
Doe v. Deloitte LLP Grp. Ins. Plan, No. 23 CIV. 4743 (JPC), __ F. Supp. 3d __, 2025 WL 586670 (S.D.N.Y. Feb. 24, 2025) (Judge John P. Cronan)
Our case of the week is a published district court decision that tackles two important issues in ERISA benefits litigation. The first is a classic procedural issue that often bedevils parties, and the second involves the increasingly scrutinized question of what constitutes an adequate health benefit denial under ERISA.
The plaintiff in the case is an anonymous father, John Doe, who had medical coverage through his employment with the professional services firm Deloitte LLP. His minor son received care at an adolescent mental health residential treatment facility in New Mexico called Sandhill Center.
However, when plaintiff submitted claims for his son’s treatment to Deloitte’s health insurance plan, which was administered by Aetna Life Insurance Company, Aetna denied his claims, based largely on the argument that Sandhill was out-of-network under the plan. Aetna then denied plaintiff’s appeals, and thus he brought this action, alleging an improper denial of benefits under 29 U.S.C. § 1132(a)(1)(B).
Before the court evaluated the case’s merits, it addressed two procedural issues: (1) whether the case should be decided by summary judgment under Federal Rule of Civil Procedure 56 or by a bench trial under Federal Rule of Civil Procedure 52; and (2) whether the denial of benefits should be reviewed de novo or for abuse of discretion.
Courts across the country have differed on which Federal Rule is appropriate for disposing of ERISA benefit cases. Here, plaintiff argued that Rule 52 applied because the court was engaged in making findings of fact. The plan, on the other hand, contended that summary judgment proceedings under Rule 56 applied because the underlying facts were undisputed and it was entitled to judgment as a matter of law.
The court determined that Rule 56 was “the proper vehicle for the parties’ motions.” The court offered two reasons for this decision. First, “[i]f Defendant is correct that it is entitled to judgment based on the law and the undisputed facts in the record, the Court’s role as a fact-finder under Rule 52 is unnecessary. Second, it must be clear to the parties that the Court is proceeding under Rule 52 before the Court can engage in fact-finding.” The court concluded that it could not just skip past Rule 56 as suggested by plaintiff: “If the Court determines that genuine issues of material fact persist which preclude summary judgment,” only then could “the parties could proceed under Rule 52.”
As for the appropriate standard of review, the court dodged this issue by giving away the rest of the decision: “The Court need not resolve this issue. Even assuming Defendant is correct that abuse of discretion review applies, summary judgment in favor of Plaintiff remains warranted.” This was because “the denial of benefits was arbitrary and capricious” and “without reason.”
The court agreed with Aetna that the treatment received by plaintiff’s son was out-of-network, and that the plan generally excludes such treatment from coverage. This was not the end of the story, however. Plaintiff acknowledged the treatment was out-of-network, and thus had asked Aetna for a “single case agreement,” which is an exception to the network requirement allowed by the plan in certain cases. Plaintiff contended that such an exception was appropriate for his son because “the Plan’s in-network options were inadequate” to treat his son, and because Aetna had “considered inappropriate criteria in making its decision.”
The court ruled that “Aetna’s denials did not address either issue, nor is it apparent that Aetna even considered during the administrative appeals process whether Sandhill, notwithstanding its out-of-network status, should be provided a single case agreement and therefore Plaintiff should be afforded exception-based coverage.” Instead, Aetna’s denials “stated perfunctorily that Sandhill was not covered because it was an out-of-network provider.”
Aetna suggested that its invocation of the network rule in its denials implicitly included a rejection of the single case agreement exception. However, this argument did not appease the court because “what criteria Aetna used in reaching that decision and how they applied those criteria to Sandhill during the appeals are not apparent from the record – an issue which severely hampers this Court’s ability to review whether the denial of benefits was supported by substantial evidence.” For example, the court noted that it was unable to tell whether Aetna followed the utilization review process described in the plan, and could not decipher what criteria Aetna may have used in determining whether a single case agreement was justified.
As a result, the court found that Aetna’s denials violated ERISA because they did not give plaintiff adequate notice of the specific reasons his claims had been denied, and did not give him a “full and fair review” on appeal. The court found that Aetna’s letters “gave only the barest explanation which – while technically accurate in that Sandhill was out-of-network – did not engage with Plaintiff’s actual claim seeking a single case agreement.” Indeed, it did “not even attempt[] to grapple with” plaintiff’s argument.
Aetna contended that the court’s review was not limited to the denial letters, and urged it to examine “the context of the parties’ relationship as evidenced through the ‘entire administrative record.’” The court rejected this argument, explaining that a plan administrator cannot “make up for blatant deficiencies in its denial letters by pointing to other communications in the administrative record which may or may not have served as the actual basis for denial upon review.”
The court further pointed out that Aetna’s argument “would be disjoined from the statutory framework,” which focuses on the content of the denials themselves. Moreover, “relying on the larger administrative record to fill in what the denial letters omit raises a severe risk that a beneficiary would ‘be sandbagged by after-the-fact plan interpretations devised for purposes of litigation.’”
As a result, the court dismissed Aetna’s arguments regarding communications between the parties because they “cannot by themselves cure the deficient notice provided in the appeal denial letters.” As for Aetna’s other arguments which offered “other possible bases for the denial,” the court declined to “speculate whether these were the reasons that Aetna considered in its decision to deny benefits.”
The only issue left was a suitable remedy. The court ruled that “[t]he appropriate relief in such a situation is to remand this case for further administrative review.” The court directed Aetna to conduct a new review in which it must “specifically address in any decision whether Sandhill should be granted a single case agreement, including consideration of Plaintiff’s arguments concerning the adequacy of in-network offerings.” The court also ruled that it would maintain jurisdiction over the case and stay the proceedings pending the result of its remand.
Plaintiff John Doe was represented by former Kantor & Kantor LLP attorney Elizabeth K. Green of Green Health Law and Dimitri Teresh of The Killian Firm, P.C.
Below is a summary of this past week’s notable ERISA decisions by subject matter and jurisdiction.
