As usual, the end of the federal court reporting period under the Civil Justice Reform Act (every March 31 and September 30) resulted in a slew of cases last week, which will likely continue into next week. It turns out federal judges are procrastinators just like the rest of us.

Fear not, however, as Your ERISA Watch was on top of it. No single case stood out, and there was only one appellate decision (from the Second Circuit, on the navel-gazing topic of “what is a plan asset anyway?” (Powell v. Ocwen Financial)), but there is plenty to chew on below.

Read on to learn about: (1) three medical benefit cases returning to the District of Utah after they were remanded to healthcare giant United Healthcare for further review, with diverging results (Anne A. v. United, Amy G. v. United, and D.B. v. United); (2) three cases asserting the misuse of forfeited plan contributions, with all three ending in predictable strikeouts for the plaintiffs (Gaetano v. MVHS, Estay v. Ochsner, Parker v. Tenneco); (3) two cases by disability benefit recipients complaining that Hartford Life & Accident Insurance Company miscalculated their benefits (Sakwa v. Hartford, Harling v. Hartford); (4) two cases asserting shenanigans in the valuation of employee stock ownership plans (Secretary of Labor v. Gleason, Daly v. West Monroe Partners); and last, but not least, (5) a monster healthcare provider case involving 63,390 claims of emergency medical care and $272,913,789 in billed services (South Austin Emergency Center v. Blue Cross Blue Shield of Texas). Maybe everything really is bigger in Texas!

Come back next week and see if the deluge continues…

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

Breach of Fiduciary Duty

Second Circuit

Gaetano v. MVHS, Inc., No. 6:25-CV-118 (AJB/CBF), 2026 WL 850360 (N.D.N.Y. Mar. 27, 2026) (Judge Anthony J. Brindisi). John Gaetano, Bertha Nogas, Kathi Martin, and Maryanne Taverne are former employees of Mohawk Valley Health System, Inc. (MVHS) and participants in the MVHS, Inc. 401(k) Plan, an ERISA-governed defined-contribution retirement plan. Plaintiffs allege that MVHS mismanaged the plan by failing to prudently select and monitor plan investments, charging excessive fees, and improperly using forfeited funds. Plaintiffs asserted four counts: (1) breach of fiduciary duties by failing to investigate alternative share classes and funds, failing to monitor recordkeeping fees, and improperly using forfeited funds; (2) breach of the duty of prudence by failing to monitor recordkeeping fees; (3) violation of ERISA’s anti-inurement provision; and (4) engaging in prohibited transactions by using forfeited accounts to lessen MVHS’ matching contributions. MVHS filed a motion to dismiss for lack of standing and failure to state a claim. The court tackled the standing issue first. It ruled that (a) Martin lacked standing for all claims as she was not a plan participant, (b) Taverne lacked standing for claims related to funds she did not invest in, and (c) all plaintiffs lacked standing for claims regarding the plan’s stable fund options because they did not invest in them. The court further determined that plaintiffs had standing for remaining claims related to the John Hancock Fund and the Harbor Fund, excessive recordkeeping fees, and improper use of forfeited funds, as these involved plan-wide mismanagement affecting all participants. The court ruled that plaintiffs had class standing to bring these claims as well, finding that “Plaintiffs’ incentives are aligned with those of the absent class members because they each allege they personally lost a portion of their retirement savings due to defendant’s challenged conduct.” This was a short-lived victory for plaintiffs, however, as the court ruled that they did not meet their pleading burden on the merits. The court found that (a) plaintiffs’ “conclusory” allegations did not provide sufficient factual support for their claims of imprudence regarding share class selection and recordkeeping fees, (b) the claims related to forfeitures were not viable because the plan explicitly allowed MVHS discretion in how to use forfeitures, and plaintiffs did not allege that they received less than what the plan promised, (c) the use of forfeitures to reduce employer contributions did not constitute a prohibited transaction under ERISA, and (d) the anti-inurement claim failed because plaintiffs did not allege that forfeited assets were removed from the plan or used for purposes other than paying obligations to the plan’s beneficiaries. As a result, while plaintiffs had standing to bring some of their claims, those claims were not pled sufficiently. Thus, MVHS’s motion was granted and the case was dismissed.

Powell v. Ocwen Financial Corp., No. 23-999, __ F. 4th __, 2026 WL 828159 (2d Cir. Mar. 26, 2026) (Before Circuit Judges Chin, Carney, and Sullivan). The six named plaintiffs in this case are trustees of The United Food & Commercial Workers Union & Employers Midwest Pension Fund. They invested in six classes of residential mortgage-backed securities (RMBSs), which are financial instruments pooling large amounts of residential loans. The trustees sued nineteen defendants, including Ocwen Financial Corporation, Ocwen Loan Servicing LLC, Ocwen Mortgage Servicing, Inc., and Wells Fargo Bank, N.A., alleging that they were responsible for servicing the underlying mortgages, mismanaged those loans, engaged in self-dealing, and failed to act in the best interests of their investors. The trustees contended that this conduct amounted to breaches of fiduciary duties and prohibited transactions under ERISA. The defendants filed a motion for summary judgment which the district court granted. The district court reasoned that while the RMBSs may have been plan assets, the mortgages underlying the plan’s investments were not. As a result, defendants were not liable under ERISA for any malfeasance in managing the mortgages. (Your ERISA Watch covered this ruling in our June 7, 2023 edition.) Plaintiffs appealed to the Second Circuit, which issued this published decision. The appellate court acknowledged that “identifying a plan’s assets is a critical step in identifying plan fiduciaries,” but, unhelpfully, “ERISA does not explicitly define what constitute ‘plan assets.’” Instead, Congress delegated this job to the Department of Labor, which enacted a regulation outlining a “general rule” that “when a plan invests in another entity, the plan’s assets include its investment, but do not, solely by reason of such investment, include any of the underlying assets of the entity.” However, the regulation also has a “look-through” exception, which extends ERISA’s fiduciary protections where the plan’s investment is in certain “equity interests.” The purpose of the exception is to include “‘investments that are vehicles for the indirect provision of investment management services’…such as ‘pooled investment funds[.]’” The question in this case was “whether the Plan’s investments in the six trusts are ‘equity interests’ under the DOL’s plan-asset regulation” and therefore qualified for the regulation’s “look-through” exception. The Second Circuit split the six RMBS classes into two groups: the “Indenture Trusts” and the “REMIC [real estate mortgage investment conduit] Trusts.” For the Indenture Trusts, the court affirmed the district court’s ruling that the notes issued by these trusts did not qualify as plan assets under ERISA. The notes were treated as indebtedness with no substantial equity features, and the mortgages backing these notes were not considered plan assets. The court emphasized that the notes reflected a traditional debt structure, exposing noteholders only to credit risks, not equity risks. However, the court arrived at a different conclusion regarding the REMIC trusts. The Second Circuit concluded that the regular-interest certificates issued by these trusts represented beneficial interests, thus qualifying as equity interests under the plan-asset regulation. Consequently, the mortgages underlying these certificates were considered plan assets. The court highlighted that the trust agreements clearly identified certificate holders as beneficiaries, entitling them to trust income, which aligned with the definition of a beneficial interest. Finally, the court briefly addressed the issue of Ocwen’s fiduciary status. Ocwen and Wells Fargo argued that “even if the mortgages are plan assets, we should nonetheless affirm the district court’s judgment on the alternative ground that Ocwen’s servicing of the mortgages does not qualify as a fiduciary function for purposes of ERISA.” However, the Second Circuit noted that the district court did not reach this issue and it declined to do so in the first instance. It therefore remanded “to allow the district court to consider in the first instance whether Ocwen acted in a fiduciary capacity with respect to the mortgages underlying the three REMIC trusts.”

Schultz v. Glens Falls Hosp., No. 1:25-CV-00581 (MAD/PJE), 2026 WL 850332 (N.D.N.Y. Mar. 26, 2026) (Judge Mae A. D’Agostino). Kimberley Schultz is an employee of Glens Falls Hospital and receives health insurance through the ERISA-governed Glens Falls Hospital Health Plan. Schultz alleges that under the plan she is assessed a “tobacco surcharge” of approximately $20 per paycheck, totaling $520 per year, which she must pay in order to maintain her insurance. Schultz contends that the plan violates ERISA’s statutory requirements and implementing regulations and thus brought this action asserting two claims for relief. First, Schultz alleged that the tobacco surcharge is unlawful because it is imposed without a wellness program, as required by ERISA, 29 U.S.C. § 1182. Second, Schultz alleged that the hospital breached its fiduciary duties to the plan and plan participants by imposing and collecting the allegedly unlawful surcharges, thereby violating 29 U.S.C. §§ 1104 and 1106. The hospital moved to dismiss, arguing that Schultz lacked Article III standing to bring her claims and that the complaint failed to state a claim. Addressing count one first, the court found that Schultz plausibly alleged a concrete injury for standing purposes because she asserted that she paid a tobacco surcharge that the hospital was not legally authorized to levy. The hospital argued that Schultz did not allege that she used tobacco, but “[w]hether Plaintiff uses tobacco is entirely irrelevant.” The court also dismissed the hospital’s argument that “even if there was a wellness program, Plaintiff would not have qualified,” because she suffered the $20 weekly injury “despite Defendant’s failure to implement any wellness program, as statutorily required.” As for the merits of count one, the court rejected the hospital’s argument that tobacco use is not a health status-related factor under Section 1182. The hospital also made arguments regarding what constituted a “reasonable alternative standard” under ERISA, but the court stated, “The glaring problem with Defendant’s arguments as to the merits of Count One is…there is no wellness program at all. As such, setting aside any interpretation of the Regulations, Defendant has failed to comply with ERISA’s statutory requirements entirely. Simply put, the Court cannot evaluate the technical compliance of a wellness program that does not exist, so Defendant’s reasonable alternative standards and notice arguments are irrelevant.” As for count two, the court ruled that Schultz had standing for the same reasons it found she had standing to bring count one. However, the court ruled that Schultz failed to plausibly allege that the plan suffered any losses from the hospital’s alleged fiduciary breaches, which was required because she was bringing her claim under Section 1132(a)(2). The court noted that individual injuries alone cannot support a Section 1132(a)(2) claim, and Schultz’s allegations of self-dealing did not demonstrate harm to the plan itself.  Additionally, the court found that Schultz’s argument regarding prohibited transactions was insufficient, as the complaint did not allege that the hospital retained the surcharge proceeds beyond the 90-day limitation for withheld wages to become plan assets. As a result, Schultz’s claim for unlawful imposition of a discriminatory surcharge will proceed, but her breach of fiduciary duty claim was dismissed.

