Johnson v. Reliance Standard Life Ins. Co., No. 23-13443, __ F.4th __, 2025 WL 3251015 (11th Cir. Nov. 21, 2025) (Before Circuit Judges William Pryor, Grant, and Kidd)

Your ERISA Watch would like to take this opportunity to wish you all a joyous Turkey Day and hope you can all find thanks for something in these trying times. As for us, we are very thankful to have you as readers, and we hope you find our weekly missives informative, educational, and maybe even occasionally entertaining. As always, feel free to drop us a note if you have any comments or suggestions.

It will be an especially happy Thanksgiving for Cheriese Johnson, the plaintiff in our case of the week. In 2015, things started going downhill for Johnson, who began suffering from a variety of unexplained symptoms. These included fatigue, muscle weakness, nausea, vomiting, nosebleeds, joint swelling, dizziness, and cognitive impairment.

Johnson continued working, however, and was hired by The William Carter Company in its human resources department in July of 2016. Three months later, she became covered under Carter’s employee long-term disability benefit plan, insured by defendant Reliance Standard Life Insurance Company.

Unfortunately, Johnson only lasted until January of 2017 at Carter’s, at which time she was forced to stop working due to her worsening symptoms. She applied for benefits with Reliance, but because she had stopped working within one year of the beginning of her coverage, her claim was subject to investigation pursuant to the plan’s preexisting condition provision.

This provision stated that benefits “will not be paid” for a disability that is “caused by,” “contributed to by,” or “resulting from” a preexisting condition. “Preexisting condition” was defined as “any Sickness or Injury for which the Insured received medical Treatment, consultation, care or services, including diagnostic procedures, or took prescribed drugs or medicines” during the three-month “look-back” period before coverage began – here, July through October of 2016.

Johnson certainly received significant treatment during this period. She was treated for many of the symptoms noted above and diagnosed with a number of potential conditions, including fibromyalgia, borderline lupus erythematosus, hypertension, and bronchitis.

However, it was not until February of 2017 that Johnson discovered the true cause of her symptoms. At that time, she underwent a lung biopsy, which led to a diagnosis of scleroderma. Scleroderma is a rare autoimmune disease that causes the thickening and hardening of skin and connective tissue. Serious cases can affect internal organs. Unfortunately, there is no cure.

Reliance completed its investigation and concluded that Johnson was not entitled to benefits because the preexisting condition provision applied. Johnson appealed, arguing that because no doctor suspected she had scleroderma until after the lookback period ended, the provision could not apply. Reliance countered that the symptoms and findings from the lookback period were consistent with scleroderma, and thus it upheld the denial “on the basis that the claimed disability [was] caused by, contributed to by, or the result of” scleroderma.

Johnson filed suit, but the district court agreed with Reliance and granted it summary judgment. (Your ERISA Watch reported on this decision in our October 11, 2023 issue.) Johnson appealed to the Eleventh Circuit Court of Appeals.

The Eleventh Circuit used its six-step approach to determine if Reliance’s decision should be overturned (although it only made it to step three). First, it addressed whether Reliance’s decision was “de novo wrong,” i.e., whether its interpretation of the preexisting condition provision was correct or not, without any deference to Reliance.

The court ruled that it was incorrect. It focused on the words “for which” in the definition of preexisting condition, i.e., was Johnson’s disability the result of an illness “for which the Insured received medical Treatment” during the lookback period?

The court stated, “A lot hinges on for – a word that ‘connotes intent.’” There was no intent to treat scleroderma here, according to the court. “No one ‘intended or even thought’ to treat Johnson ‘for’ scleroderma during the lookback period… Because neither Johnson ‘nor her physicians either knew or suspected that the symptoms she was experiencing were in any way connected with’ scleroderma, it would make little sense to say that she was treated for scleroderma.”

However, this was not the end of the story. Under step two of its analysis, the court concluded that the benefit plan gave Reliance “discretionary authority to interpret the Plan and the insurance policy and to determine eligibility for benefits.” Thus, the court moved on to step three to discuss whether Reliance’s interpretation, even if it was “de novo wrong,” was still “reasonable” under the deferential arbitrary and capricious standard of review.

The court emphasized that this standard of review “really is deferential.” However, “There will be times when ‘the plain language or structure of the plan or simple common sense will require the court to pronounce an administrator’s determination arbitrary and capricious.’” The court determined, “This is one of those times.”

