Beard v. Lincoln Nat’l Life Ins. Co., No. 25-2950, __ F.4th __, 2026 WL 1279959 (8th Cir. May 11, 2026) (Before Circuit Judges Shepherd, Erickson, and Grasz)

This week’s notable decision represents the latest foray by the federal courts into the Serbonian Bog of “just what is an accident anyway?” The Eighth Circuit declined to wade in very far and instead deferred to the interpretation of the plan’s claim administrator. As a result, the rest of the case was a foregone conclusion.

The plaintiff was Tina D. Beard, who was married to Edward Beard. Mr. Beard was a participant in an ERISA-governed accidental death and dismemberment (AD&D) plan sponsored by his employer. At the time of his death Mr. Beard was suffering from stage IV pancreatic cancer. The cancer and his chemotherapy treatments caused side effects such as generalized weakness, chronic diarrhea, and an elevated risk of blood clots. To mitigate the risk of blood clotting, Mr. Beard took a blood thinner.

On December 16, 2022, Mr. Beard fell and hit his head while rushing to the bathroom. Although a CT scan conducted at the emergency room showed normal results, Mr. Beard became unresponsive the following morning, leading to a second CT scan that revealed a large subdural hematoma compressing his brain. He died the next day.

Mrs. Beard submitted a claim for benefits under the AD&D plan to the plan’s insurer and claim administrator, Lincoln National Life Insurance Company. The plan provided that benefits were payable when an insured “suffers a loss solely as the result of accidental Injury that occurs while covered.” “Injury” was defined as “bodily impairment resulting directly from an accident and independently of all other causes.” Furthermore, the plan excluded coverage “for any loss that is contributed to or caused by…disease, bodily or mental illness (or medical or surgical treatment thereof).”

Lincoln denied Mrs. Beard’s claim, contending that Mr. Beard “did not suffer a loss solely as the result of an accidental injury independently of all other causes,” and that coverage was excluded because the blood thinner Mr. Beard was taking “contributed to the subdural hematoma[.]” Lincoln supported these conclusions with reports from two physicians, who examined Mr. Beard’s medical records and determined that Mr. Beard’s “blood thinner usage contributed to the subdural hematoma that caused his death.”

Mrs. Beard then filed this action in the United States District Court for the Southern District of Iowa under ERISA Section 1132(a)(1)(B), seeking payment of the benefits at issue. Lincoln filed a motion for judgment, which was referred to a magistrate judge. The magistrate judge recommended that Lincoln’s motion be granted, and the assigned Article III judge (Hon. Rebecca Goodgame Ebinger) agreed, overruling Mrs. Beard’s objections.

Mrs. Beard then appealed to the Eighth Circuit, which issued this published opinion. The court reviewed Lincoln’s decision for abuse of discretion because the plan granted Lincoln discretion to construe its terms and determine benefit eligibility. Under this standard, the court explained that it was required to uphold Lincoln’s decision if it was reasonable and supported by substantial evidence.

The court examined both of Lincoln’s reasons for denying Mrs. Beard’s claim, declaring, “We agree with Lincoln Life on both issues.” First, the court stated that Mrs. Beard had the burden to prove that her claim should be covered, and thus she was obligated to show that Mr. Beard suffered a loss “solely as the result of accidental injury, independently of all other causes.” This meant that Mrs. Beard had to prove that “the injury that caused Mr. Beard’s death resulted directly from his fall.”

The Eighth Circuit agreed with the district court that Mrs. Beard did not meet her burden. Lincoln’s denial letter explained that Mr. Beard’s blood thinner usage contributed to his hematoma, Mrs. Beard “did not come forward with any contrary evidence while her claim was before Lincoln Life,” and she conceded in her appellate briefing that the blood thinner probably did contribute to the hematoma. As a result, “because Mrs. Beard did not show Mr. Beard’s hematoma was caused by his fall, independently of all other causes, her claim was not covered.”

As for the plan’s exclusion for “disease, bodily or mental illness,” the Eighth Circuit noted that the burden shifted to Lincoln on this issue because “’when the administrator of an ERISA plan denies a claim based on an exclusion, it ‘has the burden of proving that the exclusion applies.’”

The court noted that “Mrs. Beard states in her brief that she ‘has no objection’ to Lincoln Life interpreting ‘contribute’ as ‘to give or furnish along with others towards bringing about a result.’” As a result, the “the only thing left for us to decide is whether Lincoln Life supported its conclusion that Mr. Beard’s blood thinner usage contributed to his death with substantial evidence.”

The court concluded that Lincoln had met its burden. Lincoln had relied on reports from its two physicians, both of whom “expressly concluded Mr. Beard’s blood thinner usage contributed to his death.” These doctors noted that subdural hematomas “mainly occur” in people who use blood thinners “because blood clots less easily and any bleeding…is likely to be more severe.” In such scenarios, “the outcome is likely to be worse, the risk of death doubles, and the hematoma is more likely to expand.” As a result, the court found that “a reasonable mind might accept” these opinions “‘as adequate to support [Lincoln Life’s] conclusion’ that Mr. Beard’s blood thinner usage gave or furnished along with his fall toward bringing about his death.”

Mrs. Beard contended that Lincoln’s evidence “only showed Mr. Beard’s blood thinner usage contributed to his hematoma, not his death,” but the court found that this argument “misses the mark for two reasons.” First, even if the court was not employing a deferential review, Mrs. Beard’s argument “invites us to conflate contributed to with something like effective cause.”

Second, under deferential review “we can only review for abuse of discretion and ‘must defer to [Lincoln Life]’s interpretation of the plan so long as it is ‘reasonable,’ even if [we] would interpret the language differently as an original matter.’” Mrs. Beard “concedes Lincoln Life’s interpretation is reasonable. We are therefore bound to apply that definition, as we did above.”

As a result, the Eighth Circuit affirmed the district court’s judgment and upheld Lincoln’s denial of Mrs. Beard’s claim for AD&D benefits.

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

Attorneys’ Fees

Third Circuit

Barragan v. Honeywell Int’l Inc., No. 24-CV-4529 (EP) (JRA), 2026 WL 1229040 (D.N.J. May 5, 2026) (Judge Evelyn Padin). This is a putative class action in which Luciano Barragan, on behalf of the Honeywell International Inc. 401(k) Plan, contends that Honeywell and related defendants violated fiduciary duties and engaged in prohibited transactions under ERISA by using forfeited employer contributions to the plan to offset future employer contributions to the plan instead of defraying administrative costs. In August of 2025 the court granted defendants’ motion to dismiss the case. The court ruled that the plan participants received all the benefits to which they were entitled, and that defendants followed plan rules and did not violate any fiduciary duties under ERISA, which gives plan administrators freedom in designing and administering plans. (Your ERISA Watch covered this decision in our August 27, 2025 edition.) Barragan has appealed this decision to the Third Circuit Court of Appeals, and in the meantime, defendants filed a motion for attorney’s fees. The court noted that federal courts have “significant discretion to manage their dockets as they see fit,” and decided to exercise that discretion to “defer deciding Defendants’ Motion until Plaintiff’s Appeal is resolved.” The court stated that deciding the motion before the appeal could lead to unnecessary steps if the Third Circuit reverses the dismissal. The court further emphasized that a decision from the Third Circuit would provide clarity on the merits of defendants’ motion, particularly regarding the Ursic factors, which courts in the Third Circuit use to decide whether attorney’s fees should be awarded. These factors included the degree of Barragan’s culpability and the relative merits of the parties’ positions. The court was “mindful” that many other courts have ruled that a pending appeal is insufficient to delay adjudication of an attorney’s fees motion, but “[t]he Court finds this action distinguishable in several respects. Most notably, Plaintiff commenced this action only two years ago, and Plaintiff has not made it past the pleadings stage (i.e., there has been no trial).” Thus, “the Court is of the view that in this action, it makes most sense to decide the Motion once Plaintiff’s Appeal has been resolved. While the Court recognizes the decisions to the contrary by several District Courts in this Circuit, the Court respectfully disagrees with their reasoning and is of the view that such a deferral is appropriate here.” The court thus ordered defendants’ motion to be administratively terminated, and allowed them to refile their motion “upon the resolution of Plaintiffs’ Appeal.”

Sixth Circuit

Chalk v. Life Ins. Co. of N. Am., No. 3:25-CV-133-RGJ, 2026 WL 1252337 (W.D. Ky. May 7, 2026) (Judge Rebecca Grady Jennings). Jennifer Chalk filed this action against Life Insurance Company of North America (LINA), alleging wrongful denial of her claim for ERISA-governed long-term disability (LTD) benefits. In November of 2025 the court ruled that LINA failed to render a decision on her claim within 45 days in violation of 29 C.F.R. § 2560.503-1(f)(3). As a result, the court remanded to LINA, finding that this procedural violation prevented a full and fair review and resulted in an incomplete and insufficient administrative record. (Your ERISA Watch covered this ruling in our November 5, 2025 edition.) In its ruling, the court indicated it would entertain a motion for attorney’s fees, so Chalk filed one. In the meantime, LINA requested additional information from Chalk, including medical records and other documentation, which Chalk provided. LINA then asked Chalk to undergo an independent medical evaluation (IME), which Chalk refused, arguing that her claim was “no longer ‘pending,’” and instead was on appeal, due to LINA’s failure to make a timely decision. Chalk then filed a motion to reopen the case, contending that LINA’s deadline to decide had passed. LINA scheduled the IME for January of 2026, but Chalk did not attend. LINA eventually approved Chalk’s claim for three months but denied it thereafter, citing her failure to attend the IME and the opinion of its medical director that her restrictions were consistent with her occupation. As a result, the court faced two motions: one to reopen the case and one for attorney’s fees. LINA opposed the motion to reopen, arguing that the applicable ERISA deadlines were not violated because the remand required a full initial review, not an appeal. The court sided with LINA, ruling that LINA had acted in a timely fashion because “LINA never conducted an initial review and thus there was no initial claim determination for Chalk to appeal.” The court thus ruled that “Chalk’s LTD claim remains properly before LINA on administrative review, consistent with the terms of the LTD Policy and all applicable ERISA requirements. For the avoidance of doubt, Chalk must exhaust her administrative appeal before reopening this case. In the interest of fairness, however, the Court will permit Chalk 180 days from this Order to file her appeal, though she may of course proceed sooner.” As for attorney’s fees and costs, the court granted Chalk’s request for costs but denied her request for fees. The court agreed that Chalk had achieved “some success on the merits” by obtaining a remand. However, in applying the Sixth Circuit’s five-factor King test, the court found that LINA’s failure to comply with ERISA’s notice requirements was due to a procedural mistake, not bad faith. The court further determined that a fee award would not deter other plan administrators from making honest mistakes and that the remand did not resolve a significant legal question or confer a common benefit on other plan participants. As a result, Chalk’s motion to reopen was denied, her request for $20,921 in fees was also denied, and she walked away from the skirmish with only $450.37 in costs.