Fifth Circuit

Anderson v. Southwest Airlines Co., No. 3:25-CV-0214-S, 2026 WL 820860 (N.D. Tex. Mar. 25, 2026) (Judge Karen Gren Scholer). The plaintiffs in this putative class action are participants in the ERISA-governed Southwest Airlines Co. Retirement Savings Plan. Plaintiffs contended that one of the funds in the plan, the Harbor Capital Appreciation Fund, an actively managed large-cap growth fund, “has chronically underperformed both similar comparator funds and its own self-selected target benchmark” over three-, five-, and nine-year periods. Plaintiffs argued that a prudent fiduciary would have removed the Harbor Fund from the plan by 2019. Plaintiffs alleged that Southwest and related defendants breached their fiduciary duties by retaining the Harbor Fund and failing to monitor fiduciaries to whom they delegated responsibilities. Defendants moved to dismiss, arguing that (1) plaintiffs cannot state a claim for breach of fiduciary duty based solely on underperformance, (2) plaintiffs did not plead any meaningful benchmarks, (3) plaintiffs cannot assert imprudence based on challenging a single fund, (4) other prudent investors selected the Harbor Fund, and (5) plaintiffs’ failure to monitor claim was derivative of its breach of fiduciary duty claim, and, in any event, “the Fifth Circuit has not recognized such a claim.” The court made short work of the motion in denying it. The court declined to adopt the “meaningful benchmark” requirement at the motion to dismiss stage, as neither the Supreme Court nor the Fifth Circuit has established such a requirement. Furthermore, the court stated there was “no binding precedent explaining what, exactly, a meaningful benchmark is,” and thus “the Court is left without a reliable standard to determine whether Plaintiffs’ proffered comparator funds are sufficiently similar to the Harbor Fund to constitute meaningful benchmarks.” The court further found that challenging a single fund does not preclude a breach of fiduciary duty claim because “the Fifth Circuit has not established any such rule, and courts in this circuit have refused to dismiss breach of fiduciary duty claims involving a single fund.” The court also noted that “[r]egardless of other investors’ decisions about the Harbor Fund, the Court concludes that Plaintiffs have adequately pleaded imprudence in the context of the Plan.” Finally, regarding the failure to monitor claim, the court found sufficient support for its existence and allowed it to proceed, as multiple district courts within the Fifth Circuit have recognized such claims. As a result, the case will continue as pled.

Estay v. Ochsner Clinic Foundation, No. CV 25-507, 2026 WL 809570 (E.D. La. Mar. 24, 2026) (Judge Jane Triche Milazzo). Plaintiffs Megan Estay and Francesca Messore are long-time employees of Ochsner Clinic Foundation and participants in Ochsner’s 401(k) retirement plan. They allege in this putative class action that Ochsner, as the sponsor of the plan, and the Retirement Benefits Committee, as the plan administrator, “breached their duties under ERISA when they used plan forfeitures to reduce Ochsner’s matching contribution obligation rather than defray the administrative expenses of the plan.” Under the plan, forfeitures occur when a participant’s employment is terminated before matching contributions from Ochsner vest. The plan allows these forfeitures to be used at the fiduciaries’ discretion to either pay administrative expenses or reduce future employer matching contributions. Plaintiffs argued that defendants consistently chose to use forfeitures to reduce Ochsner’s matching contributions, which was in Ochsner’s best interest rather than the participants’ best interest. They also claimed that the defendants failed to use the full forfeiture amounts and left some unused at the end of the year. Plaintiffs asserted several claims under ERISA, including breach of the duty of loyalty, breach of the duty of prudence, prohibited transactions under § 1106(a)(1) and (b)(1), and failure to monitor other fiduciaries. Defendants moved to dismiss, and in September of last year, the court granted their motion, ruling that defendants acted in compliance with the plan and ERISA by making a discretionary choice to allocate forfeitures to employer matches. (Your ERISA Watch covered this ruling in our September 24, 2025 edition.) However, the court gave plaintiffs leave to amend. They filed an amended complaint, which was followed by another motion to dismiss which the court evaluated in this order. Once again, the court granted defendants’ motion, this time with prejudice. The court found that the plan gave the defendants discretion to allocate forfeitures to reduce employer contributions or pay administrative expenses. The plaintiffs failed to establish a breach of loyalty because ERISA does not require fiduciaries to maximize profits, only to ensure participants receive promised benefits. The court also noted that plaintiffs’ theory would require forfeitures to be used for administrative expenses, creating an additional benefit not contemplated in the plan. The court noted that in its first ruling, it observed that “a majority of courts had reached the same conclusion. Since that time, the list of courts joining the majority continues to grow.” As for the duty of prudence, the court held that the plaintiffs did not allege specific facts indicating a flawed decision-making process. The court acknowledged plaintiffs’ “detailed factual allegations,” but “at bottom Plaintiffs still contend that an inference of imprudence is created when a fiduciary chooses to apply forfeitures to discretionary employer matching contributions over administrative fees. Without more, giving credence to such an inference would create a categorical rule that fiduciaries are always assumed to act imprudently when they apply forfeitures to discretionary employer matching contributions over administrative fees. This Court refuses to assume imprudence simply because Plaintiffs would have preferred a different outcome.” The court also rejected the claim that delays in utilizing forfeitures constituted imprudence, as the plan explicitly stated that forfeitures are to be “held in the Trust and will continue to share in the allocation of earnings” until an allocation decision was made. As for plaintiffs’ prohibited transaction claim, the court found that they failed to allege a “transaction” within the meaning of Section 1106. The use of forfeitures for employer contributions was an “intra-plan transfer” and not a transaction. Furthermore, the payment of administrative fees from participant accounts “surely does not implicate the sort of self-dealing contemplated by § 1106(b).” Finally, the court ruled that plaintiffs’ claim alleging failure to monitor was derivative of their other claims and thus failed for the same reasons. The court thus granted defendants’ motion and closed the case.

Sixth Circuit

Dawson v. Brookfield Asset Mgmt. LLC, No. 1:25-CV-00852-PAB, 2026 WL 835553 (N.D. Ohio Mar. 26, 2026) (Judge Pamela A. Barker). Simon Dawson, an employee of Brookfield Asset Management LLC and a participant in the Brookfield 401(k) Savings Plan, filed this putative class action against Brookfield and the plan’s investment committee. Dawson alleged that defendants selected and retained imprudent American Century Fund Target Date Funds (TDFs) despite the availability of more suitable options. He also alleged that defendants failed to monitor the fiduciaries responsible for the plan’s administration and management. Dawson’s complaint included two primary claims: (1) breach of the fiduciary duty of prudence under ERISA, and (2) failure to adequately monitor other fiduciaries under ERISA. He alleged that the American Century TDFs underperformed compared to their benchmarks and other large TDFs in the market, including those in the same Morningstar category. Dawson also highlighted the funds’ high turnover rates – i.e., how often the funds changed their investments – as a red flag that should have prompted further investigation by the fiduciaries. He claimed that these issues resulted in significant financial losses for the plan participants. Defendants filed a motion to dismiss for failure to state a claim. The court agreed with defendants that Dawson failed to allege sufficient underperformance of the American Century TDFs to infer imprudence. The court noted that the alleged underperformance was modest, with the funds generally showing positive returns despite slightly underperforming their benchmarks. The court emphasized that merely pointing to another investment that performed better over a short period does not suffice to plead an imprudent decision, as fiduciary duty focuses on the decision-making process rather than short-term results. The court specifically addressed Dawson’s comparisons to the S&P 500 Target Date Index, alleged Morningstar comparators, and alleged “Large TDF Comparator Funds.” It found that (a) the S&P Index was not an adequate comparator because the American Century TDFs were actively managed, and in any event the TDFs “had positive returns, and only slightly underperformed the S&P 500 Target Date Index,” (b) plaintiff’s allegations regarding the Morningstar comparators were “more robust,” but still did not demonstrate “meaningful underperformance,” and (c) the Large TDF Comparator Funds, like the Morningstar funds, did not demonstrate sufficient underperformance. Additionally, the court found that Dawson’s allegations of high turnover rates did not independently infer imprudence, especially given the lack of substantial underperformance. The court noted that high turnover rates, combined with underperformance, could suggest imprudence, but Dawson’s allegations did not meet this threshold. Finally, because Dawson’s duty-of-prudence claim failed, his derivative failure-to-monitor claim also failed. The court thus granted defendants’ motion to dismiss.

