It was another slow week in ERISAland as the federal courts digested the results of last week’s blockbuster midterm elections.

There were several interesting decisions, however, including: (1) a case allowing a disability plan participant to sue the plan’s insurer for breach of fiduciary duty for failing to tell him he might be eligible for benefits (Ramos v. Standard); (2) a case allowing a medical plan participant to sue her insurer for breach of fiduciary duty for misleading her into believing her surgery would be covered (Robinson v. Health Care Serv. Corp.); and (3) a curious case allowing a plaintiff to proceed based on a theory that the defendants “treated similarly situated claimants differently,” even if the life insurance denial at issue wasn’t an abuse of discretion (Richards v. LifePoint).

Finally, on this Veteran’s Day Your ERISA Watch would like to thank all who have served or are serving our country. Here’s a list of unusual and thought-provoking places to reflect, including the Polar Bears Memorial in Troy, Michigan, and the Grave of Sinbad the Dog in Barnegat Light, New Jersey.

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

Breach of Fiduciary Duty

Seventh Circuit

Ramos v. Standard Ins. Co., No. 26-cv-01477, 2026 WL 3320290 (N.D. Ill. Nov. 3, 2026) (Judge Sharon Johnson Coleman). Raul Ramos, a machine operator for G&W Electric, participated in the company’s ERISA-governed short-term and long-term disability plans, both administered by Standard Insurance Company. Although Standard administers claims under both plans, Standard is only financially responsible for benefits under the long-term plan, while the short-term claims are self-funded by G&W. Ramos stopped working in 2023 because of gout, tendinopathy of the right bicep, polyarthralgia, osteoarthritis in the right ankle and foot, asthma, and other conditions. He did not know he might be eligible for disability benefits and believed his condition “would be addressed solely through worker’s compensation.” Eventually he learned about the disability plans and applied for benefits in 2025, nearly two years after he stopped working. Both plans contained deadlines requiring proof of loss within specified periods after the waiting period and providing that “[i]f Proof Of Loss is filed outside these time limits, your claim will be denied.” Ramos sued in February of this year after Standard “failed to issue a decision with respect to his application for benefits.” Standard responded with a motion to dismiss. Ramos then amended his complaint without opposition, and the parties agreed that the amendment did not moot the motion. Standard argued that the plain language of the plans excluded Ramos from coverage because his application was untimely and that it breached no fiduciary duty. The court first addressed Ramos’s claim for benefits under § 502(a)(1)(B). Standard had calculated filing deadlines of January 20, 2024, for the short-term plan and April 14, 2024, for the long-term plan. Ramos did not dispute those calculations, did not argue that he lacked capacity, and did not point to any tolling provision. Because “[i]t is…clear under strict construction of the terms of the Plan policies that Mr. Ramos’ benefits application was untimely,” the court dismissed any claim he might have for benefits under the plan. However, it reached a different result on equitable relief. Ramos’s amended complaint did not expressly allege a breach of fiduciary duty, but the court considered the argument in his response brief because a plaintiff “may elaborate on [] allegations [in a brief] so long as the elaborations are consistent with the pleading.” The court cited the three elements of such a claim: a plaintiff must show that (1) the defendant is a fiduciary, (2) the defendant breached its duty, and (3) the breach caused harm. The first and third elements were “easily satisfied” because Standard, as a plan administrator, was “certainly a fiduciary,” and a breach would have caused Ramos to miss his deadline and lose eligibility for benefits. As for the second element, the court cited a fiduciary’s duty to affirmatively communicate material facts, which requires that a fiduciary “cannot remain silent if it knows or should know that the beneficiary is laboring under a material misunderstanding of plan benefits” and its obligations are not excused “merely because [the beneficiary] failed to comprehend or ask about a technical aspect of the plan.” However, the court also recognized that “ERISA does not require plan administrators to investigate each participant’s circumstances and prepare advisory opinions for literally thousands of employees.” The court stated that it “understands the critical question in this case to be whether Standard Insurance knew or should have known that Mr. Ramos was eligible (or potentially eligible) for benefits. If so, then Standard Insurance likely had a fiduciary duty to inform Mr. Ramos about his potential eligibility and the deadlines for applying for benefits.” The complaint did not definitively allege Standard’s knowledge, but at the pleading stage the court drew reasonable inferences in Ramos’s favor. If Ramos received workers’ compensation, G&W must have known of his ailments, and Standard would have known if it administered G&W’s workers’ compensation fund. Even if not, it was “reasonable to assume that G&W is in regular communication with Standard Insurance (the administrator of the Short-Term Plan) about its actual and potential financial obligations under the Short-Term Plan.” While “concrete proof is lacking,” the allegations showed more than a “mere possibility” of a breach, and “the question of what Standard Insurance knew and when is an issue of Standard Insurance’s state of mind that is not usually appropriate to resolve on a motion to dismiss.” The court also rejected Standard’s argument that it could not be liable for short-term plan benefits because only G&W pays them. Although a benefits claim must be brought against the party obligated to pay, “the question of whether Mr. Ramos is entitled to legal relief under the Short-Term Plan (which the Court has already resolved in the negative) has no bearing on the question of whether Standard Insurance breached its fiduciary duty as the administrator of the Short-Term Plan.” Thus, “It would be premature at this point to dismiss any such claims for equitable relief against Standard Insurance.” As a result, Standard’s motion was only partly granted; Ramos’s equitable relief claim will proceed.