Breach of Fiduciary Duty
Sixth Circuit
Reynolds v. Security, Police & Fire Prof’ls of Am., No. 23-cv-13099, 2025 WL 582547 (E.D. Mich. Feb. 21, 2025) (Judge Mark A. Goldsmith). Two labor union members of the Security, Policy and Fire Professionals of America, plaintiffs Atarah Reynolds and Tammy Tuck, bring this action under Section 404 of ERISA against the trustees of the union’s health and welfare benefit plan and its 401(k) retirement plan alleging they breached their fiduciary duties through their handling of the transfer of residual contributions from the health and welfare plan into the 401(k) plan. Defendants moved to dismiss the complaint entirely. They argued that plaintiffs could not assert causes of action for breach of fiduciary duty as the relief they seek can be attained through, and only through, bringing a denial of benefits claim under Section 502(a)(1)(B). Moreover, defendants add that plaintiffs cannot bring claims for benefits because they have failed to plead that they adequately exhausted the required administrative remedies before filing suit. Plaintiffs, however, responded that defendants were mischaracterizing their complaint, which they averred seeks broad plan-wide relief and equitable remedies not available under Section 502(a)(1)(B). Among these competing positions, the court aligned itself with defendants and granted their motion to dismiss. It stated how the “Sixth Circuit has held that claims that fall within the ambit of Section 501(a)(1)(B) may not be brought under other provisions of ERISA,” and that “remedies for breach of fiduciary duty are available only where the denial-of-benefits remedy is inadequate.” Applied to the present matter the court expressed that in its view plaintiffs failed to satisfactorily argue why a benefits claim could not provide them with complete relief. “In fact,” the court said, “the allegations made and relief requested by Plaintiffs [related to Plaintiffs’ allegations regarding their own benefits – and any potential shortfall] indicate that § 502(a)(1)(B) would be sufficient.” Accordingly, the court concluded that plaintiffs’ fiduciary breach claims were actually claims for benefits which must be brought under Section 502(a)(1)(B). Additionally, the court agreed with defendants that because plaintiffs could not bring this suit as a fiduciary breach action, they were required to exhaust the applicable administrative remedies before bringing this claim for denial of benefits. Also, the court agreed with defendants that plaintiffs failed to plead exhaustion, or to persuasively argue that exhausting the appeals processes would have been clearly futile. Because the court found plaintiffs failed to plead such exhaustion, it determined that they could not simply replead their fiduciary breach claims as claims for denial of benefits. For these reasons, the court granted defendants’ motion to dismiss in its entirety.
Discovery
Second Circuit
Snyder, M.D. v. Neurological Surgery Practice of Long Island, PLLC, No. 24-CV-06911 (JMW), 2025 WL 591314 (E.D.N.Y. Feb. 23, 2025) (Magistrate Judge James M. Wicks). Plaintiff Brian J. Snyder, M.D., individually and in his corporate form as a medical practitioner, brings this action against defendants Neurological Surgery Practice of Long Island (“NSP”) and NSP Management Services of Long Island, Inc. alleging six claims arising out of his employment for defendants: (1) ERISA claims under Section 502 and 510; (2) breach of employee agreement and of the covenant of good faith and fair dealing; (3) declaratory judgment; (4) breach of a stock purchase agreement and Employee Stock Ownership Plan (“ESOP”) Note; (5) breach of a retainer agreement and executive employment agreement; and (6) breach of an operating agreement. Broadly, Dr. Snyder alleges that he was wrongfully terminated to prevent his ESOP shares from fully vesting due to his disability status (Dr. Snyder has Stage IV lung cancer). Dr. Snyder seeks to recover payments and benefits in connection with the ESOP. Additionally, the doctor asserts that he is unable to seek new employment due a restrictive covenant that prevents him from practicing medicine. Before the court here was defendants’ motion to stay discovery pending the outcome of their anticipated motion to dismiss. The court granted the motion to stay discovery only with respect to the depositions and otherwise denied the motion, ordering defendants to proceed with paper discovery while the motion to dismiss is pending. To the court, the strength of defendants’ anticipated motion to dismiss was a tale of two halves. On the one hand, the court agreed with defendants that several of the counts are likely subject to arbitration. On the other hand, the court expressed that the ERISA claims and the breach of the Stock Purchase Agreement and ESOP Note claim were likely to survive a motion to dismiss. “To allow an employer – that seemingly fired Snyder right before his benefits were going to vest due to his disability – to argue that their former employee is entitled to nothing because of their alleged pressure campaign, would be to reward the unscrupulous behavior from employers that ERISA was enacted to prevent.” The court was unmoved by defendants’ assertion that Dr. Snyder was not an eligible employee or plan participant. It stated “the only reason [Snyder was] no longer an employee of NSP Management was due to the alleged pressure campaign to force [him] to sign a new employment contract prior to his benefits vesting due to his disability status.” Viewing these facts in the light most favorable to the doctor, the court concluded that he plausibly alleged claims under ERISA, “as Snyder was never paid the vested percent of his account balance upon termination, and his termination as an employee of NSP Management may have been entirely predicated on his disability status.” Moreover, the court stated that the breadth of discovery sought weighed against granting the stay of discovery, as did Dr. Snyder’s serious medical condition. Accordingly, the court ordered that most of discovery continue apace, but granted the stay with regard to the depositions which will not take place until after the motion to dismiss is decided.
ERISA Preemption
Third Circuit
Anatomic & Clinical Lab. Assocs. v. Cigna Health & Life Ins. Co., No. 23-3834, 2025 WL 609194 (E.D. Pa. Feb. 25, 2025) (Judge Juan R. Sanchez). A healthcare provider, plaintiff Anatomic and Clinical Laboratory Associates, P.C., sued a health insurer, Cigna, and the middleman, MultiPlan, Inc., alleging the pair violated state contract law when they decided to stop providing reimbursement for services they previously covered. Defendants each moved to dismiss the case for failure to state a claim under Rule 12(b)(6). The motion to dismiss was denied as to the breach of contract claim against MultiPlan and as to the third-party beneficiary breach of contract and unjust enrichment claim against Cigna and granted as to all other claims alleged against each defendant in this decision. Relevant to our newsletter was the discussion on ERISA preemption. Rather quickly, in an otherwise fairly lengthy decision, the court concluded that the state law claims here were not conflict preempted by ERISA Section 514. The court agreed with plaintiff that its claims were based on an independent contractual relationship with the parties stemming from the MultiPlan network agreements. “Viewing the allegations in light most favorable to [plaintiff], the claims do not require the interpretation of ERISA plans because the plans are not ‘critical factors in establishing liability.’” However, for other reasons unrelated to ERISA, the court concluded that complaint failed to meet the elements of several of the state law causes of action that the complaint alleged against each defendant and as such dismissed them, leaving only the one cause of action against MultiPlan and two causes of action against Cigna as explained above.