The court ruled that Reliance’s interpretation was unreasonable “because it completely elides the distinction between receiving medical care for symptoms not inconsistent with a preexisting condition and receiving medical care for a preexisting condition itself.” The court presented an analogy:

It is no exaggeration to say that under Reliance Standard’s view, a patient told to drink more water because her headache was likely caused by her dehydration has been treated for cancer if she turns out to have a brain tumor. And that is true even if dehydration really was the root cause of the headache. Headaches, after all, are a symptom of both brain tumors and dehydration. So, to Reliance Standard, treatment for a headache during the lookback period converts any disease or condition that causes headaches into a preexisting condition under the policy.

The court deemed this position “unreasonable – full stop.” Quoting Justice Samuel Alito, from an opinion he wrote when he was on the Third Circuit Court of Appeals (Lawson v. Fortis), the court stated, “considering treatment for symptoms of a not-yet-diagnosed condition as equivalent to treatment of the underlying condition ultimately diagnosed might open the door for insurance companies to deny coverage for any condition the symptoms of which were treated during the exclusionary period.” This type of “backward-looking reinterpretation of symptoms to support claims denials would so greatly expand the definition of preexisting condition as to make that term meaningless: any prior symptom not inconsistent with the ultimate diagnosis would provide a basis for denial.”

In the end, the court viewed Reliance as attempting to rewrite its policy after the fact – “reading it as if it barred coverage for claims arising from conditions that may have originated or existed during the lookback period, not conditions that were treated during that period.” In other words, Reliance’s interpretation “warps the ‘plain and ordinary meaning’ of the policy language, converting a preexisting-condition exclusion into a preexisting-symptom exclusion.” As a result, the court concluded that Reliance’s interpretation was arbitrary and capricious, and reversed and remanded for further proceedings.

The panel was not unanimous, however. Judge William Pryor penned a dissent in which he concluded that Reliance’s interpretation was reasonable. Judge Pryor criticized the majority for relying so heavily on the word “for” in the definition of preexisting condition, and for misinterpreting it. This word “has, at least, eleven different definitions.”

Judge Pryor argued that “‘for’ is read more naturally in the exclusion as meaning ‘because of.’” He agreed with Reliance that Johnson received treatment during the lookback period “‘for the very conditions and symptoms’ that prove that she suffers from scleroderma.” As a result, it was unimportant for the purposes of the preexisting condition provision whether Johnson’s physicians knew that scleroderma was the cause of the symptoms they were treating.

Judge Pryor conceded that “Ms. Johnson’s condition is unfortunate[.]” However, “the terms of her policy plainly contemplate that a condition need not be diagnosed or even suspected to be pre-existing.” As a result, Judge Pryor would have affirmed Reliance’s decision to deny Ms. Johnson’s claim.

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

Breach of Fiduciary Duty

Second Circuit

Carlisle v. The Bd. of Trustees of the Am. Fed. of the N.Y. State Teamsters Conference Pension & Retirement Fund, No. 25-511, __ F. App’x __, 2025 WL 3251154 (2d Cir. Nov. 21, 2025) (Before Circuit Judges Calabresi, Chin, and Lee). In this compact and unpublished decision, the Second Circuit affirmed a district court’s dismissal of a putative fiduciary breach ERISA class action against the trustees and service providers of the New York State Teamsters Conference Pension and Retirement Fund. The panel concluded that the district court properly dismissed the complaint on the ground that it failed to plausibly allege a breach of fiduciary duty against any of the defendants. It held that plaintiff-appellant Robert Carlisle failed to sufficiently allege that the plan’s actuary, Horizon Actuarial Services, LLP, had fiduciary duties under ERISA. And while the trustees and the plan’s financial advisor, Meketa Investment Group, Inc., were undoubtedly fiduciaries and functioned as such regarding the challenged investment strategies, the court of appeals nevertheless found that Mr. Carlisle failed to plausibly allege they breached their duties “based on information available ‘at the time of each investment decision.’” The panel explained that while the complaint alleges that the fiduciaries were aware of the risks associated with their strategies and that other similarly situated plans favored stabler investments, such allegations “do not indicate that the Plan fiduciaries did more than engage in the normal practice of weighing ‘tradeoffs’ and selecting from a ‘range of reasonable judgments’ in the circumstances.” At bottom, the allegations in the complaint simply failed to convince the Second Circuit that the plan’s investment approach was “such an extreme outlier from ‘peer’ multiemployer plans that it was imprudent.” As for the claims of disloyalty, the court of appeals held that it could not plausibly infer from the complaint’s allegations that Meketa’s conflict due to its dual role as both the plan’s non-discretionary investment advisor and its private markets investments manager or the trustees’ investment decisions “were for the purpose of benefiting Meketa or any party other than the plan.” Accordingly, the court found that Mr. Carlisle failed to state fiduciary breach claims and as a consequence the district court properly dismissed his lawsuit.

