The federal courts were quite busy this week, despite the MLK Day holiday, issuing numerous rulings on procedural and substantive issues across the ERISA spectrum. No one case stood out, but there is something for almost everyone in the cases discussed below.

Read on to learn about (1) a tough week for disability claimants (they went 1-for-5, with the lone bright spot a long-COVID California plaintiff (Doe v. LINA)); (2) the dismissal of two putative class actions alleging the misuse of retirement plan forfeitures (Tillery v. WakeMed, Curtis v. Amazon), a common theme over the last year; (3) the approval of two class action settlements in cases alleging mismanagement of retirement plans (Singh v. Capital One, Nado v. John Muir Health); (4) a case ruling that Lockheed Martin was arbitrary and capricious when it refused to pay pension benefits to a plan participant’s estate after his death (Marchetti v. Lockheed); and (5) a case encouraging siblings at legal war with each other to “embrace…forgiveness, self-reflection, and grace, predicated on the very faith instilled in them by their parents” (Maas v. JTM Provisions). Good advice for all! We’ll see you next week.

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

Arbitration

Fifth Circuit

Elmihi v. PayPal Holdings, Inc., No. 2:25-CV-00025, 2026 WL 92046 (S.D. Tex. Jan. 13, 2026) (Judge David S. Morales). This order addresses a dispute over the enforceability of an arbitration agreement between plaintiff Sameh Elmihi, proceeding pro se, and his employer, defendant PayPal Holdings, Inc. The assigned magistrate judge issued a memorandum and recommendation that the court grant PayPal’s motion to compel arbitration, stay the case pending the outcome of arbitration, and deny all of Elmihi’s pending motions as moot. Elmihi raised eight objections to the recommendation; only one of those objections related to ERISA. (The court noted that Elmihi’s amended complaint had removed all references to ERISA, but Elmihi contended he was still pursuing ERISA remedies, so to avoid all doubt the court discussed the issue.) Elmihi contended that his ERISA claim “falls squarely within the narrow but critical exception where arbitration cannot apply.” Specifically, he argued that his claim sought injunctive and prospective relief, which an arbitrator lacked the authority to enforce, thereby preventing him from effectively vindicating his rights. The court rejected this argument, ruling that the arbitration agreement specifically granted the arbitrator the authority to award any legal or equitable relief authorized by law in connection with the asserted claim. The court noted that Elmihi did not provide any reason why the arbitral forum would be inaccessible and that district courts have the authority to confirm and enforce an arbitrator’s award of equitable relief. Therefore, the court overruled Elmihi’s objection regarding the non-arbitrability of his ERISA claim. It also upheld the remainder of the magistrate’s recommendations, except for Elmihi’s claim under the Dodd-Frank Act. The court construed this claim as raising issues under the Sarbanes-Oxley Act, which contains an anti-arbitration provision, and therefore sustained Elmihi’s objection as to this claim only. However, in the end, because most of Elmihi’s claims were arbitrable, the court arrived at the same conclusion as the magistrate judge. It stayed all claims pending arbitration, denied Elmihi’s pending motions, and ordered the parties to file a joint status report at the conclusion of arbitration.

Attorneys’ Fees

Ninth Circuit

Sarruf v. Lilly Long Term Disability Plan, No. C24-0461-JCC, 2026 WL 89621 (W.D. Wash. Jan. 13, 2026) (Judge John C. Coughenour). In our July 9, 2025 edition we reported on this victory by plaintiff David Sarruf in which Sarruf convinced the district court that the administrator for Eli Lilly and Company’s employee long-term disability benefit plan erred by denying his claim as untimely. The court agreed that defendants were estopped from arguing untimeliness because their written statements reasonably led him to believe that his claim complied with the plan’s procedures. The court demurred from deciding whether Sarruf was disabled and entitled to benefits, and instead remanded the case for further review by the administrator. However, the court did rule that Sarruf was entitled to attorney’s fees for his efforts thus far. His motion for fees was decided in this order. Defendants argued that a fee award was not warranted based on the Ninth Circuit’s five-factor test set forth in Hummell v. S.E. Rykoff & Co. These factors include the degree of the opposing parties’ culpability or bad faith, their ability to satisfy a fee award, whether a fee award would deter similar conduct, whether the fee-seeking parties aimed to benefit all ERISA plan participants or resolve a significant legal question, and the relative merits of the parties’ positions. The court found that these factors supported a fee award, citing the following: the plan administrator’s unreasonable denial of Sarruf’s appeal, which “evinced bad faith”; Eli Lilly’s ability to satisfy the fee award; the deterrent effect of a fee award; the “significant legal issue” regarding conflicting plan documents and federal guidance on COVID-19; and Sarruf’s argument that “a simple remand would award the plan administrator for its unreasonable conduct.” As for the amount, Sarruf sought $239,900 in fees and $7,026.73 in costs, based on 267.2 hours spent by three experienced ERISA attorneys. This resulted in a “blended rate” of $897.83 per hour, which the court found exceeded the rates typically allowed in the Puget Sound region for similar work. Instead, the court ruled that a blended hourly rate of $500 was more appropriate. The court applied this rate to the hours reasonably incurred in support of the litigation, which excluded 43.1 hours spent on matters outside of the litigation, such as the administrative appeal. Consequently, the court’s total award was $112,050 in attorney fees, and the full amount of requested costs, $7,026.73. (Disclosure: Kantor & Kantor LLP is counsel of record for Mr. Sarruf in this action.)