Fifth Circuit
Townley v. Aetna Health Inc., No. 4:24-CV-3513, 2025 WL 625494 (S.D. Tex. Feb. 25, 2025) (Magistrate Judge Dena Hanovice Palermo). Pro se plaintiff Erin McCain Townley sued Aetna in state court in Texas alleging breach of contract, promissory estoppel, and violations of the state’s Deceptive Trade Practices Act (“DTPA”) after the insurer denied claims for medical care of her newborn baby. Ms. Townley alleges in her complaint that Aetna wrongfully denied payment of these claims as the terms of the group insurance policy state that her child was covered under it for 31 days after birth whether the baby was enrolled in the policy or not, and thus Aetna was wrong to deny the claims for the newborn’s care because it was not enrolled in the plan. Aetna removed the action to federal court, asserting the claims were all preempted by ERISA. It then moved to dismiss the claims as preempted. Ms. Townley opposed Aetna’s motion and moved to remand her action back to state court. The court in this order first addressed the threshold issue of its jurisdiction over the matter and Ms. Townley’s motion to remand. It quite easily agreed with Aetna that Ms. Townley’s breach of contract claim was completely preempted under ERISA Section 502(a). “Here, Plaintiff alleged that she brought ‘this action to recover benefits that she is entitled to receive as an enrolled member of a group health insurance policy,’ and ‘to recover amounts to certain claims for covered medical care, for which the Defendant wrongfully denied payment.’ In her breach of insurance contract claim, Plaintiff argues that ‘Defendant’s denial of claims for Plaintiff’s newborn infant medical care…constitutes a clear material breach of the insurance policy.’ ERISA completely preempts this claim because Plaintiff, without question, seeks to recover benefits allegedly due to her under the terms of the plan and to enforce her rights under the terms of the plan, and does not allege the violation of any other independent legal duty.” Accordingly, the court concluded that it has federal subject matter jurisdiction over this action and therefore denied the motion to remand. The court then tackled the motion to dismiss. Having already determined that the breach of contract claim was completely preempted by ERISA, the court assessed the promissory estoppel claim and DTPA claim and concluded that they were conflict-preempted under Section 514. It concluded that the promissory estoppel claim could not be resolved without relying on the terms of the plan and it therefore depends on the ERISA plan and naturally relates to it. The court then held that the DTPA claim was preempted as it was addressing an area of exclusive federal concern – establishing standards of conduct for fiduciaries of employee benefit plans – which affects the relationship among traditional ERISA entities. Thus, the court agreed with Aetna that all three causes of action are preempted by ERISA. The court therefore granted the motion to dismiss. Finally, the court ended the decision by stating that Ms. Townley may replead her claims as causes of action under ERISA should she wish to.
Ninth Circuit
Airlines For Am. v. City of San Francisco, No. 21-cv-02341-EMC, 2025 WL 604666 (N.D. Cal. Feb. 25, 2025) (Judge Edward M. Chen). The City of San Francisco owns and operates SFO – San Francisco International Airport. In 1999, the City introduced its Quality Standards Program at the airport, establishing the contractual requirements for employers at the airport, including hiring and compensation standards for certain covered employees. The Quality Standards Program has expanded over the years. Most recently, in November 2020, during the height of the COVID-19 pandemic, the City’s legislative branch enacted the Healthy Airport Ordinance (“HOA”) which created standards for minimum medical insurance coverage to be offered to covered employees under the Quality Standards Program. The ordinance requires SFO employers to offer at least one “platinum” healthcare plan (providing a level of coverage actuarially equivalent to at least 90% of the value of the benefits provided) to its employees and their families, to cover all services the state of California has deemed essential, and to absorb 100% of the plans’ costs, without any cost sharing between employer and employee. If the employers do not wish to provide health benefit plans to their employees meeting these requirements they can make monetary contributions for covered employees to a City fund instead. This City option program is expensive though. It requires employers to pay $9.50 per employee per hour into a health access program account. Covered employees can then access the contributions to the City program through medical reimbursement accounts. Failure to comply with the obligations under the HAO for covered employees isn’t cheap either. Employers who violate the ordinance’s requirements face steep penalties, including a fine equal to $1,000 per violation/employee per day and a bar from entering into any future contract with the City for three years. Given the choice between two costly options and the threat of stiff penalties, it is perhaps unsurprising that ten days after the HOA went into effect Airlines for America (“A4A”), a trade organization of well-known United States airlines, sued the City arguing that the HOA violates the Contracts Clauses of the state and federal constitutions and is preempted by ERISA and the Railway Labor Act. Shortly after the litigation commenced the court agreed to the parties’ proposal that the case should be bifurcated to resolve on summary judgment the threshold issue to A4A’s preemption claims – the City’s market participant defense. On April 5, 2022 the court granted the City’s motion for summary judgment on the market participant issue. However, plaintiff appealed the decision to the Ninth Circuit, and the court of appeals overturned it, finding that the City was acting as a regulator, not a market participant, when it enacted the ordinance and thus not subject to the market participant exception to federal preemption. The case was then remanded back to the district court. Before the court here was the City’s partial motion to dismiss certain of A4A’s claims and request for monetary relief. The City’s motion challenged the trade organization’s standing as to its requests for monetary relief as well as claims regarding ERISA preemption and violations of the Contracts Clause of the U.S. and California State Constitutions. In this decision the court denied the City’s motion. It disagreed with its basic contention that A4A lacked associational standing. To begin, the court agreed with plaintiff that it has associational standing to assert its ERISA preemption claims under both the “connection to” and “reference with” categories of ERISA Section 514(a) preemption. The court stressed that “ERISA exists to ensure the ‘uniformity of’ ERISA ‘plan administration,’ and found that if the ordinance is preempted as to one airline carrier it is preempted to them all. Moreover, the court said that “judging preemption ‘on a carrier-specific basis’ would frustrate the purpose of the preemption clause. Therefore, a uniform determination regarding ERISA preemption best preserves the purpose of ERISA because it would be untenable for ERISA preemption to apply to one airline and not another.” Accordingly, the court determined that proving this theory poses no associational standing issues related to individualized proof. However, the court did recognize that representational standing could impose a discovery-related hardship. To mitigate this issue, the court ordered plaintiff to provide a “test case” of a single member airline to use to prove its ERISA preemption arguments. Similarly, the court found that A4A has associational standing to bring its Contract Clause claims on behalf of its member airlines. The court was persuaded by the organization’s argument that its Contracts Clause claims concern whether the HAO substantially impairs its members’ collective bargaining agreements, which can be resolved without quantifying the magnitude of the financial impact, and as such does not require individualized proof. Finally, the court rejected the City’s contention that calculating disgorgement will require individualized proof from each member airline. While the court acknowledged that claims for monetary relief do often involve individualized proof, it stated that there is no per se blanket prohibition on granting an association standing to seek monetary damages, particularly where, as here, calculating the amount will not require complicated individualized proof but rather simple math of data the City already possesses. For these reasons, the court denied the City’s partial motion to dismiss.
