Your ERISA Watch would like to take this opportunity to wish a happy 250th birthday to the United States of America. This year’s celebration was unfortunately not as unifying and good-natured as our 200th, but your editor is optimistic that by 2076 American patriots of all political stripes will have resolved their differences and we will be living in peace and harmony. After all, ERISA will be 100 years old by then and surely all of its issues will have been ironed out as well. Maybe the U.S. will even win a World Cup by then. (I will leave it up to the reader to decide which of these is most unlikely.)

Until then, we must trudge on. It was a light week for the federal courts, but keep reading to learn about (1) ERISA’s preemption of California state and local laws regulating sick pay in the dockworker context (Hill v. Pacific Maritime Ass’n), (2) the dismissal of a class action alleging mismanagement of Molson Coors’ 401(k) plan (Hensley v. Molson Coors), (3) the settlement of a complex class action involving the alleged dilution of shares in an employee stock ownership plan (Howell v. Argent Trust), and last, but certainly not least, (4) the end of a case that was originally filed in 1992(!), just after the country’s quasquibicentennial (Breidenbach v. IBEW).

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

Breach of Fiduciary Duty

Seventh Circuit

Hensley v. Molson Coors Beverage Co. USA LLC Governance Committee, No. 25-C-1371, 2026 WL 1878633 (E.D. Wis. June 30, 2026) (Judge William C. Griesbach). This case revolves around the 401(k) retirement plan established by Molson Coors Beverage Company USA LLC for its employees. The plan is a huge one, with more than $1.5 billion in assets and 9,700+ participants. The plaintiff is Winston Hensley, a plan participant and former employee, who accuses the company, its governance committee, and the plan investment subcommittee of mismanaging the plan by maintaining the Fidelity Stable Value Fund (SVF) as an investment option in the plan. Hensley contends that the SVF “is a ‘synthetic investment contract’ that carried significantly more risk and provided a significantly lower rate of return than other comparable funds that Defendants could have made available to Plan participants.” Hensley’s complaint asserted claims for breach of fiduciary duty, failure to monitor fiduciaries, and engaging in transactions prohibited by ERISA. Defendants filed a motion to dismiss for failure to state a claim. Addressing the claim for breach of the fiduciary duty of prudence first, the court agreed with defendants that “Plaintiff improperly relies upon hindsight and a cherry-picked assortment of comparators in the [complaint].” The court found that Hensley’s exemplar funds were not “meaningful benchmarks” when compared with the Fidelity SVF. While Hensley did provide other SVFs for comparison, “the mere fact that a fund falls in the SVF category is not enough to show it is comparable to other SVF investments.” Indeed, “[s]ynthetic stable value funds are generally the least risky because principal is guaranteed by multiple wrap providers and plan participants own the assets of the underlying funds.” This was by design, because “[t]he principal objective of an SVF is capital preservation, not maximization of returns.” The court found that Hensley’s comparator SVFs did not reflect similar investment strategies, risk profiles, or potential rewards. Furthermore, “out of the fourteen putative comparator funds in the [complaint], Plaintiff only cited one other SVF…that he alleges outperformed the Fidelity SVF in each year of the putative class period. And even that fund is sufficiently dissimilar to belie any fair comparison[.]” As a result, the court granted defendants’ motion to dismiss Hensley’s duty of prudence claim. Because this claim failed, his derivative claim for breach of the duty to monitor was also dismissed. Finally, the court agreed with defendants that Hensley lacked standing to bring his prohibited transaction claim. “Plaintiff’s bare allegation that Defendants violated ERISA by allowing contractual payments by plan fiduciaries to third parties in exchange for plan services may be enough to state a claim, but it does not establish the injury necessary to satisfy the Article III requirement of standing.” The court ruled that Hensley did not show that “the fees paid to Fidelity were unreasonably high or more than it would have had to pay a non-party in interest.” As a result, defendants’ motion was granted. Moreover, because Hensley had already amended his complaint once and had not indicated how he would overcome the identified defects, the dismissal was with prejudice. “Considering the high costs of litigation, such ‘cat and mouse game[s] of motions to dismiss followed by a motion to amend,’ need not be allowed.”

Class Actions

Sixth Circuit

Breidenbach v. IBEW Local No. 82, No. 3:92-CV-184, 2026 WL 1894213 (S.D. Ohio July 1, 2026) (Judge Walter H. Rice). No, that case number is not a typo – this case originated in 1992. As a result, it was no surprise that the court opened this order by “first acknowledg[ing] the unconscionable length of time which this case has been pending. The Court extends its deepest appreciation to parties and counsel for their efforts in achieving final resolution.” The case is a class action by Fredric S. Breidenbach and others similarly situated against IBEW Local No. 82 and associated defendants. The court held an initial fairness hearing on a settlement agreement in 2008, which required defendants to deposit $232,000 with the clerk of the court, to be paid to Breidenbach with interest upon final regulatory approval. The trustee for the pension fund was to hold contributions made by the class members in escrow, to be transferred from a defined benefit plan to a defined contribution plan upon ultimate approval of the settlement agreement. A letter requesting a private letter ruling from the IRS was submitted in 2010, but the IRS did not give final approval until 2020. Meanwhile, Breidenbach passed away. The settlement agreement included a “clawback” provision to prevent participants from receiving duplicate benefits from both of the plans at issue. In this ruling the court addressed multiple motions, including a motion for release of funds to the estate of Breidenbach, a motion for attorney’s fees, and a joint motion for approval of class action settlement agreement. The court granted all three motions and overruled objections to the proposed settlement agreement. The court found that the clawback provision was part of the agreement from the start, as evidenced by testimony and documentation, and was necessary to prevent “double-dipping” by class plaintiffs. The court further determined that the settlement agreement was fair, reasonable, and adequate, considering the costs, risks, and delay of trial and appeal. “[T]he alternative to settlement is for this matter to continue for several more years, during which time even more class members will likely pass away without ever getting the option to move from the DB to DC Plan. The best and most comprehensive relief available to the Plaintiff class is the submitted settlement agreement.” The court commended counsel for effectively providing notice of the settlement and deadlines for election to class members. The court also found that the requested attorney’s fees (which only totaled $25,000 because the attorney had only “been on the case for less than a year”) were reasonable given his work in finalizing the settlement. The court concluded that the class representatives adequately represented the class and that the proposal was the product of an arm’s-length negotiation. The court thus approved the settlement agreement and directed the court clerk to disburse the $232,000 in the escrow account, plus (presumably significant) interest, to the administrator of Breidenbach’s estate.

Eleventh Circuit

Howell v. Argent Trust Co., No. 1:22-CV-03959-SDG, 2026 WL 1876784 (N.D. Ga. June 29, 2026) (Judge Steven D. Grimberg). This is a complicated class action concerning The North Highland Company Employee Stock Ownership Plan. The plaintiffs are plan participants and beneficiaries who alleged that a corporate reorganization significantly diluted plan equity to their detriment. They alleged 17 causes of action against various defendants under ERISA. In 2024, the court granted in part and denied in part defendants’ motion to dismiss and to compel arbitration, holding that certain claims were time-barred but that defendants could not compel arbitration of the remaining claims. (Your ERISA Watch covered this ruling in our October 9, 2024 edition.) Defendants appealed, and the appeal was held in abeyance while the Eleventh Circuit decided a case with similar arbitration issues. (That case was Williams v. Shapiro, which adopted the effective vindication doctrine in the ERISA context and was one of our cases of the week in our December 24, 2025 edition.) Meanwhile, the parties continued to discuss settlement and eventually reached an agreement. The parties stipulated to a limited remand from the Eleventh Circuit so that the district court could enter an order granting plaintiffs’ unopposed motion for preliminary approval of class settlement and certification of a settlement class. In this order the court granted plaintiffs’ motion. The court found that the proposed settlement (the details of which were not itemized, but apparently totals $2.375 million) was fair, reasonable, and adequate, meeting the requirements of Federal Rule of Civil Procedure 23(e)(2). The court further found that the settlement was negotiated in good faith at arm’s length between experienced attorneys and facilitated by an experienced mediator. The court certified a class under Rule 23(b)(1) composed of all participants in the plan who held vested shares in North Highland ESOP Holdings, Inc. between dates in 2016 and 2025. The court appointed the three named plaintiffs as class representatives and Bailey & Glasser LLP as class counsel. The plan of allocation was deemed fair, reasonable, and adequate, “as it proposes to compensate each class member based on the number of shares held in [the ESOP] over the Class Period, which is a fair proxy for the harm alleged, which was based on the number of shares held in the ESOP when shares were diluted[.]” The Court also approved the notice of settlement as reasonable. Simpluris was appointed as the settlement administrator and will be responsible for the duties in the settlement agreement, including establishing a qualified settlement fund. The court scheduled a fairness hearing for November of this year to determine final approval of the settlement and any applications for attorneys’ fees and costs.

Disability Benefit Claims

Sixth Circuit

Smith v. Unum Life Ins. Co. of Am., No. 1:21-CV-294-KAC-CHS, 2026 WL 1949312 (E.D. Tenn. July 6, 2026) (Judge Katherine A. Crytzer). Jeffrey Scott Smith was a senior software engineer for Silicon Graphics International Corporation when he became disabled in 2015. Unum Life Insurance Company of America, the administrator of the company’s ERISA-governed employee long-term disability benefit plan, approved his claim based on cervical and lumbar radiculopathy and memory loss. However, in 2020 Unum changed its mind and concluded that Smith could return to the duties of his old occupation. Smith unsuccessfully appealed and then brought this action against Unum and its corporate parent, alleging that their termination of his claim was arbitrary and capricious. The parties filed cross-motions for judgment, and Smith also filed a motion to determine the extent of deference that should be given to Unum’s decision, arguing that defendants’ financial interests tainted their decision-making process. The motions were referred to the assigned magistrate judge, who issued a report and recommendation. The report recommended denying Smith’s motion regarding deference, but “still considers Defendants’ financial interests in assessing whether Defendants’ denial was supported[.]” The report further recommended that the court grant Unum’s motion for judgment and deny Smith’s. Smith filed an objection to the recommendation, making three arguments: (1) defendants’ denial was unreasonable because “because it ‘relied on inconsistent file reviewing physicians’ and, in any event, ‘the weight of the evidence shows’ that he ‘is disabled due to cognitive deficits’”; (2) the report “erred ‘[i]n finding Unum’s reliance on file review credibility determinations appropriate’ and ‘granting no weight to Unum’s failure to physically examine’ Plaintiff”; and (3) the report did not adequately consider defendants’ bias. First, the court found that defendants did not abuse their discretion in terminating Smith’s claim, concluding that new evidence in the form of updated neuropsychological testing justified their changed position. The court also found that defendants adequately accounted for other testing which may have supported Smith’s claim. Specifically, that evidence was sufficiently countered by Unum’s reviewing physicians, who determined that the results “do[] not reflect a significant function deficit,” and that Smith’s “mild relative weakness” did not prevent him “from performing his own occupation.” The court stated that defendants’ decision was not unreasonable “just because the administrator ‘chooses to rely upon the medical opinion of one doctor over that of another.’” Second, the court concluded that defendants acted within their discretion in relying on file review physicians and the available record, and they were not required to conduct a physical examination. The court did not agree with Smith that Unum’s doctors were making “credibility determinations”; instead, those doctors relied on the same testing as Smith’s physicians but “just reached different conclusions from the testing.” Third, the court determined that there was insufficient evidence of bias affecting defendants’ decision-making process. The court agreed that defendants had a structural conflict of interest, but rejected the idea that bias was proven by (1) tracking reports showing monthly termination goals, (2) bonuses for which defendants’ on-site physicians might be eligible “if the Company succeeds,” or (3) Unum’s regulatory settlement agreement from 2004 and subsequent jury verdicts against them. None of these facts showed that defendants’ conflict “materialized in a concrete way to influence the administrator’s decisional process” in this particular case. As a result, the court overruled Smith’s objections, adopted the conclusions of the magistrate’s report and recommendation, and entered judgment in defendants’ favor.

ERISA Preemption

Ninth Circuit

Hill v. Pacific Maritime Ass’n, No. 24-CV-00336-JSC, 2026 WL 1909997 (N.D. Cal. July 2, 2026) (Judge Jacqueline Scott Corley). This is an action by unionized California dockworkers who “allege Defendants violated California law and several local ordinances by failing to pay them and the putative class sick pay.” The defendants are the Pacific Maritime Association (PMA) and its more than 50 member companies, which consist of marine terminal operators, cargo-handling specialists, and other related port businesses. As the court explained, West Coast port operations are “unique”; dockworkers do not work for any specific PMA member company, but instead are dispatched to jobs for multiple employers based on collective bargaining agreements and local rules. They can choose when to seek work and can decline jobs offered through dispatch. PMA functions as a centralized payroll agent, collecting funds from member companies to pay dockworkers. PMA also administers certain benefits through several ERISA-governed trust funds. In this action plaintiffs have asserted claims under California’s Healthy Workforce Healthy Families Act (HWHFA) and local sick leave ordinances enacted in the cities of Los Angeles, Oakland, San Francisco, and San Diego. They contend that these laws require defendants to implement a sick pay policy; they request an injunction to that effect and restitution for past sick pay owed. Plaintiffs also added a claim for retaliation based on allegations that defendants excluded Local 26 Watchmen from a $70 million Pandemic Appreciation Pay fund. Plaintiffs contend that this was done to punish Local 26 for filing complaints with the California Labor Commission regarding the lack of sick leave. Before the court was defendants’ motion for summary judgment, which asserted that ERISA preempts all of plaintiffs’ claims. The court was sympathetic because plaintiffs were contending that “California state and local laws require Defendants to adopt a paid sick leave plan, that is, an employee welfare plan within the meaning of ERISA. As a result, their sick leave claims are related to an ERISA plan [] are preempted.” Indeed, the court noted that the other benefit plans in which plaintiffs participated were ERISA-governed, strongly suggesting that any new plan established by defendants would have to be also. Plaintiffs contended that defendants “could adopt a sick leave plan that falls within ERISA’s payroll practice exemption,” but the court found this argument “unpersuasive” for two reasons. First, “the record does not include evidence that supports a finding any defendant could pay sick leave out of its general assets.” The court emphasized that the benefits plaintiffs already received were not paid from PMA’s “general assets,” and neither would the benefits they sought in this action. Instead, all benefits originate from the member companies. Second, because of the unusual nature of employment assignments, any proposed plan would have to consider which workers were taking leave from which assignments, and “how to allocate paid sick leave payments when a dockworker does not make herself available to dispatch due to sickness.” For these complicated logistical reasons, “It is thus unsurprising Plaintiffs cannot cite a single case – or even an actual example – of dockworker benefits being paid from anything other than an ERISA plan.” Thus, defendants’ motion was granted as to plaintiffs’ sick-leave claims. The court also denied plaintiffs’ request for additional discovery, finding it untimely and unsupported by a sufficient explanation for the delay. However, the court denied defendants’ motion regarding plaintiffs’ Pandemic Pay retaliation claims. “Unlike sick leave, Defendants have not shown that pay – including bonuses – falls within ERISA’s definition of an employee benefit plan… So, even though the record shows that to make such payments Defendants would have to adopt a plan and separate fund to allocate payments among them to the excluded watchmen, Defendants have not shown that plan would fall within ERISA.” The court thus only granted defendants’ summary judgment motion in part.

