Another week has passed without any major ERISA rulings from the federal courts. There was still plenty of action, however, including: (1) a ruling that a multiemployer health fund does not have to arbitrate its claims against its administrator over the administrator’s alleged mishandling of claims (Aetna v. Board of Trustees); (2) final settlement approval in a class action alleging SeaWorld breached its fiduciary duties in managing its 401(k) employee retirement plan (Coppel v. SeaWorld); (3) two victories by disability claimants against Unum Life Insurance Company of America (Jahnke v. Unum, Rogers v. Unum); (4) a case where an non-ERISA plan mysteriously turned into an ERISA plan even though none of its terms changed (LaRocque v. LINA); (5) yet another blow to the hot new legal theory contending that employers are breaching their fiduciary duties in their handling of forfeited plan contributions (Dimou v. Thermo Fisher); and (6) an unfortunate reminder than ERISA welfare benefits, unlike pension benefits, are not vested and thus plans can be amended at any time to yank them away (Smith v. Midwest Operating Engineers Pension Fund).
Read on for even more, and we’ll see you again next week.
Below is a summary of this past week’s notable ERISA decisions by subject matter and jurisdiction.
Arbitration
Second Circuit
Aetna Life Ins. Co. v. Board of Trustees of the AGMA Health Fund, No. 3:24-CV-1461 (VDO), 2025 WL 2611947 (D. Conn. Sep. 10, 2025) (Judge Vernon D. Oliver). In July of 2024, the Board of Trustees of the AGMA Health Fund commenced an action in Southern District of New York against Aetna Life Insurance Company under Sections 502(a)(2) and 502(a)(3) of ERISA alleging that Aetna breached its fiduciary duties by failing to timely pay medical claims incurred by plan participants. The New York case was stayed pending resolution of Aetna’s petition to compel arbitration. On June 30, 2025, Magistrate Judge Maria E. Garcia issued a report and recommendation recommending that the petition for an order to compel arbitration be denied. Aetna timely filed objections to the Magistrate’s report. In this decision the court slightly modified the report, but adopted its recommendation to deny Aetna’s motion. Aetna made the following objections to the report: (1) the arbitrator should determine the arbitrability of the Board’s claims in the New York action, not the district court; (2) the Board’s ERISA claims in the New York action did not fall under the arbitration provision’s carve-out; and (3) it is not a plan fiduciary. To begin, the court concluded that the Magistrate Judge properly found that the court, not an arbitrator, should decide arbitrability because there is no evidence of the parties’ clear and unmistakable intent to have arbitrability issues resolved by an arbitrator. Next, the court determined that the report did not err in concluding that the Board’s claims seeking the equitable remedy of surcharge are equitable claims under ERISA which are exempt from arbitration. Because there is no genuine dispute that the Board’s claims do not touch matters covered by the arbitration provision and instead fall within the carve-out, the court adopted the Magistrate’s recommendation to deny Aetna’s petition for an order compelling arbitration. However, the court respectfully disagreed with the Magistrate’s decision on the third issue regarding whether Aetna is a fiduciary. The court stated that such a determination is premature because a court may not rule on the potential merits of the underlying claims. As a result, the court modified this one aspect of the report and recommendation.
Attorneys’ Fees
Eighth Circuit
Wessberg v. Unum Life Ins. Co. of Am., No. 22-94 (JRT/DLM), 2025 WL 2624369 (D. Minn. Sep. 11, 2025) (Judge John R. Tunheim). In July of 2024, the court concluded that Unum Life Insurance Company of America wrongfully terminated plaintiff Ann D. Wessberg’s long-term disability benefits in violation of ERISA after she was diagnosed with bilateral invasive breast cancer. (Your ERISA Watch covered that decision in our July 24, 2024 edition.) In that ruling the court ordered Unum to reinstate Ms. Wessberg’s disability benefits, pay her retroactive benefits owed, and award her reasonable attorneys’ fees, costs, and prejudgment interest. The parties were unable to come to an agreement on the reasonableness of attorneys’ fees or costs, so the court stepped in with this ruling. To begin, the court ordered Unum to pay Ms. Wessberg retroactive benefits in the amount of $663,234.14 and prejudgment interest in the amount of $77,851.17, for a total amount owed of $741,085.31, as these amounts were undisputed among the parties. The court then turned to the more substantial issue of attorneys’ fees. Ms. Wessberg requested $445,488.75 in attorney’s fees. Unum suggested $93,603.59 instead. The court did not award either of these amounts. Rather, it came up with its own figure of $314,440.29. The court first assessed the reasonableness of Ms. Wessberg’s counsel’s hourly rates. It found that the rates of Elizabeth Wright and Christopher Daniels, $390 and $475 per hour respectively, were reasonable given their decades of experience, the prevailing rates in Minnesota, and their work handling complex litigation. However, the court found attorney Michael Rothman’s requested rate of $675 an hour to be slightly elevated, despite his impressive resume. The court instead applied a rate of $550 per hour for Mr. Rothman. Next, the court applied a 50% reduction to the 215.8 hours spent on unsuccessful motions and arguments to expand the administrative record and compel discovery and attempt to procure a bench trial. However, the court disagreed with Unum that any reduction was warranted for any block-billing, time spent on research, or so-called “overlawyering” of the case. The court did, however, reduce the rate for the 16 hours billed for administrative and/or clerical tasks to $185 per hour. Finally, the court applied an overall 15% reduction to the total fee award to account for what it saw as excessive and duplicative time spent on drafting and preparing the pleadings and motions. Applying these reductions, the court was left with its ultimate fee award of $314,440.29, which landed much closer to Ms. Wessberg’s requested amount than to Unum’s. Finally, the court turned to costs. Ms. Wessberg sought $9,797.09 in costs, which Unum argued should be reduced to $430 to account solely for the court filing fee and copying charges. Again, the court adopted neither figure. Instead, it awarded Ms. Wessberg costs totaling $2,698.15. The court reached this number by excluding $2,158.18 in costs that Wessberg’s counsel sought for computer-aided research fees from Westlaw/LexisNexis and PACER, the $132.61 in costs she sought for postage expenses, courier service, and parking expenses, and the $4,807.15 in costs she sought for data storage. The court found that these excluded expenses were either not recoverable costs or else were not proportional to the needs of the case. In sum, the court ordered Unum to pay Ms. Wessberg retroactive benefits owed in the amount of $663,234.14 and prejudgment interest in the amount of $77,851.17, attorney’s fees in the amount of $314,440.29, and costs in the amount of $2,698.15.