Gipson v. Medical Mutual of Ohio, No. 1:24-CV-00103, 2026 WL 836617 (M.D. Tenn. Mar. 26, 2026) (Judge William L. Campbell, Jr.). The plaintiffs in this case were all beneficiaries of an ERISA-governed medical insurance plan sponsored by Reserve National Insurance Company. The plan included a portability provision which allowed them to continue receiving benefits in the event of a change in employment or cancellation of the plan’s underlying group insurance policy. Plaintiffs obtained continuing coverage through this provision, and were undergoing cancer treatment, when they were notified that their coverage would end. This cancellation occurred shortly after Reserve National was acquired by Medical Mutual of Ohio. Plaintiffs brought this action contending that Reserve National and Medical Mutual, and their parent companies, Kemper Corporation and United Insurance Company of America, “collectively executed a plan to terminate substantially all of the ported group supplemental coverage Reserve National had in force on its books, in effect closing a book of business that was providing cancer and dread disease coverage to over 30,000 insureds.” Plaintiffs asserted their claims under 29 U.S.C. § 1132(a)(3), seeking declaratory and injunctive relief and payment of all benefits wrongfully withheld. Previously, defendants Kemper and United Insurance filed a motion to dismiss, which the court denied. (Your ERISA Watch covered this ruling in our July 23, 2025 edition.) In this order the court considered the motion to dismiss by the remaining two defendants, Reserve National and Medical Mutual. They sought dismissal under Federal Rule of Civil Procedure 12(b)(1) for lack of subject matter jurisdiction and under Rule 12(b)(6) for failure to state a claim. The court quickly dispensed with the jurisdictional argument, agreeing with plaintiffs that regardless of whether ERISA governed the plan at issue, it had diversity jurisdiction and the case satisfied the requirements of the Class Action Fairness Act. The court found that the class exceeded 100 members, was minimally diverse, and had an amount in controversy exceeding $5,000,000. Next, the court addressed defendants’ arguments regarding equitable relief. They contended that plaintiffs were impermissibly attempting to “repackage denial-of-benefit claims as claims for equitable relief,” and thus plaintiffs’ claims would be better adjudicated under Section 1132(a)(1)(B). The court disagreed, noting that plaintiffs’ claims were “based on the alleged wrongful termination of coverage in violation of plan terms, not claim adjudication… Here, Plaintiffs allege an injury beyond the mere non-payment of claims. They allege injury from the cancellation of their policies while undergoing approved treatment.” Thus, while this injury may have resulted in denied claims, “the Court is not persuaded that Section 1132(a)(1)(B) provides an adequate remedy for the injury alleged by Plaintiffs[.]” The court further found that plaintiffs’ requested remedy, a constructive trust, constituted appropriate equitable relief. Second, defendants argued that plaintiffs could not sue them for breach of fiduciary duty because they were not acting as fiduciaries when they terminated ported group supplemental coverage under the plan. The court rejected this argument as well. The court stated that the decision to terminate coverage directly related to defendants’ obligations under the plans and constituted an exercise of control over plan management or assets. As a result, the court denied defendants’ motion to dismiss.

Parker v. Tenneco, Inc., No. 23-10816, 2026 WL 852046 (E.D. Mich. Mar. 27, 2026) (Judge Judith E. Levy). This case, which has been up to the Sixth Circuit and back, is a putative class action concerning two retirement plans: the DRiV Plan and the Tenneco Plan, which merged into a single Tenneco Plan in July of 2022. The named plaintiffs, Tanika Parker and Andrew Farrier, are participants in the plans who contend that the defendants, fiduciaries under the plans, breached their fiduciary duties under ERISA by mismanaging the plans. Plaintiffs have named 46 defendants, including company sponsors, boards of directors, committees that administered the plans, and individuals who are members of those boards or committees. Plaintiffs contend that defendants failed to replace target date mutual funds with less expensive collective trust versions, chose recordkeeping service providers that charged excessive fees, used forfeited funds to reduce company contributions instead of participant fees, failed to replace investment options with less expensive alternatives, failed to offer the lowest-cost share classes, and chose managed account service providers that charged excessive fees. Defendants filed a motion to dismiss plaintiffs’ second amended complaint. In this order the court granted their motion in part and denied it in part. The court addressed plaintiffs’ forfeiture claims first, ruling that there was no breach of fiduciary duty because plaintiffs “have not provided any context or circumstances related to Defendants’ financial status or actions” that would make defendants’ forfeiture decisions imprudent. Furthermore, defendants’ use of forfeitures for company contributions was not a prohibited transaction because it was not a “transaction” under 29 U.S.C. § 1106(a)(1)(A) or § 1106(b)(1): “The use of forfeitures for company contributions is not a sale, exchange, or lease of property.” Nor did this violate ERISA’s non-inurement provision because the forfeited assets at issue never left the plans; the forfeitures “remain in the Plans and are still being used to ‘provid[e] benefits to participants in the plan.’” Next, the court addressed plaintiffs’ excessive fee claims. The court dismissed several of these due to insufficient allegations. For example, plaintiffs failed to allege adequate comparators for recordkeeping fees and the DRiV plan’s managed account services. However, the court found plaintiffs’ allegations sufficient and allowed claims to proceed relating to the T. Rowe Price Mutual Funds in both plans, the DRiV Plan’s single class investments and Vanguard index funds, and the failure to obtain lower-cost share classes in the DRiV plan. Finally, the court reconsidered a prior order and allowed plaintiffs to include failure to monitor claims in the case for certain defendants, finding that plaintiffs had sufficiently alleged that these defendants controlled or oversaw other fiduciaries who allegedly breached their duties.

Eleventh Circuit

Secretary of Labor v. Gleason Research Assocs., Inc., No. 5:24-CV-01352-MHH, 2026 WL 852129 (N.D. Ala. Mar. 27, 2026) (Judge Madeline Hughes Haikala). Gleason Research Associates, Inc. is an engineering and scientific consulting company that provides services to the government. In 2015 Gleason established an employee stock ownership plan (ESOP) which acquired 100% of Gleason’s outstanding shares for approximately $21.5 million, financed through a loan from Gleason. The ESOP committee, consisting of Charles Vessels, James Kelley, and Brenda Showalter, was appointed to manage the ESOP. Later, new stock was issued, and the Department of Labor contends all three members of the committee breached their fiduciary duties of loyalty and prudence under ERISA as fiduciaries and plan administrators of the ESOP by profiting from the purchase and sale of the new shares at the expense of ESOP participants. The DOL further claims that Gleason, as the plan administrator, failed to monitor the three fiduciaries. The complaint asserts that defendants engaged in self-dealing and authorized transactions that diluted the equity interests of plan participants without adequate compensation. Additionally, the DOL alleges that the defendants caused Gleason to redeem warrants and stock appreciation rights at inflated prices, harming the ESOP’s economic interests. Defendants moved to dismiss for failure to state a claim. The court found that the DOL properly pled that Vessels, Kelley, and Showalter owed fiduciary obligations to the ESOP and its participants and beneficiaries, as they were appointed to the ESOP Committee and acknowledged their fiduciary roles. The court determined that the DOL’s allegations raised a reasonable expectation that discovery would reveal evidence of wrongdoing, and the DOL sufficiently alleged that the defendants breached their fiduciary duties by prioritizing their financial gain over the interests of the ESOP participants. Additionally, the court held that the claims for co-fiduciary liability against Kelley and for failure to monitor against Gleason were derivative of the primary fiduciary breach claims and should proceed. As a result, the court denied defendants’ motion.

Class Actions

First Circuit

Adams v. Dartmouth-Hitchcock Clinic, No. 22-CV-099-LM, 2026 WL 821803 (D.N.H. Mar. 25, 2026) (Judge Landya McCafferty). The plaintiffs in this case are participants in the Dartmouth-Hitchcock Retirement Plan and the Dartmouth-Hitchcock Employee Investment Plan, which are ERISA-governed employee retirement plans. They filed this putative class action in 2022 alleging that the Clinic and related defendants breached their fiduciary duties in managing and monitoring the plans. These failures allegedly led to excessive administrative costs and imprudent investment decisions. Defendants filed a motion to dismiss, but the court denied it. The parties subsequently conducted discovery, negotiated with the assistance of an independent mediator, and reached a settlement. Before the court here was plaintiffs’ unopposed motion seeking preliminary approval of the parties’ proposed class action settlement agreement and preliminary certification of the proposed class for settlement purposes. The court granted the motion, finding that the proposed settlement was likely to be fair, reasonable, and adequate. The settlement was negotiated at arm’s length with the assistance of a mediator after conducting extensive discovery. The settlement amount of $850,000 was “significantly less than what plaintiffs originally estimated their damages to be (over $10,000,000),” but “plaintiffs represent that information learned during discovery and the uncertainty of ongoing litigation has the potential to reduce plaintiffs’ recovery significantly, if not completely.” As a result, the court deemed the settlement reasonable given the potential risks and costs of continued litigation. As for class certification, the court determined that the class met the requirements of Rule 23(a) and Rule 23(b)(1)(B). The class was sufficiently numerous, with over 31,000 participants, and shared common legal and factual questions regarding the defendants’ alleged fiduciary breaches. The claims of the class representatives were typical of the class, and there were no conflicts of interest. The court also found that Capozzi Adler, P.C., the proposed class counsel, was qualified and experienced. The court was concerned with the agreement’s provision regarding class counsel’s attorney fees, which would “amount to no more than one-third of the Gross Settlement Amount.” The court “does not find this percentage to be per se unreasonable, but it notes that such a figure, under the circumstances of this case, gives the court some pause.” Thus, the court indicated that while it would preliminarily approve the proposed fees, it would probe this number further at the upcoming fairness hearing. Finally, the court approved Analytics LLC as the settlement administrator and agreed to the parties’ proposed notices to class members, with some minor corrections to better inform class members of their due process rights.