Medical Benefit Claims

Tenth Circuit

E.O. v. Premera Blue Cross, No. 2:23-CV-00443-TS-JCB, 2026 WL 1875695 (D. Utah June 30, 2026) (Judge Ted Stewart). E.O. is a participant in an ERISA-governed medical benefit plan, and his son, E.L., is a beneficiary of the plan, which is insured by Premera Blue Cross. E.L. was diagnosed with ADHD and dysgraphia in third grade and experienced significant mental health issues which only grew worse as he progressed to high school. E.L. began to have severe panic attacks and thoughts of suicide, and was sometimes violent and aggressive. His treating physicians stated that “outpatient treatment would be unsuccessful given the severity of E.L.’s condition” and recommended residential treatment. In 2022 E.L. attended blueFire, an outdoor behavioral health program, after which he was admitted to Gateway, a residential treatment center. However, Premera denied E.O.’s claim for benefits for E.L.’s treatment at Gateway, contending that his treatment there was not medically necessary. E.O. unsuccessfully appealed and then brought this action against Premera, asserting two claims: (1) for recovery of benefits under 29 U.S.C. § 1132(a)(1)(B), and (2) under the Mental Health Parity and Addiction Equity Act of 2008. The case proceeded to cross-motions for summary judgment, where the court applied the arbitrary and capricious standard of review. The court identified numerous procedural violations by Premera. Premera’s denial letters did not reference specific plan provisions or adequately explain the basis for the denial. “[H]ere, any discussion of or citation to the Plan is entirely absent. Premera provides no explanation as to how the referenced admission guidelines, including the InterQual criteria and Premera’s internal policy, apply to the terms of the Plan.” The court also noted that “any citation to the record to support [its] conclusions is entirely absent. Likewise, Premera offers no explanation of clinical judgment regarding how it applied the terms of the Plan and InterQual criteria to those health conclusions such that denial was warranted.” Premera further “mischaracterized and unreasonably applied the InterQual criteria.” Premera did not consider all of the relevant criteria, misinterpreted the criteria, and limited its review to evidence as of a specific date, thereby excluding relevant evidence. Finally, and “[p]erhaps most egregiously, the Court finds that Premera blatantly failed to consider, engage with, or even acknowledge the letters from E.L.’s clinicians who opined that residential mental health treatment was medically necessary.” Premera conceded that it did not engage with the provider opinions, but argued that an “administrator is not required to engage provider opinions that do not contain information relevant to medical necessity of benefit claimed.” The court found Premera’s arguments “misplaced and reflect Premera’s failure to even consider the provider opinions,” which contained relevant evidence supporting medical necessity. The court emphasized that while an administrator is not required to defer to the opinions of a treating physician, it must address medical opinions, particularly those that may contradict its findings. In the end, the court found an “overwhelming amount of evidence supporting” severe functional impairment, an inadequate support system, E.L.’s inability to be managed safely in the community, and a lack of success at lower intensity treatment levels. In its briefing Premera attempted to rectify its errors, offering arguments to counter E.L.’s treatment providers, but “[t]hese rationales were never communicated to Plaintiff and thus are late and will not be considered in determining whether Defendant properly provided Plaintiff with a full and fair review.” The court addressed them anyway and found them unpersuasive. As a result, the court ruled that Premera acted arbitrarily and capriciously in denying benefits for E.L.’s treatment and issued judgment in E.O.’s favor. As for a remedy, the court awarded retroactive benefits. The court stated, “Not only did Premera admit to not performing its core duty to provide a full and fair review, the reasons articulated for not doing so are egregious.” Remand was inappropriate for this reason and because it would give Premera a second “bite at the apple” to re-evaluate the claim based on rationales not raised in the administrative record. The court denied E.O.’s Parity Act claim as moot and ordered additional briefing regarding interest, attorney’s fees, and costs.

Retaliation Claims

Fifth Circuit

Engler v. Paycom Payroll, LLC, No. CV 25-145, 2026 WL 1872309 (E.D. La. June 30, 2026) (Judge William J. Crain). Kaitlin Gates Engler was employed as a sales representative at Paycom Payroll LLC in 2022 when she accepted a promotion to sales manager. As part of the promotion, Engler moved from St. Louis to New Orleans and received unvested shares of company stock under its long-term incentive plan. At the time, the company knew Engler was pregnant and would require medical leave. Engler went on approved leave under the Family and Medical Leave Act (FMLA) after her daughter was born in December of that year. However, while she was out, one of Engler’s subordinate sales representatives at Paycom resigned and accused Engler of directing sales representatives to falsify records. After an investigation (which Engler claims was incomplete and biased), Engler was terminated in March of 2023, shortly after returning from leave. Engler filed this action, asserting three claims: (1) retaliation under the FMLA; (2) retaliation under section 510 of ERISA; and (3) detrimental reliance under Louisiana Civil Code article 1967. Paycom filed a motion for summary judgment. The court denied Paycom summary judgment on Engler’s FMLA claim. The court found that Engler had established a prima facie case of retaliation by showing temporal proximity between her FMLA leave and termination, which was sufficient to establish a “causal link.” The court accepted that Paycom had provided a legitimate, non-discriminatory reason for termination, citing violations of its ethics code, and thus the burden shifted to Engler to show that the reason was pretextual. Engler offered evidence that “(1) no one else was ever fired for falsifying time and attendance records; (2) Paycom did not follow its usual practice of progressive discipline before the ultimate act of firing her; and (3) Engler was fired without an opportunity to defend herself.” Paycom disputed these allegations, but “[t]he court cannot resolve such conflicts without weighing credibility, which cannot be done on summary judgment.” Paycom had better luck on Engler’s remaining two claims. The court found that the stock awards Engler received with her promotion “neither provide retirement income nor defer income beyond termination.” As a result, the awards were not part of any ERISA-governed plan, and thus Engler could not bring a claim under ERISA for retaliation. Finally, the court granted Paycom summary judgment on Engler’s detrimental reliance claim. Her claim failed because the promise on which she relied was fulfilled: she was awarded shares under the incentive plan as promised, even if they did not vest right away. The court found no clear and unambiguous promise that they would vest regardless of her employment status. “A detrimental reliance claim cannot rest on something Paycom never promised.” As a result, the case will proceed, but only on Engler’s FMLA claim.

Reyna v. Walmart Inc., No. 1:25-CV-02159-ABD-SH, 2026 WL 1920919 (W.D. Tex. July 2, 2026) (Magistrate Judge Susan Hightower). This order begins, “Reyna is a vexatious litigant,” and it goes downhill for plaintiff Joseph Anthony Reyna from there. Reyna is subject to a Pre-Filing Injunction in the Western District of Texas, where he has been “BARRED from filing future complaints…without obtaining prior approval from a district or magistrate judge” because he “has filed more than two dozen lawsuits in federal courts across Texas since June 2025,” almost all of which have been dismissed. As for this action, it is an employment discrimination suit against Walmart which was originally filed in two different places: the federal Southern District of New York and Travis County state court in Texas. The two cases were transferred and consolidated in the Western District of Texas, after which Walmart filed a motion to dismiss the complaint under Federal Rule of Civil Procedure 41(b) for Reyna’s failure to comply with the court’s Pre-Filing Injunction and under Rule 12(b)(6) for failure to state a claim. Reyna opposed the motion “and brings a litany of frivolous and duplicative motions and notices in response.” The assigned magistrate judge recommended granting Walmart’s motion on multiple grounds. First, the court found that Reyna violated the Pre-Filing Injunction by bringing the lawsuits without obtaining prior approval. The court stated that the injunction applied to transferred and removed cases; “To find otherwise would defeat the purpose of the sanction.” Second, although Reyna was granted in forma pauperis status based on his financial status, the court found his suit to be “malicious” because it violated the Pre-Filing Injunction. The court thus recommended dismissal under § 1915(e)(2)(B)(i). Third, the court found that Reyna failed to state a plausible claim for relief under the ADA and ERISA. Under his ADA claims, Reyna “fails to allege sufficient facts that he was qualified for the job or subject to an adverse employment action because of his purported disability.” His allegations were instead vague and conclusory. Similarly, on his ERISA claims, Reyna “alleges no facts showing that Walmart took any adverse employment action against him for exercising his rights under ERISA.” Reyna also alleged that Walmart did not give him plan documents upon request, but he did not adequately plead “that Walmart was the plan administrator or that he was denied any records. Walmart points out that it was not the plan administrator and that Reyna’s own allegations show he received the requested documents in November 2025.” Because these rulings disposed of Reyna’s federal claims, the court recommended declining to exercise supplemental jurisdiction over his remaining state law claims. Finally, the magistrate recommended dismissing Reyna’s “thirteen non-dispositive motions and recommends that the District Court dismiss his two dispositive motions.” She further recommended that the Pre-Filing Injunction be amended “to specifically state that he is barred from proceeding as a plaintiff in this Court, including in removed and transferred cases, without prior leave.”

Ahn v. Cigna Health & Life Ins. Co., No. 25-1723, __ F.4th __, 2026 WL 1813215 (3d Cir. June 24, 2026) (Before Circuit Judges Hardiman, Scirica, and Ambro)

ERISA is famous for many things, but near the top of the list is its sweeping preemptive force. 29 U.S.C. § 1144 provides that ERISA “shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.”

As Justice Thomas noted in his concurrence in Gobeille v. Liberty Mut. Ins. Co. (2016), ERISA “contains what may be the most expansive express pre-emption provision in any federal statute.” He was not a fan: “Read according to its plain terms, § 1144 raises constitutional concerns.” Justice Thomas worried that ERISA’s “relate to” language, taken to an extreme, might unduly infringe on powers typically reserved to the states.

While Justice Thomas was concerned with structural issues, other Justices have been troubled by remedies. Justice Ginsburg, in her concurrence in Aetna Health Inc. v. Davila (2004), agreed with “the rising judicial chorus urging that Congress and [this] Court revisit what is an unjust and increasingly tangled ERISA regime.” She opined that ERISA’s expansive preemptive scope, combined with a “cramped construction” of its remedies, has resulted in a “regulatory vacuum” in which “virtually all state law remedies are preempted but very few federal substitutes are provided.”

Regardless of how you feel about ERISA preemption, until the Supreme Court (or Congress) changes course, ERISA’s preemptive power will continue to thwart efforts to apply state law in cases involving employee benefits. This week’s notable decision provides yet another example.

The plaintiff in the case is Dr. Jeffrey M. Ahn, an otolaryngologist. He is not part of Cigna Health and Life Insurance Company’s provider network, but some of his patients are insured by Cigna. Dr. Ahn alleges that he submitted claims to Cigna for several of these patients. However, Cigna denied his claims “about 50 times.” In its explanations of benefits (EOBs) Cigna allegedly stated that it “did not pay for services performed by unlicensed providers – i.e., that Dr. Ahn was not licensed to practice medicine.” When Dr. Ahn appealed these claims, “Cigna allowed them in whole, in part, or denied them for a reason unrelated to his licensed status.”

Dr. Ahn was annoyed by Cigna’s insinuation that he did not have a license to practice medicine, so he filed this action in New Jersey state court, asserting claims against Cigna for defamation, defamation per se, and tortious interference. Dr. Ahn contended that the EOBs harmed his professional reputation and interfered with his business relationships.

Cigna removed the case to federal court and moved to dismiss or, alternatively, for summary judgment, citing ERISA preemption. The district court initially found that it was premature to rule on Cigna’s preemption argument because it could not determine from Dr. Ahn’s complaint which of the allegedly defamatory EOBs related to Cigna’s administration of ERISA-governed plans.

The parties thus conducted discovery, after which Cigna once again moved for summary judgment on all of Dr. Ahn’s claims, again relying on ERISA preemption. Dr. Ahn withdrew his defamation and tortious interference claims, leaving only his defamation per se claim.

On this sole remaining claim the district court granted Cigna’s motion. The court found that the plans at issue were all governed by ERISA, and that ERISA preempted Dr. Ahn’s claim. (Your ERISA Watch covered this decision in our March 26, 2025 edition.) Dr. Ahn appealed to the Third Circuit, which issued this published opinion.

The appellate court began by identifying two categories of state laws that ERISA preempts: those that have a “reference to” ERISA plans and those that have an impermissible “connection with” ERISA plans. Cigna relied on the second category, in which a state law “governs…a central matter of plan administration” or “interferes with nationally uniform plan administration.”

The Third Circuit agreed with Cigna that Dr. Ahn’s claim fell within this second category. The court emphasized that “[t]he communication of claim adjudications to plan participants and beneficiaries is a ‘central matter of plan administration.’” ERISA requires plans to “provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial.”

Here, Cigna fulfilled this duty by issuing EOBs. As a result, “statements therein about the reasons for the denial of a claim are inseparable from Cigna’s duty to provide a written explanation of claim denials under ERISA. And any state-law claims challenging the content of such statements would impermissibly allow state law to regulate matters squarely within ERISA’s ‘heartland.’”

In so ruling, the court relied heavily on the Fifth Circuit’s decision in Mayeaux v. Louisiana Health Service & Indemnity Co. (2004), in which that court dismissed a physician’s tort claims, including defamation, that challenged an insurance carrier’s claims handling. Mayeaux held that allowing such claims “would undoubtedly jeopardize the relationships among the traditional ERISA entities, of which the treating physician is not one. These are the sort of claims that go to the very heart of the ERISA administration process.”

Dr. Ahn attempted to distinguish Mayeaux, arguing that “accusing a medical professional of being ‘unlicensed’ does nothing to establish standards of conduct, responsibility and obligation for fiduciaries of employee benefit plans.” However, this was irrelevant to the court: “[T]he relevant inquiry is not whether defaming providers is central to an administrator’s fiduciary duties. It is not. The right question to ask is whether communicating benefits determinations to subscribers and beneficiaries is a central matter of plan administration. It is.”

The Third Circuit further concluded that Dr. Ahn’s claim, if allowed to proceed, would interfere with nationally uniform plan administration. The court noted that one of ERISA’s “principal goals” is “to establish a uniform administrative scheme, which provides a set of standard procedures to guide processing of claims and disbursement of benefits.”

Dr. Ahn’s claim would upset this goal. “Uniformity is impossible if plans are subject to different legal obligations in different states.” The court explained that ERISA provides a civil enforcement mechanism for claims, making state tort claims like defamation “unnecessary and impractical.” Allowing state law tort claims “would require plan administrators and fiduciaries to consider not only ERISA’s requirements but also the common law of each state, undermining the congressional goal of minimizing administrative and financial burdens on plan administrators.”