Fifth Circuit

Brown v. Peco Foods, Inc., No. 3:25-CV-491-TSL-RPM, 2025 WL 3210857 (S.D. Miss. Nov. 14, 2025) (Judge Tom S. Lee). Plan participant Jayson Brown filed this putative class action against his former employer, Peco Foods, Inc., alleging that it violated the terms of its 401(k) retirement plan and its fiduciary duties under ERISA by using forfeitures to reduce its future matching contribution obligations rather than to reduce the plan’s administrative costs. Mr. Brown asserts claims of disloyalty, imprudence, breach of plan document, and prohibited transactions. Peco moved to dismiss them all. In this concise decision the court granted the motion to dismiss. First, the court was persuaded by Peco’s argument that the plan language did not require forfeitures to be spent on administrative expenses before they could be used to reduce employer contributions given the plan’s use of the permissive word “may.” “Here, the court, having considered the parties’ arguments, is of the opinion that the provision at issue, in view of the use of the permissive term ‘may’…does not unambiguously require that Peco apply the forfeitures to administrative expenses before it may apply them to offset employer contributions. Peco’s reading, under which it has discretion to decide how to apply the forfeitures, e.g., whether to apply them, first, to pay administrative expenses of the Plan or to instead offset employer contributions, is a fair and reasonable interpretation of the provision and thus is accepted as the correct interpretation. It follows that Peco’s use of the forfeitures to offset employer contributions did not violate the terms of the Plan and thus, that plaintiff has failed to state a claim.” Furthermore, the court agreed with Peco that its chosen use of the forfeitures was not a violation of its fiduciary obligations, because ERISA requires only that plan participants receive the benefits they are promised. The court noted that “over a dozen” other district courts have considered and rejected similar arguments presented in these forfeiture cases, while “only a handful of courts” have found merit to them. Finally, the court dismissed the prohibited transaction claims. It concluded that inter-plan reallocation of plan assets functioned as a benefit to the plan, and therefore cannot be considered a transaction under Section 1106. Based on the foregoing, the court decided that Mr. Brown failed to state his claims, and ordered that his complaint be dismissed.

Ninth Circuit

Hernandez v. AT&T Services, Inc., No. 2:25-cv-00676-ODW (PVCx), 2025 WL 3208360 (C.D. Cal. Nov. 14, 2025) (Judge Otis D. Wright, II). This decision is the latest in a series of rulings dismissing putative class actions involving forfeited employer contributions in ERISA-governed 401(k) plans. In many ways, this was a cut and paste order which deferred to and drew from numerous rulings we have covered at Your ERISA Watch over the past year in similar actions. As in those cases, the court flat-out rejected plaintiff’s theory of the case, which was that spending forfeited employer contributions on the cost of future employer contributions rather than on defraying administrative expenses violates ERISA’s anti-inurement provision, its prohibition on self-dealing, and the statute’s fiduciary standards. In this particular lawsuit plaintiff Luis Hernandez alleged that AT&T Services, Inc. improperly applied forfeited contributions to reduce future employer obligations in its defined contribution plan. Relying on the precedent set by district court decisions from throughout the country, AT&T moved for dismissal of all causes of action pursuant to Rule 12(b)(6), arguing that Mr. Hernandez’s “sweeping theories of liability…do not state a plausible claim for relief.” The court strongly agreed. It began by addressing the fiduciary breach claims. At bottom, the court held that Mr. Hernandez’s views fail because they contravene ERISA, decades of settled precedent, and set out to create benefits beyond those promised to the participants in the plan. For these reasons, the court dismissed the claims of imprudence, disloyalty, and failure to monitor. Next, the court tackled the anti-inurement claim. It found that AT&T could not have violated 29 U.S.C. § 1103(c)(1) because it did not remove any assets from the plan or use the forfeitures for any purpose other than to pay its obligations to the plan participants. Accordingly, the court dismissed this claim too. Finally, it discussed the prohibited transaction claim. The court ultimately held that Mr. Hernandez could not state such a cause of action because there was no “transaction” here, and because the funds were not “used in a prohibited manner.” As a result, the court granted the motion to dismiss the entirety of the action. Moreover, it determined that amendment would be futile given its steadfast position that Mr. Hernandez’s “ERISA claims rest on a misinterpretation of the Plan’s terms and a novel legal theory that is unsupported by present law.” Thus, the court’s dismissal was without leave to amend.