Breach of Fiduciary Duty
Sixth Circuit
Ramseur v. Lifepoint Health, Inc., No. 3:24-cv-00994, 2025 WL 2619151 (N.D. Tenn. Sep. 10, 2025) (Judge William L. Campbell, Jr.). Participants in the LifePoint Health 401(k) employee retirement plan allege that there is circumstantial evidence that plausibly suggests that the plan paid unreasonable recordkeeping and administrative costs and that the fiduciaries of the plan failed to engage in a prudent process to evaluate these fees, which constituted breaches of their fiduciary duties of loyalty and prudence under ERISA. Plaintiffs maintain that during the relevant timeframe the plan, which qualifies as a jumbo plan in terms of both assets and number of participants, paid approximately twice as much as comparable plans for the services that were provided. In their complaint plaintiffs list the services that were provided and allege the Lifepoint Plan and the comparator plans were receiving similar services, including in quality. They aver that had defendants conducted a request for proposal during the relevant period it would have resulted in a significant cost reduction. To support this conclusion the plaintiffs pointed to another plan that reduced its recordkeeping expenses by 30% when it changed recordkeepers in 2019 after conducting a request for proposal. Defendants did not agree with these allegations, and moved to dismiss the action. In this concise decision the court denied the motion to dismiss. It wrote, “Defendants’ motion to dismiss repeatedly oversteps the boundaries of Rule 12(b)(6) by improperly weighing the allegations, drawing inferences in their own favor, and inviting the Court to consider matters outside the pleadings.” The court instead adhered to the principles of notice pleading and declined to engage with factual disputes or competing interpretations, and instead assumed that the allegations in the complaint are true. Drawing all reasonable inferences in plaintiffs’ favor, the court was confident that it could plausibly infer that defendants violated their duties of prudence, loyalty, and monitoring regarding the plan’s recordkeeping and administrative costs. As such, the court denied the motion to dismiss.
Ninth Circuit
Dalton v. Freeman, No. 2:22-cv-00847-DJC-DMC, 2025 WL 2605618 (E.D. Cal. Sep. 9, 2025) (Judge Daniel J. Calabretta). This putative class action litigation concerns two stock transactions in the O.C. Communications Employee Stock Ownership Plan (“ESOP”). Relevant to the present decision ruling on defendant Alerus’s motion to dismiss, plaintiff Connor Dalton and Anthony Samano allege that Alerus, as trustee of the ESOP, is liable for breach of the fiduciary duties it owed to the plan participants, approval of a transaction prohibited under ERISA, and for the breach of duties by a co-fiduciary thanks to the 2019 sale, when O.C. Communications’ assets were sold to TAK Communications CA, Inc. for what they allege was less than fair market value, and again in 2020, when the ESOP redeemed shares of O.C. Communications for substantially less than the 2019 purchase price for those shares. Alerus argued that the claims asserted against it are not viable because plaintiffs fail to plausibly allege that it owed a fiduciary duty and because their prohibited transaction claims are time-barred by the three-year statute of limitations. For the most part, the court disagreed. To begin, the court denied the motion to dismiss the breach of fiduciary duty claim related to the 2019 asset sale transaction. It concluded that plaintiffs plausibly alleged that Alerus breached its fiduciary duty when it failed to bring a derivative shareholder suit since it had an obligation as the ESOP trustee to “undertake all appropriate actions to protect the ESOP.” The court then considered plaintiffs’ fiduciary breach claim related to the 2020 redemption transaction and forfeiture of unallocated shares. The court determined that plaintiffs sufficiently alleged facts to state a viable claim that Alerus breached its fiduciary duty based on the failure to acquire fair market value for the shares. The court highlighted plaintiffs’ allegations that in the span of one year between the 2019 sale and the 2020 redemption the value per share dropped from $0.62 to only $0.32, and that this substantial decline in value was seemingly not tied to any obvious business factor. However, the court granted the motion to dismiss the claim as it related to allegations that Alerus breached its fiduciary duty in agreeing to an exchange of unallocated shares for forgiveness of promissory notes. This portion of the claim surrounds allegations that the ESOP overpaid for two promissory notes in 2011. The court stated, “Plaintiffs cannot use the 2020 forfeiture as a window to contest the original value of the shares when they were purchased in 2011.” Accordingly, the motion to dismiss was granted on this basis. The court further dismissed plaintiffs’ fiduciary breach allegations which stemmed from Alerus’s distribution of plan assets and administrative fees. The court held that plaintiffs “failed to identify what fiduciary function Defendant Alerus was engaged in that would create breach of fiduciary duty liability for the distribution of the termination of the ESOP and distribution of its assets.” Having ruled on the fiduciary breach claim, the court turned to the prohibited transaction claim and Alerus’s argument that it is untimely. Plaintiffs did not contest that the three-year statute of limitations has run. Rather, they argued that their claims are timely because they relate back to their initial complaint that was filed within the three-year limitations period. The court agreed, and on this basis denied the motion to dismiss the prohibited transaction claim. Finally, the court granted in part and denied in part the motion to dismiss the derivative breach of co-fiduciary duty claim to mirror its rulings on the underlying fiduciary breach cause of action. Thus, although plaintiffs’ fiduciary breach claims were slightly whittled down, plaintiffs nevertheless maintained all three of their causes of action.