Eleventh Circuit
Lynch v. Filice, No. 2:24-cv-340-SPC-NPM, 2025 WL 589029 (M.D. Fla. Feb. 24, 2025) (Judge Sheri Polster Chappell). This action arises from competing claims to life insurance proceeds from coverage decedent John Lynch had through his employment. His widow, plaintiff Maureen Lynch, brought a state court action alleging twelve counts against fourteen defendants, including the Newport Group, Inc. and Anne McTigue (together the “Newport defendants”), taking issue with the events surrounding an attempt the change the beneficiary of the policy from her to two others – Randazzo Filice and Anne Dowdell. Ms. Lynch alleges there was a real hullabaloo. According to her complaint, this attempted change of beneficiary occurred near the very end of her husband’s life when he was hospitalized and suffering physical and cognitive decline. She alleges that the employer defendants and the Newport defendants withheld information and relevant documents from her, disclosed to her that there was no effort to change the named beneficiary, and planned to redirect the proceeds to Filice and Dowdell. Concerned, she filed civil litigation. Then, Mr. Dowdell sued in state court too, claiming that the beneficiary change form was effective. The state court consolidated the two actions although the Newport defendants only removed Ms. Lynch’s case and only her litigation was at issue here. Defendants argued that her causes of action against them are completely preempted by ERISA and moved to dismiss them. Ms. Lynch moved to remand her action. Thus, the central issue presented in the motions was whether the claims were completely preempted by ERISA. As a preliminary matter, Ms. Lynch unsuccessfully argued that the life insurance policy is not governed by ERISA. The court quickly disagreed, finding that there is a plan, established and maintained by an employer, for the purposes of providing benefits, and the safe harbor exception is obviously inapplicable under the relevant circumstances. The court also easily established that Ms. Lynch has standing to sue under ERISA because she asserts she is the rightful beneficiary under the plan. Moreover, it was clear to the court that the claims are completely preempted by ERISA because they seek to enforce rights under the plan and to recover benefits under the plan. A dispute over a change of beneficiary form, the court said, “in no way defeats ERISA preemption.” Ms. Lynch, the court found, could not defeat ERISA preemption simply by arguing that she seeks extracontractual relief. Instead, her claims obviously fall within the scope of ERISA Section 502(a). Further, Ms. Lynch did not seriously challenge whether any independent legal duty supports her claims. Instead, the court agreed with the Newport defendants that her claims “directly turn on the implementation of the ERISA-governed plan and do not arise out of an independent duty.” In sum, it found that they were completely preempted by ERISA. Confident in its jurisdiction, the court denied the motion to remand. It also granted defendants’ motion to dismiss the preempted state law causes of action. Finally, the court granted Ms. Lynch’s request for leave to amend her complaint to replead under ERISA.
Life Insurance & AD&D Benefit Claims
Fourth Circuit
FINRA Pension/401(k) Plan Comm. v. Napoleon Roosevelt Lightning, No. RDB-23-2336, 2025 WL 590478 (D. Md. Feb. 24, 2025) (Judge Richard D. Bennett). Plaintiff FINRA Pension 401(k)/Plan Committee filed this interpleader action to judicially resolve a dispute between decedent Anita Lightning’s siblings and her nieces and nephews over the distribution of plan benefits. Before the court was a motion for summary judgment brought by the three siblings, which was unopposed by the nieces and nephews. Concluding that there was no genuine dispute of material fact that the siblings were entitled to the plan benefits, the court granted their motion for summary judgment and ordered distribution be given to them as beneficiaries and not to the competing claimants. Specifically, the court found that beneficiary designation naming each of the ten interpleader defendants as primary beneficiaries, each to receive one-tenth of the proceeds, was invalid because Anita Lightning did not personally sign it. Thus, the court agreed with the three siblings that the earlier beneficiary designation form designating them as beneficiaries, with each to receive one-third of the money, remained valid. “At bottom, the Interpleader-Plaintiff properly denied benefits to the Nieces and Nephews,” the court concluded, given its discretion and the uncontested fact that one of the nieces – not Anita Lightning – signed the change of beneficiary form which “simply does not conform with the Committee’s requirements.” In short, the court found that the record created no genuine issues of material fact and concluded that the three siblings were entitled to judgment as a matter of law.
Eighth Circuit
Butler v. Hartford Life & Accident Ins. Co., No. 23-cv-3144 (KMM/DJF), 2025 WL 580892 (D. Minn. Feb. 21, 2025) (Judge Katherine Menendez). In 2019, Patrick Butler was diagnosed with terminal colon cancer. Mr. Butler was married, with three children, and working as a senior tax manager for the accounting and financial company CBIZ, Inc. After his diagnosis, Mr. Butler went on short-term, and later long-term, disability benefits. Mr. Butler was concerned about maintaining life insurance coverage. His employer informed him that he was eligible for and continued to be enrolled in two life insurance policies it sponsored for its employees, insured by Hartford Life & Accident Insurance Company. Mr. Butler continued to pay a monthly premium payment for both of the insurance policies, which included the two life insurance policies in question. At no point did either CBIZ or Hartford inform Mr. Butler that he was paying premiums for coverage that was terminated after he stopped working. Instead, Hartford continued to collect premiums up until Mr. Butler died at age 51, in April of 2023. His widow, plaintiff Susan Butler, only learned this fact after she submitted a claim for payment of the death benefits. Her claim was denied, with Hartford stating that Mr. Butler’s coverage was terminated before his death as he failed to exercise a conversion right. Ms. Butler appealed this adverse decision to no avail and then took legal action. In this lawsuit Ms. Butler seeks to recover the life insurance proceeds of her late husband. She sued both the employer and the insurer alleging state law contract claims and two claims under ERISA – one for benefits under Section 502(a)(1)(B) and the other for fiduciary breach under Section 502(a)(3). Defendants moved to dismiss. In this order the court granted Hartford’s motion to dismiss and granted in part and denied in part CBIZ’s motion to dismiss. To begin, the court agreed with defendants that Ms. Butler’s state law claims seeking benefits under the policies were preempted under ERISA’s broad preemption provisions as they relate to the benefit plans and supplant ERISA’s exclusive statutory remedies. These claims were accordingly dismissed. Next, the court considered the claim for benefits under ERISA. As a threshold matter, the court agreed with CBIZ that it was not a proper defendant to this cause of action because the plan unambiguously delegates control of the plan and benefits eligibility decision to Hartford. However, the court further determined that Ms. Butler could not maintain a benefit claim against Hartford either, because it was undisputed that Mr. Butler did not utilize any portability rights to convert his existing coverage to individual policies and that he therefore lost his life insurance coverage when he stopped working. Ms. Butler argued in response that her husband would have invoked his conversion rights but for the misinformation they received. But the court stressed that the fact remains that irrespective of this argument, Mr. Butler had no life insurance at the time of his death and thus it was clear that he was not eligible for benefits under the policies. Despite this ruling, the court did not leave Ms. Butler without any avenue of relief. It concluded that the fiduciary breach/equitable relief claim was another matter. Reading the complaint in the light most favorable to Ms. Butler, the court was assured that a reasonable fact-finder could conclude that CBIZ breached its duties to Mr. Butler by misinforming him, failing to properly notify him that his coverage would terminate despite having knowledge of his terminal illness, and by failing to maintain an adequate administrative system. Therefore, the court denied CBIZ’s motion to dismiss the Section 502(a)(3) claim against it. The same was not true with regard to Hartford. The court emphasized that the complaint failed to allege that Hartford made any misrepresentations to the family regarding Mr. Butler’s coverage. Additionally, the court asserted that Ms. Butler could not maintain a fiduciary breach claim against Hartford based on a failure to provide notice or its continued acceptance of premium payments. It wrote that Harford was not required by ERISA “to inform participants of their conversion and portability rights, when their coverage expires, or whether and how any continuation provisions will apply.” As for accepting premiums, it stated that courts “have consistently ruled that mistakenly accepting premiums does not obligate the insurer to offer coverage for which the policyholder would not otherwise qualify.” Accordingly, the court found that Ms. Butler failed to plead a plausible fiduciary breach claim against Hartford and therefore granted its motion to dismiss wholly. Thus, Ms. Butler’s action was refined by the court’s decision and she is left with only a claim of fiduciary breach against the employer.
