It was another light week at Your ERISA Watch. Perhaps the courts are exhausted as the year winds down. And speaking of exhaustion, that peculiar ERISA topic rears its head in several interesting decisions this week, so read on to learn more about this and other ERISA developments.

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

Arbitration

Sixth Circuit

Parker v. Tenneco Inc., No. 23-cv-10816, 2024 WL 5004326 (E.D. Mich. Dec. 6, 2024) (Magistrate Judge Kimberly G. Altman). In this putative class action, participants of the DRiV 401(k) Retirement Savings Plan and the Tenneco 401(k) Investment Plan seek to hold the plans’ fiduciaries responsible for allegedly breaching their duties under ERISA. The defendants previously moved to compel individual arbitration, but the court denied their motion and the Sixth Circuit affirmed the denial of defendants’ motion to compel individual arbitration. Defendants have since filed a petition for writ of certiorari with the United States Supreme Court, and now move to stay the case and discovery pending the Supreme Court’s ruling on their petition. In this decision, the district court denied these motions to stay. Defendants, the court concluded, could not demonstrate that there is a reasonable likelihood the Supreme Court will grant certiorari, and even if it were to do so, that it would reverse the decision of the Sixth Circuit. Nor could defendants show that they would face irreparable harm without a stay. On the likelihood of certiorari being granted, the court was unconvinced that there is a circuit split over the application of the effective vindication doctrine in ERISA plans. At the very least, the court noted that the majority of circuit courts, including the Second, Third, Sixth, and Tenth, are in lock-step. “In trying to demonstrate the existence of a split, Defendants point to an unpublished Ninth Circuit memorandum opinion, Dorman v. Charles Schwab Corp., 780 Fed.Appx. 510 (9th Cir. 2019), and a Seventh Circuit ruling stating that while ERISA claims may be arbitrable in general ‘the ‘effective vindication’ exception bar[red] application of the plan’s arbitration provision’ to the plaintiff’s ERISA claims.” To the court, this was insufficient evidence to demonstrate that a circuit split exists such that the Supreme Court is likely to grant their petition for certiorari. In fact, the court noted that the Supreme Court has denied three similar petitions already, “even after the issuance of the Seventh and Ninth Circuit opinions cited by Defendants.” Moreover, the court was seemingly unmoved by defendants’ attempt to distinguish their cert petition from the earlier failed ones by arguing that the Supreme Court will be friendlier to arguments rejecting the application of the effective vindication doctrine because of its decision in Loper Bright Enters. v. Raimondo, 144 S. Ct. 2244 (2024). The court pointed out “that a petition for certiorari has been denied following the issuance of Loper Bright in June 2024.” The court was therefore unconvinced that the fiduciaries here will fare better with their own petition. But even if they should, the court was quick to note that defendants fail to establish that they will be harmed or unduly burdened absent a stay. Accordingly, the court denied both of defendants’ motions – (1) to stay the case pending order on petition for writ of certiorari, and (2) to stay discovery pending a ruling on defendants’ “garden-variety Rule 12(b)(6) motion” to dismiss plaintiffs’ amended complaint.

Attorneys’ Fees

Second Circuit

Mundell v. Natsios-Mundell, No. 24-cv-2800 (JSR), 2024 WL 4979295 (S.D.N.Y. Dec. 3, 2024) (Judge Jed S. Rakoff). The family of the late Nobel Prize-winning economist Dr. Robert Mundell dispute the beneficiary designation of Dr. Mundell’s $4 million retirement account. His children and grandchildren allege that his widow fraudulently logged onto her husband’s online portal to change his designated beneficiary from his four children to name herself the sole beneficiary. The children and grandchildren sued the widow in state court to hold her liable for the alleged fraud. The widow then removed the action to federal court, arguing the family’s dispute was preempted by ERISA. Ultimately, the court disagreed, and on October 8, 2024, it issued a decision granting the plaintiffs’ motion to remand their action back to state court. (You can read our summary of that decision in Your ERISA Watch’s October 16, 2024 edition.) Plaintiffs now move for attorneys’ fees under the removal provision, 28 U.S.C. § 1447(c), for the costs they incurred from defendant’s removal. The court denied their motion in this decision, finding that the removal was objectively reasonable given the complexity of ERISA preemption. “Although plaintiffs accurately observe that governing law clearly foreclosed diversity jurisdiction as a basis for defendant’s removal, defendant’s argument that complete preemption under ERISA supplied federal-question jurisdiction presented a close call.” Simply, the court stated that although its bottom-line outcome came out in plaintiff’s favor, this result nevertheless does not provide a basis for an award of attorneys’ fees. Furthermore, the court noted that its position declining to award attorneys’ fees aligns with many other decisions addressing the same issue. Thus, plaintiffs were not awarded any fees to compensate them for the removal.