Seventh Circuit

Daly v. West Monroe Partners, Inc., No. 21 CV 6805, 2026 WL 851252 (N.D. Ill. Mar. 27, 2026) (Judge John Robert Blakey). Matthew Daly was employed by West Monroe Partners, Inc., a digital consulting firm, and was a participant in the West Monroe Employee Stock Ownership Plan, a defined contribution plan governed by ERISA. The plan was designed to invest primarily in company stock and hold that stock in a trust for the benefit of plan participants. Argent Trust Company acted as the plan’s trustee. In April of 2021, Argent Trust completed an annual valuation of the company stock held by the plan, which Daly alleges was too low. Based on this valuation, the value of company stock as of December 31, 2020, was announced to be $515.18 per share. Daly left the company in November of 2020 and elected to take a distribution of his account balance between June and August of 2021. In October of 2021, West Monroe sold 50% of the company to MSD Partners, L.P. at a price of $1,616 per share. The Plan was terminated in November of 2021, and remaining participants received the higher price for their shares. Daly brought this suit against the company, Argent Trust, and other defendants alleging that they breached their fiduciary duties under ERISA by failing to conduct a prudent valuation of the stock in 2020, failing to ensure participants received fair market value for their stock, and failing to disclose material facts to beneficiaries. Before the court here was Daly’s motion for class certification. The court granted Daly’s motion under Rule 23(b)(1). The court found that the proposed class satisfied all four requirements of Rule 23(a): numerosity, commonality, typicality, and adequacy of representation. Specifically, the class was numerous with 146 members, common questions of law or fact existed because defendants’ conduct was uniform with regard to all class members at the time of the 2020 valuation, Daly’s claims were typical of the class, and he could adequately represent the class. Defendants argued that Daly was motivated by animus and thus would not serve as a good class representative, but the court was unimpressed by Daly’s comments, stating that “[c]ases invalidating a plaintiff’s ability to represent a class based upon animus require far more severe expressions of animosity than what Plaintiff’s comments exhibit.” Next, the court concluded that the claims were suitable for class treatment under Rule 23(b)(1) because adjudication of Daly’s suit would be dispositive of the interests of other participants, and separate actions would impair the ability of other participants to protect their interests. Defendants argued that Daly was “‘not seeking to represent the Plan as a whole’ as required by § 502(a)(2) and is not a suitable representative of the plan under the same section because of ‘potential conflict with the interests of other participants in the Plan.’” However, the court ruled that these arguments were foreclosed by precedent, which allowed Daly to represent only a portion of plan participants, and thus no intra-class conflict existed. Finally, the court noted that 33 members of the class had signed class action waivers. The court found that these waivers were valid and enforceable, and not void under the effective vindication doctrine because that doctrine only applied to arbitration waivers, whereas the waivers in this case arose from employment termination agreements. As a result, the court excluded the 33 employees from the class, which was certified as follows: “All participants in the Plan who received a distribution in an amount determined based on the 2020 Valuation of Company stock who did not sign a class action waiver as part of any employment termination agreement with Company.”

Disability Benefit Claims

Second Circuit

Bianchini v. The Hartford Life and Accident Ins. Co., No. 24-CV-6535 (JGLC), 2026 WL 810303 (S.D.N.Y. Mar. 24, 2026) (Judge Jessica G.L. Clarke). Chiara Bianchini was a director of digital marketing and social media advertising at Blackstone Administrative Services Partnership, L.P. She contracted COVID in 2020 and 2022, subsequently experiencing symptoms of long COVID, which included extreme fatigue, headaches, blurred vision, heart palpitations, and cognitive impairments. Bianchini filed a claim for short-term disability benefits under Blackstone’s ERISA-governed employee disability benefit plan, which was insured by Hartford Life and Accident Insurance Company. Hartford denied it. Bianchini subsequently submitted a claim for long-term disability benefits, which Hartford also denied, citing a lack of restrictions or limitations preventing her from performing sedentary work. Bianchini appealed this decision in June of 2024, submitting new evidence. Before Hartford rendered a final decision on the appeal, Bianchini filed this action, asserting a single claim for long-term disability benefits under 29 U.S.C. § 1132(a)(1)(B). Hartford filed a motion for summary judgment, arguing that Bianchini failed to exhaust administrative remedies, while Bianchini filed a motion to supplement the administrative record with live testimony at trial. Addressing Hartford’s motion first, the court found that Hartford violated ERISA’s claims procedure regulation by improperly tolling its appeals determination deadline and failing to properly extend its determination deadline. The court emphasized that Hartford could not toll the deadline while it was waiting on information from third parties: “Fairness…requires that ‘a claimant’s appeal is not stalled indefinitely while the plan seeks information from third parties beyond the claimant’s control.’” Thus, Hartford’s self-granted 45-day extension of its determination deadline was also incorrect because it was based on its tolling calculation error. The court further found that these procedural violations were not for good cause or due to matters beyond Hartford’s control. Thus, Hartford failed to comply with ERISA’s claim regulation and “[a]ccordingly, Hartford’s violations deemed Plaintiff’s administrative remedies exhausted.” The court then moved on to Bianchini’s motion, which was also unsuccessful. The court ruled that Bianchini did not demonstrate good cause to supplement the administrative record with live testimony. The court found that neither Hartford’s structural conflict of interest as both claims administrator and payor nor its procedural deficiencies adversely affected the development of the administrative record. The court noted that the requested testimony would not introduce new factual material but would only assess credibility and clarify existing evidence, which did not warrant supplementation. As a result, both parties’ motions were denied, and the court directed the parties to meet and confer regarding setting the case for trial.

Pistilli v. First Unum Life Ins. Co., No. 24 CIV. 5266 (AKH), 2026 WL 836647 (S.D.N.Y. Mar. 26, 2026) (Judge Alvin K. Hellerstein). Lia Pistilli brought this action asserting that First Unum Life Insurance Company wrongly denied her claim for benefits under her employer’s ERISA-governed long-term disability benefit plan. On October 3, 2025, the court evaluated the parties’ cross-motions for judgment and found that Unum did not act arbitrarily or capriciously in denying her claim. (Your ERISA Watch covered this ruling in our October 8, 2025 edition.) Pistilli has appealed this ruling to the Second Circuit. Meanwhile, on November 15, 2025, Pistilli was awarded disability benefits by the Social Security Administration (SSA). Pistilli filed a motion for relief from judgment based on this award under Federal Rule of Civil Procedure 60(b)(2), or, alternatively, an indicative ruling pursuant to Rule 62.1(a)(3). In this order the court denied Pistilli’s motion. The court stated that it lacked jurisdiction over the Rule 60(b) motion because Pistilli had already filed an appeal. As for Rule 62.1(a), the court explained that it would deny this motion as well because the SSA decision did not exist at the time of the trial and thus did not constitute “newly discovered evidence.” Additionally, the court determined that even if the SSA decision were considered to be newly discovered evidence, it would not change the outcome because “[t]he SSA took the same set of facts and reached a different conclusion on a different standard of analysis. Such an administrative body’s conclusion has no bearing on my assessment and determination on the facts presented to me and would not, and does not, change my decision.” Pistilli also attempted to frame her claim under Rule 60(b)(6), a catchall provision for relief from judgment. However, the court found this unavailing because the reasons for relief could be considered under the more specific Rule 60(b)(2). Even if considered under Rule 60(b)(6), the court concluded that the SSA decision would not have altered the litigation’s outcome for the reasons it already identified. As a result, Pistilli’s motion was denied and she will have to obtain relief from the Second Circuit.

Seventh Circuit

Sakwa v. Hartford Life & Accident Ins. Co., No. 1:25-CV-04546, 2026 WL 822460 (N.D. Ill. Mar. 25, 2026) (Judge Sharon Johnson Coleman). Stuart H. Sakwa was an equity partner at the venerable Chicago law firm of Arnstein & Lehr LLP and was covered under the firm’s ERISA-governed long-term disability benefit plan, which was insured by Hartford Life and Accident Insurance Company. Sakwa became disabled in January of 2013 and was approved for benefits under the plan by Hartford. His benefits were calculated based on his Pre-Disability Earnings (PDE) and Current Monthly Earnings (CME), with the policy excluding contributions to 401(k) and Keogh retirement plans from the definition of “earnings.” However, from 2013 to mid-2018, Hartford included these contributions in its calculations, which increased both PDE and CME, and thus increased Sakwa’s benefits. This was the result of “numerous conversations and written exchanges discussing how Sakwa’s CME would be calculated,” and was memorialized in two 2014 letters from Hartford to Sakwa. However, in 2018 Hartford changed its methodology without notice, claiming it had overpaid Sakwa for the 2016 tax year because his CME should have been calculated without including his 401(k) contributions. Meanwhile, confusingly, it continued to use the original methodology to pay his ongoing benefits. Several appeals by Sakwa and decisions by Hartford followed, during which Hartford advanced new arguments and backtracked on previous arguments. Ultimately, Sakwa filed this action under ERISA, alleging two counts: one for breach of fiduciary duty because Hartford did not consider his 2020 appeal, and one challenging Hartford’s calculation of his monthly disability benefits. Hartford filed a motion to dismiss Sakwa’s first claim based on “(1) ERISA’s three-year statutory limitations period; (2) the Plan’s contractual three-year limitations period; and (3) preclusion under § 1132(a)(3) because the statute provides an adequate remedy.” Hartford contended that Sakwa had “actual knowledge of the alleged breach no later than April 22, 2020 – the date Hartford refused to consider his further appeal,” and thus his first claim was time-barred. The court agreed, ruling that there is “no question that Sakwa became aware of the relevant information on that date,” and thus his claim was late. Additionally, the court found that Sakwa’s equitable relief claim was duplicative of his second count, as an adequate remedy was available under § 1132(a)(1)(B), thus “foreclosing recourse to the catchall provision as a matter of law.” The court then turned to Sakwa’s second claim, which Hartford sought dismissal of because Sakwa “failed to exhaust his administrative remedies by not appealing Hartford’s December 6, 2022 benefit determination within the Plan’s 180-day window.” The court determined that “Sakwa had already exhausted his administrative remedies before filing suit” because Hartford’s April 25, 2022 letter confirmed that its decision “is now final as administrative remedies available under the Policy have been exhausted.” The court stressed that “Hartford cannot represent to a claimant that his administrative remedies have been exhausted, then argue in litigation that the claimant failed to exhaust those remedies.” Furthermore, the court ruled that the December 2022 letter “was not a substantive resolution of the underlying dispute, but instead a ‘correction’ of an arithmetic error that Hartford itself identified without reopening the administrative process.” In any event, “Sakwa was not required to file that appeal because doing so would have been futile” given the unresolved issues over the preceding nine years. As a result, Sakwa will not be able to continue with his breach of fiduciary duty claim, but his claim for recalculation of benefits will proceed.