Breach of Fiduciary Duty

Fourth Circuit

Tillery v. WakeMed Health & Hospitals, No. 5:25-CV-408-D, 2026 WL 125784 (E.D.N.C. Jan. 15, 2026) (Judge James C. Dever III). Jeanette Tillery filed this putative class action against her employer, WakeMed Health & Hospitals, and related defendants alleging violations of ERISA in their management of WakeMed’s defined contribution retirement savings plan for its employees. WakeMed makes contributions to the plan which vest after three years. However, if an employee leaves before three years, WakeMed’s contributions are forfeited. Tillery alleges that WakeMed violated ERISA by not using forfeitures to pay plan expenses, and instead used them to reduce future employer contributions. She claimed this breached ERISA’s duties of loyalty and prudence, its anti-inurement provision, and its prohibited transactions provision. She also alleged a failure to monitor the committee responsible for the plan. Defendants filed a motion to dismiss, which the court adjudicated in this order. Defendants made two preliminary arguments: (1) Tillery sought benefits beyond what the plan entitled her to, contradicting plan documents and ERISA principles; and (2) her claims contradicted established understandings of the Treasury Department and Congress regarding the use of forfeitures. The court opted not to rule on these arguments for two reasons. “First, whether the Plan permits defendants’ actions is not dispositive because fiduciary duties ‘trump[ ] the instructions of a plan document.’… Second, proposed regulations lack the force of law, enacted regulations interpreting law do not bind the court, and legislative history documents are, at best, minimally persuasive evidence of congressional intent.” The court thus addressed the merits of Tillery’s claims. It noted, “Most courts have rejected duty of loyalty claims concerning forfeitures, reasoning that ‘[w]hen (1) a plan document gives a plan fiduciary discretion in how to use forfeitures and (2) participants otherwise receive everything guaranteed by the plan’s terms, plan fiduciaries do not violate their duty of loyalty merely by declining to use forfeitures to cover administrative expenses.” The court “agree[d] with the weight of authority.” The court distinguished Tillery’s authorities, explaining that the plan language in those cases differed and they were less persuasive than the majority cases. As for Tillery’s breach of prudence claims, they focused on defendants’ decision-making process regarding forfeitures and their failure to use all forfeitures by year-end. The court found that Tillery’s allegations did not plausibly suggest a breach of prudence, as they were based on assumptions and did not demonstrate imprudent conduct. The court also noted that the mere existence of forfeiture balances did not give rise to an inference that a breach had occurred. As for Tillery’s anti-inurement claims, the court ruled that using forfeitures to pay benefits to participants did not violate this provision, as it benefited participants and did not constitute an impermissible employer benefit. The court also ruled that the plan was permitted to use plan assets to forgive defendants’ debts because contributions, unlike debts, were discretionary. The court also dismissed Tillery’s prohibited transaction claims because it found that using forfeitures to fund contributions was not a prohibited transaction, as no assets left the plan and contributions were paid to participants. The court further dismissed Tillery’s failure to monitor claim because her other ERISA claims failed. Finally, the court noted that Tillery’s claims were barred to the extent they predated May 4, 2021, due to a class action settlement in Conte v. WakeMed. That settlement released claims related to the Plan’s management and administration, including fiduciary breaches. The court found that Tillery’s claims shared the same factual predicate as the Conte settlement, thus barring them. As a result, the court granted defendants’ motion and dismissed Tillery’s complaint with prejudice.

Ninth Circuit

Curtis v. Amazon.com Servs., LLC, No. C24-2164RSM, 2026 WL 124323 (W.D. Wash. Jan. 16, 2026) (Judge Ricardo S. Martinez). Cory Curtis and Jonathan Torres, former employees of Amazon.com Services, LLC, filed this action against Amazon and related defendants alleging breaches of fiduciary duties and other violations under ERISA in the administration of Amazon’s 401(k) Savings Plan. They contend that defendants improperly assessed administrative fees and expenses on their accounts without utilizing forfeited plan assets to offset these costs, which reduced the funds in their accounts. Defendants filed a motion to dismiss, arguing that plaintiffs’ “theory of liability has been rejected by nearly every court that has considered it.” In this concise order, the court agreed. Relying primarily on the district court’s ruling in Hutchins v. HP (which Your ERISA Watch covered in our June 26, 2024 edition), the court found that “Defendants did not breach any fiduciary duty in this case because they followed the terms of the Plan, and that Plaintiffs’ theory that this nevertheless violated ERISA is not plausible for the reasons stated in Hutchins… The Court agrees with the many courts who have found that, under Plaintiffs’ theory, a fiduciary would always be required to use forfeitures to pay administrative costs even if the plan document gave it the option to reallocate those funds to reduce employer contributions. This, in essence, would use the fiduciary duties of loyalty and prudence to create a new benefit to participants that is not provided in the plan document itself.” (Hutchins is currently on appeal to the Ninth Circuit; briefing is complete and hopefully oral argument will take place this spring.) The court also rejected plaintiffs’ prohibited transactions claim, again relying on Hutchins to find that “Plaintiffs have failed to plausibly allege an unlawful transaction.” Finally, the court ruled that plaintiffs could not cure these deficiencies in an amended pleading and thus granted defendants’ motion to dismiss with prejudice.

Tenth Circuit

Estate of Victor Harold Forsman v. Barnes, No. 2:25-CV-00283-JNP-CMR, 2026 WL 84252 (D. Utah Jan. 12, 2026) (Judge Jill N. Parrish). Victor Harold Forsman died in 2021. At the time, he had an account in a 401(k) plan managed by Empower Retirement, which contained approximately $750,000. Believing Rory Jake Barnes was the beneficiary of the account, Empower transferred the proceeds to him in 2022 after receiving his claim. The plaintiff, the personal representative of Forsman’s estate, brought this action asserting claims against both Barnes and Empower. Against Barnes, plaintiff asserted a wrongful conversion claim, alleging that Barnes, without authorization, sent a beneficiary designation to Empower using Forsman’s computer, which “interfered with the estate’s rights to the plan proceeds.” Against Empower, plaintiff brought a single claim under ERISA, alleging that Empower’s decision to treat Barnes as the beneficiary without a valid designation was a breach of its fiduciary duty. Empower filed a motion to dismiss, contending that plaintiff failed to state a claim for three reasons: “(1) ‘Plaintiff fails to plead facts showing the availability of any equitable relief, which is [a] required element of a breach of fiduciary duty claim under ERISA’; (2) ‘Plaintiff fails to plead facts showing that Empower acted as a fiduciary under ERISA’; and (3) ‘[e]ven if Plaintiff could plead facts showing that Empower acted as an ERISA fiduciary, Plaintiff fails to allege any conduct by Empower that constitutes a breach of fiduciary duty under ERISA.’” The court focused on the second argument – Empower’s fiduciary status – and because the court “ultimately finds this argument convincing,” it determined that it “need not address Empower’s other arguments.” The court noted that a party can be a fiduciary under ERISA either as a named fiduciary or a functional fiduciary. The court found “no indication that Empower was a named fiduciary,” so it examined Empower’s functional fiduciary status. Empower argued that its activities were limited to processing beneficiary designations and payments, which were purely ministerial tasks not implicating fiduciary status. Plaintiff responded that it had received a statement from a plan trustee suggesting that Empower processed claims without oversight, which meant that it exercised fiduciary duties. However, the court found this insufficient to create fiduciary status: “the statement does nothing to exclude, or even make unlikely, the possibility that Empower’s activities were tightly controlled by established rules and policies and thus ministerial. Indeed, the ministerial nature of Empower’s activities may be the most likely explanation for why the plan trustee…did not bother to oversee Empower.” The court also responded to a new argument made by plaintiff at the hearing on the motion, which was that Empower’s fiduciary status was “established by the allegation that Empower treated Barnes as the beneficiary sua sponte without receiving any communication or information suggesting that Barnes had been designated as the beneficiary.” However, the court stated that “Plaintiff’s current suggestion that Empower’s decision to treat Barnes as a beneficiary was unprompted and not made pursuant to existing procedures and policies is simply missing from the complaint and, consequently, does not change the court’s analysis.” As a result, the court granted Empower’s motion to dismiss the sole claim brought against it.