Breach of Fiduciary Duty

Eleventh Circuit

Ulch v. Southeastern Grocers LLC, No. 3:23-CV-1135-TJC-MCR, 2026 WL 1243069 (M.D. Fla. May 6, 2026) (Judge Timothy J. Corrigan). Joyce Ulch, an employee of Southeastern Grocers LLC (SEG), brought this putative class action against SEG, contending that it has mismanaged the recordkeeping fees of its ERISA-governed 401(k) retirement savings plan, in which she is a participant. The plan’s recordkeeper is Fidelity Investments Institutional, which has received both direct and indirect compensation for its services. Ulch claims that the direct compensation the plan paid Fidelity was excessive relative to the services provided, and that SEG could have obtained cheaper fees because the plan has over $1 billion in assets and more than 12,000 participants, making it a “mega” plan with significant bargaining power. Additionally, she claims that Fidelity received excessive indirect compensation through “float” on participant money and revenue sharing from investments in the plan. SEG filed a motion to dismiss. At the outset, the court addressed the exhibits attached to SEG’s motion, which included “an attorney declaration, overviews of the Plan, Form 5500 reports, and documents from the earlier administrative process.” Ulch objected to these, contending that SEG was “asking the Court to weigh evidence and make factual determinations about disputed facts and to decide those disputed facts in Defendant’s favor at the dismissal stage.” The court agreed, ruling that many of the facts in the exhibits were disputed, and that SEG was “improperly…attempting to expand the appropriate record before the Court[.]” On the merits, the court found Ulch’s allegations regarding direct compensation plausible, as she “provided five comparable benchmarks of similar retirement plans with substantially lower reported recordkeeping fees than the Plan at issue here. By doing so, she has pled factual content that allows the Court ‘to draw the reasonable inference’ that SEG breached its fiduciary duty under ERISA by allowing Fidelity to receive excessive direct compensation.” As for indirect compensation, the court stated, “Although SEG raises some important questions about the strength of Ulch’s indirect compensation arguments, these questions cannot be decided on a motion to dismiss.” The court emphasized that the duty of prudence under ERISA is context-specific and cannot be fully assessed without discovery. On the complaint before it, the court concluded that “it is plausible that SEG breached its duty of prudence by failing to monitor Fidelity’s float and revenue sharing income.” As a result, although the court “makes no prediction on how this case will ultimately be decided on the merits,” Ulch’s complaint was sufficient to get past SEG’s motion to dismiss, which was denied.

Class Actions

Ninth Circuit

In re Sutter Health ERISA Litig., No. 1:20-CV-01007-LHR-BAM, 2026 WL 1283323 (E.D. Cal. May 11, 2026) (Judge Lee H. Rosenthal). In this class action, participants of the Sutter Health 403(b) Savings Plan alleged that plan fiduciaries violated their duties of prudence and loyalty by selecting and maintaining certain funds in the plan’s portfolio which had poor performance histories, and by charging participants unreasonable fees. Plaintiffs were able to dodge a motion to dismiss in 2023, and the parties subsequently reached a settlement. The court previously granted preliminary approval of the settlement, preliminary certification of the class for settlement purposes, and scheduled a fairness hearing. The court conducted that hearing in April, and in this brisk and efficient order the court granted final approval of the settlement agreement, finding it fair, reasonable, and adequate for the plan and the settlement class. The court certified the class under Federal Rules of Civil Procedure 23(a) and (b)(1), noting that the class was ascertainable, numerous, and had common questions of law or fact. The claims of the class representatives were typical of the class, and they were deemed capable of adequately protecting the class’s interests. The court also found that separate actions by individual class members could lead to inconsistent adjudications. As for the terms of the agreement, the court approved the settlement amount of $4,300,000, considering it fair and reasonable given the costs, risks, and potential delays of continued litigation. The settlement was negotiated at arm’s length with the assistance of a neutral mediator, and both parties had sufficient information to evaluate the settlement’s value. The court also approved the plan of allocation and found that the notice provided to the class was adequate and satisfied due process requirements. The court awarded $1,433,33.33 in attorneys’ fees to class counsel and $12,500 in compensatory awards to the class representatives, finding these amounts fair and reasonable based on the efforts and results achieved. The court dismissed the operative complaint with prejudice, entered judgment, and retained jurisdiction to resolve any disputes related to the settlement agreement.

ERISA Preemption

Seventh Circuit

Herbst v. Progress Rail Servs. Corp., No. 3:26-CV-145 DRL-SJF, 2026 WL 1238543 (N.D. Ind. May 4, 2026) (Judge Damon R. Leichty). Kody Herbst filed a lawsuit in state court against his former employer, Progress Rail Services Corporation, and a related entity, claiming that Progress Rail “misrepresented the date on which his employer-sponsored health coverage would end. In reliance on that representation, he incurred medical expenses that were not covered because his health plan terminated earlier.” Herbst brought claims for breach of contract, negligent misrepresentation, promissory estoppel, and equitable estoppel. Progress Rail removed the case to federal court on ERISA preemption grounds. Herbst moved to remand, arguing that the removal was untimely and the court lacked jurisdiction. Addressing timeliness first, Herbst argued that service was complete upon mailing the summons and complaint on December 31, 2025, under Indiana Trial Rule 5. However, the court clarified that Rule 5 applies to subsequent filings, not the original complaint. Service of the summons and original complaint is governed by Rule 4, which requires receipt for service to be effective. Service of these documents was deemed complete on January 5, 2026, making Progress Rail’s February 4, 2026 removal timely. As for jurisdiction, the court applied the two-part test from Aetna v. Davila to determine whether ERISA preemption applied. Apparently neither side applied this test in their briefing, so the court “treads lightly.” It found that Herbst’s negligent misrepresentation and estoppel claims were not preempted as they arose from “separate oral representations” and involved legal duties independent of ERISA. Mr. Herbst’s breach of contract claim was more complicated. The court stated that it was based on two theories. The first theory, alleging modification of the benefits arrangement, would likely be preempted by ERISA. The second theory, based on an enforceable employment agreement, would not necessarily depend on ERISA. Because federal law was only essential to only one theory, not both, the court determined that the contract claim was not completely preempted. Progress Rail argued in the alternative that Herbst’s claims constituted a “classic ERISA fiduciary-breach claim,” which would be preempted. However, the court found this argument “underdeveloped” because Progress Rail did not fully explain how it was a fiduciary or what its fiduciary duties were. The court noted that Progress Rail bore the burden of proving that removal was proper, and “doubts are resolved in favor of remand.” Finally, the court denied Herbst’s request for attorney fees, despite Progress Rail’s “underdeveloped” presentation of the removal issue: “§ 1447(c) isn’t a fee-shifting mechanism merely for unsuccessful advocacy, and the court cannot say the removal position was so clearly foreclosed as to be called objectively unreasonable.” Thus, Herbst obtained his requested remand, but he had to pay for the privilege.

Pension Benefit Claims

Seventh Circuit

Brya v. Pfizer Inc., No. 1:25-CV-06481, 2026 WL 1245461 (N.D. Ill. May 6, 2026) (Judge Sharon Johnson Coleman). In 2003, Thomas J. Brya was terminated by his employer, Pfizer Inc.  At that time, he received $427,230.16 in severance benefits in exchange for signing a release agreement that discharged Pfizer from any claims, including those under ERISA. In 2023 Brya received $548,514.14 in pension benefits. He contended that this number was miscalculated by Pfizer, but Pfizer denied his claim and subsequent appeal. As a result, in 2025 Brya filed this action against Pfizer and related defendants, alleging multiple violations of ERISA. His claims included: “(1) a breach of fiduciary duty claim for Defendants’ failure to provide accurate and comprehensive plan communications and for denying his pension claims without addressing substantive factual and legal considerations; (2) a claim for self-dealing and fraudulent nondisclosure stemming from Defendants’ use of administrative processes to deter participants from obtaining benefits; (3) violation of claims procedure for failing to provide Brya with a full and fair review on his benefits claim; (4) incorrect calculations and denial of pension benefits, (5) a claim for fiduciary misconduct against [a Pfizer manager] for transacting for her own benefit; (6) and a claim for breach of co-fiduciary duties against all Defendants.” Defendants moved to dismiss for failure to state a claim, arguing that (1) Brya’s claims were time-barred, (2) Brya’s claims were precluded by a decision in another case, Walker v. Monsanto, and (3) Brya released his claims in his severance agreement. The court agreed with all three arguments. First, the court found that Brya’s claims were barred by ERISA’s six-year statute of repose. The alleged miscalculation of Brya’s initial cash balance occurred in 1997, and the cessation of restoration credits to his plan account occurred in 2014, both outside the six-year period. Brya’s arguments for tolling the statute due to fraud and concealment were rejected because he was aware of the changes to his pension plan “long before filing suit.” Furthermore, Brya “has not pointed to any ‘steps taken by [the Committee] to cover their tracks’ or ‘to hide the fact of the breach.’” Second, the court determined that Brya’s claims were precluded by the ruling in the Walker class action, which addressed the same issues identified by Brya under the same plan provisions. The court noted that Brya was part of the class certified under Rule 23(b)(1) and (b)(2), which did not require notice or opt-out options for class members. Because Brya was a member of the class in Walker, and the Seventh Circuit ruled in favor of the plan in that case, his claims were barred by res judicata and collateral estoppel. Third and finally, the court concluded that Brya’s claims were barred by the release agreement he signed in 2003, which discharged Pfizer from any claims, including those under ERISA. The court further noted that Brya had not tendered back the severance payment, which was a condition precedent to challenging the validity of the release. As a result, Pfizer’s motion to dismiss was granted, with prejudice.

Pleading Issues & Procedure

Third Circuit

Aramark Services, Inc. v. QCC Ins. Co., No. CV 26-1664, 2026 WL 1284841 (E.D. Pa. May 11, 2026) (Judge Gerald J. Pappert). Aramark Services, Inc., along with its Group Health Plan, Uniform Services Health and Welfare Plan, and Benefits Compliance Review Committee initiated this action against QCC Insurance Company, Independence Blue Cross, and Independence Health Group, Inc. Aramark contends that defendants violated ERISA by breaching their fiduciary duties to Aramark’s plan and engaging in prohibited transactions, although the details of those allegations were not revealed in this order. Instead, this order evaluated QCC’s motion to seal parts of exhibits to Aramark’s complaint. Aramark asked for sealing relief first, although its request was more expansive; it wanted to file the entire complaint and three exhibits under seal. The court denied Aramark’s request, ruling that Aramark failed to overcome the federal courts’ presumption against sealing. In response, QCC moved to re-seal the three exhibits and file redacted versions on the public docket. The court acknowledged the public’s “presumptive right of access to judicial records,” which includes “pleadings and other materials submitted by litigants.” To overcome this presumption, the court stated that QCC had to show that “the material [sought to be sealed] is the kind of information that courts will protect and that disclosure will work a clearly defined and serious injury to the party seeking closure.” The information at issue was contained in the administrative services agreement (exhibit 1), network services contract (exhibit 2), and proposal for services (exhibit 3) between the parties, and included charges and fees as well as details about QCC’s cost reduction and savings program. QCC argued that this information was “not publicly available, is closely guarded by [QCC] in the ordinary course of business, and is disclosed to counterparties only subject to contractual confidential protections.” This was good enough for the court, which accepted that “the information might harm QCC’s competitive standing… Competitors could reverse-engineer its fees to undercut QCC’s competitive bids or replicate its cost-saving methods.” Furthermore, the redactions proposed by QCC “are limited to commercially sensitive information,” “minimally impact the public’s right to access,” and were “largely irrelevant” to the issues raised by the action. As a result, the court granted QCC’s motion.

Fourth Circuit

L.P. v. North Carolina Dental Soc’y, No. 1:26-CV-00104-MR, 2026 WL 1265748 (W.D.N.C. May 8, 2026) (Judge Martin Reidinger). L.P. is an employee enrolled in the ERISA-governed North Carolina Dental Society Healthcare Plan, and C.P. is L.P.’s dependent child and a beneficiary under the plan. From August 2024 through June 2025, C.P. received treatment at a residential facility for mental health issues. L.P. sought coverage for the treatment costs under the plan, but the claims administrator, Interactive Medical Systems Corporation (IMS), denied the claims. After exhausting the plan’s appeals, L.P. filed this action, asserting two claims for relief under ERISA: one for recovery of benefits under 29 U.S.C. § 1132(a)(1)(B), and the second for equitable relief under 29 U.S.C. § 1132(a)(3) for violation of the Mental Health Parity and Addiction Equity Act (MHPAEA), 29 U.S.C. § 1185a(a)(3)(A)(ii). Plaintiffs filed a motion to proceed anonymously, arguing that the case involves sensitive information about C.P.’s mental health challenges. (No defendant had yet appeared in the case so there was no opposition.) The court evaluated plaintiffs’ request using the Fourth Circuit’s five-factor test under James v. Jacobson. Under this test, the court denied plaintiffs’ motion. The court reasoned that (1) the core allegation – IMS’s denial of benefits for treatment – was not extraordinarily sensitive or personal, as it is a common assertion in ERISA actions; (2) plaintiffs acknowledged that there was no danger of direct retaliatory harm if they were not allowed to proceed anonymously; (3) although C.P. was a minor when the treatment began, C.P. had reached the age of majority by the time of the case was filed, and Federal Rule of Civil Procedure 5.2 does not require initials for adults; (4) the defendants were private companies, which weighed against allowing anonymity; and (5) plaintiffs were correct that there was no risk of harm to the defendants from the use of initials because defendants already possessed the relevant documents in unredacted form. Thus, only one factor weighed in favor of plaintiffs. In the end, “the Court must balance the Plaintiffs’ interest in anonymity against the public’s interest in openness… Here, the public has a strong interest in openness. To the extent these proceedings involve particularized, private, and sensitive information, redactions and filing under seal can limit access when needed without altogether concealing the identity of the litigants from the public.” Plaintiffs’ motion was thus denied, and the court directed them to file an amended complaint with their full names.