Ninth Circuit

Gupta v. Intel Short-Term Disability Plan, No. 25-CV-00871-NC, 2026 WL 821590 (N.D. Cal. Mar. 25, 2026) (Magistrate Judge Nathanael M. Cousins). Udit Gupta was employed as a Cloud Software Development Engineer at Intel, where he was covered by Intel’s ERISA-governed short-term disability (STD) and long-term disability (LTD) benefit plans, which were administered by Reed Group LLC. The STD benefits included two plans: the Short Term Disability Plan (STD Plan) and the California Voluntary Short Term Disability Plan (CA-VSTD Plan). From February to September of 2022, Gupta was approved for leave under these plans, supported by medical records from his psychiatrist, chiropractor, and acupuncturist. However, in October of 2022, Reed terminated Gupta’s STD Plan and CA-VSTD Plan benefits on the ground that his medical records no longer demonstrated disability. Gupta appealed the STD Plan denial, but Reed upheld its decision after further evaluations. In August of 2023, Gupta’s counsel initiated an LTD claim, which Reed denied on the ground that Gupta did not satisfy the 52-week elimination period because of the denial of his STD claims. Gupta filed suit under ERISA against Intel, the plans, and other defendants, alleging improper denial of benefits and breach of fiduciary duty. The parties filed cross-motions for judgment under Federal Rule of Civil Procedure 52 which the agreed-upon magistrate judge ruled on in this order. First, the court agreed with defendants that Gupta failed to exhaust administrative remedies by not appealing the denial of his CA-VTSD Plan benefits to the California Employment Development Department, as required by the plan. Second, the court granted Gupta judgment on his claim for STD Plan benefits. The court agreed with defendants that the abuse of discretion standard of review applied because the plan unambiguously conferred discretion on Reed to determine benefit eligibility. The court also agreed that Reed used a reasonable job description in evaluating Gupta’s claim. However, the court found that Reed abused its discretion by improperly dismissing the opinions of Gupta’s treating physicians in favor of its consulting experts’ paper reviews. The court criticized Reed’s medical reviewers, noting that they “did not attempt to contact Plaintiff’s providers,” “did not appreciate that Plaintiff was being treated by a psychiatrist,” inappropriately offered opinions outside their areas of expertise, and did not “explain what evidence supports their conclusions regarding Plaintiff’s ability to work.” The court determined that remand was unnecessary and ordered defendants to pay Gupta STD Plan benefits. As for Gupta’s LTD claim, the court noted that its decision on the STD Plan benefits undermined the support for Reed’s LTD denial as well. Furthermore, “[t]he Court lacks evidence regarding Plaintiff’s condition past February 2023 and, even if it did have that evidence, it would be improper to evaluate it and make an LTD determination.” Thus, the court remanded to Reed for further consideration. Finally, the court granted defendants summary judgment on Gupta’s claim for breach of fiduciary duty, finding that the Intel defendants were not fiduciaries and that Gupta’s claim was duplicative of his claim for benefits. The court ordered the parties to meet and confer regarding its ruling and submit a joint report.

Serrata v. Unum Life Ins. Co. of Am., No. 24-CV-02421-HSG, 2026 WL 849298 (N.D. Cal. Mar. 27, 2026) (Judge Haywood S. Gilliam, Jr.). Edward R. Serrata was working for Sherwin Williams Company as a salesman when, in 2006, he was diagnosed with multiple sclerosis (MS) after experiencing vision issues. Serrata continued working until 2011, when his MS symptoms, including fatigue, leg pain, weakness, and further vision problems, made it difficult for him to perform his job duties. He applied for and received benefits under Sherwin Williams’ ERISA-governed employee disability benefit plan. First, he received short-term disability benefits, which were converted in 2012 to long-term disability (LTD) benefits by the plan’s insurer and claim administrator, Unum Life Insurance Company of America. However, in 2023 Unum terminated Serrata’s LTD benefits, claiming he was not disabled from performing a sedentary occupation. Serrata appealed, but Unum upheld its decision in 2024 and thus Serrata filed this action. In his complaint Serrata contended that his benefits were wrongfully terminated; he sought benefits from the date of termination to the date of judgment. The parties filed cross-motions for judgment under Federal Rule of Civil Procedure 52, and agreed that the default de novo standard of review applied. The court granted Serrata’s motion for judgment and denied Unum’s. The court found that Serrata met his burden of proving by a preponderance of the evidence that he was disabled from any gainful occupation at the time his LTD benefits were terminated. The court credited the opinions of Serrata’s treating neurologist, Dr. Kriseman, and Dr. Cassini, a neurologist with extensive experience in treating MS patients, who both concluded that Serrata’s MS symptoms precluded him from performing sedentary occupational demands on a full-time basis. The court also noted that Unum had paid Serrata LTD benefits for more than nine years under the applicable “any gainful occupation” standard, which supported the conclusion that he continued to be disabled. The court rejected Unum’s reliance on a form completed by Dr. Kriseman on March 10, 2023, which indicated Serrata could perform sedentary work, as Dr. Kriseman later clarified that she did not intend to suggest Serrata was no longer disabled. The court also found that Unum’s conclusions about Serrata’s activity level, MRI stability, and treatment were not sufficient to justify the termination of benefits. Additionally, the court gave minimal weight to the opinions of Unum’s retained physicians, who concluded Serrata could perform sedentary work, because their assumptions were unsupported and they did not consider all relevant evidence. Ultimately, the court concluded that Serrata was unable to perform any gainful occupation due to his MS symptoms, and Unum erred in terminating his benefits. The court directed the parties to meet and confer regarding the filing and briefing schedule for any motion for attorneys’ fees and costs.

Eleventh Circuit

Harling v. Hartford Life & Accident Ins. Co., No. 6:24-CV-1237-ACA, 2026 WL 837100 (N.D. Ala. Mar. 26, 2026) (Judge Annemarie Carney Axon). Evelyn Harling receives benefits under an ERISA-governed long-term disability benefit plan insured by Hartford Life and Accident Insurance Company. Harling was also approved by the Social Security Administration for two benefits: a disability benefit and a benefit for disabled widows. After approving Harling’s claim, Hartford calculated her benefits by only offsetting the primary benefit, and not the disabled widow benefit, even though the plan arguably allowed it to offset both. In February of 2024, after extensive communication on the issue, Hartford informed Harling that both offsets applied and she had been overpaid by over $16,000. Hartford requested reimbursement. Harling then filed this action to prevent Hartford from recovering the funds and reducing her future payments. The parties filed cross-motions for summary judgment which were decided in this order. The court addressed the standard of review first, determining that the arbitrary and capricious standard of review applied because the plan granted Hartford discretion to determine eligibility for benefits and to interpret the policy terms. Harling argued that the de novo standard should apply because (a) the case involved interpretation of statutory definitions, (b) Hartford offered “post hoc” rationales for its decision, and (c) Hartford did not give her a full and fair review. The court disagreed, ruling that (a) Hartford did not incorporate statutory definitions in the policy, (b) post hoc rationales do not change the standard of review, and (c) Harling did not explain how she was prejudiced by Hartford’s alleged failure to provide documentation. On the merits, the court ruled that Hartford’s determination that the disabled widow’s benefit qualified as an offset was reasonable. The policy defined “Other Income Benefits” to include “disability benefits under…the United States Social Security Act,” and thus it was reasonable for Hartford to interpret the disabled widow’s benefit as a “disability benefit” under this definition. Harling made several arguments for why the court should rule in her favor despite this finding, but the court found them unpersuasive. First, the court rejected Harling’s argument that Hartford’s correction of its overpayment constituted a reconsideration of its initial decision. The court found that Hartford’s initial determination letter informed Ms. Harling that her benefits were subject to an offset due to both Social Security benefits, and Hartford’s “invocation of the error provision” to recover the offset payments was not a new determination. Second, the court dismissed Harling’s equitable arguments, including the voluntary payment doctrine, laches, and misrepresentation. The court noted that ERISA federal common law, not state law, governed the action, and Ms. Harling failed to provide sufficient evidence or federal case law to support her claims under these doctrines.  Finally, the court rejected Harling’s argument that the widow’s benefit is not an offset now that she has turned 60, and her claim for equitable estoppel. The court found the first argument premature, and the second was unviable because the policy was not ambiguous and the written representations from Hartford contradicted her position. As a result, the court granted Hartford’s summary judgment motion and denied Harling’s.