Class Actions

Fourth Circuit

Leon v. Maersk Inc., No. 3:23-cv-00602-RJC-SCR, 2024 WL 4942394 (W.D.N.C. Dec. 2, 2024) (Judge Robert J. Conrad, Jr.). Participants of the Maersk Inc. retirement plan moved unopposed for final approval of class action settlement and for attorneys’ fees, costs, administrative expenses, and a case contribution award in this breach of fiduciary duty action alleging the fiduciaries mismanaged the plan by saddling it with excessive administrative fees and recordkeeping expenses. In a very succinct order, the court granted plaintiffs’ motions, concluding that the $225,000 settlement of the class action was fair, reasonable, and adequate to the plan and the class and the result of informed, good-faith, and arms-length negotiations. The court also briefly reiterated a prior finding that the settlement for the class of participants and beneficiaries meets all of the requirements of Rule 23(a) and 23(b)(1). Moreover, the court approved the form and methods of notifying the class of the settlement. The court also noted that class members had the opportunity to voice any issues regarding the settlement and the release of claims relating to the settlement agreement and that there were no objections to the settlement or plan of allocation. Further, an independent fiduciary has reviewed the settlement and approved it, also concluding that it represents a fair and reasonable outcome for the parties. Accordingly, the court granted the motion for final approval of the settlement, and, pursuant to its terms, ordered defendants to conduct a request for proposal for plan recordkeeping services within three years following the settlement effective date. Although not discussed in any detail, the motion for attorneys’ fees, costs, expenses, and case contribution award were all granted as well pursuant to the terms of the settlement agreement. Thus, the class action settlement was given final approval, plaintiffs released their claims, and the settlement administrator was granted final authority to delegate the share of the net settlement amount to each eligible plan participant as agreed to under the plan of allocation.

Disability Benefit Claims

Fifth Circuit

Black v. Unum Life Ins. Co. of Am., No. 3:22-CV-2116-X, 2024 WL 4960010 (N.D. Tex. Dec. 2, 2024) (Judge Brantley Starr). In 2014, plaintiff Catherine A. Black underwent surgery to remove her gallbladder. Unfortunately, she suffered complications from the surgery and was unable to return to work. Ms. Black submitted a claim for disability benefits under a policy administered and insured by defendant Unum Life Insurance Company of America. Unum approved the claim. Years passed and Ms. Black was diagnosed with thoracic outlet syndrome and her symptoms persisted. In 2021, following more surgery, Ms. Black’s health began to improve. Her own doctors even cleared her to perform sedentary work. In response to this, Unum terminated Ms. Black’s disability benefits. She protested and appealed Unum’s decision, arguing her pain remained debilitating. Nevertheless, Unum affirmed its decision on appeal based on the conclusions of its reviewing nurse. Ms. Black once again requested Unum reconsider its position, and when it declined to, she filed this ERISA action. At the summary judgment stage, the court agreed with Ms. Black that Unum failed to provide her claim with a full and fair review as required under the statute. “The Court’s opinion ruled that Unum denied coverage based on medical judgment and in doing so, ‘did not meet ERISA’s procedural requirements for two reasons: (1) Nurse Abbot’s review essentially gave deference to the initial denial of Black’s claim; and (2) Nurse Abbot was not a qualified health care professional to perform the consultation.’” The court therefore granted Ms. Black’s motion for partial summary judgment and remanded the case back to Unum to conduct a new review of her claim in compliance with ERISA’s requirements. On remand, Unum consulted with a doctor of osteopathy and a vascular surgeon. Both reviewing doctors agreed that there were no clinical or diagnostic findings in Ms. Black’s medical record to support restrictions and limitations precluding her from performing sedentary occupational demands. Unum therefore denied Ms. Black’s claim again. In this decision, the court granted judgment on the record in favor of Unum on its determination post-remand. It found that the review substantially complied with ERISA’s statutory requirements because the insurer consulted with doctors who were “certainly qualified to conduct a review of Black’s medical records and form [opinions] on which Unum could rely.” More broadly, the court stated that it could not disturb Unum’s decision given that substantial evidence supports the denial, particularly as this case is unlike ones where the parties’ respective physicians disagree strongly on the plaintiff’s disability status. In this case, the court wrote the physicians “largely agree,” and Black’s own treating doctors cleared her for sedentary work as of September 17, 2021. The court therefore upheld the denial and entered judgment in favor of Unum.