Provider Claims

Fifth Circuit

Abira Medical Laboratories, LLC v. Healthy Blue, Civ. No. 24-1039-SDD-SDJ, 2026 WL 1276441 (M.D. La. May 8, 2026) (Judge Shelly D. Dick). Abira Medical Laboratories, LLC, doing business as Genesis Diagnostics, is a provider of medical laboratory testing services and a frequent litigant asserting claims against insurers and benefit plans. In this action it sued a managed care organization called Healthy Blue, alleging that Healthy Blue refused to pay for out-of-network services provided by Abira. Abira contends that the requisitions for testing services that it submitted on behalf of Healthy Blue’s enrollees conferred third-party beneficiary status on it and allowed it to sue Healthy Blue under federal and state law. Specifically, Abira asserted claims for (1) violation of ERISA, (2) breach of third-party beneficiary contract, (3) breach of third-party bad faith, (4) quantum meruit/unjust enrichment, and (5) negligence. Healthy Blue filed a motion to dismiss, which the court converted into one for summary judgment. Abira failed to file a response, and thus the outcome was no surprise. The court granted Healthy Blue’s motion, dismissing all of Abira’s claims with prejudice. The court found that Abira had entered into a participating provider agreement with Healthy Blue in 2018, making it a participating provider in Healthy Blue’s network. This meant that the only viable claim Abira could have asserted was a breach of the agreement for failing to reimburse amounts due under the agreement, which was not alleged in the complaint. As a result, the court (1) dismissed the ERISA claim because Healthy Blue “does not issue, fund, underwrite, or administer employee health benefits plans, and does not issue, fund, underwrite, or administer commercial health insurance policies,” (2) ruled that Abira failed to provide evidence of any contract conferring third-party beneficiary status, (3) ruled there was no third-party bad faith for the same reason, (4) dismissed Abira’s quantum meruit claim because providing healthcare services to an insurance policy participant does not confer a benefit on the insurer, and (5) ruled that Abira’s claims were governed by the Medicaid framework and the parties’ agreement, and thus its negligence claim was not viable.

Standard of Review

Ninth Circuit

Farris v. Life Ins. Co. of N. Am., No. 25-CV-04164-RS, 2026 WL 1270071 (N.D. Cal. May 8, 2026) (Judge Richard Seeborg). Heather Farris lives in California and was employed by Lowe’s Companies, Inc., which is incorporated in North Carolina. Farris was a participant in Lowe’s ERISA-governed long-term disability employee benefit plan, which was insured by Life Insurance Company of North America (LINA). The policy insuring the plan was issued to Lowe’s in North Carolina, effective September 1, 2013, and includes a provision stating it is governed by North Carolina law. Farris submitted a claim for benefits to LINA under the plan, but LINA denied it, so Farris subsequently brought this action. Before the court here was LINA’s motion regarding choice of law and the applicable standard of review. The court treated the motion as one for partial summary judgment under Federal Rule of Civil Procedure 56 because LINA attached declarations and plan documents to its motion. Farris opposed the motion, contending that the plan was governed by California Insurance Code Section 10110.6, which became effective January 1, 2012, and provides that if a disability insurance policy is “offered, issued, delivered, or renewed, whether or not in California…that reserves discretionary authority to the insurer…to determine eligibility for benefits or coverage [or] to interpret the terms of the policy…that provision is void and unenforceable.” The court found first that the North Carolina choice of law provision was valid. Farris argued that the policy contained notices for residents of other states which vitiated the provision, but the court disagreed: “The statement, on the cover page of the Policy, that the Policy ‘shall be governed by [North Carolina’s] laws’ unambiguously reflects a choice of North Carolina law.” The court then ruled that the choice of law provision was enforceable. The court stated that choice of law provisions are enforceable under federal law so long as they are “not unreasonable or fundamentally unfair.” The court noted that various courts in the Northern District of California have upheld non-California choice of law provisions, even when they do not provide the protections intended by California Insurance Code § 10110.6. The court found “no persuasive reason to break from those cases.” (Your ERISA Watch covered the most recent of these cases, Moorhead v. Unum, in our April 8, 2026 edition.) The court ruled that “North Carolina choice of law is fair and reasonable for similar reasons as in those cases. Lowe’s is headquartered in North Carolina with hundreds of thousands of employees in states across the country, and so uniform application of North Carolina law to each dispute arising under the LTD policy is reasonable… Accordingly, the North Carolina Provision is enforceable as a choice of law provision, and the Discretionary Review Provisions are not voided by Section 10110.6.” The court thus granted LINA’s motion, and Farris’ claims will be decided under the abuse of discretion standard of review.

Aramark Servs., Inc. Grp. Health Plan v. Aetna Life Ins. Co., No. 24-40323, __ F.4th __, 2026 WL 1154313 (5th Cir. Apr. 28, 2026)

This week’s notable decision is not a decision at all. Instead, it’s a two-paragraph order in which the Fifth Circuit vacated its December 18, 2025 published opinion in this case and agreed to rehear it en banc.

In its December ruling (which Your ERISA Watch covered as one of our cases of the week in our December 24, 2025 edition), a three-judge panel of the Fifth Circuit examined an arbitration provision in an agreement between an employee health plan sponsored by Aramark Services, Inc. and the third-party administrator of the plan, Aetna Life Insurance Company. Aramark had sued Aetna, contending that Aetna was liable for breach of fiduciary duties and prohibited transactions under ERISA based on Aetna’s improper payment of provider claims, retaining undisclosed fees, and engaging in claims-handling misconduct.

Aetna filed a motion to compel arbitration, but the district court denied it. The district court ruled that (1) the parties had not clearly and unmistakably delegated the issue of arbitrability to the arbitrator, and thus it was the court’s job to decide the issue, and (2) Aramark’s claims were equitable in nature and thus not subject to arbitration, because the arbitration clause exempted “temporary, preliminary, or permanent injunctive relief or any other form of equitable relief.”

The Fifth Circuit panel affirmed, ruling that the arbitration provision was ambiguous and thus, under the rule of contra proferentem (ambiguous language should be construed against the drafter, i.e., Aetna), the issue of arbitrability was for the court to decide. The Fifth Circuit further ruled that the relief requested by Aramark, even though it was monetary, was equitable in nature and could be sought pursuant to the Supreme Court’s 2011 guidance in Cigna Corp v. Amara and the Fifth Circuit’s 2013 decision interpreting Amara in Gearlds v. Entergy Servs., Inc.

The decision was not unanimous. Judge Edith H. Jones agreed with the first part of the decision regarding arbitrability, but wrote a vigorous dissent in which she accused Amara of causing “confusion,” characterized its discussion of equitable surcharge as dicta, and contended that the dicta was at odds with the holdings of other Supreme Court cases. As a result, she contended that the Fifth Circuit “should repudiate Gearlds” and rule that the monetary remedy sought by Aramark did not constitute “equitable relief.”

This week’s order does not explain which part of the panel’s decision attracted the interest of the full court, but the smart money is obviously on the second part which antagonized Judge Jones. Will the Fifth Circuit jettison Gearlds and follow the path blazed by the Fourth Circuit (in Rose v. PSA Airlines, Inc. (2023)) and Sixth Circuit (in Aldridge v. Regions Bank (2025))? Or will it stick to its guns and deepen a circuit split? We will of course keep you in the loop.

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

Attorneys’ Fees

Third Circuit

Allied Painting & Decorating, Inc. v. International Painters & Allied Trades Indus. Pension Fund, No. CV 21-13310 (RK), 2026 WL 1168178 (D.N.J. Apr. 29, 2026) (Magistrate Judge Tonianne J. Bongiovanni). This is a withdrawal liability case under the Multiemployer Pension Plan Amendments Act of 1980 (MPPAA) in which the International Painters and Allied Trades Industry Pension Fund contended that Allied Painting & Decorating, Inc. owed the fund $427,195 based on Allied’s withdrawal from the fund in 2005, even though the fund did not pursue payment until 2017. An arbitrator found that the fund did not act “as soon as practicable” in issuing a notice and demand to Allied, but still ruled in the fund’s favor because Allied was not prejudiced by this delay, thereby dooming its laches defense. However, the district court vacated this award, citing “‘a reasonable appearance of bias against Allied,’ which resulted in the ‘deprivation of a fair hearing.’” The fund appealed to the Third Circuit, which affirmed in July of 2024. The appellate court ruled that Allied did not even need to raise its laches defense, let alone prevail on it. Instead, the duty to provide notice of withdrawal liability assessment and demand payment “as soon as practicable” was a statutory prerequisite to obtaining relief, and the fund flunked this requirement with its twelve-year delay. (Your ERISA Watch reported on this decision in our July 17, 2024 edition.) Fresh off this victory, Allied renewed its motion for attorney’s fees, which the district court assessed in this order. The parties agreed that in withdrawal liability cases fees may be awarded to a prevailing party under 29 U.S.C. § 1451(e). However, the parties disagreed over what standard to apply under that statute. Allied contended that the court should use the Third Circuit’s five-factor test as set forth in Ursic v. Bethlehem Mines, while the fund contended that the court should use the standard set forth in the Third Circuit case of Dorn’s Transp., Inc. v. Teamsters Pension Tr. Fund of Philadelphia & Vicinity. The court noted that “the MPPAA was not at issue in the Ursic matter, which instead involved a request for attorney’s fees based on an employee’s successful claim under § 510 of ERISA to recover past and future pension benefits.” Dorn’s, on the other hand, was an MPPAA case, and thus “Dorn remains the applicable Third Circuit precedent for determining whether to award attorneys’ fees and expenses to a prevailing employer under the fee shifting provisions of the MPPAA.” Under Dorn’s, a prevailing employer “is entitled to attorneys’ fees only if the Plan’s assessment of withdrawal liability was frivolous, unreasonable or without foundation.” Under this demanding standard the court denied Allied’s motion for attorney’s fees. The court noted that prior to the Third Circuit’s decision in this case, it was “generally understood” that “even where there was a delay in a fund asserting a payment demand, an employer would still have to raise a laches objection” and establish prejudice. However, the Third Circuit clarified in its ruling that “prejudice and, indeed the laches defense, have no place in the withdrawal liability calculus[.]” This ruling “represents a significant shift in the law that could not have been reasonably anticipated or foreseen by the Fund.” Thus, “while the Fund ultimately did not prevail, under the circumstances presented, the Court finds that the Fund’s assessment of withdrawal liability was not frivolous, unreasonable or without foundation. As a result, Allied’s motion for attorney fees and expenses is DENIED.”