Dimou v. Thermo Fisher Scientific Inc., No. 23-cv-1732-BJC-JLB, 2025 WL 2611240 (S.D. Cal. Sep. 9, 2025) (Judge Benjamin J. Cheeks). Plaintiff Konstantina Dimou initiated this action against her employer, Thermo Fisher Scientific, Inc., and the management pension committee of Thermo’s 401(k) retirement plan in a representative capacity on behalf of the plan, alleging that defendants breached their duties of loyalty and prudence and engaged in prohibited self-dealing in plan assets through the use of forfeited employer contributions. The court previously dismissed Ms. Dimou’s action, with leave to amend. She did so, and defendants once again moved for dismissal. In this decision the court granted the motion to dismiss, this time with prejudice. In its previous dismissal order the court rejected Ms. Dimou’s theory that Thermo’s self-interested use of forfeitures to reduce its own contribution expenses violated ERISA. Ms. Dimou’s amendments failed to change the court’s mind. The court wrote that her “interpretation of ERISA requiring fiduciaries to discharge their duties ‘solely in the interest of the participants and beneficiaries’ by ‘maximiz[ing] pecuniary benefits’ whenever ‘a fiduciary exercises discretionary control over a plan’ is unavailing.” Such a view, the court stated, “flies in the face of decades of ERISA practice” and conflicts with “the settled understanding of Congress and the Treasury Department regarding defined contribution plans.” Considering the court’s views, it was unsurprising that it dismissed the breach of loyalty and breach of prudence claims. And because the court already afforded Ms. Dimou the opportunity to amend her complaint, it concluded that further amendment would be prejudicial to defendants. Moreover, the court stressed that because the ERISA claims “rest on a novel legal theory that is unsupported by present law,” it saw amendment as fundamentally futile. Thus, the court dismissed the fiduciary breach claims without further leave to amend. The court’s dismissal of the prohibited transaction claim was likewise with prejudice. As far as the self-dealing claim was concerned, the court emphasized that Ms. Dimou failed to identify a “transaction,” and flatly rejected her argument that Section 1106(b) can also apply to non-transactional self-dealing with account assets. For these reasons, the court granted the motion to dismiss entirely, dismissing the action with prejudice.
Class Actions
Ninth Circuit
Coppel v. SeaWorld Parks & Entertainment, Inc., No. 21-cv-1430-RSH-DDL, 2025 WL 2617246 (S.D. Cal. Sep. 10, 2025) (Judge Robert S. Huie). Plaintiffs in this ERISA class action are former employees of SeaWorld Parks and Entertainment, Inc. and participants in SeaWorld’s 401(k) retirement savings plan. Plaintiffs commenced their action in 2021 alleging that the fiduciaries of the plan were breaching their duties under ERISA which resulted in high costs and poorly performing investment options. On May 8, 2024, the court granted plaintiffs’ motion to certify three subclasses of plan participants. A few months later, the parties notified the court they had reached a settlement. In exchange for class members releasing their claims, the SeaWorld defendants agreed to pay a gross settlement amount of $1,250,000. On May 8, 2025, the Court granted preliminary approval of the settlement (Your ERISA Watch reported on this ruling in our May 14, 2025 edition), and on August 28, the final approval hearing was held. Accordingly, all that remained was the final step of ruling on plaintiffs’ unopposed motion for final approval of class action settlement, as well as their motion for attorneys’ fees and costs, service awards, and settlement expenses. The court accomplished that final step in this decision granting the motion and approving the settlement. In its preliminary decision, the court determined that the settlement was fair, reasonable, and adequate under the Rule 23(e) factors. In the absence of any evidence to the contrary, the court reaffirmed “its previous analysis and conclusions as to these factors.” Moreover, the fact that only one class member out of the 25,654-member class filed an objection to the settlement, led the court to conclude that the reaction of the class members further supports granting final approval of the settlement. Accordingly, the court granted final approval of the settlement. The court then discussed plaintiffs’ motion for attorneys’ fees and costs. The court found that the results achieved when weighed against the risks of continued litigation, the fact that counsel took the case on a contingent fee basis, and the lodestar cross-check all supported an attorneys’ fee award at 30% of the gross settlement funds, for a total of $375,000. In addition, the court awarded counsel the full requested amount of $273,540 in costs consisting of filing fees, runner services, research, mailing costs, travel fees, mediation fees, and expert fees. Next, the court took up the issue of incentive awards. Plaintiffs requested an incentive award in the amount of $7,500 for each of the five named plaintiffs, totaling $37,500. The court concluded that this amount was too high as it amounts to 3% of the gross settlement amount in the aggregate, and as it would put the named plaintiffs in a starkly different position from the other members of the class. For these reasons, the court decided to adjust the incentive award downward to reduce each named plaintiffs’ award to $5,000 instead. Finally, the court approved class counsel’s request for $74,500 in settlement administration costs, $1,500 in recordkeeper fees and expenses, and $17,500 in costs for the evaluation of the settlement by an independent fiduciary, concluding that the request was reasonable. Based on the foregoing, the court granted the motion for final approval of the settlement and approved of the settlement agreement with the slight modification of the service awards.