Ninth Circuit

Gray v. United of Omaha Life Ins. Co., No. 24-700, __ F. App’x __, 2024 WL 5001915 (9th Cir. Dec. 6, 2024) (Before Circuit Judges Gould, Clifton, and Sanchez). Plaintiff-appellant Kandice Gray appealed a judgment from the district court in favor of defendant-appellee United of Omaha Life Insurance Company in this ERISA disability benefits action. Under de novo standard of review, the district court held that Ms. Gray failed to meet her burden of proof to demonstrate she was entitled to additional short-term disability or long-term disability benefits under the policy. On appeal, the Ninth Circuit agreed, finding no clear error in the district court’s decision. The court of appeals stressed that Ms. Gray only submitted four doctors’ appointment records to defendant while her claim was under review, and two of these doctors were not specialists in the relevant field of medicine for her disabling condition, lumbar radiculopathy. The Ninth Circuit wrote that these “medical findings are too thin and dependent on Gray’s subjective reporting to be given substantial weight.” Moreover, despite what the court of appeals categorized as “many opportunities to submit additional medical records while her claims were still under review,” Ms. Gray failed to include MRI results or respond to United’s “repeated reasonable requests for details.” The Ninth Circuit therefore agreed with the lower court that special circumstances did not exist here which would justify considering evidence that was not before United when it made its claim determination. Accordingly, the court of appeals affirmed the judgment in favor of United of Omaha.

Discovery

Third Circuit

Stallman v. First Unum Life Ins. Co., No. Civ. 23-20975 (JXN) (LDW), 2024 WL 4988603 (D.N.J. Dec. 5, 2024) (Magistrate Judge Leda Dunn Wettre). Plaintiff Jeremy Stallman filed this action against First Unum Life Insurance Company to challenge its denial of his claim for long-term disability benefits. Mr. Stallman moved for limited discovery related to his claim. The court broke Mr. Stallman’s discovery request into three sections: (1) administrative record discovery; (2) conflict of interest discovery; and (3) affirmative defenses discovery. The decision began with the discovery seeking to confirm the completeness of the administrative record produced by First Unum. In this category of discovery, Mr. Stallman sought his short-term disability claim file, First Unum’s claims manual and guidelines, and communications relating to his long-term disability claim. First Unum agreed to produce its claims manual and guidelines and the communications, mooting these requests, but argued vociferously against producing Mr. Stallman’s short-term disability claim file. First Unum contended that the short-term disability file should not be considered part of the administrative record because it was a separate and distinct file, not considered or relied upon with regard to the long-term disability claim given that the respective claims were based on wholly unrelated disabilities – a pelvic fracture in the first instance and depression and anxiety in the second. The court was persuaded by these arguments, and thus denied Mr. Stallman’s request for production of his short-term disability claim file. Furthermore, the court denied Mr. Stallman’s request for a 30(b)(6) deposition to confirm and ensure that First Unum included all internal and external communications regarding his long-term disability claim in the administrative record. The decision next turned to the conflict of interest discovery. As a preliminary matter, the court established that such discovery is only permissible when a plaintiff expresses a reasonable suspicion that a structural conflict of interest adversely affected the way his or her claim was handled. Mr. Stallman argued that he had a reasonable suspicion of misconduct in his case given First Unum’s longstanding history of unfair claim handling practices which resulted in a Regulatory Settlement Agreement with the Department of Labor in 2004, its general practices in the way it tracks and monitors claims, and the fact that First Unum granted his claim for short-term disability benefits but denied his claim for long-term disability benefits. None of these arguments were “especially persuasive” to the court. It was unconvinced that historical or general practices create a per se reasonable suspicion of misconduct affecting all benefit claims. And the court was skeptical that the denial of Mr. Stallman’s long-term disability benefit claim immediately after his approved short-term disability benefit claim was evidence of misconduct, as the two claims related to different disabilities. Nevertheless, despite the court’s view that Mr. Stallman failed to present much in the way of compelling evidence demonstrating a reasonable suspicion, it found it appropriate to permit Mr. Stallman “to serve one interrogatory addressed to whether the compensation or performance evaluations of First Unum’s claims and medical personnel involved in plaintiff’s LTD claim decision has been based, during relevant time periods, in any respect on the outcome of their claims determinations. In the Court’s view, this is the information that most directly bears on whether any bias stemming from the structural conflict actually may have influenced the outcome of the LTD claim.” In all other respects, Mr. Stallman’s “wide-ranging” conflict of interest requests were denied. Finally, the court denied Mr. Stallman’s merits discovery request into First Unum’s affirmative defenses, as it stated this type of discovery “is prohibited in abuse-of-discretion cases.” Thus, as described above, Mr. Stallman’s motion for discovery was granted in part and denied in part by the court.