Medical Benefit Claims

Sixth Circuit

James L.W. v. American Health Holding, Inc., No. 1:25-CV-239, 2026 WL 849864 (S.D. Ohio Mar. 27, 2026) (Judge Mathew W. McFarland). James L.W. is an employee of Meyer Tool, Inc. and a participant in Meyer’s self-funded ERISA-governed employee health benefit plan. James’ minor child, K.W., is a beneficiary of the plan. In 2022 and 2023 K.W. received inpatient psychiatric care at a facility in Utah. Plaintiffs requested coverage and reimbursement from the plan for these services, but it only approved benefits for part of K.W.’s treatment. Plaintiffs unsuccessfully appealed and then filed this action against Medical Benefits Administrators, Inc. (MedBen), the plan’s “benefit manager,” and American Health Holding, Inc. (AHH), the plan’s “utilization review service.” Plaintiffs asserted claims for recovery of benefits under ERISA pursuant to 29 U.S.C. § 1132(a)(1)(B) and for violation of the Mental Health Parity and Addiction Equity Act (MHPAEA) pursuant to 29 U.S.C. § 1132(a)(3). MedBen and AHH filed motions to dismiss. MedBen’s motion was based on failure to state a claim under Federal Rule of Civil Procedure 12(b)(6), while AHH’s motion was based on lack of subject matter jurisdiction under Rule 12(b)(1). The court applied the Rule 12(b)(6) standard to both motions, and first addressed defendants’ argument that “they lack control over the administration of the Plan and are not Plan fiduciaries, meaning they also are not proper defendants with regard to both claims asserted in the Complaint.” The court rejected this argument and found that the complaint plausibly alleged that MedBen and AHH were ERISA fiduciaries. Although Meyer was named in the plan as the plan administrator, MedBen and AHH had roles that involved discretionary authority over claims decisions, which could plausibly qualify them as fiduciaries. Plaintiffs alleged that MedBen “was responsible for supervision of the management, consideration, investigation, and settlement of claims,” while AHH “was responsible for determining whether to grant Plan beneficiaries pre-admission certification for inpatient care at a covered facility,” and “determining whether to review the medical necessity of continued inpatient care for a Plan beneficiary.” Both entities allegedly “sent Plaintiffs letters responding to concerns, explaining benefits, and relaying final decisions.” The court noted that fiduciary status under ERISA is not limited to those explicitly listed as plan administrators but also includes those exercising discretionary authority over plan management, and thus plaintiffs’ allegations were satisfactory. As for plaintiffs’ MHPAEA claim, the court rejected MedBen’s effort to dismiss it as duplicative of plaintiffs’ claim for benefits. MedBen argued that “the claims cannot proceed together because they stem from the same injury,” but the court focused on remedies rather than common facts. The court noted that dismissal of a § 1132(a)(3) claim as duplicative is only warranted where § 1132(a)(1)(B) provides a full remedy for the alleged injuries. Here, the MHPAEA claim sought remedies unavailable under § 1132(a)(1)(B), such as addressing violations of ERISA itself rather than enforcing plan terms. As a result, the court denied defendants’ motions in their entirety and the case will proceed.

Tenth Circuit

Anne A. v. United Healthcare Ins. Co., No. 2:20-CV-00814-JNP, 2026 WL 811540 (D. Utah Mar. 24, 2026) (Judge Jill N. Parrish). The plaintiffs in this case, Anne A. and her daughter Kate A., brought this action seeking recovery of benefits under the Apple, Inc. Health and Welfare Benefit Plan, an ERISA-governed employee group health benefit plan administered by United Healthcare Insurance Company. Mental health benefits were administered by United Behavioral Health. In 2016 and 2017 Kate received mental health treatment at Chrysalis, a residential treatment center, but defendants denied benefits for this treatment, resulting in a $250,000 bill. Plaintiffs filed this action in 2020, seeking benefits under 29 U.S.C. § 1132(a)(1)(B). In March of 2024, the court ruled that “Defendants arbitrarily and capriciously denied plan benefits for Kate’s treatment at Chrysalis” by not engaging with plaintiffs’ arguments, providing only vague and conclusory explanations, and failing to refer to the medical records. The court thus remanded for further review. Your ERISA Watch covered this ruling in our April 3, 2024 edition, noting that the court’s order was strongly worded and placed limitations on what evidence and rationales defendants could use on remand: “Given these restrictions, it’s unclear how any denial on remand could be anything but another abuse of discretion.” Defendants apparently did not get the same message because on remand they upheld their denial of plaintiffs’ claim. As a result, plaintiffs filed a motion to re-open the case and the parties once again filed cross-motions for summary judgment; plaintiffs also filed a motion for attorney’s fees. Plaintiffs argued that defendants “ignored the court’s remand instructions,” to which defendants shrugged: “Defendants, for their part, do not contest that their post-remand denials blatantly ignored the guardrail instructions the court set.” The court was not happy: “The court is hard pressed to understand Defendants’ actions up to this point[.]” However, defendants got away with it because the court concluded that “its initial remand instructions were too restrictive.” The court decided not to enforce its previous limit on citations to the record, although it “continues to adhere to the limit on new rationales, which the Tenth Circuit has endorsed.” Under this more lenient approach, buttressed by the arbitrary and capricious standard of review, the court found that defendants’ post-remand denials were reasonable and supported by substantial evidence because Kate’s treatment at Chrysalis was not medically necessary. The court agreed with defendants that her condition could have been managed at a lower level of care. The court further found that defendants’ letters “clearly articulated” their conclusions, cited appropriately to Kate’s medical records, and addressed plaintiffs’ arguments and evidence. As a result, defendants’ persistence paid off as the court granted their summary judgment motion and mostly denied plaintiffs’. The only bright spot for plaintiffs was the court’s decision to award them attorney’s fees. The court recognized that plaintiffs initially prevailed in obtaining a remand, and stated that “an award of attorney’s fees would serve an important deterrence function” and “will incentivize plan administrators to engage in a full and fair review in the first instance.” The court ordered plaintiffs to file a separate motion for fees which will be decided at a later date.

D.B. v. United Healthcare Ins. Co., No. 1:21-CV-00098-JNP-CMR, 2026 WL 851250 (D. Utah Mar. 27, 2026) (Judge Jill N. Parrish). Plaintiff D.B. is a participant in an ERISA-governed health benefit plan; A.B. is D.B.’s son and a plan beneficiary. A.B. received treatment at Triumph Youth Services, a residential treatment center, from 2018 to 2020 due to depression, anxiety, and suicidal ideation. However, United Behavioral Health, the plan’s mental health benefit administrator, denied benefits for the treatment, contending that it was not medically necessary, and that he could have been treated in a less intensive setting. D.B. unsuccessfully appealed and then brought this action under ERISA, seeking recovery of benefits and asserting violations of federal mental health parity laws. On June 1, 2023, the judge previously assigned to this case (J. Bruce S. Jenkins) found that UBH’s denial was arbitrary and capricious and remanded the case to UBH for further review. (Your ERISA Watch covered this ruling in our June 7, 2023 edition.) On remand UBH stuck to its guns and upheld its denial. D.B. thus moved to re-open the case in 2024. The court granted the motion, and in 2025 the parties filed cross-motions for summary judgment which were decided in this order. The court applied a deferential standard of review, focusing on whether the denial of benefits was arbitrary and capricious. The court noted that “Judge Jenkins provided Defendants a second chance at engaging in a full and fair review of the claim, in addition to clear remand instructions on how to cure prior deficiencies… Despite this renewed opportunity, Defendants’ post-remand denials, while more detailed than the pre-remand denials, are rife with issues such that the court again finds them to be arbitrary and capricious.” The court found, among other things, that (1) UBH’s denial letters contained conclusory statements without reasoning or citations to the medical record, preventing a full and fair review, (2) UBH did not meaningfully engage with a detailed psychiatric evaluation, providing only a perfunctory two-sentence response to the 47-page report, (3) UBH failed to follow Judge Jenkins’ remand instructions to address specific arguments and evidence presented by D.B., and (4) UBH relied on new guidelines (CALOCUS-CASII) not previously used, which constituted an improper post hoc rationale for denial. The court stated that because of UBH’s failures, “the court is unable to definitively find that A.B.’s treatment was medically necessary,” which “would normally suggest that remand is appropriate.” However, “this case diverges from the norm.” The court found that because of UBH’s “clear and repeated procedural errors… it would be contrary to ERISA fiduciary principles to mandate a remand and provide an additional ‘bite at the apple.’” The court stated that “the specter of continued remand opportunities would simply provide Defendants with, in essence, a way to hack the ERISA process. The court accordingly awards benefits to Plaintiffs, finding remand inappropriate.” The court also determined that attorney’s fees and prejudgment interest were appropriate. Finally, the court declined to rule on D.B.’s Parity Act claim because it was not renewed post-remand, and in any event the court had already awarded plan benefits.

Amy G. v. United Healthcare, No. 2:17-CV-00413-DN, 2026 WL 836549 (D. Utah Mar. 26, 2026) (Judge David Nuffer). This is an action for benefits under an ERISA-governed health care plan. On September 12, 2024, the court concluded that the decision of defendants United Healthcare and United Behavioral Health to deny benefits was arbitrary and capricious, and thus the court entered judgment in plaintiffs’ favor. However, the court did not award benefits and instead remanded the case to defendants for reconsideration. (Your ERISA Watch covered this ruling in our September 18, 2024 edition.) In October of 2024, defendants issued a decision on remand, denying plaintiffs’ claim once again and advising that plaintiffs could appeal. Plaintiffs were unhappy with this decision and filed a motion to reopen the case in December of 2024, seeking to file a motion for summary judgment. Plaintiffs contended that defendants failed to comply with the remand order by considering evidence not part of the administrative record. In the alternative, plaintiffs requested that they be allowed to appeal the redetermination. Defendants opposed this motion, arguing that their reevaluation complied with the remand order and that plaintiffs should have pursued an administrative appeal. Defendants further suggested that any challenge to their redetermination should be made in a new lawsuit. The court was slightly annoyed that “[b]oth parties’ briefing on Plaintiff’s Motion attempt to use the Remand Order as both shield and sword to justify their actions or inaction following the remand of Plaintiffs’ claim for benefits, as well as for reopening the case.” The court noted that “neither party sought clarification of the Remand Order” on the disputed issues, and “[s]uch clarification might have rendered Plaintiff’s Motion unnecessary.” The court further stated that plaintiffs’ motion “is not the appropriate procedural vehicle to make findings of fact and conclusions of law regarding the merits of Plaintiffs’ challenge to the propriety of Defendants’ redetermination denying benefits. It is also not the appropriate procedural vehicle to make findings of fact and conclusions of law on Defendants’ argument regarding a failure to exhaust the Plan’s administrative appeals process.” The court thus limited its inquiry only into whether the case should be reopened, and on this basis it granted plaintiffs’ motion. The court found that plaintiffs’ motion complied with the remand order’s directive by “‘identif[ying] the legal basis on which the case may be reopened and the specific issue or issues for which determination is sought.’ Requiring Plaintiffs to file a new lawsuit to obtain the determinations they seek is contrary to the language and intent of the Remand Order, as well as the purpose of ERISA to promote the ‘efficient resolution of benefits claims.’” The court thus reopened the case and ordered the parties to meet and confer regarding setting a briefing schedule for dispositive motions.