Disability Benefit Claims

Eighth Circuit

Regulus v. Ascension Long Term Disability Plan, No. 4:25-cv-00616-SRC, 2026 WL 3320297 (E.D. Mo. Nov. 3, 2026) (Judge Stephen R. Clark). Raven Regulus, a behavioral-health counselor, stopped working in 2021 after reporting symptoms she attributed to mold and toxin exposure during workplace renovations. She participated in Ascension’s ERISA-governed long-term disability plan, which delegated claim administration to Sedgwick Claims Management Services, Inc. Under the plan, benefits continue after 24 months only if a participant cannot perform “any work or service for which the Participant is reasonably qualified,” and the plan conditioned benefits on proof of disability satisfactory to the claims administrator, defined as “objective medical evidence.” Sedgwick approved long-term disability benefits from 2022 through 2024, when it told her she would have to satisfy the plan’s “any occupation” definition to continue. Sedgwick requested additional medical information from Regulus and her doctors and, when the information it received did not establish that she could not work in any occupation, extended her benefits so she could undergo another examination. The examining physician, Dr. Liana Palacci, concluded that Regulus “should be able to perform sedentary work for any occupation after completing her current course of physical therapy,” and two vocational evaluations identified sedentary occupations in her labor market that fit her background and training. As a result, Sedgwick terminated Regulus’s benefits. On appeal, Regulus submitted additional medical records, and Sedgwick referred the file to two more physicians, Dr. Henry Richardson, board certified in physical medicine and rehabilitation and pain management, and Dr. Sandy Lee, board certified in rheumatology and internal medicine. Both disagreed with her treating providers about her functional impairment, with Dr. Lee citing the “paucity of provider documentation.” Sedgwick told Regulus that it would decide the appeal unless she submitted more information or requested more time, and Regulus said she had no additional information, asked for a decision that day, and waived the 21-day comment period. Sedgwick upheld the termination, and Regulus brought this action against Ascension and Sedgwick, which proceeded to cross-motions for summary judgment. The parties agreed that the plan gave Sedgwick discretionary authority, so the court reviewed the decision for abuse of discretion. The court noted that an administrator may choose between reliable but conflicting medical opinions and may accept reviewing physicians over treating physicians unless the record does not support the denial. The court found that “Sedgwick did what the law commits to claim administrators: It weighed evidence and came to a decision that has support in the record.” Its denial letters detailed the plan’s definition of disability and the records reviewed, which included the examination, the opinions of Drs. Richardson and Lee, the vocational analyses, and more than seventy records from more than forty providers. Each of the three reviewing doctors concluded that Regulus lacked a qualifying disability, and Drs. Richardson and Lee “simply evaluated her disability differently” than her providers did. The court noted that Sedgwick “wasn’t required to favor Regulus’s doctors’ opinions just because they were her treating physicians,” and indeed, “[a] plan administrator may even prefer the opinion of its own consulting physician over that of an applicant’s treating physician.” The court rejected Regulus’s two principal objections. She argued that Sedgwick refused to credit her treating physicians’ opinions as legally sufficient evidence of disability, but the court, relying on its prior analysis, held that Sedgwick and its reviewing doctors acted within their discretion in disagreeing with her providers. Regulus also argued that Sedgwick’s notices violated 29 C.F.R. § 2560.503-1(g) by never telling her what she needed in order to prove that her “constellation of impairments” was disabling. Regulus focused on a nurse case manager’s statement about “the lack of supporting medical information” and on a short excerpt from the June 2024 denial letter. However, the court found that Regulus’s excerpt abridged a lengthy passage in the denial letter that listed the kinds of evidence she could submit on appeal, including provider observations and findings, office visit notes, lab and radiology reports, and therapy notes. Considering all of Sedgwick’s communications, the court found the notice sufficient. As a result, the court granted Ascension and Sedgwick’s motion for summary judgment and dismissed the case with prejudice. The court declined, however, to award Ascension and Sedgwick their requested attorneys’ fees.

