Good morning, ERISA Watchers!  I just returned from the ABA Employee Benefits Committee Mid-Winter Meeting in Nashville, where I got to see many of you and add several new subscribers!  As a reminder, and for the new folks, all the cases discussed in this newsletter are hyperlinked to the full text of the decision if you want to read more.

The first of this week’s notable decisions is The Depot, Inc. v. Caring for Montanans, Inc., No. 17-35597, __F.3d__, 2019 WL 453485 (9th Cir. Feb. 6, 2019), a published decision from the Ninth Circuit addressing fiduciary actions, plan assets, remedies and preemption. Continue Reading No Preemption! 9th Circuit Revives Employers’ State-Law Claims Against Health Insurance Companies for Hidden Surcharges and Kickbacks

This week’s notable decision is Rittinger v. Healthy All. Life Ins. Co., No. 17-20646, __F.3d__, 2019 WL 391771 (5th Cir. Jan. 31, 2019), a case involving the denial of coverage for bariatric surgery and follow-up surgery for complications.  The Fifth Circuit reversed the district court’s determination in favor of Rittinger and found that Anthem did not abuse its discretion in the handling of Rittinger’s appeals.  This is yet another case where the standard of review makes all the difference.  As the court explained, “[A]lthough not the paragon of procedural propriety, Anthem satisfied the very low, very deferential abuse-of-discretion standard.”  Because the court found that Rittinger is not entitled to any damages, the court dismissed her cross-appeal to determine the exact dollar amount of damages she is owed.     Continue Reading Fifth Circuit Holds that Anthem Did Not Abuse Its Discretion in Denying Coverage for Bariatric Surgery

Happy Monday, ERISA Watchers!  Today’s notable decision is a good one on equitable remedies, made possible by CIGNA Corp. v. Amara, 563 U.S. 421 (2011).  In Snitselaar v. Unum Life Insurance Company of America, 2019 WL 279995 (N.D. Iowa Jan. 22, 2019), Unum denied Snitselaar’s claim for dependent life insurance benefits on the life of her ex-husband, Gerard, who died about three months following the finalization of their divorce.  Unum found that Gerard was no longer an eligible dependent under the terms of the Plan as of the date of the divorce.  Snitselaar claimed that when she signed up for the life insurance benefits, she was informed that they could not lose the insurance for life changes after the two-year waiting period and they were never informed about divorce affecting the policy.  In addition, the life insurance premiums continued to be deducted from her paychecks after the divorce and even after Gerard’s death.  Snitselaar also claimed that neither she nor Gerard were informed of their right to convert to an individual life policy without evidence of insurability after the divorce was finalized. Continue Reading Employer Must Pay Dependent Life Insurance Benefits to Employee Due to Failure to Provide Summary Plan Description