Class Actions

Second Circuit

Singh v. Capital One Fin. Corp., No. 1:24-CV-08538-MMG, 2026 WL 92311 (S.D.N.Y. Jan. 13, 2026) (Judge Margaret M. Garnett). The plaintiffs in this class action allege ERISA violations against Capital One and other related defendants arising from their administration of the Capital One Financial Corporation Associate Savings Plan. The parties reached a settlement, after which plaintiffs submitted a proposed order to the court seeking preliminary approval of the settlement, preliminary certification of a class for settlement purposes, approving the form and manner of a settlement notice, preliminarily approving a plan of allocation, and scheduling a date for a fairness hearing. The court signed off on the proposed order, conditionally certifying a settlement class that includes all persons who participated in the plan during the class period, excluding the defendants and their beneficiaries. The court found that the settlement class meets the requirements of Federal Rules of Civil Procedure 23(a) and (b)(1), including numerosity, commonality, typicality, and adequacy of representation. The court also preliminarily approved the settlement as fair, reasonable, and adequate, noting that it was negotiated at arm’s length and the settlement amount of $9.6 million is within the range of settlement values obtained in similar cases. The court also noted that a qualified settlement fund has been established, and the settlement administrator, Analytics LLC, has been appointed to manage the fund and distribute the settlement. The court approved the forms of settlement notice and directed the defendants to provide class data to facilitate the notice process. The court also set deadlines for filing petitions for attorneys’ fees, litigation costs, and case contribution awards, as well as for filing objections to the settlement. The court scheduled a fairness hearing for June 25, 2026 to determine the final approval of the settlement, address any objections, and consider the adequacy of class counsel’s representation.

Ninth Circuit

Nado v. John Muir Health, No. 24-CV-01632-AMO, 2026 WL 82232 (N.D. Cal. Jan. 12, 2026) (Judge Araceli Martínez-Olguín). The plaintiff, Conan Nado, filed this putative class action on behalf of himself and similarly situated participants and beneficiaries of the John Muir Health 403(b) Plan against John Muir Health and its board of directors. Nado contended that defendants breached their fiduciary duties under ERISA by “paying excessive recordkeeping and administrative service fees and misallocating plan forfeitures.” Nado asserted four causes of action: two claims for breach of the fiduciary duty of prudence and two claims for breach of the fiduciary duty of loyalty. With the help of a mediator, the parties reached a settlement which the court preliminarily approved in June of 2025. Before the court here was Nado’s motion for final approval, attorney’s fees and costs, administrative expenses, and case contribution award, which was granted. Under the terms of the settlement, defendants agreed to pay $950,000 to a common settlement fund. The parties agreed that class counsel’s fees would not exceed $237,500, and its expenses would be capped at $35,000. The settlement also provided for a case contribution award for Nado of up to $5,000, at the court’s discretion. The agreement also required defendants to conduct a request for proposal for plan recordkeeping services within two years of the settlement effective date. The net settlement amount will be distributed to approximately 20,000 eligible class members, with specific provisions for those with and without accounts in the plan. The court found these terms fair, reasonable, and adequate, found the notice to be adequate, and noted no objections from class members. The court also approved the allocation plan, which distributes the settlement fund on a pro rata basis among class members. Class counsel was awarded $237,500 in attorney’s fees, which was 25% of the gross settlement amount, and $22,817.88 in litigation expenses. The settlement administrator was paid $31,986, and an independent fiduciary, Gallagher Fiduciary Advisors, LLC, was paid $15,000 for its review of the settlement. Nado was awarded a $5,000 incentive award for his participation in the litigation. The court thus ordered that the action and all released claims be dismissed with prejudice. The parties were required to file a post-distribution accounting no later than one year and one day from the entry of the order.

Disability Benefit Claims

Third Circuit

Hans v. Unum Life Ins. Co. of Am., No. CV 25-3595, 2026 WL 116487 (E.D. Pa. Jan. 15, 2026) (Judge Mark A. Kearney). Ryan Hans was a river pilot, responsible for navigating commercial vessels on the Delaware River and Bay and ensuring maritime safety. Through the Pilots’ Association for the Bay & River Delaware, he was covered by an ERISA-governed long-term disability (LTD) benefit plan insured by Unum Life Insurance Company of America. The plan delegated claims administration to Unum, granting it discretionary authority to make benefit determinations. Hans experienced various medical symptoms and stopped working as a river pilot in May of 2023. He sought medical treatment for long COVID and consulted with multiple healthcare providers, including cardiologists and a primary care physician. He experienced symptoms such as rapid heart rate, left axillary pain, and neurological symptoms. Hans received treatment from a COVID specialist, who diagnosed him with long COVID and prescribed medications. Hans applied for LTD benefits from Unum, claiming he was unable to safely pilot vessels due to physical and mental limitations. Unum determined Hans’ occupation in the national economy was “Pilot, Ship,” with physical demands classified as light work. Unum’s medical reviewers further concluded that the evidence did not support restrictions and limitations precluding him from full-time work in this occupation. Hans appealed unsuccessfully and then filed this action. The parties filed cross-motions for summary judgment which were decided in this order under a deferential standard of review. First, the court ruled that Unum’s determination of the material and substantial duties of Hans’ regular occupation was not arbitrary and capricious. Unum’s vocational consultants concluded that Hans’ occupation as a ship pilot required light work, and the court found no basis to disturb this conclusion, despite Hans’ argument that his job was better described by a more taxing “composite ship pilot and deckhand” occupation. Next, the court ruled that Unum’s denial based on its medical review was not arbitrary and capricious. According to the court, Unum’s medical reviewers provided reasoned explanations for discounting the opinions of Hans’ treating providers, and the court found no evidence that Unum arbitrarily refused to credit their opinions. The court also ruled that Unum properly sought objective evidence of Hans’ functional limitations resulting from long COVID, rather than improperly seeking objective evidence of the diagnosis itself. Finally, the court considered Unum’s structural conflict of interest, as Unum was both the evaluator and payor of benefits. The court found that Unum’s structural conflict was “a neutral factor” and did not weigh in favor of finding its denial arbitrary and capricious. As a result, the court concluded that Unum’s decision was “reasonable and supported by relevant evidence,” and thus it granted Unum’s motion for summary judgment while denying Hans’. (Disclosure: Kantor & Kantor LLP is counsel of record for Mr. Hans in this action.)