Dr. Ahn, citing two other Third Circuit cases – Plastic Surgery Ctr., P.A. v. Aetna Life Ins. Co. (2020) and Pascack Valley Hosp., Inc. v. Loc. 464A UFCW Welfare Reimbursement Plan (2004) – attempted to argue that his claim was not preempted because it “neither seeks benefits under an ERISA plan nor requires more than a cursory examination of an ERISA plan.” However, according to the Third Circuit, this approach “offers a mistaken understanding of the governing caselaw.” The court stated that “Plastic Surgery applied the same standards we apply today,” and Pascack Valley “involved a different ERISA preemption provision than this one.”

Thus, for the Third Circuit, this case was a simple one: “ERISA broadly preempts state-law claims. The explanation of benefits forms at issue in this appeal fall well within the scope [of] ERISA preemption. We will therefore affirm the District Court’s summary judgment.”

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

Breach of Fiduciary Duty

Third Circuit

Fumich v. Novo Nordisk Inc., CV 24-9158 (ZNQ) (JBD), 2026 WL 1816026 (D.N.J. June 24, 2026) (Judge Zahid N. Quraishi). This putative class action alleges mismanagement in the administration of Novo Nordisk Inc.’s 401(k) Savings Plan by various defendants, which include the company, its board of directors, and the company’s retirement committee. Plaintiffs, who were participants in the plan, allege that the plan’s assets included Schwab Managed Retirement Target Date Funds (TDFs), which underperformed compared to other funds. They also allege that defendants engaged in a prohibited transaction by contracting with Schwab for recordkeeping and administrative (RKA) services, and that those fees were unreasonably high. Plaintiffs’ amended complaint contains three claims for relief under ERISA: (1) breach of the fiduciary duty of prudence against the retirement committee for selecting the Schwab TDFs and failing to minimize recordkeeping fees; (2) failure to monitor other fiduciaries against the company and the board; and (3) prohibited transactions against all defendants. Defendants filed a consolidated motion to dismiss and motion to strike; the motion to dismiss was directed at the first two counts (but only regarding the TDFs, not the RKA fees) while the motion to strike was directed at the third count. Taking plaintiffs’ claims in order, the court first found that plaintiffs failed to allege sufficient facts to show that the committee acted imprudently in selecting the Schwab TDFs. Plaintiffs pointed to comparator funds (the T. Rowe Price Retirement Target Date A Series, the American Funds Target Date R6 Series, the Callan GlidePath Target Date Cl Z Series, and the MFS Lifetime R6 Series) to support their claim, but the court found that these funds were not “meaningful benchmarks” because they were actively managed and had different asset allocations. Furthermore, the court noted that the Schwab TDFs only slightly underperformed plaintiffs’ selected comparators. “These levels of underperformance do not plausibly suggest that Defendants acted imprudently when selecting the Schwab TDFs for the Plan and courts have routinely dismissed claims where the alleged underperformance was minimal, as it is here.” Because count one failed, plaintiffs’ derivative second claim for failure to monitor also failed. As for plaintiffs’ third claim, the court granted defendants’ motion to strike because the claim exceeded the scope of the leave to amend previously granted by the court. The court noted that “Plaintiffs’ initial Complaint did not include a prohibited transaction claim, nor did the Court identify any defects that could be addressed regarding such a claim.” (Your ERISA Watch reported on the court’s previous order in our August 27, 2025 edition.) The claim was thus “unauthorized.” The court “exercise[d] its discretion to strike Count Three of the Amended Complaint without prejudice to Plaintiffs’ right to seek leave to amend their complaint.” As a result, defendants succeeded on all their arguments, although the dismissals were without prejudice.

Ninth Circuit

Dawson-Roberts v. Norman S. Wright Mech. Equip. LLC, No. 26-CV-01171-AGT, 2026 WL 1834788 (N.D. Cal. June 25, 2026) (Magistrate Judge Alex G. Tse). Norman S. Wright Mechanical Equipment LLC offers retirement benefits through an employee stock ownership plan (ESOP), which primarily invests in the company’s stock but also holds other assets in an Other Investments Account (OIA). Between 2021 and 2024, the OIA grew from $4.1 million to $11.9 million, invested entirely in cash equivalents. Christopher Dawson-Roberts, an ESOP participant and former employee of the company, alleges that his ESOP account would be more valuable if the OIA assets had been invested in more appropriate asset classes for long-term retirement savings, such as stocks and bonds. Dawson-Roberts alleges that because of this failure defendants (the company, the governing committee, and the committee members) breached their duties of prudence and loyalty under ERISA. He also alleges a breach of duty of disclosure related to the company’s 2024 conversion from an S-corporation to a limited liability company, which he claims was not communicated to ESOP participants. Defendants filed a motion to dismiss, asserting a host of arguments, which Dawson-Roberts opposed. In this order the court marched briskly through the eight issues raised. First, the court found that Dawson-Roberts had Article III standing to pursue his claims based on a theory of “relative loss,” even if the plan did not suffer an “absolute loss.” Second, the court concluded that Dawson-Roberts plausibly alleged a breach of the duty of prudence. The committee defendants allegedly left the OIA in cash equivalents that earned minimal returns, which was inconsistent with the ESOP’s long-term investment objectives. The court noted that Section 1104(a)(2) (which provides that “an ESOP fiduciary’s investment in the employer’s stock cannot be challenged as imprudent on the basis of insufficient asset diversification”) did not bar a prudence claim because that section “is limited to diversification-based objections to the ‘acquisition or holding’ of ‘qualifying employer securities’ or real property[;] it does not, by its terms, immunize the management of non-employer-security assets such as the OIA from scrutiny[.]” Defendants argued that they had “good reasons for keeping high OIA cash balances,” and the court did not discount them, but “those reasons are more appropriately considered on a full factual record, not on a motion to dismiss.” Third, the court found that Dawson-Roberts plausibly alleged a breach of the duty of loyalty. The committee defendants allegedly managed the ESOP to ease corporate liabilities, rather than in the interest of the participants, by maintaining a large OIA cash balance to relieve the company from its obligation to repurchase shares. Fourth, the court determined that Dawson-Roberts stated a plausible claim under 29 U.S.C. § 1106, as a 2024 transfer of OIA assets constituted a “transaction” under the statute. Fifth, the court ruled that Dawson-Roberts’ allegations were sufficient to state claims against the committee members as individual defendants, as they were plausibly ESOP fiduciaries. Sixth, the court found that Dawson-Roberts plausibly alleged that the company breached its duty to monitor the committee, as it failed to remove or change the committee’s investment decisions despite imprudent investments. Seventh, the court rejected defendants’ argument for dismissal of the co-fiduciary liability claim because, as explained above, Dawson-Roberts had stated actionable underlying claims. Eighth, and finally, the court dismissed Dawson-Roberts’ duty-to-disclose claim, as he did not identify a viable source for the duty related to the corporate conversion. The court noted that ERISA’s fiduciary duties do not apply in “the settlor context,” i.e., decisions regarding the form or structure of the plan. As a result, Dawson-Roberts’ complaint survived defendants’ motion to dismiss almost entirely unscathed; the court even gave him leave to amend the only casualty, his duty-to-disclose claim.

Ninth Circuit

Williams v. Lawrence Livermore Nat’l Security, LLC Benefits & Investment Committee, No. 24-CV-07593-VC, 2026 WL 1865363 (N.D. Cal. June 29, 2026) (Judge Vince Chhabria). Dean Williams had been employed at Lawrence Livermore National Security (LLNS) for more than 30 years when he faced a choice: retire, or enroll in one or both of two disability programs offered by LLNS. He consulted two benefits personnel at LLNS, and based on their advice he chose to enroll in both the traditional long-term disability program and the “Defined Benefit Eligible Disability” program. He alleges he was led to believe by the personnel that enrolling in the second program would result in him receiving pension credit for his time on disability, thereby increasing his pension payments upon retirement. However, this turned out to be incorrect. He thus brought this action against the LLNS Benefits and Investment Committee and related defendants, asserting a claim for breach of fiduciary duty under ERISA based on the misrepresentations. The case proceeded to cross-motions for summary judgment, which the court ruled on in this order. Defendants contended first that the two employees were not acting as fiduciaries when they advised Williams. The court disagreed, noting that the employees “advised Williams on which benefits he should choose and why,” and one of the employees had the title of “Retirement Counselor” (and was later named Delegate of Plan Administrator), which “strongly suggests” that she “was entrusted with discretion, ‘one of the central touchstones for a fiduciary role.’” Defendants further argued that any misrepresentation was not actionable unless it was “accompanied by ambiguous plan language on the same topic.” However, the court emphasized that ERISA imposes a duty on fiduciaries to convey complete and accurate information, regardless of whether the misrepresentation was intentional or inadvertent: “If a fiduciary advises a beneficiary to take a course of action based on the fiduciary’s misunderstanding of the plan, and the beneficiary takes that course of action to their detriment, it’s unclear why it should matter whether the advice was intentionally or inadvertently erroneous, or whether the advice was clearly contrary to the plan or just potentially contrary to the plan.” In any event, the plan language at issue was “embarrassingly ambiguous” because two different provisions explaining pension calculations were in “direct contradiction” of each other. The court characterized defendants’ attempt to harmonize them as “ridiculous.” Next, the court dismissed defendants’ argument that Williams’ reliance on oral misstatements was unreasonable due to his failure to consult written plan documents. The court highlighted that reliance is a context-specific inquiry and found that Williams reasonably relied on the advice given the ambiguous plan language and the fiduciary role of the advisors. Turning to remedies, the court discussed the options of equitable estoppel and surcharge. For equitable estoppel, Williams “must satisfy the traditional requirements for equitable estoppel as well as three ERISA-specific requirements.” The court found the plan terms ambiguous and that the representations were interpretations of the plan rather than amendments or modifications, but noted insufficient evidence regarding the intent requirement. “Specifically, it’s unclear whether [the employees] acted with the intent to induce Williams to enroll in the defined benefit disability program or acted in a way that entitled Williams to believe that their intent was to induce him to enroll in the program.” While the requirements for proving surcharge were not as onerous, the court still noted that there were issues of fact as to whether and how Williams was harmed by the misrepresentations. As a result, regardless of which remedial theory applied, the court ruled that a trial was necessary to establish the amount of compensation Williams could receive.

Class Actions

Third Circuit

Cezus v. Konica Minolta Bus. Solutions U.S.A., Inc., No. CV 21-792 (JXN)(LDW), 2026 WL 1801135 (D.N.J. June 23, 2026) (Judge Julien Xavier Neals). This case has its origins in the merger of Konica and Minolta in 2003. The new company maintained separate offices in Connecticut (Konica) and New Jersey (Minolta) at first. However, in 2016 it decided to consolidate most of its operations in New Jersey, although some jobs in Connecticut would remain. (The company eventually closed the Connecticut office in 2025.) Unsurprisingly, this consolidation resulted in job terminations. The company had a severance plan under which employees terminated due to a reduction in force (RIF) were eligible for severance, but those refusing a transfer were not. Plaintiff James Cezus, who had worked in the Connecticut office for more than 30 years, refused a transfer and was terminated. Cezus made an unsuccessful claim for severance benefits and then filed this putative class action in New Jersey state court, alleging that the company used the relocation “as a guise to conduct a mass layoff without having to pay severance.” He claimed that the company knew most Connecticut employees would not accept a transfer to a facility 123 miles away and that the positions were effectively eliminated, constituting a RIF which entitled him and others to severance benefits under the plan. The company removed the case to federal court, after which Cezus filed a motion to certify a class of employees who were denied severance benefits under the plan. The company opposed the motion, arguing that the relocation was not a RIF, that the plan’s eligibility requirements must be determined individually, and that the class was not clearly defined or ascertainable. (The company did not oppose the motion based on numerosity or adequacy of counsel.) The court granted Cezus’ motion. The court found the class ascertainable because it was narrowly and specifically defined as Connecticut employees who were selected for transfer, did not accept the transfer, were terminated, and were “ineligible for severance benefits under the Plan as an employee ‘who has refused an offer of employment in another division, department, office, or unit of the Company.’” Company records could identify these class members “without extensive and individualized fact-finding or ‘mini-trials.’” The court further determined that the class satisfied the requirements of Federal Rule of Civil Procedure 23(a): numerosity was met because the class included up to 400 members, and no fewer than 100; commonality was satisfied because the case “presents common questions of liability and relief,” such as whether the relocation constituted a RIF; typicality was met because Cezus’ claims were based on the same legal theories and facts as the class; and adequacy was satisfied because Cezus’ interests aligned with the class and counsel was qualified. The court also found certification appropriate under Rule 23(b)(1) because “[i]ndividual cases could produce different interpretations of the Plan and set incompatible standards of conduct for the Plan and its administrator[.]” The court did not address certification under Rules 23(b)(2) or (b)(3) because Rule 23(b)(1) was satisfied. As a result, Cezus’ motion for class certification was granted.

Disability Benefit Claims

Ninth Circuit

Jump v. Unum Life Ins. Co. of Am., No. 25-1021, __ F. App’x __, 2026 WL 1847149 (9th Cir. June 26, 2026) (Before Circuit Judges Wardlaw, Owens, and De Alba). Denise Jump brought this action seeking benefits under an ERISA-governed long-term disability plan. The district court ruled in favor of the plan’s insurer, defendant Unum Life Insurance Company of America, and in this terse memorandum disposition the Ninth Circuit quickly affirmed. The court noted that it “review[s] for abuse of discretion the district court’s denial of benefits under an ERISA plan that grants the administrator discretionary authority… Under this standard, we reverse only when we are convinced that ‘the reviewed decision lies beyond the pale of reasonable justification under the circumstances.’” The appellate court found that the district court did not abuse its discretion by not explaining “why its conclusion differed from that of the Social Security Administration (‘SSA’).” Jump contended that while the district court took judicial notice “of the fact that the SSA awarded benefits,” it “did not delve into the actual reasoning behind the SSA’s decision[.]” However, “such an explanation was not required,” and in any event, “even if the district court wanted to provide a more detailed explanation of why its decision differed from that of the SSA, it could not have; Jump never submitted the SSA’s award notice to the district court.” The court further ruled that the district court did not abuse its discretion by not remanding the matter to Unum for further consideration of the SSA award. The Ninth Circuit noted that the award was issued after Unum’s final decision, so Unum “cannot be faulted for not considering it.” As a result, the judgment in Unum’s favor was affirmed.