Disability Benefit Claims
First Circuit
Rogers v. Unum Life Ins. Co. of Am., No. 1:22-CV-11399-AK, 2025 WL 2625324 (D. Mass. Sep. 11, 2025) (Judge Angel Kelley). In July 2022, plaintiff Robert M. Rogers, Ph.D. filed this action challenging Unum Life Insurance Company of America’s denial of his claim for long-term disability benefits. On October 9, 2024, the court issued an order granting in part and denying in part the parties’ cross-motions for summary judgment and remanding to Unum for further administrative proceedings. In that order the court held that Unum’s letters to Dr. Rogers were deficient in several ways, including their failure to meaningfully engage with the opinions of his treating physicians, their heavy reliance on the absence of objective findings, their failure to afford any weight to Dr. Rogers’ subjective symptoms, and their failure to link the medical findings to the actual demands of Dr. Rogers’ occupation as a senior scientist. On remand, Unum issued a revised determination letter which again denied Dr. Rogers’ claim. Dr. Rogers felt the revised letter suffered from the same flaws as before and that its denial once again lacked a reasoned basis. In this decision the court agreed that there were continued deficiencies in the revised letter, that these deficiencies were not minor, and that Unum’s denial was arbitrary and capricious. Although the court stated that the remand decision remedied some of the shortcomings it had previously identified “in form,” it stated that it did not do so “in substance.” The court held that Unum continued to discount the opinions of Dr. Rogers’ providers without adequate explanation, and again put undue emphasis on the absence of certain objective test results, “without addressing the clinical reality that fatigue, pain, and reduced stamina, central to Dr. Rogers’s disability, are inherently subjective but nonetheless medically significant.” Moreover, the court said that Unum offered no persuasive explanation for how Dr. Rogers could be deemed unable to work “for purposes of short‑term disability, FMLA, and Social Security, yet simultaneously capable of performing his occupation for LTD purposes during the same timeframe.” It added that “[t]his unexplained inconsistency undermines the reasonableness of the LTD denial.” And again, the court criticized the fact that Unum classified Dr. Rogers’ occupation as “light work” without closely scrutinizing the actual cognitive and physical demands of his role. Finally, the court found a recent decision out of the Western District of Pennsylvania persuasive and helpful. In that decision the court criticized Unum’s record-only review, its decision to discount evidence as not time-relevant, and its selective review of the medical record. To the court, those same issues were present here. “Although Mundrati arose in a different jurisdiction and under a different factual record, its reasoning underscores the importance of transparent engagement with treating-source opinions and the impropriety of unexplained discounting of relevant medical evidence. The parallels here reinforce the conclusion that Unum’s decision was arbitrary and capricious.” Taken as a whole, the court found that the record clearly demonstrates that Unum has failed to provide Dr. Rogers with a full and fair review, even during its remand opportunity. As a result, the court determined that the record “supports only one conclusion: Dr. Rogers was disabled, as defined by the Policy, during the elimination period,” and that he is therefore entitled to an award of long-term disability benefits. The court ended the decision stating it would entertain a motion for attorneys’ fees and costs, and provided Dr. Rogers until September 18 to file such a motion.
Sixth Circuit
Jahnke v. Unum Life Ins. Co. of Am., No. 24-10274, 2025 WL 2603390 (E.D. Mich. Sep. 9, 2025) (Judge Judith E. Levy). The termination of plaintiff Marla N. Jahnke’s long-term disability benefits by Unum Life Insurance Company of America led to this litigation. Dr. Jahnke is a pediatric dermatologist who became disabled from a variety of symptoms following the birth of her second child in June of 2019. After Dr. Jahnke gave birth to her second child she reported pelvic pain and was twice hospitalized. She was then put on bedrest for eight months. Citing this issue, as well as generalized weakness, fatigue, and joint dysfunction, Dr. Jahnke applied for disability benefits under her two policies with Unum. Unum originally approved the claim. However, in December of 2021, the insurer determined that Dr. Jahnke was no longer disabled as defined by her policies. Following an unsuccessful appeal, Dr. Jahnke commenced this lawsuit. The parties each moved for judgment based on the administrative record. In addition, Unum moved to dismiss Dr. Jahnke’s state law breach of contract claims, arguing that ERISA preempts them. Dr. Jahnke did not respond to defendant’s preemption arguments. Concluding that this non-response constituted waiver, the court granted the motion to dismiss the state law claims. However, as to the core issue of whether as of December 1, 2021, Dr. Jahnke was disabled under her two policies, the court issued judgment in plaintiff’s favor and reversed Unum’s decision. Upon de novo review of the record, the court concluded that a preponderance of the evidence supports Dr. Jahnke’s position that her medical conditions left her unable to perform the occupational duties of a pediatric dermatologist. The court noted that plaintiff pointed to “ample evidence to demonstrate” that after the date her benefits ended she remained qualified as disabled under her policies and that her treating physicians supported her restrictions and limitations. Moreover, the court agreed with Dr. Jahnke that there were flaws in the reports of Unum’s consulting doctors, including scant analysis of her fatigue, lacking explanations as to why they believed she could perform the duties of her work, and cursory analysis of the medical records. Further, the court rejected Unum’s assertion that because Dr. Jahnke does not have a clear diagnosis for her symptoms that means she cannot meet her burden of proof. The court noted that “[t]he record includes more than her subjective reports,” but also stated that it would not simply reject her subjective complaints out of hand. In conclusion, the court found, “Plaintiff has demonstrated that her issues with fatigue and endurance prevent her from performing her occupational duties. At the time her benefits were denied, her providers documented objective support for her claim, including with respect to fatigue and endurance. Defendants’ file reviews, which, as set forth above, were flawed in a variety of important respects, do not undermine that conclusion. Plaintiff was entitled to benefits under the two policies. Accordingly, Plaintiff’s Motion is granted.” Finally, the court ended its decision by ordering the parties to submit a proposed judgment.
Discovery
Sixth Circuit
Klusmann v. AT&T Umbrella Benefit Plan No. 1, No. 5:24-CV-1295, 2025 WL 2615913 (N.D. Ohio Sep. 10, 2025) (Judge Pamela A. Barker). This case concerns the denial of plaintiff Todd Klusmann’s claim for long-term disability benefits under the AT&T Umbrella Benefit Plan by defendants AT&T Services, Inc. and Sedgwick Claims Management Services, Inc. Before the court here was Mr. Klusmann’s motion for discovery, which the court denied. To begin, the court concluded that he did not produce sufficient evidence that defendants’ conflict of interest or bias adversely affected his claim to justify discovery. Although the court agreed with Mr. Klusmann that evidentiary showing is not always required in the Sixth Circuit, it nevertheless decided to exercise its discretion here to require it. The court then stated that the facts Mr. Klusmann presented were insufficient to show that he had a colorable procedural or bias claim. The court concluded that Mr. Klusmann was not entitled to discovery into bias because he only proffered evidence that the doctors defendants hired to review his claim were being paid for their services. “To allow discovery in such circumstances would require discovery in all ERISA cases, transforming the exception into the rule, and decimating case law underscoring the limited nature of ERISA discovery.” Further, the court declined to permit discovery based on defendants’ failure to timely issue a decision on his claim for benefits. While the court agreed with Mr. Klusmann that he made a colorable procedural challenge, it nevertheless denied discovery based on the procedural failing because it determined that he did not show how any of his proposed discovery requests were relevant to that procedural challenge. The court wrote, “Klusmann fails to show how his Proposed Discovery Requests are relevant to his procedural defect or irregularity claim. Interrogatory Nos. 2, 3 and 4, Request for Production No. 2, and Request for Admission Nos. 1-3 are not relevant even though Klusmann is correct that a defect in the claims administration process can impact the standard of review, because he does not show how an inquiry into the training background of the individual employees involved in processing his LTD denial relates to any procedural challenge he advances to support his ERISA claim… Request for Admission Nos. 4 and 5 are likewise irrelevant… because they ask Defendants to admit how they would treat a hypothetical claimant who files an untimely appeal, which Klusmann did not do.” Thus, the court found that none of Mr. Klusmann’s proposed discovery requests were within the scope of discovery of this case. As a result, the court denied his motion.