Disability Benefit Claims

Ninth Circuit

Baltes v. Metropolitan Life Ins. Co., No. 2:23-cv-07404-MRA-JPR, 2025 WL 3199464 (C.D. Cal. Nov. 12, 2025) (Judge Monica Ramirez Almadani). This action was filed by a former senior software engineer at Google, plaintiff Austin Baltes, who sought judicial review of the denial of his claim for long-term disability benefits by defendant Metropolitan Life Insurance Company (“MetLife”). On January 22, 2024, the court granted the parties’ joint stipulation to a de novo standard of review, and on August 26, 2024, the court held a hearing on the parties Rule 52 motions for judgment. In this decision the court issued its findings of fact and conclusions of law and entered judgment in favor of Mr. Baltes. The court found that Mr. Baltes met his burden of showing by a preponderance of the evidence that he was disabled during the relevant time period and unable to perform the substantial and material duties of his occupation due to post-viral fatigue, brain fog, and cognitive impairment. The court determined that Mr. Baltes’ self-reported symptoms were consistent, credible, and supported by corroborating medical records, lab testing results, and statements made by his treating physicians. By contrast, the court noted that MetLife’s reviewing nurses and doctors conducted paper-only reviews, failed to review the complete file or Mr. Baltes’ actual job description prior to rendering their opinions, and crucially inappropriately emphasized what they saw as a lack of objective physical findings to justify the denial of benefits. Because of these shortcomings, the court found the statements of MetLife’s reviewers “to be of little assistance” and assigned them minimal weight, particularly as they never seriously disputed Mr. Baltes’ diagnoses themselves, only the severity of his conditions. For these reasons, the court concluded that Mr. Baltes was disabled under the terms of his plan and entitled to benefits. Thus, the court granted Mr. Baltes’ motion and denied MetLife’s motion.

Eleventh Circuit

Hovan v. Metropolitan Life Ins. Co., No. 24-11167, __ F. App’x __, 2025 WL 3241521 (11th Cir. Nov. 20, 2025) (Before Circuit Judges Jill Pryor and Luck, and District Judge Virginia M. Covington). Plaintiff-appellant Stacy Hovan was employed as a commercial litigator with the law firm Troutman Sanders LLP. In February of 2019, Ms. Hovan stopped working due to a mental health crisis stemming from her bipolar disorder diagnosis. After she stopped working two things happened simultaneously. First, Ms. Hovan applied for disability benefits under an ERISA-governed policy insured by defendant-appellee Metropolitan Life Insurance Company. Second, she entered an intensive outpatient program. She remained at the program until September 22, 2020, when her providers determined that her acute crisis had stabilized. Throughout this time, Ms. Hovan had been approved for and was receiving benefits from MetLife. However, upon discharge from the treatment facility, MetLife terminated the benefits. It concluded that the notes from Ms. Hovan’s ongoing therapy sessions post-discharge failed to establish continued disability or the inability to perform the essential functions of her work as a litigator. The district court ultimately agreed with MetLife’s decision, concluding at the summary judgment stage that it was not de novo wrong. On appeal, the Eleventh Circuit concurred. “For the period after Hovan’s release from PeakView on October 16, 2020, the only evidence that Hovan submitted to MetLife in support of her continued claim of disability was the therapy notes from her sessions with Ms. Stevens. Upon review, we conclude that Ms. Stevens’s therapy notes do not show that Hovan was still disabled and unable to work as a commercial litigator after her release from PeakView.” While the therapy notes were “troubling” and certainly reflected that Ms. Hovan continued to experience psychiatric symptoms consistent with bipolar disorder, including “passive” suicidal ideation, the Eleventh Circuit nevertheless agreed with MetLife they that failed to establish that Ms. Hovan’s judgment, decision-making ability, stress tolerance, or interpersonal functioning were impaired or not adequately controlled. On the record before it, the court of appeals agreed with the lower court that Ms. Hovan could continue performing the essential duties of a commercial litigator following her discharge, despite her serious ongoing mental health concerns, including occasional depression, mania, and anxiety. For this reason, the Eleventh Circuit found that both MetLife and the district court appropriately concluded that Ms. Hovan no longer met the plan’s definition of disabled after her release from the treatment facility and that she could not provide satisfactory proof to the contrary. As a result, the Eleventh Circuit affirmed the district court’s judgment in favor of MetLife and upheld the termination of Ms. Hovan’s benefits.