ERISA Preemption

Seventh Circuit

Kelly v. NiSource Inc., No. 2:26-CV-00321-GSL-JEM, 2026 WL 3333711 (N.D. Ind. Nov. 3, 2026) (Judge Gretchen S. Lund). David Kelly, a former NiSource executive, alleged that NiSource breached a 2003 contract “executed pursuant to [his] participation in [a] Supplemental Executive Retirement Plan,” under which it agreed to pay “100% of [his] medical benefit insurance.” In January 2026, Kelly’s retiree medical coverage changed, requiring him to pay part of his premiums. In this pro se complaint he seeks to recoup those costs and restore his prior coverage. He attached six exhibits to his complaint, including a “Benefits Comparison” chart stating that “[i]f you retire on or before January 1, 2004, NiSource pays 100% of your medical cost and you pay 0%,” and an unsigned, undated list of his “termination benefits.” He also attached NiSource’s February 2026 letter responding to his claim for restored coverage, which reviewed each document he relied on, explained why none entitled him to additional benefits, and informed him of his right to appeal within 180 days and, afterward, to bring a civil action under ERISA. Kelly brought his action in Indiana state court, and NiSource removed it, arguing that his claims were completely preempted by ERISA because they challenged the terms of NiSource’s ERISA-governed “Post-65 Retiree Medical Plan,” in which Kelly admitted he participates. Kelly’s “Reply to Notice of Removal,” which the court construed as a motion to remand, argued that his “individual medical indemnity agreement” was a separate agreement not governed by ERISA. NiSource moved to dismiss on preemption grounds and for failure to exhaust administrative remedies. Addressing jurisdiction first, the court applied the two-part test of Aetna v. Davila to determine whether complete preemption applied. The first prong asks whether the plaintiff could have brought his claim under § 502(a)(1)(B). Kelly had not attached any separate contract to his pleadings, and his exhibits, read with NiSource’s briefing, suggested a dispute over the range of benefits under the ERISA plan. The benefits chart appeared to be a handout describing estimated costs and coverage options for future retirees, and the court found that the “contractual agreement” in the second exhibit “plainly refers to a group retirement plan.” NiSource’s denial letter reinforced the point, since Kelly had sought to restore his benefits through the plan’s ERISA review procedures and NiSource had addressed his claim under an ERISA framework. The court reached the same result even assuming Kelly had plausibly alleged a separate contract. In Bartholet v. Reishauer A.G. (Zurich), the plaintiff argued that he sought to enforce a contract that was not an employee benefit plan, but the Seventh Circuit held that “[a] suit based on the difference between the pension promised by contract and the pension established by the plan ‘relates to’ the pension plan,” and that while “some courts” treat a contract to enhance benefits as distinct from the plan, the Seventh Circuit “[is] not among them.” The court found “[t]hat logic applies squarely to Plaintiff’s medical plan here.” Under the second Davila prong, the court found no independent legal duty because resolving the claim would require analysis of Kelly’s current benefits, “whether [] benefits were vested, [and] whether NiSource properly administered [Kelly’s] plan.” Furthermore, Kelly was “not attempt[ing] to remedy any violation of a legal duty independent of ERISA.” The claim was thus completely preempted, the court had jurisdiction, and Kelly’s motion to remand was denied. As for NiSource’s motion to dismiss, the court held that exhaustion, though an affirmative defense, may be resolved under Rule 12(b)(6) where the plaintiff’s allegations clearly point to the defense. Kelly did not contest that he failed to appeal the February 2026 denial, as the letter instructed, and he did not allege futility, since the letter promised a full review without “deference to the adverse benefit determination.” The court thus granted NiSource’s motion to dismiss. Noting that Kelly had brought “a garden-variety state law claim” that the court had now converted into an ERISA claim, the court allowed him to amend his complaint.