Seventh Circuit

Ryan v. Hartford Life & Accident Ins. Co., No. 21-CV-592-WMC, 2026 WL 1146274 (W.D. Wis. Apr. 28, 2026) (Judge William M. Conley). Plaintiff Frances Ryan was an internal medicine physician who was a participant in an ERISA-governed long-term disability benefit plan insured by Hartford Life & Accident Insurance Company. She became disabled in 2018 after she suffered an injury to her head on vacation which caused post-concussion symptoms. Hartford initially approved Ryan’s claim in 2018, but in 2020 it terminated her benefits, contending she had no cognitive limitations and could return to work in her own occupation. Ryan unsuccessfully appealed and then brought this action. In June of 2025 the court ruled on cross-motions for summary judgment that Hartford abused its discretion in denying her claim and remanded to Hartford for further review. (Your ERISA Watch covered this decision in our June 25, 2025 edition.) On remand, Hartford caved and reinstated Ryan’s benefits. The only remaining item before the court was Ryan’s motion for attorney’s fees and costs under 29 U.S.C. § 1132(g)(1), which the court granted in this order. First, the court determined that Ryan met the threshold requirement of “some success on the merits” for fee eligibility under ERISA. Hartford argued that the court’s remand was a “purely procedural” victory and did not meet this standard. However, the court found this argument “baseless” because Ryan’s benefits were ultimately reinstated pursuant to the order. Moving on to entitlement, “the Seventh Circuit employs two tests – a five-factor test and the ‘substantially justified’ test.” Both tests yielded the same result, favoring an award. The court found that Hartford’s position was not substantially justified, it had “ample means” to satisfy an award, and an award would “deter similar conduct in the future.” Next, the court calculated the reasonableness of Ryan’s fees by using the lodestar test of multiplying reasonable hours spent by a reasonable hourly rate. Hartford did not dispute the hourly rate (sadly not mentioned in the order) claimed by Ryan’s counsel, William T. Reynolds IV, and instead argued that the total amount should be reduced for (1) lack of success on the merits, (2) work on undecided motions, (3) administrative tasks, and (4) excessive hours. The court declined to reduce fees based on lack of success on the merits, as Ryan’s victory was “essentially complete.” The court also awarded full fees for work on the undecided motions, noting that “counsel’s time is dedicated more to the litigation as a whole, rather than a discrete series of claims, meaning district courts ‘should focus on the significance of the overall relief obtained by the plaintiff in relation to the hours reasonably expended.’” The court further found that counsel did not spend excessive time on certain tasks identified by Hartford. However, the court did exclude fees for clerical tasks and costs related to mediation, which were not recoverable under 28 U.S.C. § 1920. As a result, Ryan’s motion was granted nearly in full, resulting in an award of $151,612.50 in fees and $402 in costs.

Breach of Fiduciary Duty

Fourth Circuit

Nolan v. Sonic Automotive, Inc., No. 3:25-CV-00474-KDB-WCM, 2026 WL 1195596 (W.D.N.C. May 1, 2026) (Judge Kenneth D. Bell). Joseph Nolan III was an employee of Sonic Automotive, Inc. and a participant in one of Sonic’s ERISA-governed 401(k) retirement plans. Nolan alleges that he and other participants suffered financial losses due to the mismanagement of his plan and another plan, the “California plan,” also sponsored by Sonic. He sued Sonic and related defendants, alleging (1) breach of fiduciary duties of prudence and loyalty to the plans (Counts I and II), (2) breach of co-fiduciary duties (Count III), (3) breach of fiduciary duty of prudence by Sonic for failing to monitor the plans’ benefit committee (Count IV), (4) engaging in prohibited transactions in violation of 29 U.S.C. § 1106(a) (Count V), and (5) failing to act in accordance with the governing plan documents in violation of 29 U.S.C. § 1104(a)(1)(D) (Count VI). Specifically, Nolan focused on four funds, contending that the plans selected and retained these “higher cost, lower-performing investment options,” failed to follow the investment policy statement (IPS), did not conduct periodic reviews, and paid unreasonable fees to the plans’ investment advisor. Defendants moved to dismiss for failure to state a claim. Addressing standing first, the court found that Nolan lacked standing to bring claims under the California Plan because he did not participate in it. Nolan contended that he had standing to obtain relief under that plan “because both Plans are ‘sponsored, maintained, and administered by Sonic and share the same fiduciaries,’ and because the alleged injuries are traceable ‘to the same challenged conduct.’” However, this was not good enough because of the “narrow scope of Article III standing,” under which Nolan could not “demonstrate a concrete, real-world injury stemming from the alleged violation.” As for the duty of prudence, the court found that claims related to the initial selection of funds were time-barred under ERISA’s six-year statute of limitations. On the merits, the court concluded that Nolan did not plausibly allege a breach. The court noted that the duty of prudence is “process-oriented, not results-oriented,” and Nolan failed to allege facts suggesting a flawed decision-making process by the fiduciaries. Furthermore, regarding Sonic’s growth fund, the court found that (1) Nolan chose an inappropriate benchmark by using a passively-managed index fund to compare to Sonic’s active fund, (2) Nolan relied too heavily on the fund’s information ratio, which had variable results at any rate, and (3) Sonic was not required to choose a fund with the lowest expense ratio, and the fund had minimal underperformance in any event. Regarding Sonic’s value fund, the court found that the S&P 500 index was not a good comparator and there was insufficient underperformance. For the remaining two funds, Nolan contended that lower cost share classes were available, but the court noted that it was not clear that the Sonic plans were eligible for those classes, and in any event plans are not required to always select the cheapest share class. The court also rejected Nolan’s excessive fees claim because he “attempt[ed] to repurpose the methodology for calculating reasonable attorney’s fees as a framework for evaluating the compensation paid to a financial-services firm.” Moving on to Nolan’s breach of the fiduciary duty of loyalty claim, the court dismissed this claim, stating that it impermissibly “piggybacked” on the prudence claim without independent facts suggesting a disloyal motive or self-interested conduct by defendants. The court also dismissed Nolan’s breach of co-fiduciary duty claim, and his prudence claim against Sonic, because they were derivative of his other already rejected claims. As for the prohibited transactions claim, the court again found that the claims related to the inclusion and retention of funds were time-barred, and the allegations of excessive advisory fees did not constitute a prohibited transaction. Finally, the court dismissed Nolan’s claim for failure to act in accordance with plan documents, ruling it duplicative of the breach of fiduciary duty claim and noting that the IPS was not a binding plan document. As a result, defendants’ motion to dismiss was granted in full.

Fifth Circuit

Eibensteiner v. EssilorLuxottica USA Inc., No. 3:25-CV-2443-X, 2026 WL 1140895 (N.D. Tex. Apr. 27, 2026) (Judge Brantley Starr). This case involves a dispute over the management of EssilorLuxottica USA’s ERISA-governed defined contribution retirement plan. The plan offered various investment options, including a stable value fund known as the Prudential Guaranteed Income Fund, which was backed by Prudential Retirement Insurance and Annuity Company.  Plaintiffs, who are employee participants in the plan, allege that “the Prudential Fund provided significantly lower crediting rates than comparable investments which EssilorLuxottica could have made available to plan participants. Additionally, Plaintiffs allege that Prudential improperly benefited from plan participants being invested in the Prudential Fund because the assets invested in it were held by Prudential, who kept the difference between the amount earned on the investments and the amount paid to Plan members (the ‘spread’).” Plaintiffs sued EssilorLuxottica and its benefits committee alleging that they failed to adequately monitor the Prudential Fund, investigate alternatives, or negotiate better terms, and that Prudential’s compensation structure constituted prohibited transactions under ERISA. Defendants moved to dismiss for failure to state a claim. Addressing the duty of prudence first, the court acknowledged that plaintiffs had offered examples of investments that were allegedly comparable to the Prudential Fund, but ruled that none provided a “meaningful benchmark” for comparison. The court stated that “the allegations regarding the comparators’ characteristics remain largely high-level and are wanting for substantial factual detail concerning their underlying structure, contractual terms, or specific risk exposures.” The court was also unimpressed by allegations regarding Prudential’s risky financial condition, faulting plaintiffs because they “do not allege whether these conditions were atypical within the industry, materially different from those of insurers offering the comparator products, or how those factors would have affected a prudent fiduciary’s decision-making.” Turning to the prohibited transactions claim, the court found that plaintiffs failed to allege that Prudential was a party in interest at the time of the relevant transaction: “The amended complaint does not identify whether Prudential was already providing services to the Plan or its committee at the time the relevant contract was entered. Absent such allegations, Plaintiffs fail to plausibly plead that EssilorLuxottica caused the Plan to engage in a prohibited transaction with a party in interest.” Finally, the court ruled that plaintiffs’ derivative claim for failure to monitor fiduciaries failed because the underlying breach of fiduciary duty claims were not plausibly alleged. The court thus granted defendants’ motion to dismiss, but gave plaintiffs leave to amend.

Disability Benefit Claims

First Circuit

Shortill v. Reliance Standard Life Ins. Co., No. 2:25-CV-00264-JAW, 2026 WL 1179948 (D. Me. Apr. 30, 2026) (Magistrate Judge John C. Nivison). In 2021 Susan Shortill began working at TRISTAR, a third-party insurance administrator, as a claims supervisor, a position classified as sedentary. Pursuant to her employment she was a participant in TRISTAR’s ERISA-governed long-term disability (LTD) plan, which was insured by Reliance Standard Life Insurance Company. In July of 2023, Shortill suffered a traumatic injury at home, resulting in a broken neck, shoulder pain, back pain, bruising, and a concussion. Shortill received short-term disability benefits until late January 2024, returned to work part-time in February and March 2024, and was eventually terminated as part of a layoff on March 15, 2024. At the same time, Shortill applied for LTD benefits with Reliance. Reliance determined that Shortill was disabled through April 19, 2024 due to her injury and recovery, which included surgery, but could have returned to work after that date. Shortill unsuccessfully appealed, and this action followed in which Shortill sought benefits pursuant to ERISA Section 1132(a)(1)(B). The case proceeded to cross-motions for judgment on the administrative record. The assigned magistrate judge used the arbitrary and capricious standard of review because the plan gave Reliance discretionary authority to determine benefit eligibility. Shortill contended that Reliance had a structural conflict of interest, but the court ruled that this did not change the standard of review. “[T]he record reflects that Defendant took steps to insulate the claims determination process from its financial interests by, for example, employing third party peer reviewers and an independent appeal unit,” and “Plaintiff has not cited any evidence to suggest that the structural conflict influenced Defendant’s decision in some way[.]” Thus, “the conflict is entitled to little, if any, weight in the overall analysis.” On the merits, the court found that Reliance considered Shortill’s mental health condition, including her depression, but found no evidence that it precluded her from working as a claims supervisor. The court noted that Shortill did not assert her mental health as a basis for disability in her application. As for Shortill’s physical condition, the court ruled that Reliance’s decision was supported by medical records and expert opinions, noting that Reliance reasonably considered the combined effects of her injuries and focused on the appropriate time periods in making its decision. The court also found that Reliance conducted a reasonable vocational assessment by accounting for the requirements of Shortill’s sedentary occupation as it is normally performed in the national economy. As a result, the magistrate judge concluded that Reliance’s decision was supported by substantial evidence and was not arbitrary and capricious, and thus recommended that Reliance’s motion for judgment should be granted.