Ninth Circuit
Securian Life Ins. Co. v. McAlister, No. 6:24-cv-00161-MTK, 2025 WL 580864 (D. Or. Feb. 21, 2025) (Judge Mustafa T. Kasubhai). Securian Life Insurance Company filed a complaint in interpleader to resolve competing claims for life insurance proceeds arising from the death of Kenneth McAlister. Competing for these benefits are defendant Mercedes S. McAlister, the named beneficiary, and defendant Debra A. McAlister and her minor children, asserting rights to the proceeds under the terms of a 2019 stipulated general judgment of dissolution of marriage money award that formalized the McAlisters’ divorce, which Debra maintains is a Qualified Domestic Relations Order (“QDRO”). After Securian Life deposited the proceeds with the court and was discharged from this action, Mercedes and Debra filed cross-motions for summary judgment under Federal Rule of Civil Procedure 56. The court found that the marriage separation judgment substantially complied with the requirements of § 1056(d) and that it is a QDRO as a matter of law. As a result, the court agreed with Debra that the QDRO triggers the exception to ERISA’s anti-assignment provision “elevating Mr. McAlister’s child support obligations above [Mercedes’] designated beneficiary status.” Accordingly, the court entered summary judgment in favor of Debra, and denied Mercedes’ cross-motion for summary judgement.
Eleventh Circuit
Metropolitan Life Ins. Co. v. Seidenfaden, No. 1:24-CV-113 (LAG), 2025 WL 605036 (M.D. Ga. Feb. 25, 2025) (Judge Leslie A. Gardner). In this decision the court vacated an order from last November denying interpleader plaintiff Metropolitan Life Insurance Company’s (“MetLife”) motion to deposit life insurance funds with the court. In that order the court had determined that it did not have jurisdiction over this action. MetLife responded to that holding by moving for reconsideration. It argued, persuasively, that the court erred in its analysis of federal question subject matter jurisdiction. Changing its prior position, the court wrote, “Plaintiff is correct that, as this interpleader action arises under ERISA, the Court does have federal question subject matter jurisdiction,” and it agreed “that this case is the ‘rare federal question, rule-interpleader action.’” Thus, the court granted MetLife’s motion for reconsideration and vacated its prior decision. It then permitted MetLife to deposit the life insurance sum plus any accrued interest with the clerk of the court into an interest-bearing account until the court enters an order directing disbursement of these funds.
Medical Benefit Claims
Seventh Circuit
Hecht v. The Cigna Grp., No. 24 CV 5926, 2025 WL 639405 (N.D. Ill. Feb. 27, 2025) (Judge Manish S. Shah). Plaintiffs Andrew and Andrea Hecht incurred hospital bills after their son and Andrew both received care at Edward-Elmhurst Hospital. The family supplied the hospital with their health insurance card and the hospital sent claims to be processed to the insurer, Cigna. Cigna determined that the medical claims were in-network, paid the claims, and informed the Hechts that they owed 20% of the covered expenses in co-insurance. However, the hospital told a different story. It maintains that it is out-of-network and billed the family for costs not covered by Cigna, over and above the 20% they believe they owe. Following the instructions of the plan, which state, “If the Out-of-Network provider bills you for an amount higher than the amount you owe as indicated on the Explanation of Benefits (EOB), contact Cigna Customer Service at the phone number on your ID card,” the family called Cigna to help resolve the billing dispute with the hospital. Cigna told the Hechts it would investigate the network dispute and file a complaint with the hospital but two years went by and they allege they never heard back and nothing was resolved. Accordingly, the family sued Cigna in federal court asserting claims under ERISA Sections 502(a)(1)(B) and 502(a)(3). Cigna moved to dismiss the claims. The court first analyzed the claim brought under Section 502(a)(1)(B). The family advanced two theories as to how Cigna breached the plan terms: (1) it failed to properly determine and pay benefits on behalf of the family; and (2) it did not resolve the network dispute with the hospital, thereby failing to provide a full and fair review to resolve the discrepancies. In the end the court was not convinced that either of these concepts fit neatly into Section 502(a)(1)(B) because neither was truly tied to the plan language. In fact, on the face of the complaint, the court agreed with Cigna that the family’s claim for the hospital bills was properly adjudicated pursuant to the plan and “no Plan provision requires Cigna to pay an erroneous balance bill sent by an in-network provider.” Moreover, the Hechts didn’t point to any term of the plan that they said Cigna breached by failing to resolve the dispute with the hospital to prevent it from balance-billing the family. As a result, the court concluded that the family could not currently sustain a claim as alleged under Section 502(a)(1)(B). It therefore granted the motion to dismiss this cause of action, though it did so without prejudice. While the court dismissed the first cause of action, the Section 502(a)(3) fiduciary breach claim was a horse of a different color. “Taking their allegations as true, the Hechts have alleged a ‘plausible story’ that Cigna did not operate the Plan prudently and in the interest of its members when it did not resolve the network dispute, either by correcting its own erroneous benefit determination or by using its leverage over an in-network provider to correct the provider’s error, to the detriment of the members.” The court was thus confident that the complaint sufficiently alleged that Cigna breached its fiduciary duties to the family, leaving the family with erroneous bills that are still in collections. Finally, the court rejected Cigna’s affirmative exhaustion defense. The court noted that the plan only sets out strict administrative procedures for denials of payments and other adverse benefit determinations, and that these procedures were inapplicable to the present circumstances. The court agreed with the family that they therefore did not have access to a meaningful appeals process for their specific issue and that they followed the closest procedure laid out in the plan by contacting Cigna. Based on these allegations and the language of the plan, the court denied the motion to dismiss for failure to exhaust. Accordingly, the court granted the motion to dismiss the Section 502(a)(1)(B) claim and otherwise denied it.