Discovery

Second Circuit

David F. v. Cigna Life & Health Ins. Co., No. 3:25-CV-02188 (SRU), 2026 WL 1815680 (D. Conn. June 24, 2026) (Judge Stefan R. Underhill). This action seeks relief under ERISA and the Mental Health Parity and Addiction Equity Act (Parity Act). At issue was a discovery dispute: “Although the parties agree that discovery on the plaintiffs’ ERISA claim will be limited to the administrative record, they disagree on whether limited discovery should be permitted on plaintiffs’ Parity Act claim.” In this brief order the court ruled that it would permit “limited discovery,” noting that “the nature of Parity Act claims is that they generally require further discovery to evaluate whether there is a disparity between the availability of treatments for mental health and substance abuse disorders and treatment for medical/surgical conditions.” The court observed that “information about how insurance companies process treatment limitations will often be in the hands of insurers alone,” and thus, “[i]f claimants were barred from accessing that information via discovery, they would very likely face ‘a serious obstacle’ in bringing ‘meritorious Parity Act claims.’” The court relied on other district court rulings arriving at a similar conclusion. However, the court emphasized that “[i]n submitting discovery requests to the defendants, the plaintiffs must remember not to ‘attempt to obtain indirectly what they cannot obtain directly’ with regard to their ERISA claim.”

Tenth Circuit

Mayor v. Metropolitan Life Ins. Co., No. 1:25-CV-00012-DBB-DAO, 2026 WL 1815564 (D. Utah June 24, 2026) (Judge David Barlow). This is an action for accidental death benefits against Metropolitan Life Insurance Company and two officers of Union Pacific Railroad. The deceased is Casey Mayor, who was employed by the Railroad and covered by its ERISA-governed benefit plan, and the plaintiff is his wife, Nicole Mayor. In December of 2025, defendants filed the administrative record, but Mayor was unhappy with it and responded with a motion objecting to it and requesting additional discovery. As we detailed in our May 20, 2026 edition, the assigned magistrate judge recommended granting Mayor’s motion in part and denying it in part. Mayor filed objections to the magistrate’s ruling, and this order from the district court judge was the result. The court reviewed the magistrate’s non-dispositive ruling under the “clearly erroneous or contrary to law” standard. The court first addressed Mayor’s “primary objection,” which was that the magistrate did not order the production of additional plan documents. The magistrate found her requests “speculative and unnecessary” because she did not demonstrate that “a separate master plan document must exist.” The court agreed, noting that the summary plan description could serve as the required ERISA plan document alongside the insurance policy, consistent with Tenth Circuit precedent. The court noted that Mayor would nevertheless likely obtain the documents she sought, if they existed, because “the magistrate judge still essentially granted Plaintiff’s motion by requiring production of any additional plan documents compiled in the course of denying Ms. Mayor’s claim.” Mayor also objected to the inclusion of an insurance application document in the administrative record. The magistrate allowed it because it was part of the contract and relevant to determining applicable law. The court found no clear error because “the application preceded the relevant policy and could have been considered by MetLife in denying the claim.” Mayor also contended that the application was not properly authenticated, but “Ms. Mayor offers no authority to support her assertion that each document in an ERISA administrative record must be authenticated under oath.” Finally, Ms. Mayor argued that the magistrate improperly treated defendants’ assertions as factual and mischaracterized her discovery requests. The court again found no clear error, as the magistrate independently considered each category of requested discovery and appropriately focused on “principal arguments in favor of that discovery rather than every potential application of the requested category of documents.” As a result, the court overruled Mayor’s objections and upheld the magistrate’s order in full.

ERISA Preemption

Sixth Circuit

Gessford v. July Bus. Servs., Inc., No. CV 5:25-322-KKC, 2026 WL 1834348 (E.D. Ky. June 25, 2026) (Judge Karen K. Caldwell). Doug Gessford filed this action in Kentucky state court against July Business Services, Inc., alleging that July was negligent in the transfer of his retirement funds. Gessford contends that he and his wife initiated an in-service rollover distribution from their 401(k) funds to new IRA accounts, and while July processed Ms. Gessford’s request promptly, thereby allowing her to benefit from favorable market conditions, it delayed processing Mr. Gessford’s request, which caused him to miss out on those conditions, damaging him financially. July removed the case to federal court, alleging ERISA preemption, and Gessford filed a motion to remand, which the court decided in this order. The court applied the Supreme Court’s two-part Davila test to determine whether complete preemption by ERISA was applicable. Under the first prong, the court found that Gessford was not seeking to recover benefits due under the ERISA plan but was instead seeking damages for the alleged negligence of July. The court held that “[w]here a plaintiff includes plan benefits as ‘simply a reference to [the] specific, ascertainable damages [the plaintiff] claims to have suffered as a proximate result of’ a defendant’s tortious conduct, complete preemption under § 1132 does not apply.” Under the second prong of the Davila test, the court determined that Gessford’s claim was based on Kentucky’s “universal duty of care,” which is “independent of ERISA,” because it “is not derived from, nor is it conditioned upon the terms of Gessford’s 401(k) plan.” The court relied on a similar district court case in which that court rejected preemption arguments because the plaintiff “was not seeking benefits from ERISA plan assets directly,” but was instead seeking “monetary damages relative to the diminished value of the benefit she received resulting from the agent’s improper notarization.” Similarly, Gessford sought damages from July directly, not from the 401(k) plan itself. As a result, the court found that Gessford’s claims were not preempted, granted his motion to remand the case back to state court, and denied July’s concurrently filed motion for judgment on the pleadings for lack of jurisdiction.

Eighth Circuit

Flowers v. Caremark PCS Health, LLC, No. 25-3068, __ F.4th __, 2026 WL 1859929 (8th Cir. June 29, 2026) (Before Circuit Judges Gruender, Benton, and Erickson). Kevin Flowers is a participant in an ERISA-governed prescription drug benefit program. The program is administered by the giant pharmacy benefits manager (PBM) Caremark, which maintains a provider network of pharmacies. Flowers alleges in this putative class action that Caremark “covers plan members’ ‘maintenance prescriptions,’ i.e., prescriptions taken regularly for more than ninety days, only if plan members fill those prescriptions ‘at one of its CVS retail pharmacy stores or through its mail-order delivery service.’” According to Flowers this requirement violates two Arkansas statutes: the “Mail Order Provision,” which provides that a pharmacy controlled by a PBM “shall not require that a patient receive his or her prescriptions through home delivery services,” and the “Network Adequacy Provision,” which requires PBMs to provide “[a] reasonably adequate and accessible [PBM] network for the provision of prescription drugs…[with] convenient patient access to pharmacies within a reasonable distance from a patient’s residence.” Caremark moved to dismiss Flowers’ complaint, arguing that he did not adequately plead a violation of the Mail Order Provision, and that both the Mail Order Provision and the Network Adequacy Provision are preempted by ERISA. The district court granted Caremark’s motion, and Flowers appealed. The Eighth Circuit, reviewing the case de novo, “quickly dispense[d]” with Flowers’ Mail Order Provision claim. The court noted that this provision only “prohibits PBMs from requiring that patients receive their prescriptions through home delivery services… But Caremark, as alleged, requires plan members to fill their maintenance prescriptions either by mail or at CVS pharmacies. Therefore, Flowers has not alleged facts sufficient to show that Caremark requires patients to fill prescriptions only through home delivery services.” The court thus turned to Flowers’ claim based on the Network Adequacy provision, which it admitted “is more complicated.” On this issue the court focused on whether ERISA preempted the geographic coverage requirements imposed by the statute’s implementing regulations. (The court followed the parties’ lead on this and thus stated that it would “expressly leave open the question of whether the Network Adequacy Provision, standing on its own or implemented through different regulations, would be preempted by ERISA”.) These regulations required PBMs to ensure that a certain percentage of plan members live within specified distances of a network pharmacy. The Eighth Circuit noted that state laws “relate to” an ERISA plan, and are therefore preempted by ERISA, when the law “has a connection with or reference to such a plan.” The court agreed with Caremark that the geographic coverage requirements had an impermissible “connection with” ERISA plans. Although the requirements “nominally permit PBMs to retain some flexibility to design their networks, the requirements ‘forc[e] … [a] particular scheme of substantive coverage.’” The court stated that ERISA was designed to “minimiz[e] the administrative and financial burden of complying with conflicting directives and ensur[e] that plans do not have to tailor substantive benefits to the particularities of multiple jurisdictions.” However, the requirements “bulldoze through these objectives, requiring PBMs to tailor and retailor their networks – and perhaps even build new brick-and-mortar pharmacies – to comply with a set of exacting particularities.” Flowers argued that the requirements did not “require payment of specific benefits” or “bind plan administrators to specific rules for determining beneficiary status,” but the Eighth Circuit stated that these were only examples of preempted activity and were not an “exhaustive overview…of how state laws might ‘structure benefit plans in particular ways’ and thereby risk running afoul of ERISA… ERISA can also preempt state laws that do not perform these functions.” The court thus affirmed the judgment below, agreeing with the district court that Flowers’ Mail Order and Network Adequacy claims should be dismissed.

Ninth Circuit

Estate of Gilbert Dominguez v. Estes Express Lines, Inc., No. 2:25-CV-10514-DSF-MAR, 2026 WL 1823874 (C.D. Cal. June 24, 2026) (Judge Dale S. Fischer). The complaint in this case alleges that Gilbert Dominguez, a former employee of Estes Express Lines, Inc., was severely injured in 2017 while working at a trucking terminal, and his injuries ultimately led to his death two years later. In 2019, Dominguez’ daughter contacted Estes on behalf of her father’s estate regarding his employment and was informed that he had been terminated due to his inability to return from leave, and that the estate “was not entitled to any back income or funeral costs. Dominguez and his family had been unaware of his termination.” As a result, the estate brought this action against Estes and G.I. Trucking Company, alleging causes of action under California law for wrongful discharge, physical disability discrimination, and negligence, among other claims. Defendants removed the case to federal court based on ERISA preemption, asserting that part of the estate’s case was a claim for $400,000 in ERISA-governed life insurance benefits. The estate filed a motion to remand the case back to state court. The court applied the two-prong Davila test established by the Supreme Court, noting that defendants had failed to do so in their briefing because they had conflated complete preemption (the correct test for determining jurisdiction) and conflict preemption (which is merely an affirmative defense). The court ruled, and the parties stipulated, that the estate “could have brought” a claim under ERISA § 502(a)(1)(B). Thus, the first prong was satisfied. However, the claim that defendants asserted the estate could have brought under ERISA failed under the second prong of Davila. Defendants contended that the estate “is really making a claim that Defendants terminated Dominguez in order not to pay benefits – a claim that falls within the scope of ERISA § 510.” However, “the parties filed a joint stipulation in which the Estate agreed to strike all such references and that it would ‘not seek recovery of any benefits covered by ERISA in this action.’” The court found that after disregarding such allegations there was an independent legal duty implicated by defendants’ actions, separate from any ERISA plan. The estate’s claims were based on state-law duties, such as wrongful termination due to disability, which did not require judicial review of any ERISA plan. “Such claims ‘do not rely on, and are independent of, any duty under an ERISA plan’ and ‘would exist whether or not an ERISA plan existed[.]’” Defendants relied on comments by the estate in the parties’ joint report and its discovery responses which could be interpreted as seeking employee benefits, but the court found that these were irrelevant because the correct focus was on the claims in the estate’s complaint. Thus, in the end, defendants failed to satisfy both prongs of the Davila test, which were required to establish complete preemption and federal jurisdiction. The estate’s motion was granted and the case was remanded to state court.

Exhaustion of Administrative Remedies

Fifth Circuit

Young v. Woman’s Hosp. Foundation, Civ. No. 24-518-SDD-EWD, 2026 WL 1847413 (M.D. La. June 25, 2026) (Judge Shelly D. Dick). Latasha Young was employed by Woman’s Hospital Foundation from 2021 to 2022 and participated in several of the Foundation’s ERISA-governed employee benefit plans, including a long-term disability plan. The plan required proof of loss within 90 days, and any adverse claim decision was required to be appealed to the insurance company administering the plan. After undergoing surgery in 2022, Young alleges that she inquired about her disability benefits and was informed by a human resources employee that she was not eligible. Young filed this action and has amended her complaint twice. Her complaint now contains a claim under 29 U.S.C. § 1132(a)(1)(B), alleging that the Foundation improperly denied her disability benefits, and also includes claims under 29 U.S.C. §§ 1132(a)(3) and 1132(c). These claims assert two exceptions to the plan’s exhaustion requirement: estoppel due to the Foundation’s failure to advise her to review the plan provisions, and a claim that the Foundation’s failure to follow the plan’s procedures should relieve her of the exhaustion requirement. The Foundation filed a motion to dismiss. The court first addressed the Foundation’s argument that Young impermissibly alleged Section 1132(a)(3) and 1132(c) claims, and impermissibly alleged exceptions to exhaustion, because the court did not allow such allegations in its previous ruling dismissing Young’s prior complaint. The court agreed: “The Court did not give Plaintiff leave to allege new legal theories. Nor did Plaintiff file a motion seeking such leave. Additionally, nothing in the record indicates that Plaintiff received Defendant’s written consent for these amendments.” The court thus turned to Young’s 1132(a)(1)(B) claim and the issue of exhaustion. Young admitted that she did not exhaust her administrative remedies, as she did not appeal the denial of her long-term disability benefits to the insurance company, as required by the plan. The court found no applicable exceptions to the exhaustion requirement and concluded that Young’s failure to comply with the plan’s procedures barred her from relief. As a result, the Foundation’s motion was granted and the case was dismissed with prejudice.

Pleading Issues & Procedure

Second Circuit

Rajappan v. Bloomberg L.P., No. 26-CV-785 (GHW) (BCM), 2026 WL 1803704 (S.D.N.Y. June 23, 2026) (Magistrate Judge Barbara Moses). In this putative class action Rajkumar Rajappan alleges that defendants – Bloomberg L.P., The Bloomberg Investment Committee, and The Bloomberg Retirement Plan Committee – breached their fiduciary duties under ERISA by retaining two “serially underperforming funds” in Bloomberg’s 401(k) plan for over ten years. Defendants contend that Rajappan lacks standing to challenge one of the funds because he never invested in it, and furthermore, “offers only ‘[h]indsight-based performance criticisms and cherry-picked alternatives’” and thus fails to state a plausible claim for imprudence. However, the merits of these claims were not decided in this motion; instead, the motion on the table was by defendants to stay discovery pending the outcome of their motion to dismiss. (Also pending was a motion by Rajappan for leave to amend his complaint to add a new plaintiff who had invested in both challenged funds.) The court granted defendants’ motion to stay, addressing three factors: “(1) the breadth of discovery sought, (2) any prejudice that would result, and (3) the strength of the motion.” On the first factor, the court noted that “it is fairly clear that discovery will likely involve voluminous document production and review.” Furthermore, “[i]n putative class actions under ERISA, discovery is often one-sided.” However, if defendants’ motion were to be granted, “there will be no need for discovery, and if it is granted in part…the discovery burden will be significantly reduced. In these circumstances, a stay of discovery would help avoid ‘burdensome efforts that could be unnecessary … and [may] waste [] precious resources.’” Thus, the first factor weighed in favor of a stay. The court also found that the second factor favored a stay because “plaintiff has not identified any specific prejudice that he will suffer if discovery is delayed.” Plaintiff did not assert that any particular evidence was “crucial,” and “it is well-settled that ‘the general notion that the passage of time will create prejudice’ is an insufficient basis on which to resist a discovery stay.” The court was satisfied that defendants would preserve all relevant evidence and thus plaintiff “should suffer ‘no prejudice’ from the stay.” On the third factor, “it appears to this Court that defendants’ pending motion to dismiss the [first amended complaint] raises ‘substantial arguments for dismissal.’” The court noted that case law frowned on claims relying heavily on “after-the-fact allegations” about a decrease in an investment’s value, and noted that “plaintiff pleads that the challenged funds underperformed their disclosed benchmarks by only 0.67% (on an average annual basis)[.]” Thus, the court found that defendants had a “substantial argument” in favor of dismissal, even if “plaintiff has also ‘raised significant opposition.’” Thus, “[on balance…’the scales tip in favor of a discovery stay.’” As a result, defendants’ motion was granted and discovery will be put on hold until the court rules on defendants’ motion to dismiss.