Ninth Circuit

Rushing v. Life Ins. Co. of N. Am., No. CV 24-10088-JFW(RAOX), 2026 WL 1162757 (C.D. Cal. Apr. 28, 2026) (Judge John F. Walter). Candace Rushing was employed by Peet’s Coffee & Tea and was a participant in Peet’s ERISA-governed long-term disability benefit plan, which was insured by Life Insurance Company of North America (LINA). Rushing suffered a knee injury in 2010 and became disabled. She submitted a benefit claim to LINA, which approved it. In doing so LINA initially calculated Rushing’s benefit based on her hourly base rate without accounting for commissions. After some discussion, LINA included commissions in its calculations and paid Rushing benefits until 2020, when it terminated her claim for failure to provide proof of loss. On appeal, LINA reinstated her benefits, but again the parties could not agree on how to calculate Rushing’s benefits, disputing how to account for commissions and overtime pay. Rushing exhausted her appeals and then filed this action. She claimed that LINA incorrectly calculated her commission income, failed to include her overtime pay at 1.5 times her regular pay rate, and incorrectly offset her benefits. The case proceeded to Rule 52 briefing; this order represented the court’s findings of fact and conclusions of law. At the outset, the court addressed the standard of review. LINA contended that a document titled “Employee Welfare Benefit Plan: Appointment of Claim Fiduciary” (ACF) gave it discretionary authority, thus entitling it to abuse of discretion review, but Rushing argued that the ACF was not a plan document and thus could not support deferential review. (LINA did not produce the ACF until litigation.) The court noted that “there is a split of authority over whether LINA’s ACF (or virtually indistinguishable ACF) is an enforceable Plan document sufficient to provide LINA with the requisite discretion.” The court sided with LINA, noting that “[a]n ERISA Plan may be made up of multiple documents and ‘there is no requirement that documents claimed to collectively form the employee benefit plan be formally labeled as such.’” The ACF contained the name of the plan and the plan administrator, was signed by the plan and LINA, and stated that it was effective along with the policy. Under these circumstances, “it is difficult to see how it could be anything other than a plan document.” The court thus applied abuse of discretion review, noting that even though LINA had a conflict of interest, it would view LINA’s decision with “a low level of skepticism” because “the record generally reflects that LINA engaged in an ongoing, good faith exchange of information and updated Plaintiff’s benefits following an interactive process triggered by Plaintiff providing new information.” Under this deferential standard of review, the court ruled that LINA did not abuse its discretion in calculating Rushing’s commissions, as the policy did not exclude months with no commissions and did not authorize selectively averaging only higher-earning months. However, the court found that LINA abused its discretion in calculating Rushing’s five hours per week of “overtime” by using her base rate of pay instead of her regular rate of pay. The court stated that if LINA was going to include all 45 hours per week in calculating benefits, it had to use the regular rate of pay for all 45 hours. LINA did not, however, have to use a 1.5 rate for those hours as argued by Rushing. Moving on, the court concluded that LINA did not abuse its discretion when determining Rushing’s date of disability or calculating offsets for her benefits, as these issues were either already resolved or abandoned by Rushing. Finally, the court determined that LINA paid the correct amount of interest on delayed benefits, but owed additional interest due to the miscalculation of “overtime” pay. The court ruled that ten percent was an appropriate interest rate because Rushing “endured enormous hardships,” including “paying interest on credit cards and ruining her credit, selling possessions to pay for basic necessities, relying on food banks, borrowing money from friends and family to buy food and pay her rent, declaring bankruptcy in 2021, and paying extra income tax[.]” The court ordered the parties to agree on the amount of benefits and interest owed, and in the “unlikely event” they could not agree, the court indicated it would remand to LINA for recalculation.

Pleading Issues & Procedure

Seventh Circuit

Greer v. Greer, No. 25-CV-1897-JPS, 2026 WL 1180166 (E.D. Wis. Apr. 30, 2026) (Judge J.P. Stadtmueller). Angela Greer contends that she initiated divorce proceedings against her then-husband, Shawn Greer, in 2022, which resulted in a default judgment of divorce in 2023. The divorce judgment apparently contemplated the issuance of a qualified domestic relations order (QDRO) which “required a division of [Shawn’s] retirement account at Bradley Corporation,” with Angela entitled to 65% of the account, valued at approximately $350,000. Shawn moved to reopen the divorce judgment, but before the state court could adjudicate the couple’s disputes he passed away. Angela alleged that she repeatedly provided the divorce decree to Bradley to prevent it from distributing any funds from Shawn’s retirement account while she obtained a QDRO. However, Bradley allegedly paid the funds out to the couple’s three children anyway. Angela thus filed this action against the children and Bradley, alleging breach of fiduciary duty by Bradley in connection with the plan payout. Bradley removed the case to federal court, asserting that Angela’s claims were governed by ERISA. Angela moved to remand the case back to state court, arguing that her claims did not rely on ERISA and that state and federal courts had concurrent jurisdiction. The court agreed that removal was proper because “Angela’s breach of fiduciary duty claim relies, at least in part, on ERISA, which is enough to bring this case to federal court.” Furthermore, “While Angela stylizes her claim as one for breach of fiduciary duty, it is obvious that she seeks to recover or otherwise enforce her rights under the plan.” As a result, the court construed her action as a claim for benefits under ERISA Section 1132(a)(1)(B), which meant that “state and federal courts share concurrent jurisdiction over this case.” However, even though jurisdiction was proper in federal court, the court granted the motion to remand because the removal was procedurally defective. Bradley “concedes that it did not obtain the written consent of any of the Children prior to removal,” even though at least two of the children had been served with the complaint. The court found that, “[d]ue to Bradley’s lack of reasonable diligence in determining whether the Children had been served, there is no basis to excuse Bradley’s defective notice of removal. As such, remand to the Circuit Court of Milwaukee County is required and the Court need not address the parties’ remaining arguments.” The case will thus proceed in state court.

Retaliation Claims

Seventh Circuit

Thompson v. Ascension Med. Grp. Southeast Wisconsin, Inc., No. 25-CV-1964, 2026 WL 1180165 (E.D. Wis. Apr. 30, 2026) (Magistrate Judge William E. Duffin). Melanie Thompson filed this action against Ascension Medical Group Southeast Wisconsin, Inc., Columbia St. Mary’s Hospital of Milwaukee, Inc., and Columbia St. Mary’s medical director Stephanie Momper, alleging thirteen claims for relief arising from her employment and eventual termination. Among her claims was one for violation of ERISA Section 510. Thompson signed a “Physician Employment Agreement” in 2010 to work part-time as a family medicine physician at Columbia St. Mary’s clinics and hospitals, which were operated by Ascension. The agreement specified a part-time schedule “subject to Clinic’s operational needs,” but Thompson claims that the agreement defined “part-time” as 20 hours per week, and she was assured that she would always be scheduled for 20 hours. However, over the years, Thompson’s scheduled hours varied, and she alleged that her hours were reduced significantly after 2019, leading to her constructive termination in 2024. Defendants filed a motion to dismiss, which the court ruled on in this order. The court denied the motion as to some counts (e.g. breach of contract, bad faith, Age Discrimination in Employment Act), but granted it as to others (e.g. promissory estoppel, reformation of contract, tortious interference with contract). As for Thompson’s ERISA claim, she contended that Ascension violated Section 510 because it “constructively terminated [her] employment contract prematurely in April 2024 (as it remains valid through September 30, 2026) by among others: refusing to schedule her for work a minimum of 20 hours per week, by terminating her malpractice insurance coverage, by terminating her State patient compensation fund contributions, by terminating her retirement benefits, by terminating her continuing medical education benefits and further, by attempting to claw back paid compensation before her employment contract termination date.” Thompson argued that “[t]he reasonable inference of this allegation is that Ascension intentionally refused to provide [her] with any hours from April 22, 2024 through the end of her contract, among others, for the purpose of preventing her from receiving future retirement benefits.” This was insufficient for the court, which stated that “Thompson made no allegation in her complaint that the defendants intended to interfere with her benefits.” Thompson’s termination may have led to the loss of benefits, “[b]ut any consequential loss of benefits does not give rise to a claim under § 510 every time an employee is terminated.” As a result, the court granted Ascension’s motion to dismiss Thompson’s ERISA claim, without prejudice.

Venue

Tenth Circuit

Peter T. v. Oxford Health Ins., Inc., No. 2:24-CV-00189-TC-DAO, 2026 WL 1211766 (D. Utah May 4, 2026) (Judge Tena Campbell). The plaintiffs in this action, Peter T., Maura K., and M.T., are seeking benefits for treatment that occurred at a facility called BlueFire Wilderness Therapy. The defendant is Oxford Health Insurance, Inc., the insurer of their ERISA-governed employee health benefit plan. Plaintiffs live in Connecticut, the employer sponsoring the plan is in Connecticut, Oxford is a New York corporation with its principal place of business in Connecticut, and BlueFire is in Idaho. Plaintiffs filed this action in the District of Utah, so you can guess what happened next: Oxford filed a motion to transfer venue, contending that the case should be transferred to the District of Connecticut pursuant to 28 U.S.C. § 1404(a) (“a district court may transfer any civil action to any other district or division where it might have been brought or to any district or division to which all parties have consented”). Plaintiffs sensibly did not oppose the motion. The court noted that plaintiffs alleged that “certain appeals related to coverage…‘were written by a company located in Salt Lake City, Utah,’” but the complaint “contains no further details about this allegation and Oxford counters that ‘none of the decisions at issue in this case were issued in Utah.’” As a result, the court was “uncertain whether venue is appropriate in the District of Utah: no parties reside in or may be found in Utah, and it does not appear that the plan was administered (or potentially breached) in Utah.” On the other hand, “Defendant has its principal place of business in Connecticut, where the Plaintiffs also reside, and it appears that the plan was administered in Connecticut. The court therefore finds that the District of Connecticut is an appropriate venue for this action.” The court noted that ordinarily it would run through the Tenth Circuit’s six-factor test for determining whether transfer was appropriate, but it dispensed with the test here: “Because the Plaintiffs did not file an opposition, the court does not address each of these factors in depth. But the court has carefully considered the reasons stated in Oxford’s motion and agrees that these factors taken as whole – and especially the location of potential witnesses – weigh in favor of transfer.” With that, the court granted Oxford’s motion, and the case will proceed in the District of Connecticut.

Most ERISA practitioners are familiar with Cigna v. Amara, the 2011 Supreme Court decision that helped defined the contours of ERISA’s remedial scheme. But did you know, fifteen years later, that the case is still going?

Read on to learn about Amara’s latest trip to the Second Circuit, and then stick around for this week’s other cases, which include (1) an eleven-year-old case on remand from the Second Circuit (again) involving shenanigans in a Vermont retirement plan (Browe v. CTC Corp.), (2) the demise of another putative class action alleging the misuse of forfeited unvested employer contributions to a retirement plan (Polanco v. WPP), (3) an award of long-term disability benefits stretching all the way back to 2009 (Nabi v. Provident), and last, and probably least, (4) a plaintiff who cited hallucinated AI-generated cases in her pleadings and got away with a slap on the wrist and a chance to amend those pleadings (Moore v. Wireless CCTV).

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

Attorneys’ Fees

Second Circuit

Browe v. CTC Corp., No. 2:15-CV-00267-CR, 2026 WL 1102837 (D. Vt. Apr. 23, 2026) (Judge Christina Reiss). This is an unusual case in several ways: (1) it is eleven years old; (2) it has been up to the Second Circuit and back twice; and (3) it is from your editor’s home state. The case involves a deferred compensation plan created and maintained by Bruce Laumeister for certain employees of his company, CTC Corporation. Lucille Launderville, who held various executive positions at CTC, was an administrator of the plan. Beginning in 2004, Laumeister, Launderville, and another employee, Donna Browe, “began withdrawing funds from the Plan in order to pay CTC’s operating expenses. By 2008, Plaintiffs Launderville and Browe knew that CTC was struggling financially and entered into a side deal with Defendant Laumeister, in which Defendant Laumeister was to personally fund Plaintiffs Launderville’s and Browe’s Plan benefits. Plaintiffs Launderville and Browe remained silent regarding the Plan’s shortfall and their side deal until 2015, when it fell through.” This lawsuit followed in which Launderville, Browe, and other former CTC employees alleged that defendants CTC and Laumeister violated ERISA by inadequately funding the plan and failing to pay benefits, among other claims. Defendants counterclaimed against Launderville for contribution and indemnification as a breaching co-fiduciary. In 2017-18, the district court held a bench trial and ruled in favor of plaintiffs. The case went up to the Second Circuit, which in 2021 largely ruled in favor of plaintiffs, but reversed and remanded on several issues. The district court then issued supplemental findings and remedial orders, which once again went up to the Second Circuit. That court again reversed for more fact-finding, and also ruled that Launderville and Browe were not entitled to benefits. The district court finally wrapped the merits up in an April 7, 2026 order, and in this order it ruled on motions for attorney’s fees from both sides. First the court addressed whether defendants had standing to seek fees. Plaintiffs argued that defendants, as “former fiduciaries,” lacked standing. However, the court found that defendants had already been adjudicated to be fiduciaries and thus had standing to seek fees. Plaintiffs had more success with their argument that defendants could not receive fees based on their counterclaim for contribution; the court agreed that contribution was “an equitable remedy” and “not a cause of action under ERISA for which attorney’s fees are available pursuant to 29 U.S.C. § 1132(g)(1).” Next, the court concluded that defendants had achieved “some degree of success on the merits” by successfully defending against Launderville’s and Browe’s ERISA claims, but because defendants lost regarding the remaining plaintiffs, they “may not recover attorney’s fees from the Remaining Plaintiffs.” Next, the court applied the five-factor Chambless test, concluding that it weighed in favor of awarding defendants fees against Launderville, but not against Browe, primarily because Launderville “did not act in good faith in bringing this lawsuit and because Defendants prevailed in demonstrating she was not entitled to any recovery.” The court then turned to the motion for fees by the remaining plaintiffs. The court agreed with defendants that plaintiffs’ request for $465,000 in fees included work done on behalf of Launderville and Browe, and thus their request would need to be recalculated. The court ruled that the remaining plaintiffs “undisputedly obtained some degree of success on the merits,” and after applying the Chambless factors, concluded that an award of fees was appropriate. As a result, both sides were partially victorious and now have 30 days to refile their fee requests in accordance with the court’s ruling.