Exhaustion of Administrative Remedies

Third Circuit

Murray v. United Healthcare Servs., No. 2:23-cv-02073 (BRM), 2024 WL 4986725 (D.N.J. Dec. 5, 2024) (Judge Brian R. Martinotti). Plaintiff Kathryn Murray alleges that, before undergoing two medically necessary breast reconstructive surgeries, her health insurance provider, defendant United Healthcare Services, Inc., made clear and definite promises to grant her a “gap exception” for her surgeries, essentially guaranteeing to cover the surgeries at the “in-network” benefit level because United lacked in-network physicians in her geographic location who could perform them. When all was said and done, though, United reimbursed the providers only about $6,500 for each of the two surgeries, leaving Ms. Murray with out-of-pocket expenses of $143,495.26 and $18,444.52 respectively. In this action Ms. Murray seeks the reimbursement she alleges she was promised by United. United moved to dismiss Ms. Murray’s complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). It argued that her sole cause of action under ERISA Section 502(a)(1)(B) must be dismissed because she failed to allege facts to demonstrate she exhausted administrative remedies available, and because her complaint fails to tie her claim for benefits to the specific terms of her healthcare plan. The court addressed both arguments. To begin, the court declined to dismiss the complaint for failure to exhaust administrative remedies, noting that defendant bears the burden to show failure to exhaust and that exhaustion is an affirmative defense, “not generally the basis for dismissal under Rule 12(b)(6).” The court stated it could not definitively conclude whether pursuing administrative remedies would have been futile for Ms. Murray and therefore rejected defendant’s arguments for dismissal based on failure to exhaust. Regardless, the court agreed with United that the complaint as currently pled fails to link the claim for benefits to the terms of the plan, stating, “[it] is unclear from the face of the [complaint]…what plan provisions entitle [plaintiff] to the full amount of $161,939.78 for the surgeries performed. Even when construing Plaintiff’s complaint in the light most favorable to her…it cannot be said that Defendant’s ‘clear and definite promises to Plaintiff to grant her a ‘gap exception’’ also include a promise to pay for Plaintiff’s surgeries. Instead, the plan terms indicate Defendant will pay only ‘Eligible Expenses’ incurred by ‘Covered Health Services received from an Out-of-Network provider as a result of an Emergency or as arranged by [United.]’” Stated differently, the court latched onto Ms. Murray’s apparent responsibility for any charges beyond the “Eligible Expenses,” suggesting that the plan terms seem to contradict Ms. Murray’s under-reimbursement allegations. Accordingly, the court agreed with United that the complaint is currently deficient. However, pursuant to the Third Circuit’s lenient precedent regarding leave to amend, the court allowed Ms. Murray to amend her complaint to provide additional factual content to cure this deficiency, and therefore denied United’s request that the complaint be dismissed with prejudice.

Sixth Circuit

Martinez v. Zepf Ctr., No. 3:24 CV 810, 2024 WL 4932502 (N.D. Ohio Dec. 2, 2024) (Judge James R. Knepp II). Plaintiff Henry Martinez filed this action seeking $6,000 in short-term disability benefits under a fully insured ERISA-governed plan offered by his former employer, defendant Zepf Center. Mr. Martinez stopped working following a cancer diagnosis in 2022. He originally filed this lawsuit in state court, but the action was removed by the employer. After transferring the case to federal court, the employer moved for summary judgment. Mr. Martinez failed to timely respond to defendant’s motion. In this decision the court granted the employer’s motion for summary judgment. Defendant argued, and the court agreed, that it was entitled to summary judgment on three bases: (1) Mr. Martinez cannot state an ERISA claim because he was a per diem employee and per diem employees were not eligible to participate in the short-term disability plan; (2) even if Mr. Martinez could show he was the type of employee entitled to coverage under the plan, Mr. Martinez never submitted a claim for benefits under the terms of the plan or provided written proof of disability, and the time to do so has expired under the plan’s timing requirements; and relatedly, (3) Mr. Martinez’s claim fails as a matter of law because he did not exhaust the administrative remedies provided by the plan before bringing a lawsuit.