Eighth Circuit

G.A. v. Health Care Service Corp., No. 1:26-cv-00181-SNLJ, 2026 WL 3319160 (E.D. Mo. Nov. 3, 2026) (Judge Stephen N. Limbaugh, Jr.). G.A., a minor, and his parents, Kevin and Tracey Akers, sued Health Care Service Corporation over the denial of coverage for an emergency air ambulance transport. G.A., who was seven years old at the time, was a passenger in a vehicle struck head-on by an impaired driver who crossed lanes at 90 miles per hour. He was flown from Cape Girardeau, Missouri to St. Louis for treatment of life-threatening injuries. The family was covered by a group health insurance policy provided through Kevin’s employer and administered by Blue Cross and Blue Shield of Texas, which is a subsidiary of defendant. Defendant denied the claim based on an internal determination that air transport was not medically necessary, contrary to the findings of G.A.’s treating providers. Plaintiffs exhausted their internal appeals and then filed this action in state court, asserting claims for breach of contract and vexatious refusal to pay. Defendant removed on the basis of federal question jurisdiction and moved to dismiss the claims as preempted by ERISA. Plaintiffs responded by filing a first amended complaint that asserted the contract and vexatious refusal claims in Count I and a denial of benefits claim under ERISA in Count II. Defendant then moved to dismiss the state law claims in Count I based on ERISA preemption. In this order, the court framed the motion around three questions: whether the policy was an ERISA plan, whether it fell within the ERISA safe harbor, and, if it was a plan outside the safe harbor, whether the state law claims are preempted. However, the court never got past question one because it could not determine whether ERISA preempted Count I. Defendant had submitted a policy with its removal documents, authenticated by a declaration from one of its employees, but plaintiffs disputed that it was the policy at issue and argued that it was incomplete or “silent on a number of significant issues.” (Plaintiffs did not attach a policy to their state court petition or the amended complaint.) The court rejected defendant’s argument that because plaintiffs had pled an ERISA claim in Count II, that counted as an admission that the policy is governed by ERISA. The court noted that plaintiffs added that claim only after defendant moved to dismiss on preemption grounds, and because Count I seeks recovery under state law if the policy is not governed by ERISA while Count II seeks recovery if it is. Because plaintiffs disputed the accuracy of defendant’s policy, factual issues existed which could not be resolved on a motion to dismiss. The court concluded that the preemption issue “is more properly addressed by a motion for summary judgment after the parties have engaged in discovery.” As a result, the court denied defendant’s partial motion to dismiss.