Fourth Circuit

Sramek v. United of Omaha Life Ins. Co., No. 1:25-CV-00576-MSN-LRV, 2026 WL 81903 (E.D. Va. Jan. 12, 2026) (Judge Michael S. Nachmanoff). Michael Sramek was a portfolio manager for Sands Capital Management, LLC and a participant in Sands’ ERISA-governed employee long-term disability (LTD) benefit plan, which was insured by United of Omaha Life Insurance Company. Sramek developed chronic low back pain and was diagnosed with several lumbar conditions. After unsuccessful treatment, he underwent back surgery in October 2022 and applied for LTD benefits. United initially approved his claim, but terminated it in June of 2024. According to United, Sramek had recovered from his surgery, medical records from his doctors showed normal examination findings, and a nurse’s review concluded that Sramek could perform sedentary work full-time. An independent neurosurgeon also found no evidence of limitations preventing Sramek from performing his job. Based on this evidence, United terminated Sramek’s LTD benefits, concluding there was no medical evidence supporting his inability to perform his regular occupation. Sramek appealed, but United maintained that Sramek could work with appropriate restrictions. Sramek then filed this action and the parties submitted cross-motions for summary judgment. The court applied the abuse of discretion standard of review because the plan granted United discretionary authority to make benefit determinations. Sramek made three arguments about United: “(1) it failed to employ a reasoned and principled decision-making process, (2) its determinations that Sramek could perform the physical and cognitive elements of his job were unsupported by the record, and (3) it operated under a structural conflict of interest.” The court addressed all three. First, the court found that United conducted a thorough investigation: “it assessed, among other things, medical records from Sramek’s physicians spanning years, written statements from Sramek’s physicians, an occupational analysis, observation of Sramek’s activities, information about his prescriptions, and the evaluation of a nurse and two board-certified physicians.” The court emphasized that United was not required to defer to Sramek’s physicians. Thus, “its process was both reasonable and principled.” Second, the court found that the evidence in the record supported United’s decision. This evidence included Sramek’s ability to travel and engage in activities like golf, which the court felt contradicted his claims of disability. As for Sramek’s cognitive abilities, the court found that the medical records did not demonstrate impairments due to pain or medication, and that his physician’s statements to the contrary were “conclusory.” Finally, the court considered Sramek’s conflict of interest argument. The court acknowledged that United had a structural conflict, but noted that United initially approved and paid LTD benefits for nearly two years before terminating them, and relied on independent providers to assess Sramek’s claims. “These measures strongly suggest that United of Omaha’s decision to terminate Sramek’s benefits was not the product of bias that could cast doubt on the validity of its decision.” As a result, the court concluded that United did not abuse its discretion in terminating Sramek’s benefits, and thus granted United’s summary judgment motion while denying Sramek’s.

Williams v. Friendship Health & Rehab Ctr., Inc., No. 7:25-CV-00254, 2026 WL 84417 (W.D. Va. Jan. 12, 2026) (Judge Robert S. Ballou). Leah Williams, proceeding pro se, filed this action against her former employer, Friendship Health and Rehab Center, Inc. and Friendship Foundation, alleging that Friendship failed to pay her full wages or benefits and subjected her to discriminatory treatment. She asserted a number of claims under various state and federal laws, including one under ERISA. Friendship moved to dismiss Williams’ claims, and the court granted the motion in this order. Williams was terminated in 2017, so the court concluded that “[n]early all of Williams’s claims are…time-barred under the applicable limitation periods.” The one exception was her ERISA cause of action, which involved a claim for benefits under Friendship’s employee long-term disability benefit plan. The plan’s administrator, Metropolitan Life Insurance Company, did not deny her claim until 2024 and thus “only Williams’s ERISA claim appears to be timely filed.” The court then addressed the merits of Williams’ claims, regardless of whether they were time-barred. The court concluded that Williams could not bring her ERISA claim against Friendship because it was not a proper defendant. “Williams alleges that Friendship offered a long-term disability plan as a benefit of employment but does not assert that Friendship managed the plan. To the contrary, the documents attached to the Complaint show that the Metropolitan Life Insurance Company, not Friendship, made the decision to deny her long-term disability coverage… Accordingly, Friendship is not a proper defendant to any ERISA claim.” The court further ruled that Williams’ remaining claims were not meritorious for various reasons, and as a result it granted Friendship’s motion to dismiss, with prejudice.

Seventh Circuit

Jones v. Unum Life Ins. Co. of Am., No. 24 C 3911, 2026 WL 96985 (N.D. Ill. Jan. 13, 2026) (Judge Robert W. Gettleman). McKenzie Jones began working for Whole Foods in 2018 as a Team Receiver and was a participant in Whole Foods’ employee disability benefit plan, which was governed by ERISA and insured by Unum Life Insurance Company of America. In 2022, Jones stopped working due to back pain, which he attributed to a 2018 vehicle accident and a subsequent flare-up after a busy period at work. He was approved for short-term disability benefits, as well as a few weeks of long-term disability benefits, before Unum terminated his long-term claim in June of 2023. Jones’ appeal was unsuccessful and this action followed, asserting relief under 29 U.S.C. § 1132(a)(1)(B). The parties filed cross-motions for judgment under Federal Rule of Civil Procedure 52. The parties agreed that the de novo standard of review applied; Unum conceded that the plan did not grant it discretionary authority to make benefit determinations. The case turned on Unum’s argument that “plaintiff failed to satisfy the Plan’s requirement for disability that he be under the ‘regular care of a physician’ because ‘he had absolutely no medical treatment whatsoever for at least the next 9 months after May 31, 2023.’” Jones argued that Unum could not make this argument now because it never raised this as a basis for denial while his claim was pending. The court ruled that it could consider whether Jones was under the “regular care of a physician,” even if Unum did not previously specifically assert the defense. The court noted that “although defendant did not directly discuss the ‘regular care’ issue in its decision letters, it did refer to the frequency of treatments in both letters.” Furthermore, citing Marantz v. Permanente Med. Grp., the court stated, “the Seventh Circuit has more recently made clear that courts can consider alleged ‘post hoc rationalizations’ when, as here, the ‘district court’s judicial review of [the insurers]’s decision is de novo.’” Thus, ““even if [defendant] had violated ERISA by failing to’ raise the regular-care issue ‘in its decision letters,’ it would not prevent the court from considering whether plaintiff meets the regular care requirement for being disabled.” Next, the court examined the record to determine if Jones satisfied the “regular care” provision. Unum argued that Jones received no medical care for nine months and that he failed to follow treatment recommendations, including continuing physical therapy and obtaining an MRI. Jones responded that the plan did not require continuous “regular care” to receive benefits, and that Unum’s withholding of payments prevented him from affording continuous treatment. The court agreed with Unum, ruling that the provision requires “some form of continuity in the insured’s treatment by physicians,” and that Jones “essentially stopped receiving any treatment for eight or nine months after May 31, 2023.” The court highlighted that Jones did not follow through with treatment recommendations during this period. The court was also skeptical of Jones’ argument regarding financial hardship, noting that “other cases have questioned whether financial hardship can excuse the regular-care requirement in the ERISA context.” The court ruled that even if such an argument were permitted, Jones had not offered sufficient evidence to establish that financial hardship prevented him from obtaining regular care. The court noted that Jones could have received treatment while he still had health insurance and was receiving disability benefits, but declined. Furthermore, “plaintiff provides no direct evidence of his financial condition[.]” As a result, the court concluded that Jones did not prove he was under the “regular care of a physician” as required by the plan and therefore granted Unum’s motion for judgment while denying Jones’.