ERISA Preemption
Second Circuit
Doolittle v. Hartford Financial Services Group, Inc., No. 1:25-cv-00148 (BKS/TWD), 2025 WL 2577213 (N.D.N.Y. Sep. 5, 2025) (Judge Brenda K. Sannes). This dispute arises from defendant Hartford Financial Services Group, Inc.’s decision to withhold plaintiff Micky R. Doolittle’s long-term disability payments to recover an alleged overpayment of benefits. Mr. Doolittle maintains that Hartford is wrongfully withholding his benefit payments given the fact that he and Hartford reached an agreement in 2022 wherein he paid a single lump sum payment of $10,000 based upon an understanding that the remaining overpayment balance would be waived in exchange. After exhausting his administrative appeals processes to challenge the decision to withhold his disability benefit payments, Mr. Doolittle filed an action against Hartford, pro se, in New York state court asserting two state common law claims for breach of contract and bad faith. Hartford removed the action based on diversity of citizenship between the parties and preemption under ERISA. Presently before the court was Hartford’s motion to dismiss the complaint pursuant to express preemption under ERISA Section 514(a). Because there was no dispute that the long-term disability policy is governed by ERISA, the court considered whether the two state law claims relate to the ERISA plan. It found they both did. First, the court agreed with defendant that the breach of contract claim is preempted because it is based on Hartford’s allegedly improper recovery of Mr. Doolittle’s long-term disability insurance benefits due to an overpayment under the ERISA-governed policy. Calculating any potential recovery for this claim, the court determined would necessarily require reference to the policy and would relate to the terms of the employee benefit plan. As a result, the court agreed with Hartford that the claim is preempted. Second, the court found that the common law bad faith claim is similarly preempted because it “is based on the same set of allegations as Plaintiff’s breach of contract claim.” Accordingly, the court granted the motion to dismiss the two state law claims. However, in view of Mr. Doolittle’s pro se status, the court felt it was appropriate to allow him the opportunity to amend his complaint to assert a new claim or claims under ERISA to challenge this same behavior. Thus, the complaint was dismissed without prejudice, and the court granted Mr. Doolittle time to amend his complaint should he wish to do so.
Life Insurance & AD&D Benefit Claims
Third Circuit
Pitsko v. Gordon Food Services, Inc., No. 3:24cv1055, 2025 WL 2627694 (M.D. Pa. Sep. 11, 2025) (Judge Julia K. Munley). This lawsuit arises from three major life events for the Pitsko family: (1) the father Michael’s workplace injury; (2) the termination of his employment with Gordon Food Services, Inc.; and (3) his subsequent death. Michael’s widow, Deniz, brings this action against Gordon and Hartford Life and Accident Insurance Company on behalf of herself and her minor son, Jacob, seeking benefits she alleges were wrongfully denied. Ms. Pitsko alleges that Hartford improperly reduced Michael’s long-term disability benefits by offsetting them against Jacob’s dependent benefits. In addition, she alleges that Hartford wrongfully determined that no life insurance benefits were payable upon Michael’s death. Ms. Pitsko also contends that she and her husband never received a copy of the selected benefits or instructions for continuing Michael’s benefits, despite written requests for these documents. In her action, Ms. Pitsko asserts four causes of action: (1) claims for benefits under Section 502(a)(1)(B); (2) claims for breach of fiduciary duty seeking equitable relief under Section 502(a)(3); (3) a claim alleging improper offset of Michael’s long-term disability benefits by Jacob’s dependent benefits; and (4) breach of contract under Pennsylvania law. Defendants moved to dismiss the action and also sought to strike Ms. Pitsko’s jury trial demand. The court granted in part and denied in part the motions to dismiss, and granted the motion to strike the jury demand. To begin, the court denied the motion to dismiss the claim for the life insurance waiver of premium benefit. The court found that there exists a genuine factual dispute as to whether Michael paid his life insurance premiums beyond October 2017, which cannot be resolved on a motion to dismiss. Next, the court disagreed with defendants that the fiduciary breach claims under Section 502(a)(3) were duplicative of the claims for benefits under Section 502(a)(1)(B). “Here plaintiffs’ breach of fiduciary duty claim may rest on defendants’ alleged misrepresentations regarding Plan information, which prevented the Pitskos from taking the steps necessary to continue Michael’s life insurance coverage under the Plan. These allegations are distinct from the Pitskos’ claim for wrongful denial of benefits. Whether Counts I and II are ultimately duplicative, and whether relief under Section 502(a)(1)(B) is available, are questions that must be determined after discovery and are best resolved at the summary judgment stage.” However, the court dismissed all of the claims related to the offset of Jacob’s dependent benefits against Michael’s long-term disability benefits. It determined that the reduction was proper under the unambiguous terms of the policy, as the plain language regarding offsets in the plan is not subject to reasonable alternative interpretations. The court also dismissed the state law breach of contract claims as these claims inarguably relate to the plans and are therefore preempted by ERISA. Finally, because the court dismissed the state law causes of action, it also granted defendants’ concurrent request to strike Ms. Pitsko’s jury demand. Accordingly, as explained above, the court granted parts of defendants’ motions to dismiss, but also left much of plaintiff’s complaint intact.