Fourth Circuit

Trader v. Savage, No. CV 25-975-BAH, 2026 WL 1811525 (D. Md. June 24, 2026) (Judge Brendan A. Hurson). The plaintiff in this case is Virginia Trader and the defendants are William Savage, III, Diamond State Meats LLC (DSM), Savage Poultry, Inc., and the VIP 401k Plan. It is difficult to tell from this decision exactly what claims Trader has brought, but two things are clear: Trader’s claims arise under ERISA and Savage Poultry has entered bankruptcy and taken the VIP 401k Plan with it. In this order the court addressed the bankruptcy and various discovery disputes. First, the court examined a “Joint Motion to Dismiss” filed by DSM and Savage, seeking to dismiss Savage Poultry and the VIP 401k Plan from the case with prejudice due to the bankruptcy stay. The court quickly denied this motion on procedural grounds because DSM and Savage “do not have standing to seek dismissal of the other defendants.” The court noted that Savage Poultry itself had only requested a stay, not dismissal. DSM and Savage contended that the plan was not a “true party” because it was a retirement plan, but the court disagreed, explaining that retirement plans are often proper defendants in ERISA actions. Thus, the claims against Savage Poultry and the plan remained stayed, not dismissed. Regarding the discovery issues, the court granted Trader’s motion to extend the discovery deadline for a deposition of a Merrill Lynch representative, and partially granted defendants’ motions to extend the discovery deadline. The court engaged in some finger-wagging on this issue, noting that “the parties do not appear to have strictly complied with the Court’s Local Rules requiring conference of counsel before seeking extensions of time.” Indeed, the parties’ filings were “ridden with errors and typos reflecting that the respective author took little to no time to contemplate whether the filing was appropriate or helpful, also contain competing and repetitive accusations of bad faith against opposing counsel.” The court ordered the attorneys to behave in the future or “the Court will consider appropriate sanctions to deter such behavior in the future.” Finally, the court addressed a discovery dispute concerning questions about damages, restitution, and attorney’s fees which arose during Trader’s deposition. The court found that the attorney-client privilege does not extend to billing records and expense reports, but the relevance of such information was questioned. The court concluded that Trader’s fee agreement with her counsel was not relevant to establishing liability on her ERISA claims and declined to order that her deposition be reconvened for this purpose. As for damages and restitution, the court noted that it did not have the deposition transcript and “the dispute has not been adequately raised in the parties’ joint status reports… To the extent any dispute remains, counsel are directed to the Court’s informal discovery dispute procedure.”

Fifth Circuit

Hawkins v. Wells Fargo Bank, N.A., No. 3:26-CV-00026, 2026 WL 1862614 (S.D. Tex. June 18, 2026) (Magistrate Judge Andrew M. Edison). Patrick Sean Hawkins was employed by Wells Fargo Bank and was a participant in the bank’s ERISA-governed short-term disability benefit plan. Hawkins alleges that in 2024 he became unable to perform his job duties due to severe work-related stress, anxiety, and symptoms associated with attention-deficit/hyperactivity disorder. He submitted a claim to the plan’s administrator, Lincoln National Life Insurance Company, but Lincoln denied it, contending that the medical evidence did not support a disabling impairment as of the claimed date. Hawkins thus brought this pro se action against Wells Fargo, the plan, and Lincoln, alleging two claims for relief. Count 1 is for wrongful denial of benefits under ERISA § 502(a)(1)(B), while Count 2 is under ERISA § 502(a)(3), which provides for “appropriate equitable relief.” Hawkins pleaded Count 2 as an alternative claim, “which he asserts only ‘to the extent the Court determines that relief under § 502(a)(1)(B) is unavailable, incomplete, or inadequate.’” Defendants filed a motion to dismiss Count 2, arguing that Hawkins’ claim for equitable relief was duplicative of his claim for benefits in Count 1. The motion was assigned to a magistrate judge, who recommended in this ruling that defendants’ motion be granted. The court relied on Fifth Circuit authority, which “has explained that ‘a claimant whose injury creates a cause of action under ERISA § 502(a)(1)(B) may not proceed with a claim under ERISA § 502(a)(3).’” The court stated that § 502(a)(3) is a “catchall” provision meant to offer equitable relief for injuries not adequately remedied by other sections of ERISA. Because Hawkins’ alleged injury – a wrongful denial of benefits – could be addressed under § 502(a)(1)(B), he could not simultaneously pursue a claim under § 502(a)(3). Hawkins argued that his § 502(a)(3) claim was not duplicative because it sought unique equitable remedies, such as a surcharge against fiduciaries and injunctive relief for compliance with ERISA’s procedural requirements. The court was unconvinced, finding that these remedies essentially sought the same outcome as the § 502(a)(1)(B) claim: “the value of his benefits.” The court emphasized that it “must focus on the substance of the relief sought and the allegations pleaded, not on the label used.” The court further rejected Hawkins’ argument that his claim was valid because it was pleaded in the alternative: “True, alternative pleading is allowed in most civil cases. But ERISA is different. Section [502](a)(3) is a catch-all provision.” The court thus recommended that because Hawkins’ alleged injuries could be addressed through his claim under § 502(a)(1)(B), his § 502(a)(3) claim should be dismissed.

Provider Claims

Second Circuit

Rowe Plastic Surgery of N.J., LLC v. Aetna Health & Life Ins. Co., No. 22-CV-4755 (MKB), 2026 WL 1847285 (E.D.N.Y. June 26, 2026) (Judge Margo K. Brodie). Rowe Plastic Surgery of New Jersey, LLC and its principal, Dr. Norman Maurice Rowe, are frequent litigants, and this is one of their many lawsuits against Aetna Health and Life Insurance Company. (The court noted that plaintiffs had filed “approximately thirty nearly identical lawsuits in the Southern and Eastern Districts of New York alleging that Aetna breached an oral agreement to pay for a surgery”). This dispute is based on Aetna’s allegedly “late, reduced, and unreasonable payment” for a bilateral breast reduction surgery performed in 2021 on a patient insured by Aetna. Plaintiffs contend that they sought and obtained a network exception from Aetna and relied on a representation of reimbursement at the 90th percentile of reasonable and customary rates. However, Aetna paid $90,844.28, which was “far below” the 90th percentile. Plaintiffs filed this action in New York state court asserting claims for breach of contract, promissory estoppel, unjust enrichment, and violation of New York’s Prompt Pay Law. Aetna removed the case to federal court based on ERISA preemption, after which plaintiffs filed an amended complaint including claims of fraud, fraud by omission, and fraudulent inducement. Aetna filed a motion to dismiss, arguing that plaintiffs improperly added new claims without court permission, the fraud claims failed to state a claim, and ERISA preempted plaintiffs’ claims. The court agreed with Aetna that plaintiffs’ new complaint exceeded the scope of the court’s leave to amend by adding new claims of fraud and fraud by omission without seeking permission. Although these claims were based on the same underlying facts as the fraudulent inducement claim, they were not authorized by the court’s previous order. The court also agreed that ERISA preempted plaintiffs’ claims. Plaintiffs contended that the complaint “pleads a classic rate-of-payment, not right-to-payment, dispute,” but the court disagreed. The court found that the claims were inseparable from the patient’s ERISA-governed plan because the alleged misrepresentations and network exceptions were tied to the plan’s terms. The court further found that plaintiffs’ claims were directed at rectifying a wrongful denial of benefits under an ERISA-regulated plan. The court also rejected plaintiffs’ argument that Aetna’s pre-surgery representations and network exceptions created an independent legal duty outside the ERISA plan. According to the court, the call transcript between plaintiffs and Aetna did not support an independent promise to reimburse at a specific rate, and the network exception did not provide a specific reimbursement rate. Thus, plaintiffs’ claims were centered on the plan and ERISA preempted them. The court therefore granted Aetna’s motion to dismiss.

Retaliation Claims

Fifth Circuit

Salazar v. Lockheed Martin Corp., No. 4:25-CV-1364-P, 2026 WL 1800303 (N.D. Tex. June 12, 2026) (Magistrate Judge Jeffrey L. Cureton). Marc Gabriel Salazar was employed by Lockheed Martin Corporation from 2016 until 2022. Salazar is unhappy about how his employment ended and has filed this pro se action against Lockheed alleging the following claims: (1) interference in violation of the Family Medical and Leave Act (FMLA); (2) retaliation in violation of the FMLA; (3) wrongful termination; (4) breach of contract/seniority rights; (5) interference in violation of ERISA; and (6) negligent misrepresentation. The operative pleading is Salazar’s third amended complaint, which Lockheed moved to dismiss. Meanwhile, Salazar moved for leave to file a fourth amended complaint. The motions were referred to the assigned magistrate judge, who issued this report and recommendation. The magistrate ruled that Salazar’s FMLA claims for interference and retaliation were time-barred by the two-year statute of limitations, as he filed the lawsuit nearly three years after his termination. Furthermore, the magistrate noted that FMLA violations must be “willful” in order to support a cause of action, and Salazar’s allegations “are consistent with a negligent, not a willful, violation of the FMLA.” Next, the magistrate determined that Salazar failed to state a claim for ERISA interference because he did not allege “specific discriminatory intent” by Lockheed to interfere with his benefits. The magistrate noted that “a global reading” of Salazar’s complaint “shows that Plaintiff is alleging that he was wrongfully terminated for taking FMLA, not for the purpose of interfering with his ERISA benefits.” Salazar’s allegations regarding how Lockheed incorrectly documented his seniority, which affected his benefits, were insufficient because “more than simply alleging an employer acted to deprive an employee of benefits is required” to state a claim for ERISA interference. In any event, Salazar’s ERISA claim was time-barred by the two-year statute of limitations because he was aware of the alleged interference at the time of his termination in 2022. Salazar’s remaining claims fared no better. The magistrate concluded that Salazar’s wrongful termination claim was not viable because “there is no common law cause of action for workplace discrimination or retaliation” and Salazar did not identify a statutory or constitutional violation. He also could not sue for breach of contract because he did not allege the existence of a valid contract. Salazar relied on “the CBA and company policies, which constitute a contract,” so the magistrate construed his claim as arising under the Labor Management Relations Act. However, Salazar did not allege that he had exhausted any grievance procedures, or that his union had breached any duty of fair representation. The magistrate also rejected Salazar’s negligent misrepresentation claim, noting that this claim was absent in his proposed fourth amended complaint, which the magistrate interpreted as abandonment. Finally, the magistrate considered Salazar’s pro se status and his request to file a fourth amended complaint, but concluded that “Plaintiff has already been given the opportunity to file three amended complaints,” and his proposed complaint “suffer[s] from the same defects as set forth above.” As a result, the magistrate concluded that amendment would be futile. He recommended that Lockheed’s motion to dismiss be granted with prejudice and that Salazar’s motion to amend be denied.

Severance Benefit Claims

Ninth Circuit

Foley v. Wells Fargo & Co., No. 25-CV-04795-EMC, 2026 WL 1805741 (N.D. Cal. June 23, 2026) (Judge Edward M. Chen). Terence Foley was a senior systems quality assurance analyst at Wells Fargo & Company. He contends in this action that because of a change in his work location he is entitled to benefits under Wells Fargo’s ERISA-governed severance plan. Foley worked remotely from his home in Union City, California but in September of 2024 he was informed that he would need to return to Wells Fargo’s office in Concord, California, which he claimed was more than 40 miles away. Wells Fargo denied his claim, determining that the distance was 33.1 miles, based on a computer-based mapping tool (Bing Maps API). This difference was crucial because the plan only paid benefits for a “qualifying event,” which included a “substantial position change,” which in turn included “a change to an Employee’s current position…that results in [e.g.] [a] change in work location beyond a Reasonable Commute Distance,” defined as “40 miles one way, using a mapping resource for this information, as determined by the Participating Employer.” Foley appealed the decision, arguing that the actual commute exceeded 40 miles, but Wells denied the appeal, maintaining that the shortest driving distance did not exceed 40 miles. Foley thus filed this action, asserting four claims for relief: (1) recovery of employee benefits under 29 U.S.C. § 1132(a)(1)(B), (2) inadequate notice and reasons for denial in violation of 29 U.S.C. § 1133(2), (3) failure to establish and maintain reasonable claims procedures in violation of 29 C.F.R. § 2560.503-1(b), and (4) failure to provide specific reasons for denial in violation of 29 C.F.R. § 2560.503-1(h)(3). The case proceeded to cross-motions for judgment. Wells Fargo argued, and Foley “essentially concede[d],” that his last three claims should be dismissed because they were not independent remedial bases. Thus, “the only question for the Court is whether Mr. Foley should prevail on his first cause of action under § 1132(a)(1)(B) – i.e., is he entitled to severance benefits because the change to his job resulted in a ‘Reasonable Commute Distance’ that exceeded 40 miles?” The court applied the abuse of discretion standard of review because the severance plan unambiguously provided discretion to the plan administrator. Foley argued for de novo review, citing procedural violations, but the court found no wholesale and flagrant violations of procedural requirements that would warrant such a shift. The court noted that Wells Fargo provided sufficient information about the mapping tool it used, and ruled that the lack of specific route documentation did not constitute a procedural violation. In applying abuse of discretion review, the court acknowledged Wells Fargo’s conflict of interest, but noted that “there do not appear to be any real procedural irregularities or violations,” and “there is no real indication that Wells’s actions here were in fact dictated or influenced by self-interest. There is no evidence, e.g., of malice, self-dealing, or a parsimonious claims-granting history.” The only possibly relevant irregularity was a difference in the language between the 2025 and 2026 summary plan descriptions, but the 2026 SPD was not in the record, did not govern Foley’s claim, and in any event there was “no clear inconsistency” between the two SPDs. Thus, the court’s review was “at best slightly informed” by Wells Fargo’s structural conflict of interest. As for the central merits question, Foley argued that “‘commute’ cannot simply mean distance but must also take into account, in particular, time.” However, the court found that Wells Fargo’s interpretation of “Reasonable Commute Distance” as the shortest driving distance was reasonable and consistent with the plan’s terms, which defined “commute” as “measured in miles.” The court emphasized that using the shortest driving distance was “perfectly logical” because such a standard “was objective and amenable to uniform and consistent application, free from subjective judgments and ever-changing variables.” As a result, the court concluded that Wells Fargo did not abuse its discretion in denying Foley’s claim for severance benefits.