Ninth Circuit

Doe v. Life Ins. Co. of N. Am., No. 24-CV-00859-NW, 2026 WL 125617 (N.D. Cal. Jan. 16, 2026) (Judge Noël Wise). Plaintiff Jane Doe worked as a Dynamics Analyst and Separation Dynamics Analyst on hypersonic missile programs for Lockheed Martin. As an employee of Lockheed Martin, she was covered by its ERISA-governed long-term disability (LTD) benefit plan, which was administered and insured by defendant Life Insurance Company of North America (LINA). As you might expect from her job title, Doe’s role required high-level cognitive functions, including simulating missile ascent and reentry, designing thermal protection strategies, and developing technical solutions to complex problems. Unfortunately, Doe began suffering from health issues after receiving the COVID-19 vaccine in early 2021, including chest pain, shortness of breath, fatigue, and difficulty concentrating. Eventually she developed chronic symptoms, including profound fatigue, brain fog, cognitive decline, and dysautonomic symptoms. Doe submitted a claim for short-term disability benefits, which was approved, but LINA denied her claim for LTD benefits, asserting a lack of clinical findings supporting functional impairment. Doe appealed, and on appeal LINA determined that Doe was psychiatrically impaired for a limited period, but terminated her benefits after February of 2023. This action followed. The parties filed cross-motions for judgment which the court reviewed under the de novo standard of review. First, the court found that “[t]he material duties of Plaintiff’s occupation require high-level cognitive function.” LINA emphasized the sedentary nature of Doe’s job, but the court found that her job “tasks require consistent concentration and stamina to conduct complicated analyses.” Next, the court concluded that Doe’s subjective complaints of debilitating symptoms were credible. The court emphasized that non-objective evidence can support a disability claim when subjective reports are credible, especially when objective evidence “is impossible to obtain.” The court further found that Doe’s complaints were supported by her treating doctors, who “personally observed many of the symptoms of which Plaintiff complained.” Moreover, these doctors attested that Doe was not malingering. As a result, the opinions of these doctors, who had personally treated her and had expertise in treating vaccine injured patients, were more persuasive than the paper reviews prepared by LINA and its consultants. The court thus concluded that Doe had met her burden of proving her disability under the plan’s terms because the material duties of her occupation were primarily cognitive, and her cognitive impairment rendered her unable to perform these duties. The court ordered the retroactive reinstatement of Doe’s LTD benefits from the time they were terminated to the expiration of the “regular occupation” benefits period. The court remanded the case to LINA to determine whether Doe was disabled and entitled to continued benefits under the “any occupation” standard.

Discovery

D.C. Circuit

Kifafi v. Hilton Hotels Ret. Plan, No. 25-7053, __ F. App’x __, 2026 WL 125263 (D.C. Cir. Jan. 16, 2026) (Before Circuit Judges Pillard, Katsas, and Randolph). As we explained in our March 26, 2025 edition, this case has been around for more than a quarter-century – since 1998 – during which it has been up to the D.C. Circuit Court of Appeals four times…well, make that five. Kifafi originally alleged that Hilton Hotels violated ERISA in several ways, including improperly backloading retirement benefit accruals toward the end of employees’ careers, failing to provide certain eligible employees early retirement benefits, failing to maintain sufficient data to pay benefits to surviving spouses and former employees, failing to provide benefit statements and plan documents, and breaching fiduciary duties owed to plan participants. In 2011, Kifafi eventually prevailed on his claims for violations of ERISA’s anti-backloading and vesting provisions, obtaining a permanent injunction, and the parties have been mired in enforcement proceedings ever since. The issue on appeal here was Kifafi’s “Motion for Post-Judgment Discovery and Accounting.” He “sought a wide array of information from Hilton, including: ‘all communications’ between Hilton and its officers and agents ‘related to implementation of the permanent injunction,’ all communications since February 2015 with class members who were not yet paid as of that time, and ‘individual records’ for those same class members[.]” Hilton opposed the motion, and the district court ruled for Hilton, ruling that Kifafi’s requests were not warranted because Kifafi “ha[d] not shown that there are ‘significant questions’ regarding [Hilton’s] compliance with the judgment that warrant further discovery.” Kifafi appealed, and in this short decision the D.C. Circuit affirmed, ruling that the district court did not abuse its discretion. The appellate court acknowledged that “the district court retains the power to award appropriate relief as necessary to ensure that its judgment is fully enforced,” and “[n]o one disputes that Hilton has ongoing obligations under the injunction.” However, Kifafi’s requests were simply overbroad. The appellate court suggested that Kifafi “may request current information from Hilton, such as periodic status reports listing the identified class members and basic facts relevant to compliance progress. Those facts could be reasonably discrete, such as a listing of who remains unpaid and why, how much they are due, and what actions Hilton is taking to ensure that they are paid.” However, any such request would have to be reviewed by the district court first, and the appellate court would “not opine on whether it would be within the district court’s sound discretion to deny even a tailored request for an accounting of Hilton’s efforts and progress in identifying and providing the relief due to each class member.”