Life Insurance & AD&D Benefit Claims

Fifth Circuit

Richards v. LifePoint Health Welfare Benefits Plan, No. 3:25-CV-3541-X, 2026 WL 3391457 (N.D. Tex. Nov. 6, 2026) (Judge Brantley Starr). Tiffany Richards’s husband began full-time employment with LifePoint and elected life insurance coverage on November 25, 2024. On December 26, 2024, he collapsed, was taken to a hospital, and never returned to work. He died on February 2, 2025. The policy required employees to complete an eligibility waiting period, which ended on the “first of the month following 30 days of continuous, Active Employment.” Lincoln National Life Insurance Company, the policy issuer, denied Richards’s claim because it read the policy to require active employment through the waiting period and any remaining days until coverage began. Because Mr. Richards did not work from December 26 through January 1, when his coverage would have started, Lincoln deemed him ineligible. Richards sued the plan, and the court granted LifePoint’s first motion to dismiss without prejudice. Applying abuse of discretion review, it held that LifePoint prevailed “so long as Lincoln’s interpretation of the Policy is at least on the low end of reasonableness,” and that it was “not unreasonable to conclude that the Policy requires continuous Active Employment for the entire Eligibility Waiting Period.” The court allowed Richards to amend to allege facts showing that Lincoln and LifePoint had treated similarly situated claimants differently, which could amount to an abuse of discretion or a pleading dispute requiring discovery. (Your ERISA Watch covered this ruling in our June 3, 2026, edition.) Richards filed an amended complaint in which she alleged that (1) LifePoint abused its discretion in denying coverage; (2) the deferential standard no longer applied because LifePoint failed to provide required documents and information; and (3) Texas insurance law, which bars discretionary clauses, made the abuse of discretion standard inapplicable. LifePoint moved to dismiss again. In this order the court first addressed ERISA’s claims procedure regulation, 29 C.F.R. § 2560.503-1, which requires a plan to give a claimant, upon request and free of charge, reasonable access to “all documents, records, and other information relevant to the claimant’s claim for benefits.” Under § 2560.503-1(h)(2)(iii) and (m)(8), information is relevant if, among other things, it “demonstrates compliance with the administrative processes and safeguards required pursuant to paragraph (b)(5),” which in turn calls for processes designed to ensure that plan provisions “have been applied consistently with respect to similarly situated claimants.” LifePoint argued that it had to disclose only what Lincoln relied on in making its determination, namely the policy, the plan document, and Mr. Richards’s file, and that it had done so. However, “[t]he Court agrees with Richards.” It reasoned that, having permitted her to amend to allege disparate treatment, it could not fault her for failing to do so when LifePoint “refused to provide her with any information on how it assesses similar claims by other individuals it insures.” In the court’s words, “LifePoint deprived Richards of the information the Court required her to plead and the law entitled her to.” The court therefore denied the motion as to the first and second counts. On the third count, Richards argued that Texas law, which prohibits discretionary clauses in life insurance policies, governed. LifePoint responded that Tennessee law applied, and Tennessee does not bar such clauses. The court agreed with LifePoint. The plan provided that it and each component plan should be construed under ERISA and the law of the state identified in a component plan, or, absent one, Tennessee law. The policy was incorporated by reference into the plan as a component plan, and the administrator relied on, and gave Richards, the document containing the Tennessee choice-of-law provision. The court thus held that Tennessee law applied and that LifePoint’s denial should be reviewed for abuse of discretion, a standard the policy interpretation had already satisfied. The court thus granted in part and denied in part LifePoint’s motion to dismiss, allowing the first and second counts to proceed. The court limited discovery to Richards’s claim that LifePoint treats similarly situated individuals differently for purposes of life insurance claim denials.