Pension Benefit Claims
Eighth Circuit
Hankins v. Crain Auto. Holdings, No. 24-1555, __ F. 4th __, 2025 WL 649895 (8th Cir. Feb. 28, 2025) (Before Circuit Judges Gruender, Benton, and Erickson). Plaintiff-appellee Barton Hankins was hired as an executive by the automotive dealer, Crain Automotive Holdings, LLC, in 2019. At the time, Mr. Hankins was offered a deferred compensation top hat plan by the company. Under the terms of the plan, Mr. Hankins could earn 5% of the company’s fair market value upon his exit from the company with full vesting occurring at five years. Mr. Hankins resigned from his employment after four years, at which point he was 80% vested in the plan. When he left, he sought this compensation under the plan. However, the company denied Mr. Hankins’s claim for vested compensation, referring to a section of the plan which provides that Mr. Hankins’s rights under it immediately cease if he breaches the terms of either the Employment Agreement or the Confidentiality Agreement. Here’s the thing though – neither agreement existed. Nevertheless, Crain Auto took the position that Mr. Hankins was required to create these two agreements if he was going to claim the benefit of the top hat plan. Mr. Hankins disagreed, and after exhausting the plan’s claims procedures, filed this action to challenge Crain Auto’s decision. His lawsuit was successful. The district court concluded that he was entitled to the benefits and that the company’s denial was unreasonable under the unambiguous terms of the plan. The district court disagreed with Crain Auto’s position that the deferred compensation plan required the parties to create the Employment and Confidentiality Agreements. Instead, it found that the parties knew these agreements didn’t exist when they drafted the plan and that the plan did not condition enforceability on their existence; rather, the court read them as conditions subsequent rather than conditions precedent. The district court thus concluded that Crain Auto was “simply looking for a way to avoid its obligations,” and that Mr. Hankins was entitled to his benefits. (Your ERISA Watch reported on this decision in our February 21, 2024 edition.) The district court then awarded Mr. Hankins attorneys’ fees under Section 502(g)(1) in a separate decision. Crain Auto appealed both decisions. Concluding that the lower court appropriately entered judgment in favor of Mr. Hankins and fairly decided the issue of attorneys’ fees, the Eighth Circuit affirmed both decisions in this order. The appeals court agreed with the court below that Mr. Hankins was not required to sign both an Employer Agreement and Confidentiality Agreement before he could accept the deferred compensation plan. The Eighth Circuit found that the terms relating to the two nonexistent contracts simply “operated as a condition subsequent” which “would have required Hankins to abide by both agreements if they were ever created.” Because they were not, he was not required to do anything, and it was therefore unreasonable for Crain Auto to deny benefits on this basis. The appeals court thus affirmed the grant of judgment in favor of Mr. Hankins on his claim for benefits. Moreover, the Eighth Circuit stated that under the circumstances the district court did not abuse its discretion when it granted Mr. Hankins’s motion for attorneys’ fees and awarded him $20,000 in fees.
D.C. Circuit
Gamache v. IAM Nat’l Pension Fund, No. 23-cv-1131 (APM), 2025 WL 588202 (D.D.C. Feb. 24, 2025) (Judge Amit P. Mehta). Plaintiff Michael Gamache brought this action against the IAM National Pension Fund seeking judicial review of its denial of his claim for disability pension benefits after an on-the-job injury to his ankle left him unable to continue working for the United Parcel Service in his physically demanding position as a maintenance mechanic. After Mr. Gamache indicated that he did not wish to pursue discovery, the parties filed cross-motions for summary judgment under a deferential review standard. Under the terms of the plan Mr. Gamache qualifies for disability pension benefits if he can show he is totally and permanently disabled, which the plan defines to mean that an employee cannot “engage in or perform the normal and customary duties of his occupation or any similar or related occupation for renumeration or profit” and that “such disability will be permanent and continuous for the remainder of his life.” In determining that Mr. Gamache did not qualify for benefits the Fund relied on the Social Security Administration (“SSA”) letter which found Mr. Gamache ineligible for SSDI benefits and on the conclusions of its own medical claims reviewer. The court began its discussion by stating that if “those two pieces of evidence were the full extent of the information before the Fund, the court’s task arguably would be a simple one. After all, the SSA itself determined that Plaintiff was not fully disabled and that he could perform at least ‘light work.’” Notably, however, the record evidence included more; it included medical records that “reflected the deteriorating condition of Plaintiff’s ankle and his diminished prospects of resuming employment as a maintenance mechanic.” Mr. Gamache’s treating providers opined that his post-operative status was worsening, he could only perform sedentary duties (not the highly physical demands of his employment), future improvement was unlikely, and in their opinion the disability would almost certainly be permanent. The court noted that the appeals committee had this evidence before it and that it had a duty to review it. “Yet, the court cannot say on this record whether the Appeals Committee ever considered the June 2022 records…The Fund now suggests that the Appeals Committee did in fact consider these records, but credited Dr. Broomes’s findings instead. But there is no record evidence the Appeals Committee ever exercised such judgment. Even under a relaxed reasonableness review, ‘it is important for the plan to provide a final, fully considered, and reasoned explanation for the court to evaluate.’…The Fund in this case failed to do so.” Based on this finding the court held that the denial of benefits was not reasonable. The court therefore denied the Fund’s motion for summary judgment. However, because the flaw was the Fund’s failure to adequately explain the grounds for its decision and its failure to engage with all of the evidence, the court determined that the appropriate remedy was remand. The court directed the plan administrator to reconsider the claim, take into account the medical records, and assess whether they establish Mr. Gamache is totally and permanently disabled and qualifies for benefits. While the court was careful not to make this decision itself, it did emphasize that the medical records provide some evidence that Mr. Gamache cannot engage in the normal duties of his occupation as a maintenance mechanic. Accordingly, Mr. Gamache’s motion for summary judgment was granted insofar as the court vacated the denial of his claim, but denied to the extent he requested the court enter judgment in his favor and award him benefits.