Pension Benefit Claims

Eighth Circuit

Bennett v. Ecolab, Inc., No. 24-CV-0546 (JMB/SGE), 2026 WL 810758 (D. Minn. Mar. 24, 2026) (Judge Jeffrey M. Bryan). Plaintiffs Scott Bennett, Brad Wilde, and David Statton are retired former employees of Ecolab, Inc. and participants in the Ecolab Pension Plan, an ERISA-governed defined benefit plan. The plan offers several optional forms of benefits, including a single life annuity (SLA) for unmarried participants, a joint and survivor annuity (JSA) for married participants, and an early retirement benefit. Plaintiffs, who were all married and elected JSAs, allege that Ecolab used outdated life expectancy rates from a 1971 Group Annuity Table to calculate JSAs, which they claim violates ERISA’s requirement that JSAs be “actuarially equivalent” to SLAs. Plaintiffs contended that life expectancy has “grown steadily since 1971,” and thus the Plan’s reliance on the 1971 Table “has caused proposed class members to lose ‘millions of dollars in benefits’ in the aggregate, effectively ‘penaliz[ing] participants for being married.’” Plaintiffs brought four claims against Ecolab: (1) violation of the joint and survivor annuity requirement under 29 U.S.C. § 1055; (2) violation of the actuarial equivalence requirements under 29 U.S.C. § 1054; (3) violation of ERISA’s anti-forfeiture provisions under 29 U.S.C. § 1053; and (4) breaches of fiduciary duty. Ecolab filed a motion to dismiss under Rule 12(b)(1) for lack of subject matter jurisdiction and Rule 12(b)(6) for failure to state a claim. On count 1, the court granted Ecolab’s motion as to plaintiffs Bennett and Wilde because they did not suffer an injury in fact. The court noted that they opted for early retirement, and under the plan’s early retirement calculations, their actual benefits exceeded what they would have received under Internal Revenue Code Section 417(e), which sets minimum present value requirements for pension plans, and thus they did not suffer a concrete injury. As for count 2, plaintiffs conceded that it should be dismissed because Section 1054 was inapplicable to their claims. On count 3, the court dismissed once again as to plaintiffs Bennett and Wilde due to lack of standing, as they received more than the actuarial equivalent of their normal retirement benefit. However, the court denied the motion to dismiss as to plaintiff Statton, who did not retire early and thus was not subject to the early retirement factor that offset the outdated SLA-to-JSA conversion factor. On count four, the court dismissed as to all plaintiffs because their claim was time-barred under ERISA’s six-year statute of repose. The court rejected plaintiffs’ argument that the breach recurred with each plan update, which would “render virtually meaningless the six-year statute of repose and conflicts with well-settled law.” These decisions left only counts 1 and 3 for plaintiff Statton. The court found that these counts were plausibly pled. Ecolab complained that these claims did not allege “the amount of Statton’s accrued benefit, the specific monthly amount that Statton currently receives under the Plan, nor the amount he would receive by applying section 417(e) actuarial assumptions.” However, the court considered Statton’s benefit calculation form, which was submitted to the court by Ecolab during briefing, and determined that it provided sufficient information for Statton’s claims to proceed. As a result, while Ecolab’s motion was granted in part, the case will continue.

Pleading Issues & Procedure

Sixth Circuit

Gray v. DTE Energy Co. Retirement Plan, No. 2:24-CV-11416-TGB-EAS, 2026 WL 800186 (E.D. Mich. Mar. 23, 2026) (Judge Terrence G. Berg). Vickie Gray was married to Randy Gray for over 25 years until they divorced in 2006. As part of the divorce judgment, Vickie was granted pension benefits and surviving spouse benefits pursuant to Randy’s participation in the DTE Energy Company Retirement Plan. Randy remarried to Joy Gray and retired in 2011. Vickie began receiving pension benefits in 2015, which ceased after Randy’s death in 2018. Vickie later discovered that Randy’s retirement application, signed by Joy, elected survivor benefits for Joy instead of Vickie. Specifically, Vickie alleges that in 2011 Randy and Joy submitted a new election of benefits, assigning the surviving spouse benefits to Joy and falsely certifying that “I am not currently and have never been involved in a Divorce that impacted my pension benefits.” Vickie thus filed this action against the Plan, Joy, and Randy’s estate. She contends that the Plan wrongfully denied her surviving spouse benefits in violation of ERISA, and alleged claims for fraud and misrepresentation against Joy and Randy’s estate. Vickie also sought a declaratory judgment declaring her entitlement to all rights and full surviving spouse benefits of Randy. The Plan filed an answer to Vickie’s complaint, but Joy and the estate “have failed to answer or otherwise respond to this action despite multiple attempts at personal service and alternate service as ordered by the Court[.]” Vickie thus filed a motion for default judgment against Joy and the estate. Meanwhile, Vickie and the plan filed cross-motions for judgment on the administrative record. In this order, the court denied Vickie’s motion for default judgment without prejudice. The court reasoned that in multi-defendant cases, it is the “preferred practice…to delay granting the default judgment motion against only one or some of the defendants until the court reaches a decision on the merits against all.” The court noted that granting default judgment against Joy and the estate could result in a finding that Vickie was entitled to surviving spouse benefits, which would be inconsistent with a subsequent ruling in favor of the Plan on its motion, which would necessitate finding that Vickie was not entitled to those same benefits. Therefore, the court decided to delay the entry of default judgment until Vickie’s claim against the Plan is resolved. The court emphasized that its decision was made only to prevent the possibility of inconsistent verdicts; it “expresses no opinion whatsoever as to the merits of the cross-motions for judgment on the administrative record.”

Provider Claims

Second Circuit

AA Medical, P.C., v. Iron Workers Local 40, 361 & 471 Health Fund, No. 22-CV-1249-SJB-LGD, 2026 WL 836429 (E.D.N.Y. Mar. 26, 2026) (Judge Sanket J. Bulsara). AA Medical, P.C., a surgical practice group, filed this action against the Iron Workers Local 40, 361, and 471 Health Fund challenging the Fund’s decision to deny and limit reimbursement for an arthroscopic knee surgery AA Medical performed on a Fund participant. The surgery in question was performed in 2021 and involved two procedures: (1) an arthroscopy and repair of both menisci (procedure 29883), and (2) a left knee microfracture chondroplasty (procedure 29879). AA Medical submitted an invoice for $158,438.64, but the Fund paid only $3,473.22 for the first procedure, and nothing for the second procedure, contending that it was not medically necessary. AA Medical asserted a single claim under ERISA § 502(a)(1)(B), seeking to enforce its right to benefits under the plan. AA Medical alleged that the Fund unlawfully underpaid for procedure 29883 and denied recovery for procedure 29879. The Fund moved for summary judgment. The court reviewed the Fund’s decisions under the arbitrary and capricious standard of review because the Plan vested it with discretionary authority to determine benefit eligibility. Under this deferential standard, the court found that the Fund’s decision to pay $3,473.22 for the pre-approved procedure was neither arbitrary nor capricious. The Fund relied on the FAIR Health schedule of allowances to determine the allowed amount for procedure 29883 and paid 60% of that allowance, as specified under the Plan’s terms. The court deemed AA Medical’s counter-argument as offering “no more than conclusory assertions with no citation to authority. It argues that the determination was unreasonable because the amount paid was just 2% of the total amount billed… But just because AA Medical was paid less than what it expected or charged, does not render the decision arbitrary or capricious.” In fact, the Plan “makes clear” that it does not always pay benefits equal to or based on the provider’s actual charge, and only covers the “Allowed Charge” amount, which permitted the Fund to consult the Fair Health schedule. As for the denied procedure (29879), the court upheld the Fund’s determination that the microfracture chondroplasty was not medically necessary. The Fund’s consultant reviewed the relevant medical records and concluded that the procedure was not supported by the supplied records. AA Medical argued that there was an issue of fact as to the necessity of the procedure, but the court emphasized that the issue was whether the Fund had a reasonable basis for its decision, not whether the decision was correct. The court also discounted a declaration from the surgeon, finding that it was outside the reviewable record. As a result, the court ruled that the Fund’s determinations were supported by substantial evidence and were not arbitrary or capricious, and granted its motion for summary judgment.