Tenth Circuit

David P. v. United HealthCare Ins., No. 2:19-cv-00225-JNP, 2024 WL 4988990 (D. Utah Dec. 5, 2024) (Judge Jill N. Parrish). In ERISA-world, we sometimes get inured to the oddities and peculiarities which are part and parcel of our field of coverage. Two of the many strange, some may even argue absurd, conventions to which we have become accustomed are those of court-ordered “remands” to plan administrators and the judicially-crafted requirement that claimants exhaust all administrative remedies prior to commencing legal action. The court tackled these two topics in this unusual ruling intervening in defendant United Healthcare’s decision on remand of a family’s claims for coverage of the daughter’s mental and substance-use disorder treatment at two residential treatment centers. Plaintiffs filed their federal ERISA lawsuit to challenge United’s denial of their claims for benefits, arguing successfully that United acted arbitrarily and capriciously by entirely failing to consider the daughter’s substance use as an independent basis for coverage. For relief, the court awarded plaintiffs benefits outright. However, United appealed the district court’s order, and although the Tenth Circuit agreed with the lower court that the denial was an abuse of discretion, it nevertheless reversed the district court’s chosen remedy. The court of appeals directed the lower court to instead remand the claim back to United for further consideration. Here’s where things went awry. Rather than wait for the district court to issue a remand order, or move for the court to order one, the United Healthcare defendants took it upon themselves to reconsider the claim. Once again they denied the $175,000 in benefit claims, this time strengthening their denials by providing significantly more detailed explanations and addressing the substance abuse bases for the claims. In response to this, plaintiffs moved to reopen the case for the court to review the denial of their benefit claims on reconsideration. The United defendants, for their part, argued that the family needs to once again exhaust the internal appeals processes before the court may grant their motion to reopen. The court was of an entirely different opinion altogether. It concluded that the case was never closed and that United’s voluntary reconsideration of the claims “is without legal effect because it was not made pursuant to a remand order by this court,” answering the novel question: “what legal effect, if any, does Defendants’ second denial letter have absent a remand order from this court?” The court clarified that judicial remand orders to plan administrators are not merely ministerial exercises of formal protocol, but rather serve important and practical purposes, including setting guardrails on the specific issues which can be considered on remand and structuring the procedures that must be followed to ensure the parties’ respective rights and obligations. The court elaborated that “judicial remand orders set the scope and framework for remand and provide the court a yardstick against which to evaluate the insurer’s redeterminations if the plaintiffs move for judicial review again.” The court disagreed with defendants’ assertion that the court of appeals’ decision itself constituted a remand order. Undermining this position, the court stated, was the plain language of the Tenth Circuit’s opinion requiring “a remand order from this court.” Regardless, the court specified that even if it were to construe the Tenth Circuit’s opinion itself as ordering a remand to the defendants, which it did not, it was entirely unconvinced that plaintiffs would be required to pursue the multi-step administrative appeals process anew, as such a requirement would give the administrator additional opportunities “to course correct.” Thus, displeased with United’s self-start, the court nullified its redetermination and ordered plaintiffs’ claims be remanded to the insurance company with limitations. Among these court-ordered restraints was a court-placed restriction on the scope of what United may consider during remand. The court decisively disposed of defendants’ ability to evaluate the claims based on the substance abuse rationale on remand because they entirely ignored that basis during the initial determination process. The court permitted defendants only “an opportunity [on remand] to elaborate on the rationales previously raised and conveyed.” Additionally, the court set the timeframe for the remand process. It gave defendants 60 days to reevaluate the claims, and plaintiffs 60 days to respond and object, if so desired. Assuming plaintiffs do object, United then has one month to respond to the objection. Thus, the court essentially provided the parties a one-level internal appeal process. It specified that plaintiffs must exhaust this one-level appeal before they may return to the court for any further judicial intervention. Finally, the court stated that it retains jurisdiction over the case pending the outcome on remand. Having arrived at these conclusions, the court denied plaintiffs’ motion to reopen the case as premature.