Eighth Circuit

The ERISA Industry Comm. v. Minnesota Dep’t of Commerce, No. 24-CV-04639 (KMM-SGE), 2026 WL 125166 (D. Minn. Jan. 16, 2026) (Magistrate Judge Shannon G. Elkins). This action challenges the legality of Minnesota Statute § 62W.07, which seeks to regulate pharmacy benefit managers (PBMs) and health insurers. The plaintiffs contend that “the statute is preempted by the Employee Retirement Income Security Act (ERISA), and that it is being applied extraterritorially in violation of the Constitution.” At the outset of the case, plaintiffs argued that no discovery was necessary, and that the case should go directly to summary judgment proceedings. The Department of Commerce disagreed, contending that discovery was necessary. The court sided with the Department, and it propounded written discovery. The Department gave plaintiffs extensions, and plaintiffs eventually responded, but not to the Department’s liking. As a result, the Department filed a motion to compel discovery and modify the scheduling order, which was adjudicated in this order. The court first addressed the scheduling order, and ruled that the Department had not demonstrated good cause to modify it. “[T]he Department cannot now claim that Plaintiffs’ late responses caused the need to extend discovery when it consented to the late productions and knew before the deadline that the productions were insufficient.” Furthermore, the court noted that the Department had waited until after the discovery deadline to seek an extension in order to combine its two motions, which was a “tactical decision” that did not constitute good cause. The Department had better luck with its motion to compel, which was directed primarily at defendants The Cigna Group and Cigna Health and Life Insurance Company. The court granted much of the Department’s motion, ordering Cigna to produce information regarding plans affected by the statute, the activities of PBMs within the state, requirements for participating in various pharmacy networks, recommendations made by PBMs to ERISA plan sponsors, determinations about drug coverage and pharmacy networks made by ERISA plan sponsors, drug coverage and pharmacy networks for ERISA plans, and fiduciary duties owed by PBMs to ERISA plan sponsors. The court denied other requests by the Department as either overbroad, not proportional, or because Cigna did not possess responsive documents. The court directed Cigna to comply with the order within 30 days, and extended the case deadlines in order to accommodate that compliance.

ERISA Preemption

Ninth Circuit

Montana Electrical Joint Apprenticeship & Training Committee v. Wagner, No. CV-25-78-BU-JTJ, 2026 WL 84298 (D. Mont. Jan. 12, 2026) (Magistrate Judge John Johnston). Montana Electrical Joint Apprenticeship & Training Committee (JATC) administers an apprenticeship training program funded by union employers. Participating apprentices sign Scholarship Loan Agreements (SLAs) requiring them to repay JATC for training expenses either through in-kind service by accepting qualifying union employment or by reimbursing JATC directly. JATC filed this action against five individuals, alleging breach of contract against each of them “because after allegedly receiving the training they allegedly failed to accept qualifying union employment at all or for a sufficient time to earn enough in-kind credits to repay the training costs and they failed to repay the resulting amount owed to the JATC.” Through this suit, JATC seeks to recover the cost of the training it provided. Defendants filed a notice of removal based on ERISA preemption, and JATC filed a motion to remand, contending that its claims are not preempted. Defendants opposed the motion, contending that “JATC’s apprenticeship training program and the SLAs constitute ‘employee welfare benefit plans’ under ERISA because they are maintained by employer associations and labor unions to provide apprenticeship training and scholarship funds.” In this order, the court rejected defendants’ argument and granted JATC’s motion to remand. The court explained that under the two-step test established by the Supreme Court in Aetna Health Inc. v. Davila, a state law claim is completely preempted if it could have been brought under § 502(a) and if there is no other independent legal duty implicated. The court determined that the only possible remedy JATC had under § 502(a) was pursuant to § 502(a)(3), which allows for equitable relief. However, JATC could not have brought its claims under § 502(a)(3) because it seeks legal relief in the form of monetary damages, which is not provided for under § 502(a)(3). Because defendants could not satisfy the first step of the Davila test, the court did not address the second. Defendants also argued that the court had jurisdiction under ERISA § 514(a), which provides an affirmative defense of conflict preemption. However, the court noted that even if defendants could maintain such a defense, this was insufficient to confer federal question jurisdiction. As a result, the court concluded that it lacked subject matter jurisdiction over JATC’s claims, granted JATC’s motion, and remanded the case to state court.

Life Insurance & AD&D Benefit Claims

Eleventh Circuit

Atkins v. The Prudential Ins. Co. of Am., No. 1:25-CV-2912-TWT, 2026 WL 86659 (N.D. Ga. Jan. 12, 2026) (Judge Thomas W. Thrash, Jr.). Shannon Atkins was employed by Arch Capital Services LLC and was a participant in its ERISA-governed employee life insurance benefit plan, administered by Prudential Insurance Company of America. Sadly, Shannon was diagnosed with ovarian cancer in 2020 and stopped working in December 2022 due to her illness. She was approved for short-term and long-term disability leave, and her employment was formally terminated in August 2024. She later passed away. The plaintiff in this case, Shannon’s husband William, contends that Shannon qualified for a waiver of premium and a continuation of coverage under Arch’s life insurance plan because she was disabled. William further contends that Arch and Prudential breached their fiduciary duties by misleading Shannon into believing she was receiving the full benefit of her coverage and failing to inform her about the waiver provision. William also accuses Arch of misinforming Shannon about her right to convert her employer-sponsored coverage under the plan to an individual policy. William asserted three claims in his complaint: “Count I is a benefits claim that seeks compensation under ERISA § 502(a)(1)(B)… In the alternative, Count II seeks equitable relief against Prudential and Arch for breach of fiduciary duty under ERISA § 502(a)(3)… In the alternative to Counts I and II, Count III seeks compensatory damages against Arch for the common law claim of negligent misrepresentation.” Arch filed a motion to dismiss all three claims, which the court adjudicated in this order. Under his first claim, William argued that “(1) Arch did not correct a mistake on Prudential’s conversion notice; and (2) it issued misleading statements and invoices to the decedent and failed to correct them or otherwise advise her about the death benefit clause.” The court ruled that Arch could not be held liable for Prudential’s alleged mistake in its conversion notice because Arch only had a general fiduciary duty to monitor Prudential’s activities. “Arch is not automatically responsible for every mistake that Prudential may make in the course of processing claims.” However, the court held that William plausibly alleged that Arch had a fiduciary duty to advise Shannon about the “death benefit clause” due to her “special circumstances,” such as her total disability and the importance of maintaining life insurance. Thus, the court denied Arch’s motion as to Count I. As for William’s second claim for equitable relief under Section 502(a)(3), the court dismissed it, ruling that the injury identified in this count was the same as in Count I, and Section 502(a)(3) “only provides a remedy when no such claim under § 502(a)(1)(B) is possible.” The court also dismissed Count III, holding that William’s negligent misrepresentation claim was preempted by ERISA. The court ruled that the claim “concern[s] alleged misrepresentations regarding the extent and timing of the decedent’s coverage. Courts routinely agree that ERISA preempts claims based on conduct of this sort – those brought by a plan participant or beneficiary in the pursuit of lost coverage as damages.” As a result, the court granted Arch’s motion, but only in part, dismissing Counts II and III but allowing Count I to proceed.