Exhaustion of Administrative Remedies

Tenth Circuit

Sellers v. Humana Ins. Co., No. 1:24-cv-00162-SMD-GBW, 2025 WL 3204747 (D.N.M. Nov. 17, 2025) (Judge Sarah M. Davenport). This case arises from plaintiff Michael Sellers’ claim for Accidental Death and Bodily injury benefits under a policy issued by Humana Insurance Company following the death of his wife Amber in a car accident. Humana moved for summary judgment and to strike exhibits Mr. Sellers included which it argued were outside of the administrative record. In this decision the court denied both motions, but remanded Mr. Sellers’ claim to Humana for further consideration. The court’s decision centered around the issue of administrative exhaustion. The court deemed Mr. Sellers to have satisfied the exhaustion requirement because Humana failed to comply with its regulatory duties. Specifically, the court found that Humana neglected to have a meaningful dialogue with Mr. Sellers or provide him adequate notice about the deficiencies in his third-party designation of his attorney. “Driving this conclusion is Humana’s paradoxical decision to at once reject Mr. Houliston as Plaintiff’s authorized representative yet only communicate with him regarding the signature requirement.” The court said Humana’s logic was untenable. If the lack of a signature was the difference between “effecting review of a claim denial and not, Humana [needed to] take some affirmative step to inform the claimant of this requirement.” Humana did not do so. And this failure was particularly problematic given that the plan documents do not mention the need for a signature for designating an authorized representative. Accordingly, the court found that Humana did not diligently pursue its duties to ensure that the claims procedures were clearly communicated to Mr. Sellers. Thus, the court concluded that Humana failed to dispel Mr. Sellers’ notion that he was represented by counsel and that his appeal would proceed. As a result, it held that Mr. Sellers had exhausted his administrative remedies. Nevertheless, because the administrative record has not been properly developed, the court concluded that the proper course of action is to remand the claim to Humana for a full review. Thus, the court declined to consider the merits of Humana’s decision to deny the benefit claim at this juncture. Moreover, in light of its decision to remand rather than reach the merits of the denial, the court denied the motion to strike exhibits outside of the administrative record as moot.

Life Insurance & AD&D Benefit Claims

First Circuit

Metropolitan Life Ins. Co. v. Hughes, No. 22-cv-11526-ADB, 2025 WL 3204609 (D. Mass. Nov. 17, 2025) (Judge Allison D. Burroughs). MetLife filed this interpleader action to determine the proper beneficiary of life insurance benefits associated with an ERISA-governed policy for decedent David True. Defendant Douglas Hughes, individually and as representatives of the estates of Renee True and David True, moved for summary judgment in his favor. He argued that Renee’s estate was entitled to the benefits because she was the named beneficiary and survived her husband. Moreover, Mr. Hughes argued that Ryan True, David and Renee’s son and the contingent beneficiary of the policy, was precluded from receiving the proceeds of his father’s life insurance policy, either directly or through his mother, under both Massachusetts law and federal common law because he was found guilty by a Massachusetts jury of the murder of both of his parents and sentenced to two consecutive life sentences. The court agreed with Mr. Hughes on both points and held that as the sole remaining eligible heir of Renee, Mr. Hughes was entitled to the proceeds of David’s life insurance policy. The court entered judgment to this effect.

Medical Benefit Claims

Ninth Circuit

Pritchard v. Blue Cross Blue Shield of Ill., No. 23-4331, __ F. 4th __, 2025 WL 3202338 (9th Cir. Nov. 17, 2025) (Before Circuit Judges Rawlinson and Smith Jr., and District Judge Jed S. Rakoff). A group of transgender participants and beneficiaries in self-funded employer-sponsored health plans sued their third-party administrator, Blue Cross Blue Shield of Illinois, alleging that language in their plan excluding gender-affirming care violated sex-based discrimination provisions of the Affordable Care Act (“ACA”). The district court agreed and found in favor of plaintiffs on summary judgment. Last week, however, a panel in the Ninth Circuit overturned some of the district court’s rulings and remanded for further scrutiny. Central to the Ninth Circuit’s ruling was the recent Supreme Court decision in United States v. Skrmetti, 145 S. Ct. 1816 (2025), wherein the high court found that state law restrictions on the treatment of gender dysphoria do not necessarily constitute discrimination on the basis of sex. Before it addressed Skrmetti, however, the Ninth Circuit joined the district court in rejecting three of Blue Cross’s defenses, which were: (1) the plans were not funded by the federal government; (2) it was acting at the direction of the employers; and (3) it was shielded by the Religious Freedom Restoration Act. Argument two implicated ERISA; Blue Cross argued that ERISA’s statutory emphasis on implementing plan terms as written authorized it to enforce the provisions at issue, even if they were contrary to the ACA. The court acknowledged that the two statutes potentially created a conflict, but “[t]his is a risk BCBSIL accepted when it assumed fiduciary duties to the plan. Every fiduciary faces the same dilemma when there is doubt about the legality of an action it feels compelled to take.” In the end, however, the court found no conflict: “the text and structure of ERISA…do not allow third-party administrators to flout the law on behalf of their employer-customers.” The court’s ruling rested on Section 1144(d) of ERISA, which provides that ERISA does not supersede other federal law, and thus its commands must yield to the ACA. Where the Ninth Circuit diverged from the lower court was on the basic holding that gender-affirming care exclusions are inherently discriminatory. This conclusion, the panel stated, has been undercut by the intervening authority in Skrmetti. They explained, however, that just because the district court’s reasoning failed in light of Skrmetti, the plaintiffs may still ultimately win as the district court could potentially distinguish Skrmetti. In particular, the Ninth Circuit noted that some of the plaintiffs needed hormone treatments for diagnoses other than gender dysphoria, but Blue Cross still would not treat them. The panel said this fact left open the possibility that Blue Cross’s justifications for its actions were a pretext for discrimination. Thus, the panel instructed the district court to reassess whether plaintiffs can establish discrimination under the appropriate legal standard. Judge Rawlinson penned a concurrence in which she argued that the majority had gone too far in opining as to how the district court might interpret Skrmetti on remand. “I see the majority’s analysis as exceeding a remand and conducting a ‘first view’ rather than a ‘review.’”