Sixth Circuit

Erickson v. Walsh Construction Grp., LLC, No. 2:23-CV-3296, 2026 WL 1101968 (S.D. Ohio Apr. 23, 2026) (Judge Edmund A. Sargus, Jr.). Bradley D. Erickson filed this action against his employer, Walsh Construction Group, LLC, for relief under the Fair Labor Standards Act (FLSA) and analogous state laws. Additionally, Erickson brought a claim under ERISA alleging that Walsh failed to remit insurance contributions and deductions on his behalf. The parties eventually reached a settlement, which required Walsh to pay $35,000, which included payment for wages to Erickson, payment of attorneys’ fees and costs, and a $100 payment to Erickson’s son to release any potential ERISA claims. Walsh was supposed to make these payments within 21 business days of court approval, but it failed to do so. This led to a series of court orders and motions to enforce the settlement, during which Walsh’s counsel withdrew. Eventually, the court granted Erickson’s unopposed motion to enforce the settlement, after which Erickson filed an unopposed motion for attorney’s fees. In this order the court granted Erickson’s motion, awarding $3,988.45. The court used the lodestar method to calculate the attorneys’ fees, determining that the 14.30 hours worked by Erickson’s counsel to enforce the settlement were reasonable. The court approved $600 per hour for the partner on the case, finding his rate to be “at the high end of billing rates for private employment lawyers,” but “given Attorney DeRose’s significant experience, the Court finds this rate to be reasonable.” The court also approved $215 per hour for a junior associate and $170 per hour for a paralegal.

Breach of Fiduciary Duty

Second Circuit

Polanco v. WPP Grp. USA, Inc., No. 24-CV-9548 (JGK), 2026 WL 1099370 (S.D.N.Y. Apr. 22, 2026) (Judge John G. Koeltl). Rafael Polanco and Monique Johnson are former participants in a retirement plan sponsored by WPP Group USA, Inc. They filed this action against WPP and the plan’s investment committee, alleging that defendants breached their fiduciary duties under ERISA by using plan forfeitures to reduce WPP’s contributions to the plan instead of reducing the plan’s administrative costs. Like many such plans, the WPP plan allows employees to contribute wages to individual retirement accounts, with the employer making matching contributions. Employee contributions vest immediately, while WPP’s contributions are subject to a three-year vesting schedule. If a participant leaves before vesting, the unvested contributions are forfeited. The court granted defendants’ motion to dismiss plaintiffs’ first complaint, jettisoning plaintiffs’ breach of the duty of loyalty and self-dealing claims with prejudice. The court also dismissed plaintiffs’ claims for breach of the duty of prudence and the duty to monitor, but allowed plaintiffs to amend their complaint to re-allege these claims. (Your ERISA Watch covered this decision in our November 5, 2025 edition.) Plaintiffs accepted the court’s invitation and filed an amended complaint, and again defendants filed a motion to dismiss. In their new complaint, plaintiffs continued to focus on forfeitures, arguing that the plan committee was imprudent by “failing to use Forfeitures to cover administrative costs and by failing to allocate all Forfeitures by the end of each Plan year.” Plaintiffs advanced two new theories in an effort to overcome the court’s objections to their first complaint. First, plaintiffs argued that “there is ‘no indication’ that using Forfeitures was necessary to maintain current employer-contribution levels or to cover future employer-contributions,” or that “WPP’s process in determining the amount of its Company Contributions is based on any consideration of the amount of Forfeited Plan Assets.” The court rejected these allegations, finding them “fundamentally…no different” from plaintiffs’ first complaint. The court ruled that plaintiffs had to allege “specific facts…that invite the inference that the fiduciary actually engaged in imprudent conduct. And the simple assertion that the employer did not need to use the Forfeitures for discretionary employer contributions does not suggest that it was imprudent to do so.” Second, plaintiffs argued that the committee did not “ensure[ ] that all [Forfeitures] for the plan year were promptly exhausted by year end or shortly thereafter, and did not remain in an unallocated Plan account.” This did not pass muster either “because the plaintiffs never explain why it would be imprudent for the Plan Committee not to allocate all Forfeitures at the end of the Plan year.” The court noted that “Forfeitures accrue whenever a Plan participant experiences a break in service before the employer contributions in the participant’s account vest,” and thus “the time at which Forfeitures accrue in the Plan’s Forfeitures account is variable.” As a result, “[i]t is therefore not only reasonable but entirely expected that the Plan’s Forfeitures account would contain potentially large sums of money on December 31 of each year.” Indeed, “it is difficult to imagine a situation in which the Form 5500 filings would show a balance even close to zero at year end.” As a result, the court found plaintiffs’ amended claim for breach of the fiduciary duty of prudence to be insufficient, and dismissed it. The court dismissed their derivative claim alleging breach of the duty to monitor as well. This time both dismissals were with prejudice, and thus the case is now over.

Sixth Circuit

Trout v. Meijer, Inc., No. 1:25-CV-1378, 2026 WL 1098213 (W.D. Mich. Apr. 23, 2026) (Judge Hala Y. Jarbou). Meijer, Inc., is a Midwest grocery store chain which offers an ERISA-governed health insurance plan to its employees. The plan includes a “wellness program” which requires employees to pay a $20 per week surcharge if they use tobacco products. If an employee signs a pledge at the start of the year stating they do not use tobacco products, they avoid the surcharge. Meijer collects these surcharges directly from employees’ paychecks and uses them to offset its contributions to the health plan. For employees who use tobacco, Meijer offers a cessation program as an alternative standard. If completed within the first six months of coverage, the surcharge for the entire year is eliminated. If completed later, only future surcharges are reduced. Justin Trout, a Meijer employee, paid the surcharge and filed this putative class action challenging the program. He brought claims under section 502(a)(2) and (a)(3) of ERISA, alleging that Meijer violated 42 U.S.C. § 300gg-4(j)(3)(D) by not providing the “full reward” to employees who complete the wellness program in the second half of the year. He also claimed Meijer violated § 300gg-4(j)(3)(E) by failing to disclose that physician recommendations would be accommodated. Additionally, Trout alleged that Meijer breached its fiduciary duties and engaged in prohibited transactions by collecting unlawful surcharges and using them to offset its contributions. Meijer moved to dismiss. The court addressed the “full reward” issue first, and ruled that the plan complied with ERISA. The court rejected Trout’s interpretation of the law, instead “adopt[ing] a more plausible reading: § 300gg-4 requires employers to allow employees to qualify for the full reward at least once per year. As long as employers meet that requirement, they are free to offer additional opportunities to qualify for a partial reward.” Trout complained that this did not treat “similarly situated” people the same, but the court explained that “the prohibition on unequal treatment of similarly situated individuals is designed (like the statute as a whole) to prevent discrimination based on participants’ health conditions. It is not designed to prevent discrimination based on the time of year a participant qualifies for the program.” Moving on to notice requirements, the court agreed that Trout stated a claim that Meijer violated the requirement to disclose the availability of a reasonable alternative standard. The court found that Meijer’s benefits guides described the wellness program sufficiently to trigger the notice requirement and failed to include necessary disclosures about accommodating physician recommendations. Meijer argued that this conclusion relied on Department of Labor regulations, and that Congress “did not grant the DOL authority to interpret § 300gg-4(j)(3)(E) or impose additional requirements beyond those included in the statute.” However, the court found that “a regulation clarifying § 300gg-4’s notice requirement is authorized by the general delegation in § 1135.” The DOL was thus permitted to “fill in” the details of the law, “[a]nd imposing the accommodation disclosure requirement contained in 29 C.F.R. § 2590.702 is a reasonable exercise of that authority.” The court also found that Trout had adequately alleged causation of loss because he was forced to pay the surcharge. Moving on, the court ruled that Trout did not state a claim for breach of fiduciary duties or engaging in prohibited transactions. The court found that Trout failed to allege harm to the plan and did not have standing to sue for breach of fiduciary duty, as he did not demonstrate that Meijer’s actions caused a loss to the plan or that the surcharges were plan assets. The court further noted that Meijer’s imposition of the surcharge was done in a settlor capacity, not a fiduciary capacity. The court also ruled that claims that accrued before November 5, 2021 were barred by the federal four-year catch-all statute of limitations in 28 U.S.C. § 1658. Finally, the court addressed remedies. Citing the Sixth Circuit’s recent decision in Aldridge v. Regions Bank, the court ruled that Trout could seek equitable restitution and disgorgement but not equitable surcharge because surcharge is a remedy that was not typically available in equity. However, Trout could only obtain restitution and disgorgement if he could trace the tobacco surcharges to a specific fund, which the court noted could be difficult due to commingling. In the end, Trout’s action survives, but in a greatly diminished capacity.

Disability Benefit Claims

Second Circuit

Nabi v. Provident Life & Casualty Ins. Co., No. 1:23-CV-00844-HKS, 2026 WL 1132875 (W.D.N.Y. Apr. 27, 2026) (Magistrate Judge H. Kenneth Schroeder, Jr.). Angelika Nabi was employed as the office manager of her husband’s medical practice, ENT Medical Associates, where she performed various administrative tasks. Because of her employment, she had long-term disability coverage under an ERISA-governed group policy issued by Provident Life & Casualty Company. In August of 2003, Nabi was diagnosed with glioblastoma multiforme, a type of aggressive brain cancer, after experiencing a seizure. Despite undergoing surgery, chemotherapy, and radiation, her condition was considered terminal. Over time, Nabi experienced a gradual decline in her cognitive abilities, which affected her ability to perform her job. She stopped working in December 2009 due to these impairments. Nabi should have applied for benefits with Provident at this time, but she did not, allegedly due to her cognitive decline. She finally applied in 2021 when her husband discovered the policy. By this time Nabi had undergone four brain surgeries, three facial surgeries, and two knee surgeries. Provident investigated her claim and began paying it, but only retroactively to September 8, 2021, the date of her notice. Nabi thus filed this action, contending that Provident wrongly denied her benefits from 2009 to 2021. The parties filed cross-motions for summary judgment, but the court denied both in a June 30, 2025 order in which it concluded that genuine issues of material fact existed as to whether Nabi filed her claim “as soon as reasonably possible,” as required by the policy. (Your ERISA Watch covered this decision in our July 9, 2025 edition.) The case proceeded to a bench trial in December of 2025, and this order represented the court’s findings of fact and conclusions of law. The court reviewed Provident’s decision de novo, as agreed by the parties, and ruled in Nabi’s favor. The court concluded that that due to the cognitive effects of her cancer treatments, Nabi was unable to give notice of her disability claim when she stopped working in 2009. The court determined that she filed her claim “as soon as reasonably possible” after her husband discovered the policy. The court found that the testimony of Nabi’s neurosurgeon was credible and supported the conclusion that Nabi’s cognitive impairments prevented her from filing a claim: “The full record thus supports the conclusion that Nabi’s inability to remember the policy, recognize that she could file a claim after she stopped working in December 2009, and take the necessary steps to do so was not a garden-variety memory lapse but rather the physiological result of the radiation and chemotherapy that she had undergone.” The court further concluded that Provident could not rely on the proof of loss provision as a basis for denial, as it was not a reason provided during the administrative appeal process. Consequently, the court awarded Nabi benefits retroactive to 2009 and determined she was entitled to reasonable attorneys’ fees, costs, and prejudgment interest.