Medical Benefit Claims

Ninth Circuit

Cox v. WSP USA Inc. Grp. Ins. Plan, No. 24-CV-08812-HSG, 2026 WL 121206 (N.D. Cal. Jan. 16, 2026) (Judge Haywood S. Gilliam, Jr.) Andi Cox is a transgender woman and a participant in the ERISA-governed employee group health benefit plan of WSP USA Inc. Cox has a diagnosis of gender dysphoria and sought coverage for facial feminization surgery, which Aetna Life Insurance Company, the plan’s claim administrator, denied. Aetna contended that the treatment was not medically necessary under its clinical policy bulletin covering “Facial Gender Affirming Procedures.” After unsuccessfully appealing, Cox brought this action. Previously, Cox had sued WSP for denying coverage for facial hair removal; that action was settled in June of 2024. As a result, Cox brought two claims: one for denying her benefits in violation of ERISA, and one for a declaration that the Cox I settlement did not preclude this action. In this order the court addressed several motions. First, the court granted WSP’s motion to seal portions of the settlement agreement containing Cox’s personal information and the settlement amount, finding good cause to protect her privacy and financial details. Second, the court granted WSP’s motion to incorporate by reference the plan’s benefit booklet, the policy bulletin, and the settlement agreement. However, it denied WSP’s motion to incorporate the master service agreement, wrap plan, and summary plan description, as they were not relevant to the court’s ruling on WSP’s motion to dismiss. WSP asserted two arguments in its motion to dismiss: (1) the settlement agreement barred this action; and (2) Cox failed to state a claim. The court rejected WSP’s first argument, ruling that the settlement agreement did not preclude Cox’s current claims because “[t]he released claims related to facial hair removal treatments… Although facial hair removal may be a type of facial feminization, the claims at issue in this case relate to chin surgery… And the facts and dates as alleged in the complaint support Cox’s argument that her claims regarding facial feminization surgery had not ripened when Cox I was being litigated, such that she could not have asserted them there.” However, the court agreed with WSP’s second argument on the merits. The court acknowledged that “some medical evidence appears to support [Cox’s] view that facial feminization surgery is medically necessary for people with gender dysphoria.” However, “under the terms of the plan – which are the starting and ending point of the Court’s analysis under ERISA – Cox fails to state a claim because those procedures are expressly excluded.” Cox contended that Aetna’s clinical policy bulletin “creates an exclusion, which she characterizes as an affirmative defense, and contends that she is not required to plead around affirmative defenses.” However, the court ruled that “exclusions laid out in plan documents are not considered affirmative defenses in § 502 cases and can be the basis for granting a motion to dismiss.” As a result, “the plan unambiguously excludes the denied benefit. Therefore, the amended complaint fails to state a claim.” Thus, the case appears to be over, but the court set a case management conference to discuss whether any further action needs to be taken.

Pension Benefit Claims

Second Circuit

Marchetti v. Lockheed Martin Corp., No. 3:22-CV-1527 (OAW), 2026 WL 113414 (D. Conn. Jan. 15, 2026) (Judge Omar A. Williams). Natale Marchetti worked for Lockheed Martin Corporation and Sikorsky Aircraft Corporation, a subsidiary of Lockheed, for more than 43 years before he died on October 17, 2021 at the age of 62. As a Lockheed employee, he was a participant in its pension plan and was eligible for early retirement benefits, although he had not yet retired under the terms of the plan. Before his death, in 2020, Natale executed a durable power-of-attorney form (POA) appointing his brother, Dennis Marchetti, the plaintiff in this case, as his attorney-in-fact. The form authorized Dennis to act on Natale’s behalf in matters dealing with “estates, trusts, and other beneficial interests” and “retirement plans.” However, Natale did not check the box next to “Create or change a beneficiary designation.” One day after Natale’s death, Lockheed’s administrator received a completed beneficiary designation form naming Natale’s four siblings as his beneficiaries. The form was dated and postmarked October 15, 2021, two days before Natale’s death, and was signed by “Dennis Marchetti P.O.A.” Lockheed refused to pay death benefits, stating that because Natale was unmarried at the time of his death and the beneficiary designation was invalid, the plan did not authorize payment to anyone. Dennis brought this action, both in his individual capacity and as the administrator of Natale’s estate, alleging two counts: a breach of contract claim against Lockheed for failing to pay retirement benefits from the plan, and a statutory theft claim against both Lockheed and Sikorsky for withholding Natale’s interest in the Plan. The parties filed cross-motions for summary judgment, which were decided in this order. At the outset, the court disposed of three procedural issues. First, it dismissed Sikorsky from the case because Sikorsky had no administrative authority over the plan. Second, the court agreed with Lockheed that Dennis’ claims were preempted by ERISA, ruling that “[t]he complaint clearly prays for Plan benefits.” Thus, “the court reviews the Motions in the context of a single ERISA claim against Lockheed challenging Lockheed’s denial of beneficiary status[.]” Third, the court rejected Lockheed’s argument that Dennis had failed to exhaust his appeals before filing suit. The court noted that “while Lockheed expends considerable effort supporting the general principal of exhaustion, there is almost no argument as to how exhaustion ought to have been accomplished in this specific case.” The court noted that the plan appeal process “does not apparently include in its scope challenges to a POA or beneficiary status.” Furthermore, that process was limited to participants and beneficiaries, but “Lockheed’s determination that Dennis was not a beneficiary excluded him from the process Lockheed now asserts he ought to have used. Accordingly, the court finds that Lockheed has failed to show that there was an administrative process available to Dennis for him to exhaust.” The court then turned to the merits, using the deferential arbitrary and capricious standard of review because the plan gave Lockheed “broad discretionary authority” to make benefit determinations. The court found that Dennis failed to allege any facts that might call Lockheed’s interpretation of the POA, which was made in good faith, into question. The court thus ruled that Dennis did not have authority under the POA to complete the beneficiary designation form on Natale’s behalf, rendering the form ineffective. The court next examined the plan, which stated that “if a participant is at least 55 years old, has completed at least 10 years of continuous service, and dies while still employed by Lockheed, the participant’s spouse is entitled to certain benefits, except if the participant ‘[h]ad designated a Beneficiary other than the [s]pouse[.]’” Lockheed argued that because Natale was not married and had not designated a beneficiary, there was no beneficiary, while Dennis argued that Natale’s estate should be the beneficiary. The court ruled in Dennis’ favor, finding that the plan’s definition of “Beneficiary” included Natale’s estate. The court rejected Lockheed’s argument that a “Beneficiary” must be a person with a natural life because this interpretation was inconsistent with Lockheed’s understanding of other provisions of the plan. For example, Natale was entitled to a cash balance benefit under the plan, which Lockheed had paid to his estate without complaint. The court found no reason to construe the term differently in the two provisions. The court also noted that the plan “is explicit where no benefits will be paid, and there is no language…describing situations where a participant is not entitled to any benefits at all.” Furthermore, the court stated that its “reading is consistent with the foundational principles of ERISA, as well, which generally forbids the forfeiture of a participant’s vested benefit.” As a result, the court ruled that Natale’s service-based benefit should be “reduced to an actuarially equivalent lump sum and paid to his estate.” The court thus granted Dennis’ motion for summary judgment and ordered the parties to meet and confer to determine the amount of that lump sum.