Pension Benefit Claims

Third Circuit

Princeton Univ. Retirement Plan v. Estate of Jerome F. Andrzejewski, No. 23-1501 (ZNQ) (TJB), 2025 WL 3215721 (D.N.J. Nov. 18, 2025) (Judge Zahid N. Quraishi). In this decision the district court ruled on competing motions for summary judgment filed by the potential beneficiaries of decedent Jerome Andrzejewski’s Princeton University retirement account. Relying on the Supreme Court’s precedent set in Kennedy v. Plan Administrator for DuPont Savings & Investment Plan, 555 U.S. 285 (2009), the court held that defendant Robert Moses was the rightful beneficiary of the proceeds as he was properly designated as the sole beneficiary of the account in 1993, and no change of beneficiary form was ever executed by Mr. Andrzejewski subsequent to this designation and prior to his death. The court stated that the competing beneficiaries, the Estate of Jerome F. Andrzejewski and Denis Andrzejewski, could not offer any facts to contradict this, and instead only offered speculation that Mr. Andrzejewski intended to amend his beneficiary designation as evidenced through his statements to his estate planning attorney. Because the Kennedy decision foreclosed any inquiry into the parties’ intents and desires in favor of the virtues of strict adherence to beneficiary designations, the court held that it need not consider or investigate the Estate and Denis’s arguments. Rather, because neither party established that Mr. Andrzejewski amended the beneficiary designation of his account proceeds in accordance with the plan’s directives, the court held that Mr. Moses was entitled to the benefits at issue. As a final matter, the court declined Denis’ and the Estate’s request to impose a constructive trust, given the fact that they presented no evidence that Mr. Andrzejewski’s designation of Mr. Moses stemmed from a mistake or some other wrongful act. Consequently, the court granted Mr. Moses’s motion for summary judgment, denied Denis’ and the Estate’s cross-motion for summary judgment, and ordered that the retirement benefits be paid to Mr. Moses.

Pleading Issues & Procedure

Second Circuit

Doherty v. Bristol-Myers Squibb Co., No. 24-CV-06628 (MMG), 2025 WL 3204436 (S.D.N.Y. Nov. 17, 2025) (Judge Margaret M. Garnett). On September 29, 2025, the court issued a ruling granting in part and denying in part defendant Bristol-Myers Squibb’s motion to dismiss this putative class action alleging violations of ERISA in connection with the pharmaceutical company’s pension risk transfer and annuitization of its defined benefit pension plan with Athene Annuity and Life Company. (Your ERISA Watch featured the decision as our case of the week on October 8, 2025.) Presently before the court was defendants’ unopposed motion to certify that order for interlocutory appeal. Under 28 U.S.C. § 1292(b), district courts may exercise their discretion to certify an interlocutory appeal where the decision at issue “(1) involves a controlling question of law (2) as to which there is substantial ground for a difference of opinion and (3) as to which an immediate appeal may materially advance the ultimate termination of the litigation.” Here, the court found all three factors were satisfied, and accordingly granted defendants’ motion. First, the court agreed with Bristol-Myers Squibb that its decision that plaintiffs have Article III standing involves a controlling question of law involving at least one purely legal question of whether the pension risk transfer transaction at the heart of this case caused the type of harm required to confer Constitutional standing. Second, the court emphasized that there is a split among the federal district courts as to whether pension risk transfer transactions that purport to promise the same ongoing benefits as the ERISA plans can ever confer Article III standing on the pensioners. This split, including within the Second Circuit, demonstrated to the court that there is substantial ground for difference of opinion on this fundamental issue. Finally, the court stated that the Second Circuit’s ruling will resolve a foundational legal issue and either bring the case to a close or narrow the potential issues the parties must litigate and the court must decide going forward. In either event, “substantial efficiencies will be gained by resolving the standing issue now.” For these reasons, the court agreed with defendants that its September 29 decision should be certified for interlocutory appeal. Accordingly, the court granted defendants’ motion. Finally, the court stayed the case for the pendency of the appeal other than the limited discovery agreed upon by the parties.