Medical Benefit Claims

Seventh Circuit

Robinson v. Health Care Service Corp., No. 1:25-cv-00924-SEB-CSW, 2026 WL 3371861 (S.D. Ind. Nov. 6, 2026) (Judge Sarah Evans Barker). Mona Robinson receives dependent health coverage under AT&T Umbrella Benefit Plan No. 3 through her husband’s former employment with AT&T. Health Care Service Corporation, doing business as Blue Cross and Blue Shield of Illinois (BCBSIL), is the claim administrator for the plan. Robinson’s in-network orthopedic surgeon recommended corrective surgery at North Meridian Surgery Center, where he practices and is a part owner. Before the surgery, the surgeon’s office and North Meridian sought prior authorization from BCBSIL, and Robinson alleged that she and North Meridian, on her behalf, asked to confirm that North Meridian was in her network and that North Meridian said it was. She had the surgery in May 2023. However, about six weeks later, BCBSIL told her that “[d]ue to the high dollar charges on th[e] claim,” “pre-payment review would be required,” and in July 2023 it declined coverage, explaining that the policy allows benefits only for services from Blue High-Performance Network providers and that benefits are “not guarantee[d]” when a claim is “submitted with only a PPO, Alternate network or Participating provider classification[.]” BCBSIL upheld the denial in November 2023, leaving Robinson responsible for $105,121.03. Robinson sued BCBSIL and the AT&T plan under ERISA, alleging that BCBSIL breached its fiduciary duty by preauthorizing an out-of-network surgery, and that BCBSIL and the plan breached the plan’s terms by refusing to pay benefits. BCBSIL moved to dismiss, arguing that Robinson improperly invoked § 1132(a)(3) to challenge a benefits denial that can proceed only under § 1132(a)(1)(B), and that it was not a proper defendant under § 1132(a)(1)(B). The plan moved to dismiss on grounds that mirrored BCBSIL’s, contending that Robinson failed to plead plan terms entitling her to benefits and that she could not assert a fiduciary breach claim against the plan. On the § 1132(a)(1)(B) benefits claim, the court granted BCBSIL’s motion because a claim for benefits “must be brought against the party having the obligation to pay the benefits,” and Robinson conceded that the plan, as a self-insured plan, is the proper defendant. The claim survived against the plan because Robinson alleged that the plan covers outpatient surgical services by an in-network surgeon whether or not the facility is in network. The plan language she cited, a list of covered outpatient services, offered “weak support at best,” but it was sufficient to plausibly state a claim. The plan argued that Robinson relied on the terms of a component program that did not apply to her, but this information, even if it “might ultimately prove fatal,” was outside the complaint and could not be considered. As for the fiduciary breach claim, the court dismissed it as applied to the plan. The amended complaint alleged no facts showing what the plan itself did or failed to do. Robinson argued that the plan is vicariously liable because its terms treat a third-party administrator’s actions as “an action by the Plan Administrator,” but the plan administrator, AT&T Services, Inc., was not a party. However, the court let Robinson’s fiduciary breach claim proceed against BCBSIL. Robinson plausibly alleged that BCBSIL misled her into believing the surgery would be covered by preauthorizing it without giving her complete and accurate information about her coverage, including whether North Meridian was in network. BCBSIL argued that the plan’s terms informed her that preauthorization does not guarantee coverage, but the pleadings did not identify the particular benefit program at issue, so the court could not resolve that argument. It also found unavailing BCBSIL’s argument that Robinson did not rely on any statements from BCBSIL, and instead relied on statements from her physicians, regarding whether they were in-network, as her allegations supported a reasonable inference that both she and North Meridian contacted BCBSIL. The court concluding by noting “‘[t]he more difficult [lurking] question’ of whether Ms. Robinson ‘may obtain meaningful relief’ on the theories of liability she has asserted in this case.” As for now, “her complaint is sufficient, even if barely, to survive Defendants’ pleading challenges.”

Pension Benefit Claims

Ninth Circuit

Berkeley v. Intel Corp., No. 5:23-cv-00343-EJD, 2026 WL 3322772 (N.D. Cal. Nov. 3, 2026) (Judge Edward J. Davila). Gregg Berkeley brought this class action against Intel Corporation and the Administrative Committee of the Intel Minimum Pension Plan, alleging that the plan used unreasonable actuarial assumptions when converting single life annuities to joint and survivor annuities. He claimed that the conversions, which relied on the GAM-83 mortality table and PBGC interest rates, violated the joint and survivor annuity requirements of 29 U.S.C. § 1055, the anti-forfeiture rule of 29 U.S.C. § 1053, and the committee’s fiduciary duty to the class. In April 2026, the court granted summary judgment to the defendants on all claims. On the § 1055 claim, it held that the evidence did not show that a “‘reasonableness’ requirement may be inferred from the ordinary meaning of ‘actuarial equivalent,’ from congressional intent, or from Department of Treasury regulations.” It then rejected the § 1053 claim for the same reasons, observing that although forfeiture claims are not always derivative of actuarial equivalence claims, Berkeley relied on the same theory for both, namely that the plan unlawfully decreased the value of his benefits by applying unreasonable actuarial assumptions in violation of § 1055. (Your ERISA Watch covered this ruling in our April 15, 2026, edition.) Berkeley moved under Rule 59(e) to alter or amend the judgment, challenging only the § 1053 ruling. The court noted that Rule 59(e) relief is “an extraordinary remedy, to be used sparingly in the interests of finality and conservation of judicial resources,” and generally available only to correct manifest errors of law or fact, to present newly discovered evidence, to prevent manifest injustice, or in light of an intervening change in controlling law. Berkeley argued that the court committed clear error in finding that his § 1053 claim relied on the same actuarial equivalence theory as his § 1055 claim, contending that the § 1053 claim instead rested on the statutory guarantee that an employee’s “normal retirement benefit” is nonforfeitable at normal retirement age. The court rejected the argument for several reasons. At the outset, it was not new, because Berkeley had argued in opposing summary judgment that the forfeiture provision does not turn on an interpretation of actuarial equivalence, and the court had considered and rejected it based on the complaint. The court pointed to three provisions in the complaint that supported its ruling. First, the complaint repeatedly alleged that the defendants violated § 1053 by failing to provide “actuarially equivalent” benefits, including allegations that paying less than the actuarial equivalent of an accrued benefit is an illegal forfeiture. Second, the complaint’s introductory allegations treated the two claims as resting on the same theory, asserting that the plan’s outdated mortality table violated both provisions, and its § 1053 count incorporated the reasons “explained above” in the § 1055 section. Third, although the complaint quoted the “normal retirement benefit” language, Berkeley did not actually invoke it, and the very next allegations asserted forfeiture based on “adjustments in excess of reasonable actuarial reductions.” His summary judgment opposition likewise cited the language only briefly before returning to the argument that the actuarial adjustment to his normal retirement benefit was “unreasonable.” The court also rejected Berkeley’s new argument that it should not have considered 26 C.F.R. § 1.401(a)-11(b)(2) in analyzing § 1053, because his complaint relied on that regulation for both claims. The court thus denied Berkeley’s motion to alter or amend the judgment. Given the recent decisions from the Sixth and Eleventh Circuits that disagreed with the district court’s rulings in this case (neither of which were mentioned in this order), Your ERISA Watch expects an appeal to the Ninth Circuit.