Plan Status
Ninth Circuit
Steigleman v. Symetra Life Ins. Co., No. 23-4082, __ F. App’x __, 2025 WL 602175 (9th Cir. Feb. 25, 2025) (Before Circuit Judges Hawkins, Bybee, and Bade). Plaintiff-appellant Jill Steigleman sued insurer Symetra Life Insurance Company under state law seeking judicial review of its decision to terminate her long-term disability benefits. Ms. Steigleman maintains that the Farm Bureau Agency did not create an employee benefits welfare program governed by ERISA, and steadfastly maintains that her claims are not preempted by the federal statute. The district court has found otherwise twice now. First, it granted summary judgment to Symetra, concluding that the plan was governed by ERISA as a matter of law. Ms. Steigleman appealed. In that prior appeal the Ninth Circuit reversed and remanded, concluding that the lower court erred in finding that the payment of insurance premiums, by itself, was sufficient to establish the existence of an ERISA-governed plan. The Ninth Circuit did not make any explicit or implicit determination as to the plan status of the disability welfare plan and instead remanded to the district court to accept additional evidence and decide whether further evidence supported that the plan is governed by ERISA. It did so. On remand, the district court held a bench trial and ultimately ruled again in Symetra’s favor, determining that the plan was an ERISA plan. Ms. Steigleman appealed for the second time. In this decision the Ninth Circuit affirmed. As an initial matter, the court of appeals disagreed with Ms. Steigleman that the district court violated the rule of mandate and law of the case doctrine. To the contrary, it stated that the question of the plan’s status was not decided and the district court was free to decide it. Moreover, the Ninth Circuit observed that the district court reasonably found the existence of an employee benefit welfare plan, “based not only on the Agency’s payment of insurance premiums for its employees, but also on additional factors such as Steigleman’s selection of certain coverages for her employees, placement of limitations on which individuals could receive paid premiums (employees but not family members), performance of some administrative oversight because the premiums were deducted from her commission check, and deduction of the premiums on the Agency’s income taxes as a contribution to an employee benefit plan.” The lower court made these determinations after hearing testimony and taking additional evidence during the bench trial. The Ninth Circuit therefore agreed with the district court that the Farm Bureau Agency had created an ongoing administrative scheme for the plan and in doing so had established an ERISA-governed welfare plan. As a result, the appeals court agreed with the court below that Ms. Steigleman’s state law claims against Symetra were preempted by ERISA. Thus, Ms. Steigleman’s second appeal, unlike her first, affirmed the holdings of the district court.
Pleading Issues & Procedure
Second Circuit
Cudjoe v. Bldg. Indus. Elec. Contractors Ass’n, No. 24-921, __ F. App’x __, 2025 WL 655580 (2d Cir. Feb. 28, 2025) (Before Circuit Judges Park, Perez, and Nathan). Plaintiff-Appellant Martin Cudjoe filed this putative class action against the trustees of a Taft-Hartley multiemployer defined contribution profit sharing plan in which he participated, alleging they breached their fiduciary duties and entered into prohibited transactions by paying themselves over $1 million in compensation from fund assets, which he alleges greatly exceeds any reasonable cost for the services provided. The district court dismissed all of Mr. Cudjoe’s claims, without leave to amend, holding that he failed to establish Article III standing. (Your ERISA Watch covered this decision one year ago in our March 6, 2024 newsletter.) Mr. Cudjoe did not appeal the entirety of the lower court’s decision. Instead, he appealed only as to his monetary claims under ERISA involving his interest in the defined contribution profit sharing plan. In this straightforward decision the Second Circuit reversed and remanded, determining that the complaint plausibly alleges a concrete financial injury. Specifically, the court of appeals found that Mr. Cudjoe sufficiently alleged that absent the $1 million in prohibited trustee compensation the value of his assets would have risen and “had the Benefit Funds not lost money due to the… breaches, assuming the same level of employer compensation….Union members and Class members would have received either greater cash wages and/or richer benefits.” Thus, the Second Circuit held the district court erred in dismissing the complaint and so vacated its decision.
Robin v. Bon Secours Cmty. Hosp. Subsidiary of WMCHealth, No. 23 CIVIL 9222 (CS), 2025 WL 623766 (S.D.N.Y. Feb. 26, 2025) (Judge Cathy Seibel). During the deadliest period of the COVID-19 pandemic Bon Secours Community Hospital implemented a mandatory COVID-19 vaccination policy requiring its workers to become fully vaccinated or face termination. Originally, the hospital’s policy permitted limited exemptions for medical and religious reasons. However, it removed the religious exemptions to mirror an emergency state mandate New York issued requiring hospital personnel to be fully vaccinated, which did not have a carve-out for religious objections. Pro se plaintiff Christina M. Robin worked at Bon Secours at the time as an emergency room nurse. She refused to get vaccinated, stating that doing so conflicted with her sincerely held Christian religious beliefs. She was eventually terminated for refusing the COVID-19 vaccine. Unhappy with her firing, Ms. Robin sued the hospital and her healthcare workers union. In her complaint Ms. Robin alleged that defendants violated the National Labor Relations Act, the Labor Management Relations Act, ERISA, Title VII, and that her workplace was a hostile work environment. Defendants moved to dismiss pursuant to Rule 12(b)(6). The court granted the motion and dismissed the complaint with prejudice. In her ERISA claim, Ms. Robin alleged that her employer wrongly withheld 401(b) retirement contributions for over a year after her termination, thereby violating her rights under ERISA. The court identified two problems with this claim. First, it stated that Ms. Robin failed to plead facts regarding her claim and that her “conclusory allegations” were not sufficient to state a plausible claim under ERISA. Even putting that issue aside, the court agreed with the hospital that it was clear from the face of the complaint that Ms. Robin also failed to exhaust her administrative remedies before pursuing civil litigation. Accordingly, the court dismissed the ERISA claim. The decision also found that requiring non-vaccinated employees to wear N-95 masks, separate from vaccinated workers in common break spaces, and otherwise take simple health precautions did not amount to a hostile work environment, particularly as the hospital applied these same requirements to unvaccinated workers under the medical condition exemption. The court also held that the employer did not discriminate on the basis of religion under Title VII because its policies matched state law and “Title VII cannot be used to require employers to break the law.” The court similarly concluded that Ms. Robin’s state Human Rights Law claims failed. The court further found the NLRA claims untimely. For these reasons and more the court fully granted defendants’ motion to dismiss. It also dismissed the action with prejudice because Ms. Robin has already amended her complaint two times and has failed each time to provide facts that would cure these deficiencies.