Fourth Circuit

Karnes v. Midland Credit Mgmt., d/b/a Encore Capital Grp., No. 7:24-CV-00335, 2026 WL 1103453 (W.D. Va. Apr. 23, 2026) (Judge Robert S. Ballou). Alana Marie Karnes was terminated as a Midland Credit Management employee in 2022. While employed, she participated in Midland’s ERISA-governed disability benefit plan, which was administered by Prudential Insurance Company. Karnes became disabled in 2021 and took several medical leaves of absence over the next year prior to her termination. Eventually, she was approved for both short-term disability (STD) and long-term disability (LTD) benefits from Prudential, although she was required to appeal denials of both benefits before prevailing. Karnes brought this pro se action in 2024 against Midland, asserting claims for breach of contract, disability discrimination under the Americans with Disabilities Act (ADA), interference under the Family and Medical Leave Act (FMLA), and interest on delayed benefits under ERISA § 502(a)(1)(B). The court dismissed Karnes’ complaint, but granted her leave to amend all of her claims except for her ADA discrimination claim. Karnes filed an amended complaint in which she reasserted all of her dismissed claims and also asserted “several new claims, including retaliation under the ADA, FMLA, and ERISA § 510; breach of fiduciary duty under ERISA §§ 502(a)(3) and 404; and state law claims for forgery, wrongful discharge, and defamation.” Midland moved to dismiss once again. On Karnes’ non-ERISA claims, the court (1) dismissed her ADA discrimination claim, citing res judicata, and noting that Karnes “remained disabled long after her termination and does not allege that she was able to return to work,” which meant that she could not be “a ‘qualified individual’ capable of performing the essential functions of the job with or without reasonable accommodation”; (2) dismissed her FMLA interference claim, ruling that Karnes could not show prejudice from her termination, because once again she “remained disabled and unable to work through at least February 2024, long after any FMLA leave would have expired”; (3) dismissed her claim for breach of the duty of good faith and fair dealing because she failed to plead any specific contractual obligations Midland had under the employment contract; (4) dismissed her claim for ADA retaliation because she pled no causal link between her alleged protected conduct and her termination, and failed to allege any pretext or hostility; (5) dismissed her FMLA retaliation claim for similar reasons; (6) dismissed her claim for forgery because it is a criminal offense with no private right of action; (7) dismissed her claim for wrongful discharge because she failed to plead a public policy violated by Midland; and (8) dismissed her claim for defamation because it was time-barred and her alleged defamatory statements were “merely hypothetical.” As for Karnes’ ERISA claims, the court dismissed her benefits claim which alleged “improper delay and mishandling” of her claim, noting that Karnes did not allege Midland had control over the administration of the STD or LTD benefit plans. Indeed, Karnes admitted that “Prudential ‘is responsible for conducting any ERISA mandated claim evaluation and final review rests with [Prudential] and with no other entity.’” The court also dismissed Karnes’ Section 510 retaliation claim, ruling that “Karnes does not allege facts showing that her termination was motivated by her pursuit of ERISA-protected benefits or that Midland acted with intent to interfere with her ability to obtain such benefits. Indeed, by her own admission, Karnes received all benefits she was eligible for under the plan.” The court also dismissed Karnes’ breach of fiduciary duty claim, ruling that her allegations of “reckless mismanagement of Plaintiff’s disability and leave claims” were insufficient because her “allegations appear to be attributable to Prudential, not Midland,” and furthermore, “any administrative delays or errors do not appear to have reduced the amount of benefits paid or changed the outcome of her claims.” As a result, Midland’s motion to dismiss was granted once again, this time with prejudice.

Ninth Circuit

McLeod v. Reliance Standard Life Ins. Co., No. CV 22-87, 2026 WL 1133684 (D. Mont. Apr. 27, 2026) (Judge Susan P. Watters). Dona McLeod was an operator at CHS, Inc., a refinery in Billings, Montana, and was a member of United Steel Workers Local 11-443, which provided ERISA-governed long-term disability insurance coverage to its members through a group policy issued by Reliance Standard Life Insurance Company. McLeod became disabled in 2020 following a stroke and was approved for a monthly benefit of $4,000 by Reliance. Later, McLeod became eligible to collect a pension from CHS; she elected to receive a lump-sum distribution of $75,701.89, which she rolled over into an individual retirement account (IRA). In 2021 Reliance informed McLeod that these pension benefits were “Other Income Benefits” under the policy and therefore triggered the policy’s offset provision. Reliance thus reduced her benefit to $1,261.70 per month. McLeod unsuccessfully appealed and then filed this action, seeking recovery of plan benefits and other equitable remedies. The parties filed cross-motions for summary judgment, and the assigned magistrate judge recommended granting Reliance’s motion and denying McLeod’s motion. McLeod filed an objection, arguing that the contract-interpretation doctrine of contra proferentem should apply under the de novo standard of review, which would require any ambiguities in the policy to be construed in her favor. In this order the court agreed with Reliance and the magistrate. The court applied the de novo standard of review because the policy did not grant Reliance discretionary authority to interpret the policy. The court explained that the policy identified the union as the policyholder and provided, “[t]he Policyholder and any subsidiaries, divisions, or affiliates are referred to as ‘you,’ ‘your,’ and ‘yours,’ in this Policy.” It further defined “Other Income Benefits” subject to offset as including “that part of Retirement Benefits paid for by you.” The court agreed with Reliance that “the Policy’s use of ‘you’ is clear and unambiguous when read in context,” and included CHS as an “affiliate” of the union. Because the result was clear and unambiguous, the contra proferentem doctrine did not apply. McLeod argued that “you” only applied to the union, not her employer, but the court found that this interpretation would render key provisions of the policy meaningless, and in fact would eliminate McLeod’s benefit entirely because “[u]nder McLeod’s interpretation – limiting ‘you’ to the Union – only the Union’s own employees would qualify for coverage.” The court further noted that McLeod “does not specifically challenge the finding that she ‘was not only ‘entitled’ and ‘eligible’ to receive this Retirement Benefit, but in fact received the Retirement Benefit when she rolled the lump sum distribution into an IRA.’” As a result, because the policy included the CHS pension as an offset, and she did not dispute that she received it, the court found that Reliance did not err in using the pension to reduce her disability benefit. Reliance was granted summary judgment.

Exhaustion of Administrative Remedies

Fifth Circuit

Ellis-Young v. The Prudential Ins. Co. of Am., No. CV H-26-321, 2026 WL 1075158 (S.D. Tex. Apr. 21, 2026) (Judge Lee H. Rosenthal). Sherri Ellis-Young was employed by JPMorgan Chase and was a participant in the company’s ERISA-governed long-term disability benefit plan, which was administered by The Prudential Insurance Company of America. Ellis-Young alleged she “‘suffers from multiple medical conditions resulting in both exertional and nonexertional impairments,’ which cause ‘chronic pain and limitations,’ and from ‘anxiety, depression and visual impairments.’” Prudential initially approved her claim for benefits, but terminated them less than a year later, asserting she was no longer disabled under the policy. Ellis-Young filed this action, and Prudential responded with a motion for judgment on the pleadings, arguing that Ellis-Young’s complaint should be dismissed because she failed to exhaust her administrative remedies. The court construed the motion as one for summary judgment. The court noted that the plan required Ellis-Young to appeal Prudential’s denial within 180 days of the date of denial, which was extended by COVID-19 emergency regulations to the end of the national emergency, or May 11, 2023. 180 days from this date gave Ellis-Young until January 6, 2024 to appeal. Ellis-Young argued that communications from her and her counsel during 2023 and 2024 constituted an appeal. The court did not agree, ruling that these communications expressed only an “intent to appeal” rather than constituting an actual appeal. The court cited letters which stated that Ellis-Young “will be [filing] an appeal,” provided “legal notice of Mrs. Sherri Ellis-Young’s intent to appeal,” and “repeatedly requested additional information so that she could file a proper appeal.” As a result, the court likened this case to Holmes v. Proctor & Gamble Disability Benefit Plan and Swanson v. Hearst Corp. Long Term Disability Plan, two Fifth Circuit cases on this issue. “This case has all the material facts that led to dismissal in Holmes and Swanson.” The court noted that Ellis-Young “did not submit to Prudential any factual or substantive arguments or evidence explaining her disagreement with its denial until September 2025,” which was too late. The court also rejected Ellis-Young’s argument that the exhaustion requirement should be excused, again relying on Swanson. The court found no evidence that Prudential misled Ellis-Young or failed to notify her of the appeal deadline, and thus “[t]here is no basis to excuse Ellis-Young’s exhaustion obligations.” As a result, the court ruled in favor of Prudential, granting its motion for summary judgment.

Medical Benefit Claims

Seventh Circuit

Danielle B. v. Lafayette School Corp., No. 4:26-CV-014-GSL-JEM, 2026 WL 1113353 (N.D. Ind. Apr. 23, 2026) (Judge Gretchen S. Lund). Danielle B. is the mother of a minor, I.B., and was employed by Lafayette School Corporation. Danielle B. participated in the school’s health benefit plan, which insured I.B. as well. The plan was administered by Anthem Insurance Companies, Inc., and provided coverage for mental health services. I.B. received treatment for various mental health disorders, and was eventually admitted in 2023 to blueFire, a licensed outdoor therapeutic program in Idaho. blueFire is designed to support teens with behavioral health issues in a wilderness setting, with treatment by licensed therapists. I.B. received treatment at blueFire for approximately three months; plaintiffs were charged approximately $71,500. However, when plaintiffs submitted claims to Anthem for this treatment, Anthem denied them, citing missing procedure codes, ineligible provider types, and the plan’s exclusion of wilderness programs. Plaintiffs responded by filing this action in state court against the school and Anthem, asserting two claims: one for breach of contract and declaratory relief, and one for violation of the federal Mental Health Parity and Addiction Equity Act (“Parity Act”), as amended to ERISA. Defendants removed the case to federal court and moved to dismiss the Parity Act claim only. The court denied the motion. The court found that plaintiffs sufficiently pled a facial Parity Act violation by alleging that the plan imposed “specific, enumerated accreditation requirements on residential mental-health treatment centers, while imposing no comparable, enumerated accreditation requirements on skilled-nursing, rehabilitation, or hospice facilities that provide medical or surgical care.” The court also addressed the plan’s exclusion of wilderness programs, noting that while the exclusion appeared not to violate the Parity Act on its face because it categorically denied coverage for all charges from such programs, it was still premature to dismiss at this stage. As for plaintiffs’ as-applied challenge, the court found that they adequately alleged that the plan’s accreditation requirements for mental health facilities were more stringent than for medical or surgical facilities, thus plausibly stating a Parity Act violation. The court was “puzzled” by defendants’ arguments to the contrary because plaintiffs “specifically allege[d], and specifically list[ed], the four accreditation organizations that mental-health facilities must use and that the Plan does not have the same accreditation requirements for skilled nursing or hospice facilities.” The court emphasized that dismissal of Parity Act claims at the pleading stage in the Seventh Circuit is disfavored because plaintiffs often need discovery to obtain “comparative analyses” required by the Act. As a result, the court concluded that plaintiffs plausibly stated a Parity Act violation and denied defendants’ motion to dismiss.