Retaliation Claims

Sixth Circuit

Rankin v. Coulter Ventures, LLC, No. 2:25-cv-1334, 2026 WL 3319382 (S.D. Ohio Nov. 3, 2026) (Judge Douglas R. Cole). Rayshawn Rankin worked briefly for Rogue Fitness (the public-facing name of Coulter Ventures, LLC). Hired in August 2024, he was injured on the job ten days later, and Rogue fired him on October 23, 2024, citing attendance issues, after he allegedly was assigned tasks beyond his medical restrictions and was told that Rogue would “ask [him] to resign” if he needed surgery. Rankin alleged that he communicated his health insurance elections to Rogue’s HR staff in person, that Rogue never implemented them, and that it never told him of the failure or gave him a chance to elect again. Rogue’s HR director stated in a declaration that Rankin made no elections within the 30-day enrollment window. Rankin thus brought this pro se action, asserting five claims, the majority of which arose under the ADA. His fifth claim asserted a claim of interference with benefits under ERISA § 510. Rogue moved for summary judgment on all five, arguing that the four non-ERISA claims were untimely because Rankin’s complaint was docketed more than 90 days after his right-to-sue notice, and that the § 510 claim failed on the merits. The court denied the motion as to the non-ERISA claims, holding them timely because the 90-day period was tolled while Rankin’s motion to proceed in forma pauperis was pending, including the short interval in which he submitted a revised motion in response to the court’s deficiency order. On the § 510 claim, Rogue argued that Rankin had not created a triable issue on the “purpose of interfering” element of his claim, and that he never timely elected to participate in Rogue’s benefit programs. The court said Rogue’s argument “may turn out to be correct,” but concluded that summary judgment was premature because there had been no discovery – which had been stayed – on the claim. The court recognized that Rule 56(d) ordinarily requires an affidavit or declaration explaining why the nonmovant cannot present facts essential to oppose the motion, and Rankin’s declaration did not do so. But courts are more forgiving where a party has clearly explained its need for discovery elsewhere, and in his brief Rankin explained that he had not yet had discovery and that “[i]nternal communications, policies, and training materials” bearing on his claim remained in Rogue’s control. As for Rogue’s position that Rankin never properly enrolled in benefits, that issue also required at least some discovery, and Rankin, who is pro se, said he had relied on HR staff who led him to believe his elections were complete. Whether Rogue’s failure to enroll him was motivated by a purpose of interfering with his rights would depend on what the internal communications, policies, and training materials showed. As a result, the court denied Rogue’s motion for summary judgment, without prejudice to renewal once adequate discovery has occurred.