Pension Benefit Claims
Fourth Circuit
Nordman v. Tadjer-Cohen-Edelson Associates, Inc., No. DKC 21-1818, 2025 WL 2597399 (D. Md. Sep. 9, 2025) (Judge Deborah K. Chasanow). Plaintiff Yehuda Nordman brought this ERISA action against his former employer, Tadjer-Cohen-Edelson Associates, Inc., the Tadjer-Cohen-Edelson Associates, Inc. 401(k) Profit Sharing Plan, and the plan’s administrator, along with some other individual fiduciary defendants. Following rulings on defendants’ motions to dismiss and motions for summary judgment, Mr. Nordman was left with two causes of action: (1) a claim for pension benefits under the profit sharing plan, and (2) a claim for statutory penalties with respect to defendants’ failure to provide him with the 2017-2018 and 2018-2019 Employee Stock Ownership (“ESOP”) summary annual reports and for failure to provide summary plan descriptions and other documents for the profit sharing plan. The bench trial in this case was held on December 16, 2024. It is evident from this decision that the court was displeased with the behavior of plaintiff’s counsel. The court called his approach to litigation obligations “lackadaisical” and called out the numerous missed deadlines and the “squandered” opportunity to disclose documents and present greater evidence at trial. In the end, these shortcomings came back to haunt Mr. Nordman, as this decision did not turn out much in his favor. The court began with the claim seeking payment of pension benefits under the profit sharing plan in the amount of $571,209.67. The court stated that it was Mr. Nordman’s burden to prove that he is a participant in the pension plan. “Although he was an eligible employee when hired, he clearly waived his right to participate at that time. Other than himself, no one testified to any efforts, after the waivers, by him to become a participant.” The court went on to say that Mr. Nordman’s evidence that he changed his mind after signing the waiver and requested to become a member of the plan was simply unconvincing given the lack of evidence he put forward. “Mr. Nordman did little to no discovery, has produced no documents for trial, and simply asserts that he must be a participant because he says that he received statements over the years seeming to reflect his participation. He has not produced any admissible documentation in an area where documentation should undoubtedly be available. His effort to put the burden on Defendants to disprove his assertions is obviously misplaced, as is his reliance on the doctrine of laches. It is, and always has been, his burden to prove his status; not theirs to disprove it. Without more, the court finds that he has failed to prove that he was a participant in the PS Plan.” As a result, the court entered judgment in favor of defendants on the claim under Section 502(a)(1)(B). The statutory penalties claim was a different matter, however. Because it was clear that defendants did not provide the requested documents for approximately four years, the court concluded that Mr. Nordman was entitled to a monetary penalty. Nevertheless, when the court factored in that Mr. Nordman did not brief the amount of statutory penalty despite being provided the opportunity to do so, it decided to exercise its discretion to award far less than the maximum penalty. Instead, the court chose to award Mr. Nordman the sum of $14,800, representing approximately $10 per day. For these reasons, judgment was entered in favor of Mr. Nordman on the portion of his statutory penalties claim relating to the delay in providing the ESOP documents, although not for the portion of the claim that related to the plan in which he was found not to be a participant thanks to waiver. Accordingly, other than a small statutory penalty award, Mr. Nordman was ultimately unsuccessful in his ERISA challenge, and judgment was otherwise entered in favor of defendants.
Seventh Circuit
Smith v. Midwest Operating Engineers Pension Fund, No. 23-cv-4552, 2025 WL 2614675 (N.D. Ill. Sep. 10, 2025) (Judge Jeffrey I. Cummings). On August 4, 2020, plaintiff James P. Smith filed an ERISA action against the Midwest Operating Engineers Pension Fund and the Board of Trustees of the Midwest Operating Engineers Pension Fund alleging wrongful termination of his total and permanent disability pension benefits. On February 28, 2022, the district court judge assigned to the case at that time held that the Fund’s termination of Mr. Smith’s benefits was arbitrary and capricious “because it was based on Smith’s lack of Social Security Disability award, which – at that time – was not a condition to the continued receipt of benefits under the Plan.” The judge then entered judgment in favor of Mr. Smith and remanded to the Fund’s review panel to either reinstate his benefits or to adequately explain why his disability had ceased pursuant to the terms of the plan. While the parties were still working through the remand, the Fund informed Mr. Smith that it had amended the plan to state that a participant’s disability benefits will be terminated if the participant loses his or her Social Security disability award. Because Mr. Smith’s Social Security disability award had ended, the Fund terminated his benefits effective October 2022. In response, Mr. Smith brought new ERISA claims against defendants to challenge their actions. Mr. Smith now brings claims for wrongful denial of benefits, violation of ERISA’s anti-cutback rule, and breach of fiduciary duty, and seeks reinstatement of his disability pension benefits from October 2022 onward. Defendants moved to dismiss Mr. Smith’s anti-cutback and fiduciary breach claim. The court granted the motion in this decision. Beginning with the anti-cutback claim, the court agreed with the Fund that “even though the All Work Total Disability benefits are provided for in the Fund’s master pension plan, because Smith’s disability is the very reason for those benefits, the disability benefits are welfare benefits that are not subject to the anti-cutback rule.” Moreover, the court noted that the former district judge already determined in an earlier decision that Mr. Smith’s disability pension benefits did not vest and thus would not be subject to the anti-cutback provision. The court therefore held that Mr. Smith failed to state a claim for violation of ERISA’s anti-cutback rule. Next, the court concluded that Mr. Smith could not plead a fiduciary breach violation based on the plan amendments. It stated, “it is well settled that ‘amendments to plans are not actionable under ERISA’s fiduciary obligations.” Further, the court held that any claim for breach of fiduciary duty for the Fund’s termination of Mr. Smith’s benefits based on the amendment would be duplicative of his claim for wrongful denial of benefits under Section 502(a)(1)(B). Finally, the court reiterated that the disability pension benefits are non-vested and that the plan does not proscribe amendments related to non-vested retirement benefits. For these reasons, the court granted defendants’ motion to dismiss these two causes of action. The court dismissed both claims with prejudice and it concluded that amendment would prove futile.