Venue

Eighth Circuit

Delaney v. Metropolitan Life Ins. Co., No. 4:26-CV-00039-ACL, 2026 WL 1832389 (E.D. Mo. June 24, 2026) (Magistrate Judge Abbie Crites-Leoni). George Delaney worked for Consolidated Edison, Inc. (ConEd) for approximately 40 years and was covered by a ConEd-sponsored group life insurance policy insured by Metropolitan Life Insurance Company with a face value of approximately $404,000. George died in 2016, and his ex-wife, Maura, died only eight days later. The plaintiff in this action, Andrew Delaney, is the son of George and Maura and contends that a New York court, at the time of his parents’ divorce, “issued a binding order dated October 8, 1985, awarding all of Mr. Delaney’s life insurance policies to Maura T. Delaney and directing that she be designated as beneficiary.” Nevertheless, Andrew alleges that only $192,792.91 was paid to Maura Delaney, while $211,207.09 was distributed to eight other individuals “based on a Con Edison beneficiary designation form.” Andrew filed this pro se action against MetLife and ConEd under ERISA, contending that “Defendants knew or should have known that the beneficiary form conflicted with a valid domestic relations order that had been judicially affirmed.” At issue in this order were Delaney’s two motions to proceed in forma pauperis, which were referred to the assigned magistrate judge. The court granted Delaney’s second motion (and denied the first as moot) and waived his filing fee. The court noted that Delaney was “an active litigant in many cases across the country,” but, “[l]iberally construing the allegations of the Complaint and assuming Plaintiff’s assertions as true that he has standing to bring this suit,” the court found that the case was properly brought under ERISA. However, the court flagged the issue of venue. The court stated that an ERISA action may be brought “where the plan is administered, where the breach took place, or where a defendant resides or may be found.” The court noted that the transactions at issue took place in New York, where George Delaney was employed and where the ERISA plan was administered, not in Missouri.  Therefore, the court issued an order to show cause why the case “should not be dismissed for lack of proper venue. Specifically, Plaintiff should inform the Court of all other litigation that has occurred on the current claims before the Court and provide case numbers and citations. This includes any Court proceedings concerning the administration of the estates of George and Maura Delaney, that occurred following their 2016 deaths, and any legal matters filed concerning the distribution of the life insurance proceeds at issue.”

Eleventh Circuit

Hughes v. Truist Bank, Inc., No. 1:25-CV-04667-SDG, 2026 WL 1849942 (N.D. Ga. June 26, 2026) (Judge Steven D. Grimberg). Anthony Hughes was employed by Truist Bank, Inc. and was a participant in its ERISA-governed accidental death and dismemberment (AD&D) benefit plan, which was insured by Hartford Life and Accident Insurance Company. Hughes alleges that he elected the maximum AD&D coverage for his wife, amounting to ten times his annual salary, or $830,000. His wife died in May 2024, but Hughes only received half of the elected amount, or $415,000. He then brought this action against Truist and Hartford under ERISA seeking the remainder. The defendants could not agree on how to proceed. Truist filed a motion to transfer venue to the Western District of North Carolina based on a forum selection clause in the summary plan description (SPD), and while Hughes did not oppose this motion, Hartford did on the ground that it was not a signatory to the SPD. Instead, Hartford filed a motion to dismiss for failure to state a claim. The court declined to rule on Hartford’s motion, finding instead that transfer was appropriate. The court reasoned that forum-selection clauses are generally enforceable in federal courts, and the burden is on the party opposing the clause to demonstrate inconvenience. Because Hughes did not oppose the enforcement of the clause, the court found transfer appropriate. However, this decision “leaves open the question of how to handle Hughes’s claims against Hartford,” which objected to the transfer. The court applied the “closely related doctrine,” which allows a forum-selection clause to be enforced against non-signatories. Under the doctrine, “the party must be closely related to the dispute such that it becomes foreseeable that it will be bound.” The court determined that Hartford was “closely related” to the dispute because its interests were “sufficiently derivative of Truist’s interest” in avoiding the additional payment to Hughes. “After all, had Truist not contracted with Hartford…to issue the AD&D policy under the Plan, Hartford…would not have any connection to Hughes’s dispute with Truist.” Furthermore, it was foreseeable that Hartford would be bound by the forum-selection clause because the SPD included the certificate of insurance issued by Hartford, and its representatives signed the certificate. As a result, “the SPD’s forum-selection clause can be enforced against the non-signatories and this action should be transferred in full. The ‘interest of justice’ is better advanced by transferring all claims, rather than by dividing them between two district courts. Truist’s motion was thus granted, and Hartford’s was denied without prejudice.

Justman v. Accenture LLP, No. 25-2084, __ F.4th __, 2026 WL 1742110 (3d Cir. June 17, 2026) (Before Circuit Judges Hardiman, Bove, and Fisher)

Newcomers to ERISA are sometimes bewildered by the extensive cast of characters, which can include plan sponsors, plan administrators, benefit committees, claim administrators, insurers, advisors, and others. Some entities can perform more than one of these functions, and some may be fiduciaries, while others are not. Furthermore, an entity might be a fiduciary for one purpose but not for another, and its duties might be limited depending on its role.

As a result, it is important when asserting claims under ERISA to identify who performs what role, how that entity is legally responsible, and buttress those allegations with specific facts. Otherwise, you may find yourself on the wrong end of a motion to dismiss, as explained in this published opinion from the Third Circuit.

The case revolved around Karen Justman, who was an employee of the technology consulting company Accenture LLP. Ms. Justman died suddenly in August of 2021 from septic shock when she suffered a bacterial infection from eating raw oysters.

At the time of her death, Ms. Justman was enrolled in an ERISA-governed life insurance plan offered by Accenture, which included basic accidental life insurance coverage equal to her salary and additional optional accidental death and dismemberment (AD&D) coverage of three times her salary. She had designated her husband, Mark Justman, as her beneficiary.

The summary plan description (SPD) identified Accenture as the plan administrator and Prudential Insurance Company of America as the claims administrator. The SPD stated that “[b]enefits under the Plans will be paid only if the Plan Administrator and/or Claims Administrator decide in its discretion that the claimant is entitled to them.” The SPD further stated that Accenture had delegated to Prudential the discretionary authority “to provide claim processing, claim investigation, claim control, and the daily administration of the plan.”

Mr. Justman submitted a claim for benefits to Prudential, but Prudential denied it. Prudential stated that Ms. Justman died of a “medical illness and/or sickness,” and thus her death did not constitute an accident under the plan, which was circuitously defined as “Accidental Injury…as the direct result of an Accident.” Mr. Justman’s appeal was unsuccessful, so he filed this action naming both Prudential and Accenture as defendants.

Mr. Justman settled with Prudential, leaving only his claims against Accenture. He alleged that Accenture wrongly denied his claim for benefits under ERISA § 502(a)(1)(b) and breached its fiduciary duties by failing to furnish his wife with all relevant SPDs.

Accenture moved to dismiss, and the district court granted its motion. The district court ruled that Mr. Justman did not allege facts demonstrating that “Accenture controlled the claims administration of benefits,” and that he failed to state a plausible claim for breach of fiduciary duty because he did not explain how the alleged failure to provide the SPDs constituted a breach of fiduciary duty. (Your ERISA Watch covered this ruling in our November 6, 2024 edition.)

Mr. Justman amended his complaint, but the district court dismissed the amended complaint on similar grounds, and then denied him leave to file a second amended complaint. As a result, Mr. Justman appealed to the Third Circuit, which issued this decision.

The appellate court divided Mr. Justman’s claims into two categories: the benefit denial claim and the SPD claim. Addressing the benefit claim first, the court noted that ERISA authorizes a plan beneficiary to assert a claim to recover benefits, “but it does not specify who may be sued.” Mr. Justman contended that Accenture was a proper defendant because the SPD gave it the authority to make benefit determinations.

The court disagreed: “a plausible suit for ‘benefits due’ must be brought against a party with an obligation to pay… Sometimes that will be the plan, and sometimes that will be the insurance company that adjudicates claims. The latter is the case here[.]” The court emphasized that the plan required that all proof of claim be routed through Prudential: “‘Prudential must be given written proof of the loss including any requested documentation,’ and benefits will be paid ‘when Prudential receives written proof of the loss.’”

In contrast, the plan “does not confer Accenture any authority over claims administration, and Justman does not provide evidence plausibly suggesting otherwise.” The court noted that in so ruling it was “align[ing] ourselves with five other circuits.” (The court cited cases from the Fifth, Sixth, Seventh, Eighth, and Eleventh Circuits as being directly on point, and cases from the Second and Ninth Circuits as supportive.)

The court further held that Mr. Justman’s attempts to amend his complaint did not solve this problem. Instead, his further allegations “confirmed that Prudential, not Accenture, called the shots: Prudential made the benefits determination, and Accenture could follow up if it had questions.”

Nor did the SPD language help Mr. Justman. The court noted that the SPDs were “not the terms of the plan,” and in any event “the SPD language Justman highlights shows only that, depending on the issue at hand, either Accenture or Prudential may have a particular plan responsibility.” Accenture had the authority to address issues such as enrollment and eligibility, while Prudential was in charge of processing and deciding claims. “Because Accenture delegated claims administration duties to Prudential, Prudential was the proper defendant for Justman’s denial of benefits claim.”

The Third Circuit thus turned to Mr. Justman’s SPD claim, which “fares no better.” Mr. Justman “does not indicate whether his wife received an SPD when she started employment at Accenture, when the five-year deadline arose for Accenture to provide her another SPD, or if a material modification occurred in either 2020 or 2021” which would trigger the requirement to provide a new SPD. As a result, “Justman did not plead facts that would support a claim against Accenture under ERISA § 104(b)(1)[.]”

Mr. Justman’s SPD allegations did not support a breach of fiduciary duty either. He “did not allege that Accenture’s failure to provide his late wife with the relevant SPDs deprived her of any information, or even if it had, how that deprivation was material. Nor did Justman show that he relied on the 2020 or 2021 SPDs: he did not allege the SPDs helped or harmed his claim with Prudential, or that either he or Prudential relied on them in their AD&D claim dispute.”

Mr. Justman contended that his breach of fiduciary duty claim should proceed because ERISA did not require him to prove detrimental reliance, only actual harm. However, “Even so, Justman’s claim still fails; he does not satisfy the other elements. In any case, Justman did not allege any harm, let alone actual harm stemming from Accenture’s alleged failure to provide Ms. Justman with the 2020 or 2021 SPD.”

Finally, the court disposed of Mr. Justman’s remaining arguments, including his contention that the district court abused its discretion by dismissing his claims with prejudice. The court found no error because his claims were not plausibly pleaded and further amendment would have been futile. As a result, the judgment in Accenture’s favor was affirmed.

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

Breach of Fiduciary Duty

Third Circuit

In re Quest Diagnostics ERISA Litig., No. 24-2866, __ F.3d __, 2026 WL 1783204 (3d Cir. June 22, 2026) (Before Circuit Judges Bibas, Porter, and Bove). The plaintiffs in this putative class action are participants in Quest Diagnostics’ ERISA-governed 401(k) retirement plan. They contend that two investment options offered by the plan – the Fidelity Freedom Funds and the Invesco Global Real Estate Fund – underperformed, and thus Quest breached its fiduciary duty to plaintiffs by maintaining the funds in the plan’s portfolio. Plaintiffs argued that these funds performed poorly compared to benchmarks and that the plan’s managers should have removed them from the investment options. Plaintiffs were able to get past the pleadings before one judge, but when the case was transferred to a new judge, defendants were able to successfully move for summary judgment. The district court found no triable fact as to whether Quest breached its fiduciary duty because Quest “had hired an investment advisor, actively monitored its investment menu, gotten annual training on its fiduciary duties, and taken follow-up steps about the Freedom and Invesco Funds.” Plaintiffs appealed, and this published Third Circuit decision was the result. The opening line left no doubt as to the outcome: “Sometimes, even a good process produces disappointing results.” The appellate court agreed with the district court that Quest’s fiduciaries followed a prudent process by collaborating with an outside investment advisor, meeting with fund managers, and critically examining the plan’s investment options. Regarding the Freedom Funds, plaintiffs contended that defendants were “too slow to react,” but the court stated, “A fund’s poor performance alone does not mandate drastic or sudden action.” Furthermore, “short-term underperformance does not prove long-term imprudence… So long as a plan fiduciary analyzes that underperformance and evaluates the fund’s underlying strategy, there may be sound reasons to hold on to the fund during a period of weaker returns.” In any event, the court noted that the Freedom Funds’ performance “was hardly egregious,” and sometimes out-performed benchmarks. Quest was also prudent in managing the Invesco fund by placing it on a watch list when it began underperforming, and by discussing its future in the plan’s portfolio with its advisors. The court noted that the Invesco fund was conservative in nature and thus would tend to underperform in bull markets. The court also rejected plaintiffs’ argument that Quest breached its fiduciary duty by not adhering to its investment policy statement (IPS), which they contended was “binding” under the terms of the plan. The Third Circuit characterized this argument as “novel” but concluded that it “need not decide the question.” The court found that Quest did not violate the IPS in any event because the IPS was “full of permissive language” that gave Quest “discretion to deviate” from the statements within. The court further stated that “background principles of trust law favor deferring to trustees’ judgment calls.” In conclusion, “ERISA, like trust law, does not hold trustees liable for poor performance alone. Courts review process first. A fiduciary is prudent if it hires an advisor, critically examines its recommendations and data, and follows up when needed. Quest did just that. Even if the Funds kept on its menu were not the best, they were not the worst either, and the Committee’s process was sensible. Because ERISA mandates prudence, not perfection, we will AFFIRM.”