Third Circuit

Shepard-Smith v. PMC Property Grp., Inc., No. CV 25-530, 2026 WL 86825 (E.D. Pa. Jan. 12, 2026) (Judge Harvey Bartle III). The plaintiff, Alisha Shepard-Smith, is the daughter of Charles D. Shepard, who passed away in 2018. Shepard-Smith claims that the day before her father died, he signed beneficiary forms designating her as the sole beneficiary of his 401(k) account, and that a social worker faxed these forms the same day to the human resources director of her father’s employer, defendant PMC Property Group, Inc. However, PMC claims it never received these forms, as they were not found in Mr. Shepard’s personnel files or with Empower, the plan’s recordkeeper. Furthermore, Shepard-Smith did not produce these forms until 2024, after she was informed about the benefits at issue. As a result, according to plan terms, the benefits were divided equally between Shepard’s children – i.e., Shepard-Smith and her brother – because Shepard was unmarried at the time of his death. Shepard-Smith unsuccessfully appealed this outcome and then filed this action against PMC under ERISA, claiming she was entitled to 100% of the proceeds, not 50%. The parties filed cross-motions for judgment. The court acknowledged that a reasonable factfinder could conclude either that PMC received and misplaced the faxed beneficiary form, or that it never received it. However, the court noted that it “is not sitting as a factfinder to decide de novo which version is more likely. Its role is much more limited. It must simply determine whether PMC abused its discretion in coming to the conclusion it did.” The court concluded that PMC did not abuse its discretion. It found no evidence of deception or improper motive and determined that PMC acted reasonably in determining that it never received the beneficiary designation forms produced by Shepard-Smith. As a result, “She must share the benefits with her brother.” The court thus granted PMC’s motion for judgment on the administrative record and denied Shepard-Smith’s.

Retaliation Claims

Sixth Circuit

Maas v. JTM Provisions Co., Inc., No. 1:23-CV-76, 2026 WL 124285 (S.D. Ohio Jan. 16, 2026) (Judge Jeffery P. Hopkins). This case is a dispute between brothers over the ownership and operation of their family-owned business, JTM Provisions Company, Inc. The plaintiff, Joseph R. Maas, has filed three lawsuits against his three brothers and the company “over JTM’s corporate governance and board decision making, including the Company’s continuation of its longstanding charitable giving program.” In this action Joe originally asserted thirteen claims for relief, which the court whittled down to nine at the pleading stage. Now the parties have filed cross-motions for summary judgment on the remaining claims, which include one claim for relief under ERISA Section 510. The court began its discussion by noting that “any true reconciliation and restoration of familial relations among the four brothers will not come from any judicial decision, but rather from the brothers’ own embrace of forgiveness, self-reflection, and grace, predicated on the very faith instilled in them by their parents – a faith that each of them still practices by and large in one form or another.” However, the court pressed on in an effort to “cut this corporate and familial Gordian Knot.” On the ERISA claim, the court noted there are two types of Section 510 claims: “(1) a ‘retaliation’ claim where adverse action is taken because a participant availed [him]self of an ERISA right; and (2) an ‘interference claim’ where adverse action is taken as interference with the attainment of a right under ERISA.” On the retaliation claim, Joe needed to show that he was engaged in an activity protected by ERISA, suffered an adverse employment action, and that there was a causal link between his protected activity and the adverse action. Joe asserted that defendants admitted in a state court proceeding that one reason for his termination was his request to withdraw funds from JTM’s 401(k) plan. However, the court ruled that this was not a binding judicial admission, and furthermore, “the lag between when he requested to withdraw funds…in March 2020, and when Defendants terminated him in February 2021, ‘defeats any inference of causation.’” Also, other employees had withdrawn funds from the plan during the same time period without being terminated. As for the interference claim, the court noted that Joe appeared to have abandoned it, “as he does not even address it, nor point to any evidence that would create a factual dispute as to this claim.” In any event, the court was satisfied that Joe could not state a prima facie case for interference because he could not demonstrate that Defendants engaged in prohibited conduct when they amended the plan, or that the amendment was intended to interfere with Joe’s rights. Thus, the court granted defendants’ summary judgment motion on Joe’s ERISA claims. Most of the rest of Joe’s claims suffered a similar fate, although the court did allow one claim to proceed: Joe’s mixed-motive Title VII religious discrimination claim against JTM.

Standard of Review

Second Circuit

Li v. First Unum Life Ins. Co., No. 25-411-CV, __ F. App’x __, 2026 WL 112655 (2d Cir. Jan. 15, 2026) (Before Circuit Judges Parker, Raggi, and Park). In our February 5, 2025 edition we reported on the bench trial victory in this case by defendant First Unum Life Insurance Company in plaintiff Guangyu Li’s challenge to its denial of his claim for ERISA-governed long-term disability benefits. Li appealed that decision to the Second Circuit, and in this ruling the appellate court affirmed in three brief paragraphs. The only issue on appeal was “whether the district court erred by reviewing First Unum’s benefits decision under the arbitrary-and-capricious standard rather than the de novo standard.” The default standard is de novo, but courts will apply the more lenient arbitrary and capricious standard if the benefit plan at issue grants the administrator discretionary authority to determine eligibility for benefits. The Second Circuit agreed with the district court that such authority had been conferred to First Unum and thus the deferential standard applied. The court ruled that the employer’s “plan is detailed in the Policy and the Summary Plan Description (‘SPD’), which comprises the Additional Summary Plan Description Information and the Certificate of Coverage… Together, these documents are fairly construed to grant First Unum discretionary authority to determine eligibility for long-term disability benefits. Further, First Unum complied with the claims-procedure regulation.” As a result, “We thus AFFIRM for the reasons stated by the district court in its detailed opinion and order.”