Third Circuit

The Plastic Surgery Center, P.A. v. Aetna Life Ins. Co., No. 23-CV-21439-ESK-AMD, 2026 WL 821139 (D.N.J. Mar. 25, 2026) (Judge Edward S. Kiel). The Plastic Surgery Center has filed 47 related cases in which it seeks reimbursement from Aetna Life Insurance Company for surgical procedures it performed on patients insured by Aetna. The Center, an out-of-network provider, alleges that it entered into agreements with Aetna to perform surgical procedures on the patients in exchange for payment at an in-network rate. However, Aetna reimbursed the Center at significantly lower rates. The Center has asserted three state law claims against Aetna: (1) breach of contract, (2) promissory estoppel, and (3) negligent misrepresentation. To simplify the issues, the parties agreed to present four representative cases to the court at the motion to dismiss stage; the patients involved were K.R., C.S., M.T., and N.D. Aetna contended that K.R. and M.T.’s plans were governed by ERISA, and the court agreed. The court noted that the Center’s claims were based on telephone calls and authorization letters, and that the representations made in these communications “demonstrate that the plan was central to the letter and phone conversations, rather than independent or separate” from the plans. The court found the decision in Princeton Neurological Surgery v. Aetna persuasive (as discussed in our March 8, 2023 edition), where similar claims were preempted because they were based on plan terms rather than independent agreements. As a result, the court dismissed the cases involving K.R. and M.T. As for the other two representative cases, in the C.S. case, the court dismissed the breach of contract, promissory estoppel, and negligent misrepresentation claims for failure to state a claim. The court found that the call transcripts did not demonstrate a meeting of the minds or a clear and definite promise necessary to support these claims. In the N.D. case, the court allowed the breach of contract and promissory estoppel claims to proceed, finding that the call transcripts supported the existence of an agreement to pay at an in-network rate. However, the negligent misrepresentation claim was dismissed due to the economic loss doctrine, which precludes tort claims based on breaches of contractual promises.

Fifth Circuit

South Austin Emergency Ctr. v. Blue Cross Blue Shield of Tex., No. 1:23-CV-1488-RP, 2026 WL 838337 (W.D. Tex. Mar. 24, 2026) (Judge Robert Pitman). The plaintiffs in this mammoth medical benefit case consist of five Texas emergency centers and thousands of patients who were insured by defendants and treated by the centers at their facilities. The defendants are 42 regional entities, or “home plans,” operating under the umbrella of Blue Cross Blue Shield. These defendants participate in the “BlueCard Program,” which allows insured individuals to receive healthcare services outside their plan’s regional service area. The emergency centers are out-of-network providers who allege that defendants have routinely underpaid them for medical services rendered to the patient plaintiffs under claims funneled through Blue Cross Blue Shield of Texas pursuant to the Blue Card Program. The case involves “approximately 63,390 claims for emergency medical care the SCEC Plaintiffs provided to the Patient Plaintiffs, for which the SCEC Plaintiffs billed $272,913,789.00 but only received $40,806,773.20 in reimbursement.” Plaintiffs have asserted two claims for relief: (1) violation of ERISA for claims from insurance plans governed by ERISA; and (2) breach of contract for claims from insurance plans not subject to ERISA. Defendants filed nine motions in total to dismiss the case, which were all referred to an unlucky magistrate judge. The omnibus defendants sought to dismiss the patient plaintiffs for lack of subject matter jurisdiction and to dismiss claims for declaratory judgment and implied contract for failure to state a claim. Other motions to dismiss were filed by various defendants challenging personal jurisdiction and the validity of certain claims. The magistrate judge made numerous rulings, some of which defendants objected to; the court resolved those objections in this order. First, the court addressed the personal jurisdiction arguments made by many of the home plans regarding the breach of contract claim. (The home plans acknowledged that the court had jurisdiction over the ERISA claim.) The court agreed with defendants and ruled that no agency relationship existed between BCBS Texas and the home plan defendants. The court found that BCBS Texas “forwards the claim of an insured individual who received care out of state to that individual’s Home Plan, who then makes the coverage determination and reimburses BCBS Texas for any payment it then makes on behalf of the Home Plan entity[.]” As a result, BCBS Texas did not act as the home plans’ agent and thus the court lacked personal jurisdiction over them. For the same reason, the court disagreed with the magistrate judge’s finding of a common nucleus of operative facts for pendent personal jurisdiction. The court then turned to the omnibus motion, which sought to dismiss the patient plaintiffs for lack of standing. The court noted that “there is no question whether the assignments here were valid – Plaintiffs have alleged that they exist and do not dispute their validity, and Defendants do not dispute their existence or validity either nor raise the existence of any anti-assignment claims.” As a result, because the patients had assigned their claims, they no longer had standing; only the emergency centers did. As for the rest of the magistrate judge’s rulings, they were unchallenged and upheld, and thus the case will continue.

Ninth Circuit

Valley Children’s Hosp. v. Grimmway Enterprises, Inc., No. 1:24-CV-00643 JLT CDB, 2026 WL 832895 (E.D. Cal. Mar. 26, 2026) (Judge Jennifer L. Thurston). Valley Children’s Hospital filed this action against Grimmway Enterprises, Inc. and Grimmway’s ERISA-governed health benefit plan, claiming that they wrongfully denied and failed to pay benefits for the hospital’s treatment of “Patient O,” a minor child covered under the plan. Patient O was born with serious heart defects and received extensive treatment at the hospital, which billed Grimmway and the plan for $8,188,227.20. Of this, $4,843,851.72 was the contracted reimbursable amount, but Grimmway only reimbursed $3,046,084.21, leaving an outstanding balance of almost $1.8 million. The hospital asserted a claim under 29 U.S.C. § 1132(a)(1)(B), contending that it was a proper plaintiff pursuant to an assignment of rights from Patient O. Defendants moved to dismiss for failure to state a claim, contending that the hospital lacked standing to bring the claim because Patient O’s assignment of benefits was barred by an anti-assignment provision in the plan. The hospital opposed the motion, arguing that it sought to enforce rights rather than recover benefits, which should not be precluded by the anti-assignment provision. The court agreed with defendants: “Plaintiff lacks statutory standing because, as currently pled, Patient O’s assignment was invalid.” The court ruled that the hospital’s claim to recover benefits fell within the scope of the anti-assignment provision, which was valid and enforceable under ERISA. “The anti-assignment provision clearly invalidates Patient O’s transfer of ‘benefits.’ If Plaintiff seeks to recover ‘benefits,’ it is therefore stripped of derivative standing under 29 U.S.C. § 1132(a)(1)(B).” The court disagreed with the hospital’s argument that it sought to “enforce rights” rather than “recover benefits,” concluding that “[b]ecause the Hospital sues exclusively for compensatory damages resulting from Grimmway’s alleged failure ‘to pay benefits as required by the Plan,’” its claim was one for benefits under ERISA and thus “must be dismissed for lack of standing under 29 U.S.C. § 1132(a)(1)(B).” The motion was not a total defeat for the hospital, however. The court gave the hospital an opportunity to amend its complaint to assert a procedural claim related to enforcing rights under the plan’s appeals process, “to the extent they can, consistent with Rule 11, articulate one that is not barred by the anti-assignment provision.”

Retaliation Claims

Seventh Circuit

Richards v. Centric Manufacturing Solutions, Inc., No. 25-C-1474, 2026 WL 851277 (E.D. Wis. Mar. 27, 2026) (Judge William C. Griesbach). Stephen Richards filed this action against his former employer, Centric Manufacturing Solutions, Inc., alleging that Centric terminated his employment due to the high cost of his medical treatment for cancer and the associated insurance costs in violation of ERISA. Centric asserted as an affirmative defense in its answer that Richards’ claims were barred by a release agreement he signed as part of a severance package. Centric also filed a counterclaim seeking a declaration that Richards’ ERISA claims were barred by the agreement, or, alternatively, for judgment for the amount paid to Richards under the agreement. Centric then filed a motion for judgment on the pleadings based on this defense. Richards opposed, contending that Centric breached the agreement by failing to pay the promised amounts in a timely manner, specifically the payment for unused paid time off, which he argued was a material breach allowing him to rescind the agreement. The parties agreed that Wisconsin law governed the interpretation of the agreement. The court stated that whether a breach is material is a question of fact, and that rescission is allowed “when a breach is so substantial as to destroy the essential object of a contract.” Centric contended that “Richards is not entitled to rescind the Agreement in this case because the breach he alleges can be fully redressed by an award of damages,” but the court found this argument “unpersuasive.” At this stage of the proceedings, it was not clear to the court whether Centric’s breach was “incidental and subordinate to the main purpose of the contract” or whether the remedy proposed by Centric would “provide ‘clear, adequate, and complete relief.’” Therefore, the court denied Centric’s motion and set the case for a scheduling conference.

Venue

Tenth Circuit

Mark S. v. Carelon Behavioral Health, No. 2:25-CV-00352 JNP, 2026 WL 824111 (D. Utah Mar. 24, 2026) (Judge Jill N. Parrish). Plaintiffs Mark S. and L.S. filed this action in the United States District Court for the District of Utah to recover benefits under 29 U.S.C. § 1132(a)(1)(B) against Carelon Behavioral Health, Chevron Corporation, and the Chevron Corporation Mental Health and Substance Use Disorder Plan after defendants failed to approve benefits for medical treatment received by L.S. Plaintiffs reside in Texas, and Chevron, the plan administrator, is (recently) headquartered in Texas. L.S. received treatment at The Menninger Clinic in Texas and at Solacium New Haven RTC in Utah. Before the court here was defendants’ motion to transfer venue from the District of Utah to the Southern District of Texas pursuant to 28 U.S.C. § 1404(a). The court noted that it had “broad discretion” to grant a change of venue and considered several factors, including the plaintiff’s choice of forum, accessibility of witnesses, cost of proof, enforceability of judgment, and other practical considerations. The court noted that the plaintiff’s choice of forum is given less deference when the plaintiff does not reside in the district and when the facts giving rise to the lawsuit have no significant connection to the chosen forum. Here, the only connection to Utah was L.S.’s treatment; none of the parties resided in Utah and the plan was not administered or breached there. The court found that the Southern District of Texas was a more appropriate forum because the relevant witnesses and documents were located in Texas, where the plan was administered and the breach occurred. Additionally, the court compared docket congestion and found that the Southern District of Texas had shorter times from filing to disposition and trial compared to the District of Utah, which favored transfer. The court thus concluded that practical considerations and the interests of justice supported transferring the case to the Southern District of Texas, and it granted defendants’ motion accordingly.