Plan Status
Ninth Circuit
LaRocque v. Life Ins. Co. of N. Am., No. 5:25-cv-02522-PCP, 2025 WL 2597399 (N.D. Cal. Sep. 8, 2025) (Judge P. Casey Pitts). Plaintiff Trevor LaRocque filed this lawsuit against Life Insurance Company of North America (“LINA”) to challenge its denial of his claim for long-term disability benefits. Mr. LaRocque originally asserted state law claims only, alleging that LINA’s denial constituted a breach of contract and a breach of the implied covenant of good faith and fair dealing. However, after LINA moved to dismiss those claims on the ground that they are preempted by ERISA, Mr. LaRocque filed an amended complaint asserting those same state law claims while also asserting a claim for benefits under ERISA in the alternative. LINA subsequently moved to dismiss the state law claims, contending again that they are preempted by ERISA. The parties do not dispute that the state law claims are preempted if the LINA policy is governed by ERISA. Rather, the parties disagree regarding the legal question of whether the LINA policy is part of Mr. LaRocque’s employer’s larger ERISA plan, and thus governed by ERISA, or whether it is separate. Mr. LaRocque maintains that the policy is separate from his employer’s larger ERISA-governed welfare plan because at the time it was issued it was not part of the larger plan and only covered partners such as Mr. LaRocque, not employees. LINA countered that by the time Mr. LaRocque’s claim accrued, his employer, PricewaterhouseCoopers LLP, intended for the policy to be part of its ERISA welfare plan and had integrated it into the broader plan. For four reasons, the court agreed with LINA that the non-ERISA policy became part of the ERISA plan, and subject to the requirements and preemptive effect of ERISA, after PricewaterhouseCoopers integrated it into the broader ERISA-governed plan in 2022. “First, the statutory definition of ‘employee welfare benefit plan’ includes any plan ‘established or maintained’ by an employer. 29 U.S.C. § 1002(1). By considering not only the purpose for which a plan was established but also the purpose for which it was maintained, this statutory language suggests that whether a policy is governed by ERISA should not be determined solely by the circumstances of its creation.” Second, the court noted that in other decisions the Ninth Circuit has emphasized that while the employer’s intent to constitute a single integrated plan is not dispositive it is a relevant factor that must be considered. Third, the court highlighted that the benefit policies here are intertwined as evidenced by the 2022 and 2023 amendment documents, which indicate and suggest that they constitute a single overall benefit plan. Finally, fourth, the court stated that “a rule that the circumstances at the time of a policy’s establishment are dispositive could be easily circumvented by employers seeking to create a single integrated ERISA-governed plan for employees and non-employees. In this case, for example, LINA could simply have allowed its older Policy to lapse and then purchased a new LTD policy for its partners that was part of the Plan from the time of its establishment. It is hard to see why employers should be required to undertake such a step to effectuate their intent to create a single integrated ERISA plan.” Under the circumstances, the court determined that the policy was part of the larger welfare ERISA plan at the time Mr. LaRocque’s claim for benefits arose. As a result, the court agreed with LINA that his claim is governed by ERISA and his state law causes of action are preempted. Accordingly, the court granted the motion to dismiss the breach of contract and breach of the covenant of good faith and fair dealing claims with prejudice, which left Mr. LaRocque only with his alternatively asserted claim under ERISA. (Disclosure: Mr. LaRocque is represented in this case by Kantor & Kantor LLP.)
Pleading Issues & Procedure
Eighth Circuit
Kotalik v. UnitedHealth Group Inc., Nos. 25-cv-01751 (ECT/ECW) & 25-cv-02191 (ECT/ECW), 2025 WL 2581705 (D. Minn. Sep. 5, 2025) (Magistrate Judge Elizabeth Cowan Wright). Over the course of one month two putative class actions were filed against UnitedHealth Group Inc. and the Administrative Committee for the UnitedHealth Group 401(k) Savings Plan alleging that United’s use of forfeited contributions was in violation of its fiduciary duties under ERISA. Given the similarities between the two lawsuits, the plaintiffs moved to consolidate their related actions, to file a consolidated complaint, and for the appointment of Paul M. Secunda of Walcheske & Luzi, LLC and Gerald D. Wells, III of Lynch Carpenter, LLP as interim co-lead counsel. Defendants did not object to consolidation for pre-trial purposes or to the appointment of the attorneys as interim lead co-counsel. However, they opposed the motion insofar as it sought consolidation of the related actions for trial, and they further opposed captioning the consolidated related actions as “In re UnitedHealth ERISA 401(k) Litigation.” In this order the court overruled defendants’ objections and granted the motion, ordering the two lawsuits consolidated for trial and well as pretrial purposes, appointing lead co-counsel, and captioning the action with the “In re” caption. To begin, the court held that the common question of law or fact requirement of Rule 42(a) was met because the related cases involve similar allegations relating to how defendants used forfeitures and whether such usage violates ERISA. Moreover, the court was confident that consolidation will promote efficiency as it will avoid duplicative motions and duplicative discovery. And although defendants argued that consolidation of the cases for the purposes of trial would be premature, the court saw no reason why it should not consolidate given “the clear and undisputed efficiencies.” The court also disagreed with defendants that using the “In re UnitedHealth ERISA 401(k) Litigation” caption is inconsistent with Federal Rule of Civil Procedure Rule 10. To the contrary, the court stated that cases in the district are routinely given an “In re” caption, including ERISA cases. Next, the court appointed the interim class counsel for the putative class, concluding that counsel are experienced in complex ERISA class actions and that both law firms have sufficient resources to serve as co-lead counsel. In sum, the court determined that it was in the interests of both parties to consolidate the actions. It therefore granted plaintiffs’ motion requesting consolidation as explained above.