Sixth Circuit

Bradley v. Toyota Tsusho America, Inc., No. 5:25-cv-00385-GFVT, 2025 WL 3220087 (E.D. Ky. Nov. 18, 2025) (Judge Gregory F. Van Tatenhove). Decedent Joshua Shepard worked for defendant Toyota Tsusho America, Inc. Mr. Shepard had originally designated his grandmother as his beneficiary pursuant to his coverage under the Toyota employee life insurance benefit plan. However, after the birth of his two young children, Mr. Shepard attempted to change his designation, to name the children and their mother, his longtime partner plaintiff Kaitlyn Bradley, as his beneficiaries. However, the person responsible for filing the paperwork at Toyota left the company, and Mr. Shepard’s beneficiary change form was either lost or destroyed as a result. When he learned about this, Mr. Shepard attempted to start the process over again. He acquired new forms, filled them out, and planned to submit them to the company. Things then took a tragic turn. With the completed forms in his backpack, Mr. Shepard died in a car accident. As a result, despite his clear intentions and affirmative actions to add his partner and children as his beneficiaries, Mr. Shepard was never able to submit the required paperwork. Ms. Bradley originally filed this action in state court on behalf of herself and her children alleging a common law negligence claim. Toyota removed the complaint to federal court on the basis of federal question jurisdiction and then filed a motion to dismiss the complaint pursuant to ERISA preemption. In response, Ms. Bradley amended her complaint to assert a fiduciary breach claim under ERISA instead. Thus, the question before the court here was whether Ms. Bradley’s amended complaint rendered Toyota’s motion to dismiss moot. With little fuss, the court concluded it did. “Bradley’s amended complaint no longer contains any state law negligence counts. Instead, Bradley’s amended complaint advances the lawsuit based on alleged violations of ERISA. The amended complaint and the original complaint are not substantially identical. Bradley changed the legal theory under which she seeks relief against Toyota. Bradley’s amended complaint cured the defects raised by Toyota’s motion to dismiss. Thus, the amended complaint moots the pending motion to dismiss.” Therefore, the court denied the motion to dismiss as moot, and the action will now proceed under ERISA.

Eleventh Circuit

Marrow v. E.R. Carpenter Co., Inc., No. 8:23-cv-2959-KKM-LSG, 2025 WL 3209652 (M.D. Fla. Nov. 18, 2025) (Judge Kathryn Kimball Mizelle). In this putative class action plaintiff Saroya Marrow alleges that her former employer, E.R. Carpenter Co., Inc., failed to provide sufficient notice under the Consolidated Omnibus Budget Reconciliation Act (“COBRA”) of continuing healthcare coverage in violation of ERISA. Specifically, Ms. Marrow points to two shortcomings in the COBRA notice she was mailed: (1) the notice omitted the date when the election form was due; and (2) it included conflicting statements regarding whether the initial payment had to accompany the election form. Ms. Marrow alleges that failing to elect COBRA coverage caused her economic injuries through the loss of health and dental insurance. In this decision the court concluded that Ms. Marrow lacked Article III standing to pursue her action because she failed to identify any evidence that these injuries were traceable to the deficiencies in the COBRA notice she received from Carpenter. The court held, “[r]ather than demonstrate that the notice’s deficiencies caused Marrow’s injuries, the evidence shows only that her injuries were self-inflicted. Thus, even if Carpenter’s notice contained the due date and correctly instructed Marrow of when to make her first payment, Marrow’s testimony establishes that her issues with these non-deficient portions of the notice would have prevented her from electing coverage. Marrow’s injuries are traceable only to herself. A non-deficient notice would have resulted in ‘precisely the same harm.’” Because the court concluded that Ms. Marrow set forth no evidence demonstrating factual causation between her injuries and the deficiencies in the notice she received, the court could not say that her injury was fairly traceable to Carpenter’s misconduct. As a result, the court concluded that Ms. Marrow lacked standing to bring her action, and therefore dismissed the complaint, without prejudice.