Seventh Circuit

Apex Mgmt. Grp. I, Inc. v. Verdegard Administrators, LLC, No. 24 C 7746, 2026 WL 1785159 (N.D. Ill. June 22, 2026) (Judge Robert W. Gettleman). The plaintiffs – Apex Management Group I, Inc. and its principal, Jeffrey Bemoras – develop and market self-funded health benefit plans to employers. The defendants – Verdegard Administrators, LLC, Regional Care, Inc., and DWS Holdings, LLC (d/b/a Pinnacle Peak Administrators) – entered into agreements with Apex to serve as third-party administrators for some of Apex’s plans. Enter the Department of Labor (DOL), which has charged plaintiffs with breaches of fiduciary duties under ERISA, contending that between 2018 and 2020 they directed third-party administrators such as Pinnacle and Regional to improperly transfer more than $2.7 million between unrelated participating plans to cover underfunded claims. Plaintiffs in turn brought this action against defendants, seeking equitable indemnification and contribution under Section 502(a)(3) of ERISA. (Pinnacle is also a defendant in another action brought by the Oregon Potato Company.) Regional and Pinnacle filed motions to dismiss, arguing that the claims against them should be dismissed based on arbitration agreements, the doctrine of unclean hands, and failure to state a claim. The court ruled that the arbitration clauses in the agreements between Apex and defendants did not apply to the claims at issue because the agreements did not encompass pre-2023 conduct. Furthermore, Bemoras was not bound by the arbitration clauses in the agreements because he was not a signatory to those agreements. As for unclean hands, the court rejected Regional’s argument that plaintiffs’ claims should be dismissed based on this defense. “Regional has not shown that the face of the complaint shows beyond a doubt that this affirmative defense is dispositive.” The court noted that Regional relied heavily on the DOL’s allegations, but those “are not established facts.” The court further found that plaintiffs’ claims were sufficiently pleaded to survive a motion to dismiss. Pinnacle contended that it was not a fiduciary, but the court found that plaintiffs plausibly alleged that Pinnacle was a “functional fiduciary” that “exercised discretionary control over the management and administration of the plans, and…exercised authority and control over plan assets.” Pinnacle contended that it lacked access to plan funding, but plaintiffs’ allegations that payments were remitted to Pinnacle and that it deposited them in a pooled account were sufficient to defeat its argument. The court also rejected Pinnacle’s argument that it was simply performing “ministerial” tasks because plaintiffs alleged that Pinnacle acted contrary to plan requirements, was transferring funds, and was “using the assets of one plan to pay the claims of another plan.” Finally, Pinnacle argued that plaintiffs’ claims should be dismissed because Pinnacle was not a co-defendant in the underlying DOL case, and thus plaintiffs could not seek indemnification or contribution against it. However, the court found this argument “inadequately developed and supported,” and in any event “Pinnacle concedes that the Seventh Circuit recognizes that ERISA allows indemnification among fiduciaries,” and to the extent Pinnacle had any objections, “it can contest fiduciary status and responsibility for any losses in this case – and has started doing just that with its motion here.” Thus, Pinnacle’s and Regional’s motions to dismiss were denied in full.

Eighth Circuit

In re: UnitedHealth ERISA 401(k) Litig., No. 25-CV-1751 (ECT/ECW), 2026 WL 1786167 (D. Minn. June 22, 2026) (Judge Eric C. Tostrud). This case (which began as two separate cases) involves the UnitedHealth Group 401(k) Savings Plan and the treatment of “forfeited funds” in the plan from 2019 to 2023. During this period, plan participants who left United before completing two years of service forfeited the matching and profit-sharing contributions made by United to their 401(k) accounts. The plan allowed the committee overseeing the plan to use these forfeited funds to either reduce United’s contributions or pay administrative expenses. During the relevant time period the committee chose to use the forfeited funds to reduce contributions every year. Plaintiffs, who are plan participants, have challenged that decision in this case. They have alleged five claims for relief: (1) breach of the fiduciary duty of prudence under 29 U.S.C. § 1104(a); (2) breach of the fiduciary duty of loyalty under 29 U.S.C. § 1104(a); (3) breach of the anti-inurement provision under 29 U.S.C. § 1103(c)(1); (4) breach of fiduciary duty by failing to monitor the committee and its members; and (5) violation of the prohibited-transaction rules under 29 U.S.C. § 1106(a)(1)(D) and (b). Defendants moved to dismiss for lack of subject matter jurisdiction and for failure to state a claim. Their jurisdictional argument was that plaintiffs did not allege that the plan suffered a redressable injury because using the forfeited funds for contributions did not harm the plan. The court disagreed, finding plausible plaintiffs’ argument that United’s “robust financial performance” from 2019 through 2023 “positioned the company to comfortably satisfy its matching-contribution requirements and make the same amount of discretionary profit-sharing contributions without the forfeited amounts the Committee elected to use to reduce UnitedHealth’s contributions.” As for the merits of plaintiffs’ claims, the court found that they plausibly alleged a breach of the duty of prudence. Plaintiffs alleged that from 2019 to 2023 “UnitedHealth would have made matching and profit-sharing contributions in the same amounts without the reductions resulting from the Committee’s elections,” which left the plan with “roughly $25.6 million less in cumulative assets by the end of 2023 than had the Committee chosen to use forfeitures to reduce the Plan’s administrative expenses.” Defendants raised a number of arguments, including that its decisions were made pursuant to guidance from the DOL, IRS, and Congress, but this was insufficient. “The fact that the Committee might lawfully have used forfeitures to reduce UnitedHealth’s contributions does not answer whether the Committee’s decision to do that complied with its duty of prudence.” The court further ruled that plaintiffs plausibly alleged a breach of the duty of loyalty because it was plausible that self-interest motivated the committee’s decisions. The court emphasized the subjective standard of the duty of loyalty, focusing on the fiduciary’s intent rather than on what the plan authorized defendants to do. Because plaintiffs’ duty of loyalty claim survived, their derivative claim for breach of the duty to monitor also survived. Plaintiffs’ winning streak ended with their anti-inurement claim. The court dismissed this claim because “[a]ny benefit to UnitedHealth was incidental” and there was no “reversion or diversion of plan assets to the sponsor.” For similar reasons, the court also dismissed plaintiffs’ prohibited transaction claim, ruling, “The decision to use forfeitures to reduce UnitedHealth’s contributions did not risk the Plan’s ability to pay promised benefits. It served that purpose.” Finally, the court noted (and cited) 51 recent decisions addressing the issue of ERISA plan forfeitures. The court explained that each case was premised on its own facts and claims, and that it “identified no clear trend or consensus in these decisions that might justify a particular outcome on this motion.”

Ninth Circuit

Meyer v. UnitedHealthcare Ins. Co., No. 25-3070, __ F. App’x __, 2026 WL 1734988 (9th Cir. June 16, 2026) (Before Circuit Judges Murguia, W. Fletcher, and Koh). In December of 2015 John Philip Meyer was in a skiing accident and received treatment at Billings Clinic and Community Medical Center in Missoula, Montana. Meyer was unhappy with his insurance billing for this treatment, which included charges for out-of-network rates, so he filed this action against his insurance provider, UnitedHealthcare Insurance Company. United originally asserted that Meyer’s claim was not governed by ERISA and threatened him with attorney’s fees (the court characterized United’s conduct in this regard as “troubling”), but eventually United realized its error and filed a motion to dismiss on ERISA preemption grounds. The court granted the motion, and in 2021 the Ninth Circuit affirmed. On remand, Meyer amended his complaint and restyled it as a class action alleging that United failed to pay benefits and breached its fiduciary duties under ERISA. Specifically, Meyer alleged that United failed to maintain correct billing records, failed to pay service providers for in-network services, allowed out-of-network charges at in-network facilities, and improperly reset his deductible. These allegations were centered around violations of the federal No Surprises Act. United moved to dismiss once again, and again its motion was granted. The district court ruled that Meyer failed to state a claim and that his claims exceeded ERISA’s three-year statute of limitations for breach of fiduciary duty. (Your ERISA Watch covered this ruling in our April 16, 2025 edition.) Meyer appealed to the Ninth Circuit once again, and this very brief memorandum decision left him empty-handed for a second time. The appellate court agreed with the district court that Meyer failed to plead a cognizable claim for relief under ERISA, as he did not allege sufficient facts to support his theory that United’s actions breached any fiduciary duty owed to him. The No Surprises Act did not apply to Meyer’s case because the challenged conduct took place in 2015 and 2016, well before the Act went into effect on January 1, 2022. Because the Ninth Circuit affirmed on this basis, it declined to reach the other arguments United advanced in favor of dismissal, including the issues of whether United was a fiduciary at all and whether Meyer’s claims were time-barred.

Platt v. Sodexo S.A., No. 8:22-CV-02211-DOC-ADS, 2026 WL 1782287 (C.D. Cal. June 18, 2026) (Judge David O. Carter). Robert Platt is an employee of Sodexo, S.A., the food services company. He contends that the company and related defendants imposed a $1,200 annual “nicotine surcharge” on employees who used nicotine and were participants in Sodexo’s ERISA-governed health care plan. ERISA allows discounts or surcharges in company wellness programs, provided they offer a “reasonable alternative standard” for participants “for whom participation may be unreasonably difficult or medically inadvisable due to a medical condition.” However, Platt contends that Sodexo’s program did not meet this requirement because it did not provide the “full reward” by retroactively reimbursing participants for surcharges paid before enrolling in a nicotine cessation class. He also contends that Sodexo failed to provide notice of the availability of a reasonable alternative standard. Platt’s complaint contains four claims for relief; (1) the surcharge violates ERISA by not providing a reasonable alternative standard to avoid the surcharge for the entire plan year; (2) Sodexo failed to give employees the required notice of any reasonable alternative standard; (3) Sodexo breached its fiduciary duty by assessing and collecting the surcharge, allegedly discriminating against plan participants based on health status-related factors, and (4) the surcharge violates the terms of the plan. This case has already been up to the Ninth Circuit, where that court ruled that Platt was not required to arbitrate his § 502(a)(1)(B) and § 502(a)(3) claims, and had viable defenses to arbitration on his § 502(a)(2) claim. On remand, defendants moved to dismiss, arguing that Platt’s claims were untimely and that he failed to state a claim upon which relief could be granted. Addressing timeliness first, the court ruled in Platt’s favor. For Counts I and II, the court applied the federal catchall limitations period of four years, as the claims were based on post-1990 amendments to ERISA. For Count IV, the court determined that the claim was timely because even under defendants’ proposed Maryland-based limitation period Platt plausibly did not have “actual knowledge” of the surcharge. The court then examined the merits of each of Platt’s claims. On Count I, the court found that Platt sufficiently alleged that Sodexo’s wellness program did not meet the “full reward” requirement, as participants were not reimbursed for surcharges paid before enrolling in a cessation program. The court acknowledged that the term “full reward” was open to interpretation and concluded, “There is enough legal uncertainty that the Court cannot conclude Defendants will prevail on its defense as a matter of law in its entirety[.]” On Count II, the court found it plausible that Sodexo failed to disclose the availability of a reasonable alternative standard in plan materials and thus denied defendants’ motion to dismiss this claim. On Count III, the court determined that Platt sufficiently alleged harm to the plan because he pled that Sodexo allegedly used surcharge funds to offset its contributions rather than depositing them in the plan. The court also found that defendants’ implementation and assessment of the surcharge involved fiduciary conduct. Finally, under Count IV, defendants argued that Platt did not exhaust his administrative appeals before filing suit. However, the court noted that “Plaintiff’s suit before the Court does not revolve around typical claims for benefits, but rather Sodexo’s policies in relation to ERISA jurisprudence.” As a result, it was ambiguous whether the plan’s exhaustion requirement applied to Platt’s claim. Thus, the court would not “automatically dismiss” it. As for the claim itself, the court found there were enough potential inconsistencies between plan documents to allow it to proceed. As a result, defendants’ motion was denied in its entirety.

Class Actions

First Circuit

Turner v. Liberty Mut. Ret. Benefit Plan, No. CV 20-11530-FDS, __ F. Supp. 3d __, 2026 WL 1734859 (D. Mass. June 16, 2026) (Judge F. Dennis Saylor IV). In this long-running putative class action Thomas Turner has sued various Liberty Mutual defendants, asserting that defendants incorrectly calculated cost-share obligations for post-retirement medical benefits by failing to account for employees’ years of service with Safeco Insurance Company, which was acquired by Liberty Mutual in 2008. In 2022, the court granted defendants summary judgment as to whether Turner was entitled to benefits under his Section 502(a)(1)(B) claim, ruling that the post-retirement medical benefit Mr. Turner sought was not vested. Defendants then moved for summary judgment on Turner’s remaining claims, but the court denied that motion in part, ruling in defendants’ favor on Turner’s full and fair review claim and his claim for failure to disclose plan limitations, but ruling against defendants on Turner’s claim for equitable relief. (The court found triable issues of fact as to whether defendants misled Turner and whether he reasonably relied on those misrepresentations to his detriment.) Turner then filed a motion for class certification, but the court denied it in 2024 because Turner defined his class in a way that expanded his theory of liability. Previously Turner had argued that Safeco employees were improperly denied benefits under the Liberty Mutual plan, whereas the class definition contended that they were also improperly denied benefits earned under the Safeco plan prior to the Liberty Mutual acquisition. The court denied the motion without prejudice, noting that a class more narrowly focused on the Liberty Mutual plan might be allowed. Turner responded by filing a motion for leave to amend his complaint to assert his “combined-benefits theory” that he was improperly denied both his grandfathered Safeco benefits and his earned Liberty Mutual benefits. In July of 2025 the court denied Turner’s motion, ruling that his motion was unduly and unjustifiably delayed and would impose substantial and unfair prejudice on defendants. Turner filed a renewed motion for class certification which the court adjudicated in this order. The court found that Turner’s proposed class did not meet the commonality requirement of Rule 23(a)(2). The court noted that the summary plan description was “unambiguous as to whether class members were entitled to cost-sharing credit for all their years of service at Safeco” (they were not), and the plan documents were consistent with the SPD. As a result, the only theoretically common evidence would be misrepresentations to class members, which required individualized evidence and separate findings as to whether those misrepresentations constituted a breach of fiduciary duty. The court also found that the proposed class did not satisfy any subsections of Rule 23(b). Under Rule 23(b)(1), the court again stated that Turner’s claim was based on individual misrepresentations, not plan administration, and separate proceedings would not risk inconsistent adjudications. Similarly, under Rule 23(b)(2), individualized remedies would be necessary, making class certification inappropriate.  Finally, under Rule 23(b)(3), the court found that common questions did not predominate over individual ones because, again, the claim relied on individual representations rather than common evidence. Thus, the court denied class certification.

