court found that Tascarella was unlikely to succeed on the merits of his ERISA retaliation claim. At the outset, it was unclear whether ERISA governed his short-term disability benefits; Aptiv contended that these benefits were a “payroll practice” exempt from ERISA. Furthermore, the court found that Tascarella was only able to show “at best, an inference of retaliation or improper termination.” The court was more persuaded by Aptiv, which contended that its decision to terminate Tascarella’s employment was based on business needs – i.e., keeping its Ohio factory operational – and not on any intent to interfere with ERISA benefits. On the “irreparable injury” prong, the court determined that Tascarella had not met his burden because he remained insured under COBRA and was eligible for Social Security and Medicare. The court noted that the benefits at risk were monetary in nature, and thus victory at trial would remedy any harms Tascarella might suffer. The court ruled that the remaining two factors also did not favor Tascarella. “Granting injunctive relief under these circumstances – absent a showing of Aptiv’s specific intent to avoid ERISA liability – would mean that ‘every employee discharged by a company with an ERISA plan would have a claim under § 510.’” Furthermore, “there are…reasons justifying employer decisions – however difficult or emotionally fraught they may be – to terminate an employee unable to perform the duties for which they were hired.” Thus, the public interest was not served by issuing an injunction. As a result, the court denied Tascarella’s motion for a preliminary injunction and the case will proceed as usual.

Statute of Limitations

Third Circuit

Hamrick v. E.I. du Pont De Nemours & Co., No. CV 23-238-JLH-LDH, 2026 WL 353624 (D. Del. Feb. 9, 2026) (Magistrate Judge Laura D. Hatcher). This case involves two class action complaints filed under ERISA against E.I. du Pont de Nemours and Company and related defendants. In one complaint plaintiffs Mary J. Hamrick, David B. Beckley, and Valentin Rodriguez contend that defendants “improperly reduced [Income-Leveling Option (“ILO”)] benefits for participants and beneficiaries below the amounts that they would receive if those benefits had been calculated using the Treasury Assumptions in violation of ERISA § 205(g).” They claim defendants used an outdated formula with a higher interest rate and an antiquated mortality table. In the second, James M. Manning contends that defendants “improperly reduced [Spouse Benefit Options (“SBOs”)] for participants and beneficiaries of the Plan below the amounts that they would receive if those benefits were actuarially equivalent to a [single life annuity (“SLA”)] in violation of ERISA § 205(d).” Again, outdated mortality tables were the alleged culprit. Defendants initially filed a motion to dismiss, contending, among other arguments, that plaintiffs’ claims were time-barred. The court denied this motion because defendants did not establish when plaintiffs’ claims accrued. According to the court, defendants did not meet their burden of demonstrating when the plaintiffs were on notice that their benefit calculations were wrong. (Your ERISA Watch covered this decision in our February 7, 2024 edition.) Defendants filed a motion for summary judgment in which they took a second swing at the timeliness argument. They argued that plaintiffs’ claims were subject to a one-year statute of limitations under 10 Del. C. § 8111; plaintiffs responded that laches, rather than a statute of limitations, should govern the timeliness of their claims. Relying on Third Circuit precedent, the court agreed that § 8111 (which governs claims for wages or salary) applied because it was the state law most analogous to plaintiffs’ claims regarding their benefits. Plaintiffs argued that they sought equitable relief, not the recovery of benefits, and that laches should apply. However, the court found that plaintiffs’ claims for increased benefits were legal in nature because they sought monetary relief. Even if the claims were equitable, laches would not exclude the statute of limitations as an affirmative defense. This left the question of when plaintiffs’ claims accrued. Defendants contended that “Plaintiffs’ claims accrued in 2019 when they made their pension elections, received documents from Defendants ‘making them aware of the material facts underlying their claims’ and, thereafter were not diligent in ensuring the accuracy of their benefit awards.” Meanwhile, plaintiffs contended that “documents they received did not amount to a ‘clear repudiation’ of their benefits and accordingly, they could not have reasonably discovered any actionable harm.” The court found this issue “a close call” and concluded that summary judgment was not warranted because there was a “genuine dispute of material fact regarding Plaintiffs’ diligence.” The court agreed with defendants that plaintiffs’ claims were repudiated when they were informed of their benefit amounts, but was not convinced the repudiations were “clear and made known” to plaintiffs because correspondence was ambiguous as to which assumptions defendants were using in calculating benefits. The magistrate judge thus recommended denying defendants’ motion for summary judgment without prejudice, allowing them to raise timeliness for a third time at trial.

Seventh Circuit

Garippo v. Skokie Valley Air Control Inc., No. 24-CV-03346, 2026 WL 296391 (N.D. Ill. Feb. 4, 2026) (Judge John Robert Blakey). Robert Garippo and Michael Garippo are former employees of Skokie Valley Air Control Inc. (SVAC) who filed this action against SVAC and their father (William Garippo) and uncle (Tony Garippo), who were executives at the company. Plaintiffs raised two disputes in their complaint. First, they contended that in 2011 Tony told them they could no longer contribute to SVAC’s retirement plan due to insufficient participants, which was untrue, as other employees continued to contribute. “No one told Plaintiffs that Tony’s statement was false or otherwise corrected this information about Plaintiffs’ eligibility to contribute to the Plan.” Second, plaintiffs contend that around 2005, Tony and William entered into a shareholders’ agreement that gave plaintiffs a right of first refusal to purchase the company if it ever went up for sale. In 2023 SVAC was purchased by another company, but plaintiffs allegedly were never informed of the offer or given an opportunity to match it. Plaintiffs alleged three claims for relief. The first was for breach of fiduciary duty under ERISA, and the other two claims relating to the sale of the company were brought under state law. Defendants moved to dismiss all three claims, contending first that plaintiffs’ ERISA claim was time-barred. The court agreed. The court explained that an ERISA claim for breach of fiduciary duty expires “six years after (A) the date of the last action which constituted a part of the breach or violation, or (B) in the case of an omission the latest date on which the fiduciary could have cured the breach or violation.” There is an exception for “fraud or concealment,” which delays the clock from starting until “the date of discovery of such breach or violation.” Here, because plaintiffs brought suit 13 years after they were allegedly told in 2011 that they could not contribute to the plan, they needed to satisfy the fraud or concealment exception. However, the court noted that this exception requires a plaintiff to show “actual concealment” or “‘steps taken by wrongdoing fiduciaries to cover their tracks.” Here, “Plaintiffs merely state that no one at SVAC told them the truth; the Complaint does not plead any fact reflecting actions of actual concealment. Without more, Plaintiffs’ allegations remain insufficient to trigger the fraud or concealment exception.” As a result, plaintiffs’ clock expired in 2017, and their ERISA claim was too late. As for plaintiffs’ state law claims, the court ruled that it did not have subject matter jurisdiction over them, and dismissed them without prejudice. Thus, defendants’ motion to dismiss was granted in its entirety and the case was terminated.