Retaliation Claims

Seventh Circuit

Singleton v. AT&T Enterprises, No. 1:24-cv-12485, 2025 WL 3215779 (N.D. Ill. Nov. 18, 2025) (Judge Mary M. Rowland). Plaintiff Michael Singleton brings this ERISA and Title VII action against defendants Illinois Bell Telephone Company, LLC, AT&T Enterprises, and AT&T Incorporated alleging that his termination was a form of discrimination and impermissibly interfered with his pension benefits under ERISA. Defendants moved to dismiss the claim of discrimination under Title VII of the Civil Rights Act with respect to AT&T Enterprises and AT&T Inc. and moved to dismiss the ERISA Section 510 claim in its entirety, or alternatively, with respect to just AT&T Enterprises and AT&T Inc. The court granted the motion to dismiss the Title VII claim with respect to the AT&T defendants, but entirely denied the motion to dismiss the ERISA claim. Regarding the Title VII discrimination claim, the court agreed with defendants that the complaint fails to allege that either AT&T defendant was Mr. Singleton’s direct employer or that they were his employers based on some indirect theory of liability. The complaint, the court stated, “does not allege that AT&T Enterprises and AT&T Inc. ‘directed’ the purported racial discrimination against Plaintiff. Nor does it allege that AT&T Enterprises and AT&T Inc. exercised ‘control’ over Plaintiff’s employment relationship. The Amended Complaint merely alleges in a conclusory fashion that AT&T Enterprises and AT&T Inc. were Plaintiff’s employers. This is insufficient.” Accordingly, the court granted this aspect of defendants’ motion to dismiss. However, it clarified that this dismissal was without prejudice to Mr. Singleton amending his complaint to address this deficiency. Turning to the ERISA claim, the court addressed each of defendants’ three arguments for dismissal: (1) failure to plead specific intent; (2) failure to exhaust administrative remedies; and (3) the AT&T defendants are not proper defendants to this cause of action. The court first held that the complaint sufficiently raises plausible allegations that defendants fired Mr. Singleton to save the roughly $280,000 to $560,000 they would have owed him had they kept him employed until his higher tiered pension had vested. Next, the court noted that the complaint states that Mr. Singleton exhausted all available administrative remedies, or in the event he failed to do so, that exhaustion would have been futile. The court thus declined to dismiss the action based on the affirmative defense of exhaustion. Finally, the court denied defendants’ request for dismissal as to AT&T Enterprises and AT&T Inc. Unlike Title VII, ERISA Section 510 does not require the existence of an employer relationship. The court said that the allegations in the complaint lead to a plausible inference that all defendants engaged in the adverse actions against Mr. Singleton and that each is therefore alleged to be liable for the ERISA violation regardless of whether the AT&T defendants were Mr. Singleton’s direct employer. For these reasons, the court granted in part and denied in part the motion to dismiss.

Statutory Penalties

Tenth Circuit

Mayor v. Metropolitan Life Ins. Co., No. 1:25-cv-00012-DBB-DAO, 2025 WL 3251356 (D. Utah Nov. 21, 2025) (Judge David Barlow). Following the accidental death of her husband Casey, plaintiff Nicole Mayor submitted a claim to Metropolitan Life Insurance Company (“MetLife”) for life insurance and accidental death insurance benefits as the sole beneficiary of her husband’s coverage under ERISA-governed policies. MetLife denied the claim for accidental death benefits on the basis of a policy exclusion. When Ms. Mayor appealed the denial she requested additional information about the policy from MetLife, but these requests, and ultimately the appeal itself, were denied by MetLife. Accordingly, in this action Ms. Mayor seeks the benefits that she was denied. In addition to MetLife, she has sued Casey’s former employer and the plan’s administrator, Union Pacific, and two individual officers of Union Pacific. In her amended complaint, Ms. Mayor asserts two causes of action: (1) a claim for statutory penalties for failure to provide information required by ERISA; and (2) wrongful denial of her claim. Before the court here was defendant MetLife’s motion to dismiss the statutory penalties claim on the grounds that it is the plan’s claims administrator, not the plan administrator. The court agreed and granted the partial motion to dismiss. It held that under Tenth Circuit precedent only the plan administrator can be liable for failing to provide information required under the statute. Ms. Mayor claimed that MetLife is liable for statutory penalties because it “agreed with the plan administrator that MetLife would pay any ERISA penalties for failing to provide material.” It is clear throughout the complaint that Ms. Mayor alleges that Union Pacific and its executives served as the plan administrator. The court held that her theory of liability for MetLife based on these alleged agreements creating an agency relationship between it and Union Pacific simply failed “to state a claim against MetLife for not providing the information required under ERISA.” As a result, the court granted the motion to dismiss the first cause of action as asserted against defendant MetLife.