Provider Claims
Fourth Circuit
West Va. United Health Sys. v. GMS Mine Repair & Maint., No. 1:24-CV-35, 2025 WL 580600 (N.D.W. Va. Feb. 21, 2025) (Judge Thomas S. Kleeh). West Virginia United Health System, Inc., a healthcare provider comprised of twenty affiliated medical facilities, sued the plan administrator and third-party claims administrator of the GMS Mine Repair and Maintenance fully self-funded health and welfare plan in state court in West Virginia, asserting state law contract and tort claims alleging defendants have failed to appropriately reimburse it for services from 2020-2022. Defendants removed the action to federal court asserting federal subject matter jurisdiction pursuant to complete preemption under ERISA. One interesting aspect of the provider’s complaint is its allegation that the plan’s member cards were deceptively designed to appear to be traditional commercial health insurance cards which included an insurance logo and address for claims submission and that the “fraudulent” inclusion of the logo and address reasonably led the participants and beneficiaries to believe that GMS member claims were in-network because of its contract with the insurance company for its commercial insurance plans. However, this allegation, and the others in the complaint, were not discussed in any great detail in this decision which dealt instead with plaintiff’s motion to remand their action. The court focused its analysis on prong one of the two-prong Davila preemption test – standing to sue under Section 502. Defendants argued, unsuccessfully, that the provider has the ability to sue for reimbursement as either a beneficiary of the plan, or as an assignee of benefits under the plan. As an initial matter, the court rejected defendants’ proposition that submitting claims directly to the plan was enough to confer standing. To the contrary, the court could find no existing case law nor any language in the plan to support this idea. In fact, the plan states that a provider may only submit claims directly to it “by virtue of an assignment of benefits.” Thus, the court rejected the notion that plaintiff is a beneficiary under the plan. It also determined that the provider does not have derivative standing as an assignee because it is undisputed that a written assignment of benefits does not exist. Even if there was evidence of a written assignment of benefits, the court added that the valid and unambiguous anti-assignment provision within the plan precludes the provider from bringing an action under ERISA. For these reasons, the court found that the first prong of the complete preemption test was not satisfied. And because both prongs of Davila must be met in order for ERISA to completely preempt state law causes of action, the court declined to dissect each of the provider’s ten state law causes of action to determine whether any independent legal duty supports them or whether they are trying to remedy the denial of benefits under the terms of the plan. Nevertheless, even without this further analysis, the court was confident that it lacked subject matter jurisdiction, and thus granted plaintiff’s motion to remand the case back to state court.
Statute of Limitations
Third Circuit
Bornstein v. McMaster-Carr Supply Co., No. 23-cv-02849-ESK-EAP, 2025 WL 602745 (D.N.J. Feb. 24, 2025) (Judge Edward S. Kiel). In his lawsuit plaintiff Arthur Bornstein alleges that his ex-wife was an employee of defendant McMaster-Carr Supply Company and a participant in its ERISA-governed retirement plan. According to the complaint, the ex-wife retired in 2011 and the administrator of the plan dispersed the full value of her plan assets to her without notifying him or his attorneys. Mr. Bornstein asserts that he found out that she had received the entire 401(k) proceeds by email a few years later, in 2014. Mr. Bornstein claims that he is entitled to some of the money in the retirement fund under a Qualified Domestic Relations Order (“QDRO”). Accordingly, he filed this action in 2023 against McMaster-Carr alleging it breached its fiduciary duties under ERISA by not honoring the terms of the QDRO and dispersing the full assets to his ex-wife. McMaster-Carr moved to dismiss the complaint. It also sought dismissal of claims which mirror the ones alleged in this federal action in Mr. Bornstein’s parallel state lawsuit, which it removed to federal court. In this decision the court granted the motion to dismiss the claims against McMaster-Carr in both of Mr. Bornstein’s actions with prejudice and remanded the non-consolidated Bornstein II action to state court. The court agreed with the employer that Mr. Bornstein could not sustain his fiduciary breach claims against it because his lawsuit was untimely under Section 1113. As the court noted, the lawsuit was filed twelve years after the alleged breach occurred and over nine years after Mr. Bornstein received actual notice, “far beyond even the extended period of the statute of limitations if plaintiff had properly pleaded fraudulent concealment by McMaster-Carr.” No matter which way the court sliced it, it found that the claims against McMaster-Carr were time-barred by the statute of limitations. Accordingly, the court dismissed the claims against the company with prejudice.
Venue
Seventh Circuit
Nessi v. Honeywell Ret. Earnings Plan, No. 24 C 6093, 2025 WL 623025 (N.D. Ill. Feb. 26, 2025) (Judge Matthew F. Kennelly). Plaintiff Antoinette Nessi brings this ERISA action against Honeywell International, Inc., the Honeywell Retirement Earnings plan, and ten individual defendants on behalf of herself and a class of similarly situated participants and beneficiaries. In her complaint Ms. Nessi alleges violations of 29 U.S.C. §§ 1024, 1053, 1054, and 1055. The Honeywell defendants moved to transfer venue to the Western District of North Carolina pursuant to the plan’s 2017 addition of a forum selection clause. Typically such motions are straightforward and district courts will swiftly dispatch lawsuits to the venues dictated by the terms of these clauses. But things were more complicated here. Ms. Nessi pointed to a version of the plan from 2000 which contained an amendment permitting the company only to amend the plan in order to qualify or maintain qualification of the plan under the appropriate provisions of the Internal Revenue Code. Given this provision expressly limiting Honeywell’s right to amend the plan to ensure its status under ERISA and IRS code, Ms. Nessi argued that the forum selection clause amendment was invalid and inapplicable to her. Irrespective of this language, Honeywell argued in its motion that the version of the plan from 2000 did not limit its ability to amend the plan because it has an inherent right to amend its plan given that employers are “free under ERISA, for any reason, at any time, to adopt, modify, or terminate welfare plans.” The court rejected “Honeywell’s apparent contention that it has the authority to amend the Plan in any manner it sees fit.” In a decision that was both technical and idiosyncratic the court reached its ultimate conclusion that “Honeywell is bound by the amendment procedure it elected to put in the Plan.” Because the amendment adding the forum selection clause was not needed or advisable to maintain the plan’s qualification under the Internal Revenue Code, it did not meet the amendment requirements of the controlling version of the plan and therefore did not properly amend the plan such that the forum selection clause added applies to Ms. Nessi. Accordingly, the court denied to move the case pursuant to the terms of the forum selection clause. The court then discussed whether, absent the forum selection clause, transfer of the action to the Western District of North Carolina was appropriate under Section 1404(a). Although it found some of the factors it considered marginally supported transfer, the court also concluded that many others weighed against it. It therefore found Honeywell failed to demonstrate that the proposed transferee forum was obviously more convenient. Consequently, the court declined to transfer the case and thus denied defendants’ motion requesting it do so.