Pleading Issues & Procedure

Seventh Circuit

Tran v. Veolia Util. Res., No. 1:24-cv-00121-HAB-SLC, 2024 WL 4930164 (N.D. Ind. Dec. 2, 2024) (Magistrate Judge Susan Collins). Plaintiff Hien Tran brought this action against Sun Life Assurance of Canada, Veolia Utility Resources LLC, and Lincoln Life Assurance Company of Boston seeking ERISA-governed life insurance benefits due to the death of her husband. In the alternative, Ms. Tran also asserted a breach of fiduciary duty claim against defendants. After the lawsuit was filed, Sun Life received a competing claim for the same benefits from the decedent’s former wife, Sally Ann Lombardo. In response to this, Sun Life has moved to join Ms. Lombardo as a new party to this matter. Additionally, Sun Life asked the court to bifurcate the benefit claim from the alternative breach of fiduciary duty claim. It argues that bifurcation of the two causes of action would promote judicial economy and avoid prejudice to the parties. The court addressed joinder first and agreed with Sun Life that the competing claims for benefits present a classic example of a case where a party could be prejudiced by a decision made in his or her absence and where the insurance company would be subject to a substantial risk of inconsistent judgments from multiple lawsuits. Furthermore, the court rejected Ms. Tran’s argument that joinder of Ms. Lombardo would be futile because her competing claim for the benefits lacks merit. The court stated that futility arguments about the inability of the plaintiff to prevail on the merits are not well suited to joinder analysis and arguments about futility only hold water if they refer to the inability to state a claim. Therefore, the court declined to prevent joinder of Ms. Lombardo’s claim based solely on arguments regarding the merits. Accordingly, the court granted Sun Life’s motion to join Ms. Lombardo. However, the court was not persuaded by Sun Life’s motion to bifurcate because “the Court does not foresee a scenario where separation of the two claims avoids prejudice to a party or promotes judicial economy.” Therefore, the court denied Sun Life’s motion for bifurcation of the claims in this case.

Provider Claims

Ninth Circuit

Cleanquest, LLC v. United Healthcare Ins. Co., No. 8:23-cv-00148-JWH-ADS, 2024 WL 4940540 (C.D. Cal. Dec. 2, 2024) (Judge John W. Holcomb). Plaintiff Cleanquest, LLC is a toxicology lab that provides testing services for substance abuse treatment facilities. Cleanquest is out-of-network with defendants UnitedHealthcare Insurance Company, United HealthCare Services, Inc, and United Behavioral Health. It alleges that United has stopped paying claims or is underpaying for Cleanquest’s medical services. In this action, the provider seeks payment for testing of 166 patients with plans insured by United. This action was originally brought in state court. The United defendants removed the action to federal court. Cleanquest has since amended its complaint to assert claims under ERISA Sections 502(a)(1)(B), 502(a)(2), 502(a)(3), and 1132(c), as well as three state law claims for implied contract, quantum meruit, and California’s unfair competition law. Defendants moved to dismiss the amended complaint. The court granted the motion in part and denied the motion in part in this order. To begin, the court found that the provider stated a viable claim for benefits under ERISA Section 502(a)(1)(B), as its amended complaint sufficiently pleads that United violated specific terms of the ERISA plans and plausibly alleges that defendants have misapplied plan terms and underpaid claims. Additionally, the court concluded that Cleanquest alleged it exhausted its administrative remedies prior to bringing its action. The motion to dismiss the ERISA benefit claim was therefore denied by the court. However, the court granted defendants’ motion to dismiss the Section 502(a)(2) claim as the court found it clear from the face of the complaint that this action is not brought on behalf of the healthcare plans, but plainly on behalf of the healthcare provider in its own capacity. Nevertheless, the court was not receptive to defendants’ arguments with regard to the Section 502(a)(3) claim. The court found it appropriate to leave this cause of action because it concluded Section 502(a)(1)(B) may not allow the court to appropriately remedy all of the provider’s harm given the fact that some of the plans at issue may be self-funded while others are fully insured. The court also allowed plaintiff to proceed with its claim for failure to provide requested plan documents. However, the court agreed with defendants that all of Cleanquest’s state law claims were expressly preempted by ERISA Section 514. The court concluded that these three causes of action were all premised on coverage and reimbursement under the terms of the plans rather than on independent obligations owed to the provider or promises of payment, and that they therefore could not be resolved without reference to the ERISA plans. Defendants’ motion was thus granted with respect to the three state law claims. Finally, the court clarified that the four causes of action it was dismissing were dismissed without leave to amend, as it concluded that amendment would be futile because no additional revisions could cure these deficiencies.