Pension Benefit Claims

Third Circuit

Taylor v. Sheet Metal Workers’ Nat’l Pension Fund, No. 24-CV-04321, 2026 WL 1133599 (D.N.J. Apr. 27, 2026) (Judge Christine P. O’Hearn). Plaintiff Stultz G. Taylor is the owner of STS Sheetmetal Inc. and a longtime member of the Sheet Metal Workers’ Union Local Numbers 43 and 27. As a member, he is a vested participant in the ERISA-governed Sheet Metal Workers’ National Pension Fund (NPF) pension plan. In 2018, Taylor submitted an application to NPF indicating he intended “to retire from [the] Local Union with the understanding that [he] will not be able to collect [his] pension until [he] reach[es] the age of 62 or at such time [he is] no longer the owner of STS.” He further represented that he “intend[ed] to continue operating STS” but his duties would involve “office work only.” NPF recharacterized his application as a request for information about plan benefits, explaining that he was not retiring because he would continue to own STS. Taylor continued to own STS and perform clerical work there. In 2021, Taylor applied for pension benefits effective January 1, 2022. However, NPF denied his request, concluding that his continued clerical work for STS constituted “Disqualifying Employment” under the plan. Taylor unsuccessfully appealed this decision and then filed this action, asserting four counts under ERISA: (1) failure to provide ERISA benefits; (2) breach of fiduciary duty; (3) estoppel; and (4) failure to provide a full and fair review. The case proceeded to cross-motions for summary judgment. At the outset, the court struck two affidavits offered by Taylor, ruling that they were outside the administrative record. On the merits, the court applied the arbitrary and capricious standard of review because the plan gave the appeals committee discretionary authority to make benefit determinations. The court noted that the plan required a participant to be “retired” in order to receive benefits, meaning “he has ceased working in Covered Employment, as well as in any Disqualifying Employment, and such cessation of work is intended to be permanent.” Taylor argued that his continued work was not “Disqualifying Employment,” and that he fell within one of the plan’s exceptions, but the court rejected both contentions. First, the court stated that “Disqualifying Employment is defined to include, inter alia, ‘employment with any Contributing Employer,’” and “[i]t is undisputed that STS is a Contributing Employer… And the clerical work Taylor performed for STS is certainly ‘employment’ on its face, meaning it qualifies as Disqualifying Employment under the Plan.” Thus, the plan provision was not simply limited to “trade work” as Taylor suggested. Second, Taylor did not qualify for his cited exception because the work he was doing was not covered by the collective bargaining agreement. Moving on to count two, the court ruled that Taylor’s breach of fiduciary duty claim failed because he was not seeking relief on behalf of the plan under Section 1132(a)(2), and was seeking legal, not equitable, relief, which made Section 1132(a)(3) unavailable as well. Finally, counts three and four were non-starters because they were either duplicative of Taylor’s benefits claim or not supported by an independent cause of action under ERISA. Thus, the court granted defendants’ motion for summary judgment and denied Taylor’s.

Remedies

Second Circuit

Amara v. Cigna Corp., No. 24-2913, __ F. App’x __, 2026 WL 1113470 (2d Cir. Apr. 24, 2026) (Before Circuit Judges Livingston, Jacobs, and Leval). This case turns a quarter-century old this year and refuses to die. As background, this is a class action by employees of Cigna who alleged that Cigna miscalculated their benefits under its pension plan. The highlight of the litigation was the Supreme Court’s 2011 ruling in Cigna v. Amara that federal courts are not allowed to reform benefit plans under Section 1132(a)(1)(b) of ERISA, but can achieve the same result under Section 1132(a)(3), which provides equitable relief. On remand, the plan was reformed to provide class members all accrued benefits from the defined benefit pension plan (“Part A”), plus all accrued cash balance plan benefits (“Part B”). A plus B sounds simple enough, but the parties spent years litigating over how to calculate these sums. Eventually, the math was appropriately crunched, and a judgment issued. The Second Circuit affirmed in 2014. In recent years, however, the parties have squabbled over enforcing this judgment. In 2022 the Second Circuit affirmed a lower court ruling against plaintiffs, finding that Cigna had adequately complied with the judgment. (Your ERISA Watch covered this ruling in our November 16, 2022 edition, which we foolishly titled “The End of Amara?”) Plaintiffs did not give up, however. They again filed a motion for an accounting or post-judgment discovery based on their belief that defendants were improperly calculating award payments. The district court denied this motion in May of 2024. Plaintiffs appealed, and in this summary order the Second Circuit affirmed again. The appellate court was clearly tired of the case and only devoted four paragraphs to dismissing plaintiffs’ arguments. Plaintiffs argued that the district court inappropriately required a “showing of actual noncompliance as a prerequisite for Plaintiffs to prevail on their motion.” The Second Circuit disagreed: “Instead of requiring actual noncompliance, the district court stated that ‘the question for the Court is whether, as applied here, Plaintiffs have raised ‘significant questions regarding noncompliance with a court order’ sufficient to justify the remedy sought.’” This was good enough for the appellate court, which stated that, “[i]n its careful and thorough opinions, the district court concluded that Plaintiffs did not meet their burden under this standard. For substantially the reasons in the district court’s opinions, we AFFIRM the orders of the district court.” Perhaps at long last this really is the end of Amara, but we would not dare to predict it.

Retaliation Claims

Second Circuit

Wilson v. International Alliance of Theatrical Stage Employees Local 52, No. 25-CV-2907 (OEM) (LKE), 2026 WL 1110227 (E.D.N.Y. Apr. 24, 2026) (Judge Orelia E. Merchant). This is a putative class action brought by three craftsmen working in film and television production in the New York City area. They are associated with the labor union IATSE Local 52. Local 52 distinguishes between three tiers of union membership: members, applicants, and permits. Members have more consistent work, opportunities for advancement, and eligibility for the pension plan, unlike applicants and permits. In their complaint plaintiffs asserted various challenges to the way Local 52 manages its membership and administers benefits under state and federal law. Specifically, plaintiffs alleged (1) breach of contract under Labor Management Relations Act (LMRA) § 301, (2) interference under ERISA § 510, (3) breach of fiduciary duty under ERISA § 502(a)(3), and (4) retaliation under New York State Human Rights Law (NYSHRL) § 290. They seek “several forms of relief, including class certification…; a declaration that Defendants breached…the IATSE Constitution; an award of compensatory and consequential damages for breach of the IATSE Constitution; an order for declaratory and equitable relief under ERISA §§ 510 and 502(a)(3); permanent injunctive relief…compensatory and emotional distress damages for Local 52’s retaliation; reasonable attorneys’ fees; pre- and post-judgment interest; and all ‘such other and further relief as the Court deems just and proper.’” Local 52 filed a motion to dismiss plaintiffs’ second amended complaint for lack of jurisdiction and failure to state a claim, and further argued that the court should strike the class allegations. The court addressed subject matter jurisdiction first, ruling that plaintiffs’ claims were not subject to “Garmon preemption,” which prohibits courts from deciding controversies that “arguably arise” under the National Labor Relations Act of 1935 (NLRA). (For more on Garmon preemption, check out our discussion of the case of the week in our April 8, 2026 edition.) The court acknowledged that the NLRA provides exclusive jurisdiction over some activities, but “federal courts simultaneously possess subject-matter jurisdiction over suits alleging violations of labor contracts.” Regarding ERISA specifically, the court stated that (1) “ERISA operates independently of the NLRA, governing the administration of most employee benefit plans,” and does not generally apply to unfair labor practices; (2) “[e]ven assuming that Plaintiffs’ ERISA claims raised labor issues, however, federal courts may decide such issues that arise collaterally in cases brought under independent federal remedies”; and (3) Garmon “primarily addresses potential conflicts between state and federal laws, not potential conflicts between federal laws.” However, the court found that the NYSHRL claim of one plaintiff was preempted under LMRA § 301, as it involved determining whether Local 52 violated the IATSE Constitution. As for the merits of plaintiffs’ claims, the court ruled that (1) plaintiffs plausibly stated a LMRA § 301 claim by alleging a breach of the IATSE Constitution, which provided for immediate membership upon achieving vested status; (2) the LMRA claims of one plaintiff were not time-barred because the IATSE Constitution was adopted in 2021, and his claims were brought within six years; (3) plaintiffs plausibly stated an ERISA § 510 claim because they alleged specific intent to interfere with their rights by granting certain benefits to members and not them; (4) plaintiffs could not obtain monetary damages, including “the value of lost future employment benefits,” under ERISA §§ 510 and 502(a)(3) because those sections only allow for equitable relief; and (5) one plaintiff’s NYSHRL retaliation claim could not proceed because he failed to plausibly plead “temporal proximity” which might establish a causal connection between his protected activity (filing a lawsuit against the union) and the adverse action (blocking his invitation of membership). Finally, the court denied Local 52’s motion to strike plaintiffs’ class allegations, finding it premature to rule on class certification at this stage of the litigation. As a result, Local 52’s motion to dismiss was granted in part, denied in part, and the case will continue.

Fifth Circuit

Moore v. Wireless CCTV LLC, No. CV H-25-5476, 2026 WL 1130370 (S.D. Tex. Apr. 27, 2026) (Judge Lee H. Rosenthal). Bridgett Moore filed this action against her former employer, Wireless CCTV LLC, where she worked as a regional account manager. Moore alleged that she was mistreated in numerous ways by Wireless, including Wireless’ manipulation of commission payments, failure to provide compensation information, and interference with her physician-approved medical leave and insurance coverage. Moore alleged fourteen causes of action against Wireless: “(1) breach of contract, (2) breach of implied-in-fact contract/promissory estoppel; (3) quantum meruit or unjust enrichment; (4) the procuring-cause doctrine; (5) violation of Chapter 61 of the Texas Labor Code; (6) retaliation under the FLSA; (7) retaliation under the Texas Labor Code; (8) fraud and constructive fraud; (9) negligent misrepresentation; (10) interference with protected rights under ERISA § 510; (11) COBRA notice violations; (12) intentional infliction of emotional distress; (13) ERISA breach of fiduciary duty; and (14) declaratory judgment.” Wireless moved to dismiss Moore’s complaint. Addressing the federal claims first, the court found that Moore did not allege complaints about rights protected by the FLSA, such as minimum wage or overtime, but rather about commission payments, which are not protected under the FLSA. The court also ruled that Wireless complied with COBRA obligations, as Moore’s change to unpaid, non-FMLA medical leave constituted a “reduction in hours,” and thus was a qualifying event under COBRA. On Moore’s ERISA claims, the court ruled that “Moore has pleaded no facts plausibly showing interference under § 510; the alleged facts merely show that Moore lost benefits during non-FMLA medical leave. The loss of benefits is, alone, insufficient to state a claim under § 510 anyway… For similar reasons, Moore has not plausibly pleaded an ERISA breach of fiduciary duty claim. Even setting aside Wireless’s argument that Moore failed to plead that Wireless was a fiduciary, the facts do not show that Wireless breached any fiduciary duty. Rather, the alleged facts show that Wireless properly sent Moore a notice under COBRA and properly returned a payment for an expired plan.” Moving on to the state law claims, the court dismissed Moore’s breach of contract and related claims because she had an active Texas Workforce Commission claim and had not exhausted administrative remedies. The court also found Moore’s tort claims insufficiently pleaded, lacking the necessary factual basis. The court thus granted Wireless’ motion to dismiss, but allowed Moore to file an amended complaint, likely because she had been proceeding pro se and recently retained counsel. Finally, the court agreed with Wireless in a footnote that Moore’s pleadings “indicate[d] the use of generative AI” and cited cases “that do not exist.” The court warned Moore that “briefing ‘built on AI-generated cases that stand for legal propositions in direct contravention of actual case law’ ‘is the epitome of baseless’ and that, ‘[w]hile courts afford pro se litigants considerable leeway, that leeway does not relieve pro se litigants of their obligation under Rule 11 to confirm the validity of any cited legal authority.’”