Retaliation Claims
First Circuit
Byrd v. Mott MacDonald Grp., Inc., No. 2:23-cv-00431-SDN, 2025 WL 2624384 (D. Me. Sep. 10, 2025) (Judge Stacey D. Neumann). In 2020 plaintiff Kenneth Byrd was diagnosed with mouth cancer. He received intensive cancer treatments over the next year and took a medical leave of absence from his work at the engineering and development firm Mott MacDonald Group, Inc. Mr. Byrd returned to work in 2022, but the cancer treatments left him without teeth and impacted his ability to speak and eat. Less than a year after returning to work, Mott MacDonald notified Mr. Byrd that the field services division would be eliminated and that his position as Senior Vice President of Field Services would also be eliminated as of January 1, 2023. Mr. Byrd then became an in-house consultant with the company, which was not a salaried position as his previous one had been. In February 2023, Mr. Byrd took another medical leave of absence and applied for short-term disability benefits. Under the company’s short-term disability plan full-time salaried employees are entitled to a “top off” benefit wherein Mott MacDonald pays an additional benefit on top of what the insurance provider covers. Because Mr. Byrd was no longer in a full-time salaried position, he was not eligible for this additional benefit, and he was also no longer entitled to employer contributions to his retirement plan. In the end, Mott MacDonald never eliminated its field services division, and in the fall of 2023, it hired a new person to serve as Senior Vice President of Field Services. In this action, Mr. Byrd alleges that Mott MacDonald violated federal and state employment law. He asserts eight causes of action under the Family Medical Leave Act (“FMLA”), the Massachusetts Paid Family and Medical Leave Act, ERISA, the Americans with Disabilities Act (“ADA”), the Age Discrimination in Employment Act (“ADEA”), an and the Massachusetts Fair Employment Practices Act. Mott MacDonald moved to dismiss all eight counts for failure to state a claim. The court granted the motion entirely in this decision. First, the court dismissed the FMLA interference and retaliation claims, determining that the one-year period between Mr. Byrd’s protected leave and his demotion was too remote in time to plausibly infer that the adverse employment action was retaliatory. For much the same reason, the court also dismissed the state Family and Medical Leave claim. As for the Section 510 ERISA claim, the court agreed with Mott MacDonald that the complaint offered only “labels and conclusions” without alleging enough facts to infer that the employer had the specific intent to interfere with Mr. Byrd’s ERISA rights, or even for that matter that the “top off” benefit was governed by ERISA. Finally, the court dismissed the three discrimination claims as it was clear that Mr. Byrd failed to timely file a complaint of discrimination with the Massachusetts Commission Against Discrimination and the Equal Employment Opportunity Commission. Accordingly, the court granted Mott MacDonald’s motion and dismissed all of Mr. Byrd’s claims.
Third Circuit
Delp v. Hexcel Corp., No. 3:25-cv-00233, 2025 WL 2618766 (M.D. Pa. Sep. 10, 2025) (Judge Robert D. Mariani). Plaintiff Russell Delp was hired as a machine operator by defendant Hexcel Corporation in late 2012. This lawsuit stems from Hexcel’s termination of Mr. Delp twelve years later during a period when he was experiencing mental health issues, took leave under the Family Medical Leave Act (“FMLA”), and received short-term disability benefits. Mr. Delp alleges that Hexcel forced him to take continuous leave under the threat of termination and failed to notify him of his rights and responsibilities under FMLA and that such conduct interfered with his FMLA rights. In addition, Mr. Delp argues that he was fired after he applied for short-term disability benefits in violation of ERISA Section 510. Mr. Delp contends that his former employer must be equitably estopped from terminating him, because his reliance upon Hexcel’s representations inequitably led to his termination. Defendant moved to dismiss Mr. Delp’s complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). It argued that the complaint fails to state a viable claim under FMLA or ERISA, and that he cannot state a claim for common law equitable estoppel because this doctrine is not an exception to the employment at-will doctrine under Pennsylvania law. The court agreed in part and disagreed in part. To begin, the court allowed some of Mr. Delp’s FMLA interference claim to continue to discovery. Specifically, the court found that Mr. Delp alleged “sufficient factual content to plausibly state a claim for interference under the FMLA based on the failure to advise and provide the required notices that his leave fell under the FMLA and/or that his FMLA leave had expired.” To the extent the court dismissed aspects of Mr. Delp’s FMLA claim, its dismissal was without prejudice. Next, the court granted the motion to dismiss the equitable estoppel claim. It agreed with Hexcel that the claim could not survive because Mr. Delp does not allege the existence of any employer contract between him and the corporation. “Plaintiff’s allegations that Defendant Hexcel is equitably estopped from terminating his employment based on alleged promises and misrepresentations fails at a matter of law.” Finally, the court dismissed the ERISA interference and retaliation claim as currently pled. It again agreed with defendant that the complaint lacks any factual content to plausibly demonstrate that Hexcel had the specific intent to violate ERISA by firing him after he applied for disability benefits. Again, the dismissal of this cause of action was without prejudice and Mr. Delp may amend his complaint to assert new details in support of his claim should he so desire. For these reasons, the court granted in part and denied in part the motion to dismiss.
Fourth Circuit
Johnson v. United Parcel Service, Inc., No. 1:24-CV-121, 2025 WL 2615053 (N.D.N.C. Sep. 10, 2025) (Judge Catherine C. Eagles). Plaintiff Bryan Johnson commenced this wrongful termination, discrimination, and retaliation lawsuit against his former employer, United Parcel Service (“UPS”), after he was fired shortly before his retirement benefits vested. However, because it was undisputed that UPS fired Mr. Johnson after credible and serious allegations of sexual harassment, and because UPS put forward unrebutted evidence that it did not terminate Mr. Johnson for the purpose of interfering with his pension rights, the court concluded that there was a legitimate and non-discriminatory reason for the firing and that UPS is entitled to summary judgment in full. With regard to the ERISA Section 510 claim specifically, the court noted that “[b]ecause Mr. Johnson was only two months away from his retirement benefits vesting, UPS offered him a part-time position at a different location until his benefits vested,” but “Mr. Johnson declined the part-time position and was terminated on March 20, 2023, at the age of 54.” Because of this, the court concluded there was no evidence that Mr. Johnson was discharged in order to prevent him from receiving his full retirement benefits in violation of ERISA. Accordingly, the court entered judgment in favor of UPS on the age discrimination, wrongful discharge, and ERISA claims, and terminated the action.