Exhaustion of Administrative Remedies

Second Circuit

Lucas v. Hartford Life & Accident Ins. Co., No. 24-CV-7561 (VEC), 2026 WL 1759034 (S.D.N.Y. June 18, 2026) (Judge Valerie Caproni). In 2021 Suzanne Lucas submitted a claim for benefits under an ERISA-governed long-term disability benefit plan insured and administered by Hartford Life and Accident Insurance Company. Hartford approved Lucas’ claim, and in 2024, as part of its ongoing claim administration, it required her to undergo an independent medical examination. Lucas attended the exam but left before it was completed, “refus[ing] to provide photo identification or sign paperwork.” Hartford then terminated Lucas’ claim and informed her of the appeal process. Lucas’ counsel engaged in email exchanges with two of Hartford’s claim adjusters, and eventually emailed an appeal to one of them, attaching a letter to the email. The letter was not subsequently physically mailed to the P.O. Box identified by Hartford in its denial letter. Hartford did not respond to the email within the 45-day period set forth in ERISA’s claim regulations and thus Lucas filed this action. Hartford responded by moving for summary judgment, arguing that Lucas failed to exhaust her administrative remedies as required by ERISA before filing suit. Lucas argued first that the appeal was optional because the plan stated that she “may appeal…for a full and fair review,” but the court rejected this, holding that “exhaustion was mandatory.” Thus, the court turned to whether Lucas was required to send her appeal to the P.O. Box specified in Hartford’s denial letter or whether emailing it to one of Hartford’s claim adjusters was sufficient. Lucas argued that the P.O. Box instructions were not binding because they were not present in the plan and the letter was “ineffective to amend the terms of the underlying plan.” The court did not like this argument either, stating, “the Denial Letter did not alter any portion of the Plan but, rather, instructed Plaintiff about how to file an appeal. That is consistent with the Plan’s provision that, upon rendering a decision on a claim, Hartford will provide a ‘written notification of the decision’ that ‘will…provide an explanation of the review procedure.’” However, the court concluded that it “need not resolve whether Plaintiff was strictly obligated to send her appeal to the P.O. Box” because her decision to email her appeal letter to Hartford’s claims personnel “was not unreasonable, as a matter of law,” given the communications which “may have created some ambiguity as to whether it was necessary for Plaintiff to send her appeal to the P.O. Box for the Appeals Department, as outlined in the Denial Letter, or whether sending it to one of them would suffice.” The court noted that Hartford’s communications implied that Lucas could send her appeal to the personnel, who would then forward it to the appropriate department. Thus, a reasonable factfinder could determine that Hartford’s communications created enough ambiguity about the appeals process for her to believe that her email was sufficient. In such a scenario, Lucas exhausted her administrative remedies within the required timeframe, and Hartford failed to render a decision on her appeal within the applicable 45-day period. As a result, summary judgment in Hartford’s favor on the exhaustion issue was inappropriate and its motion was denied.

Pension Benefit Claims

Second Circuit

Garan v. 1199SEIU Benefit & Pension Funds, No. 25-2086, __ F. App’x __, 2026 WL 1728129 (2d Cir. June 12, 2026) (Before Circuit Judges Livingston, Sack, and Carney). Jozef Garan, proceeding pro se throughout this action, contends that his former union’s ERISA-governed pension fund, 1199SEIU Benefit and Pension Funds, miscalculated his pension benefits because it did not credit him for service prior to 2020. The district court granted the fund’s motion for summary judgment, finding that the plan gave the fund discretionary authority to determine benefits and that the fund’s decision not to credit Garan for pre-2020 service was not arbitrary and capricious. Garan appealed. The Second Circuit agreed with the district court that the operative collective bargaining agreement indicated that Garan’s employer was not obligated to contribute to the Fund until January 1, 2020, and “only service after that point is generally credited toward benefits calculations.” As a result, Garan could not plausibly allege that the Fund’s denial of his appeal was “without reason, unsupported by substantial evidence, or erroneous as a matter of law.” The court attempted to throw Garan a bone, noting that before 2020 his employer was paying into a different pension plan (the Retirement Plan of New York-Presbyterian Lawrence Hospital). The court suggested “without opining on the merits of such a claim” that this other plan might owe Garan pension benefits for contributions made before 2020. However, “those benefits are not managed by the Fund, which is the only pension-plan Defendant in this case.” As a result, the judgment below was affirmed.

Ninth Circuit

Munger v. Cloud, No. 23-3107, __ F. App’x __, 2026 WL 1734889 (9th Cir. June 16, 2026) (Before Circuit Judges Lee, Sanchez, and H.A. Thomas). Ruth Ann Munger brought this action as the representative of the Estate of Philip Cloud. She sought payment of benefits under five ERISA-governed plans offered by Mr. Cloud’s former employer, the Intel Corporation, after his death. Mr. Cloud’s named beneficiary, his wife, Tracy Cloud, was accused of killing him. In 2023, she was convicted by a Washington jury of second-degree murder. (That conviction was upheld on appeal in 2025). Based on this conclusion, the district court granted Munger summary judgment and awarded her the benefits at issue, ruling that as Mr. Cloud’s “slayer” Ms. Cloud was not entitled to recover any benefits under the plans. (Your ERISA Watch covered this decision in our October 18, 2023 edition. We also reported in our December 13, 2023 edition on the court’s subsequent order awarding the Intel defendants $20,297.79 in attorney’s fees.) Ms. Cloud appealed and this memorandum decision from the Ninth Circuit was the result. The court found that it “need not resolve whether Oregon or California law applies, or whether their state slayer statutes are preempted by ERISA, because there is no triable factual dispute that Ms. Cloud is Mr. Cloud’s slayer and is therefore not entitled to his ERISA benefits.” The court ruled that both Oregon and California law forbid a person’s killer from benefiting from the decedent’s pension, and furthermore, “[e]ven if the state slayer statutes were preempted, federal common law refuses to allow a person to benefit financially from a murder she has committed.” The court further ruled that the district court correctly prohibited Ms. Cloud from “relitigating whether she murdered Mr. Cloud” because “[u]nder the Full Faith and Credit Act…the preclusive effect of a state court judgment…is determined by the preclusion law of the state in which the judgment was issued.” Here, “all criteria are met because Ms. Cloud was convicted for the intentional murder of Mr. Cloud which is a serious offense, and her guilt was established in the criminal case where she had a full and fair opportunity to litigate.” The court then quickly dispensed with Ms. Cloud’s remaining arguments on appeal, ruling that (1) “[w]hether Plaintiff-Appellees violated Ms. Cloud’s Fifth and Sixth Amendment rights was not pleaded or adjudicated in the district court and therefore is not properly before us on appeal,” (2) “[t]he district court did not abuse its discretion in denying Ms. Cloud’s request to appoint counsel because Ms. Cloud failed to make the requisite showing of exceptional circumstances,” and (3) “[t]he district court did not abuse its discretion in denying Ms. Cloud leave to amend to assert a counterclaim based on a rescinded state settlement agreement” because the proposed claim “was both futile and unduly delayed.” As a result, the judgment below was affirmed and Mr. Cloud’s estate will receive the benefits in dispute.

D.C. Circuit

Anderson v. BDO USA, P.C., No. 25-CV-1002 (CRC), 2026 WL 1758224 (D.D.C. June 18, 2026) (Judge Christopher R. Cooper). Kevin Anderson was a partner at the accounting, tax, and consulting firm BDO USA, and under the firm’s Partnership Agreement was entitled to an “annual retirement benefit” as a partner, which would begin after a “separation of service.” Anderson retired from the partnership in 2019 as required by company policy and signed a Retirement Agreement. However, he continued working for BDO as a salaried full-time managing director until 2023, at which point BDO began paying him retirement benefits. In this action Anderson claims that BDO underpaid him by not providing retirement benefits for his service between 2019 and 2023, arguing that these benefits had accumulated during that time period, were deferred, and should have been made in a lump sum immediately after his separation from BDO. The case proceeded to cross-motions for judgment under Federal Rule of Civil Procedure 52. The court focused on Section 7.9(a) of the Partnership Agreement, which explained when retirement benefits would be paid. The court agreed with BDO that the agreement “makes no mention of a ‘lump sum’ or ‘accrual’ of retirement benefits prior to a partner’s separation from service.” The court interpreted the Section as addressing timing only, meaning that benefits would start after Anderson’s separation from BDO. This interpretation aligned with the Retirement Agreement, which only provided that benefits would commence after separation and also did not mention any “accrual” of benefits during his employment, or any lump sum payment. Anderson attempted to rely on other parts of the Partnership Agreement to support his argument, but they were unconvincing to the court, which ruled that they did not create a right to continued accrual of retirement benefits. As a result, the court concluded that Anderson was not entitled to a lump sum of retirement benefit payments for the period between 2019 and 2023, and BDO did not improperly deny his claim. Judgment was entered for BDO.

Pleading Issues & Procedure

Third Circuit

Schertle v. Weis Markets Inc., No. 4:25-CV-02080, 2026 WL 1749547 (M.D. Pa. June 17, 2026) (Judge Matthew W. Brann). Kurt Schertle was employed by Weis Markets, Inc. starting in 2009 as Senior Vice President of Sales and Merchandising and later promoted to Chief Operating Officer in 2014. He participated in the company’s supplemental executive retirement plan (SERP), a “top hat” plan, which is an unfunded deferred compensation arrangement for executives. In 2024, Schertle disclosed a consensual romantic relationship with another employee which resulted in a meeting with the company’s human resources department and its CEO in which Schertle was informed that “leadership had lost trust in him and that the parties should separate.” Schertle alleges that “he was never formally terminated and was never informed that his separation was for cause.” He also alleges that he was terminated because of “personal animus against him” by the CEO. Schertle contended that the company “initially proposed a severance package that included payment of his full SERP benefits but later withdrew that proposal and denied payment of those benefits.” This lawsuit followed in which Schertle asserted six claims for relief against the company and its retirement committee arising from the company’s denial of “more than four million dollars” in SERP benefits. Count I asserts a claim for benefits under ERISA § 502(a)(1)(B), Counts II and VII assert breach of contract claims, Count III alleges unjust enrichment, Count IV claims breach of fiduciary duty, and Counts V and VI assert promissory estoppel claims. Defendants filed a motion to dismiss all of Schertle’s claims except for Count I, arguing that they did not state an independent claim separate from his claim for benefits. Beginning with Counts III and IV, the court found that these claims were abandoned because Schertle did not respond to the arguments for their dismissal. Regardless, the court ruled that Count III (unjust enrichment) failed because “[t]o recover under unjust enrichment, there must be an absence of written agreement between parties,” and here the SERP controlled. Furthermore, Count IV (breach of fiduciary duty) failed because top hat plans are exempt from ERISA’s fiduciary duty provisions. As for Counts II and VII, these breach of contract claims were dismissed as duplicative of Count I because they sought the same benefits and “rely upon the same operative facts and seek the same relief.” Schertle argued that “the alleged breach arises from Defendants’ purported misinterpretation and inconsistent application of the SERP’s cause provisions,” but the court ruled that this was a distinction without a difference: “Those allegations are fully encompassed within Count I.” Finally, Counts V and VI (promissory estoppel) were dismissed because the alleged material representations were either part of the contractual obligations in Count I or did not establish the “extraordinary circumstances” required by Third Circuit precedent. In essence, these claims “serve to repackage Plaintiff’s central contention that Defendants wrongly denied him benefits under the SERP plan,” which was already covered by Count I. As a result, the court granted defendants’ motion. Counts II, III, IV, and VII were dismissed with prejudice because the court found amendment would be futile, but the court granted Schertle leave to amend his promissory estoppel claims under Counts V and VI if he can “plausibl[y] allege viable facts in support of those claims.”

Tenth Circuit

Long v. Blue Shield of Cal., No. 24-CV-03352-PAB-CYC, 2026 WL 1732989 (D. Colo. June 16, 2026) (Judge Philip A. Brimmer). Jacob Long submitted medical claims for reimbursement to his insurer, Blue Shield of California, but was dissatisfied with what Blue Shield paid, so he brought this pro se action in which he alleged three state law claims for relief: breach of contract, breach of the implied covenant of good faith and fair dealing, and bad faith denial of insurance claim. Blue Shield moved to dismiss, contending that Long’s claims were preempted by ERISA. In May of 2025 Magistrate Judge Cyrus Y. Chung issued a report and recommendation recommending the court dismiss the claims as preempted, but without prejudice so that Long could replead his claims under ERISA. (Your ERISA Watch reported on this ruling in our May 21, 2025 edition.) Long did not object to the recommendation, the district court judge accepted it, the court entered judgment, and that was that for more than five months. In November of 2025 Long filed a motion to reopen the case and amend his complaint under Federal Rules of Civil Procedure 60(b) and 15(a)(2), seeking to amend his complaint to bring claims under ERISA pursuant to the court’s earlier order. Blue Shield opposed the motion, arguing that Long did not meet the standard for relief under Rule 60(b) and that the proposed amendments were futile. The court sided with Blue Shield. “Here, plaintiff made the deliberate decision not to bring his claims under ERISA. Moreover, when defendant moved to dismiss plaintiff’s claims as being preempted by ERISA, plaintiff made the deliberate decision not to amend his complaint at that time. Plaintiff could have protected against this error by bringing his claims under ERISA in the first place, or by amending his complaint to bring claims under ERISA after defendant pointed out the preemption problem in its motion to dismiss. Plaintiff’s failure to predict the legal consequence of his decision to bring preempted claims does not warrant relief under Rule 60(b)(1).” The court further denied relief under Rule 60(b)(2)’s “catch-all provision” because “there is nothing extraordinary about plaintiff’s desire to amend his complaint after it was dismissed without prejudice.” The court further pointed out that Long could have moved to alter the judgment under Rule 59(e), “where he would have faced a much more lenient standard,” and that he was free to refile his claims in a separate action because the dismissal was without prejudice. Thus, denying Long’s motion “would not offend justice.”

Eleventh Circuit

Isoviv v. Hartford Life & Accident Ins. Co., No. 1:25-CV-5865-TWT, 2026 WL 1760334 (N.D. Ga. June 18, 2026) (Judge Thomas W. Thrash, Jr.). This case is a dispute over ERISA-governed long-term disability (LTD) benefits. Hata Isoviv was a houseware coordinator for Cort Business Services Corp. and was a participant in Cort’s LTD plan, which was insured and administered by Hartford Life and Accident Insurance Company. Since 2022, Isoviv has been disabled due to a back condition, and was paid LTD benefits by Hartford. With the assistance of Allsup, LLC, she applied for Social Security disability benefits and was approved for those benefits as well. Subsequently, Hartford reduced its LTD benefit to account for the Social Security offset, Allsup allegedly collected an overpayment from Isoviv’s bank account “without informing her of Hartford’s legal options for collection,” and Hartford terminated her LTD benefits. Isoviv brought this suit against Hartford and Allsup alleging four state law and ERISA counts arising from the termination of her benefits; three were against Hartford and the fourth was against Allsup for breach of fiduciary duty. Allsup filed a motion to dismiss on several grounds but the court focused on only one: the legibility of the complaint. “Because addressing the Motion to Dismiss would require the Court to expend substantial judicial resources in order to attempt to comprehend the pleadings within the Plaintiff’s Complaint, the Court sua sponte dismisses the Plaintiff’s Complaint as a shotgun pleading.” The court explained that the complaint violated Federal Rule of Civil Procedure 8 because it failed to provide a clear and concise statement of Isoviv’s claims. The complaint realleged almost every paragraph in each count, was “replete with conclusory, vague, and immaterial facts that are not connected to any cause of action,” and failed to specify which defendants were responsible for which acts or omissions. “In other words, the Plaintiff has presented the Court with a box of parts and expects the Court to build the claim without providing an instruction manual.” The court noted that such pleadings are prohibited as they confuse the court and the defendants, making it difficult to understand what claims are being alleged and the grounds upon which they rest. The court thus granted Allsup’s motion and dismissed the complaint without prejudice, allowing Isoviv to amend.