ERISA

ERISA did not preempt an ERISA plan's suit against Bayer, the manufacturer of an allegedly defective pregnancy prevention device.  The Plan's claims for negligence, products liability, failure to warn (of defects in the device), etc. did not act immediately and exclusively on ERISA plans.  The ERISA plan was relevant to the claims only insofar as it granted the plan a… Read More

Health Net's arbitration clause did not satisfy H&S Code 1363.1's requirements.  The enrollment form did not clearly that the plan required arbitration of disputes because it said that the arbitration clause didn't apply if the plan was governed by ERISA--and the enrolling employee would have no way to determine whether ERISA applied.  Also, because of intervening text about ERISA plans,… Read More

A district court reviews an ERISA administrator's denial of benefits de novo without deferring to the administrator's decision.  However, the court's only task is to decide whether the administrator's decision is supported by the record.  The court therefore reviews only the reasons the administrator gave for its denial of benefits.  The court may not adopt new rationales for denial of… Read More

For purposes of ERISA plan insurance policies, the Ninth Circuit defines "accident" or "accidental" to mean that the insured did not subjectively expect injury or death to result from his actions--so long as those subjective expectations were reasonable from the insured's perspective.  If the insured's subjective expectation cannot be ascertained, then the court asks whether a reasonable person with a… Read More

A judgment debtor's interest in an ERISA-compliant profit-sharing or pension plan is automatically exempt from execution to enforce a money judgment.  ERISA provides that qualified pension plan interest are not assignable.  29 USC 1056(d).  Under CCP 695.030, property that is not assignable is not subject to enforcement of a money judgment. That section prevails over CCP 704.115, which allows a… Read More

The trial court correctly denied defendant's motion for reconsideration of its order granting the judgment creditor the right to execute on defendants' IRA and ERISA plan interest because the motion failed to cite new facts or law.  However, the trial court then properly exercised its inherent authority to reconsider its order because the reconsideration motion brought to its attention the… Read More

To state a viable ERISA claim against the trustees of an ESOP for continuing to invest in the employers' stock, the plaintiff must plead specific facts showing that an alternative existed and would have benefited the plan's beneficiaries more than continuing to buy the employer's stock.  See Fifth Third Bancorp v. Dudenhoeffer (2014) 134 S.Ct. 2459.  In doing so, the… Read More

Wells Fargo's ERISA plan contained a forum selection clause, choosing the District of Minnesota, where the plan was administered.  This decision holds sthat the forum selection clause is enforceable.  ERISA allows a plan beneficiary three venues for bringing suit.  29 U.S.C. § 1132.  Wells Fargo clause specified one of them.  If Congress had meant to bar forum selection clauses in… Read More

ERISA does not preempt Nevada’s statute limiting the liability of general contractors to pay benefit plan contributions that their subcontractors owe by fail to pay. Read More

A Washington Consumer Protection Act claim against an HMO over its restrictive practices regarding mental health treatment was not completely preempted by ERISA since the claims arose solely under Washington law, which requires that health insurers treat mental health conditions no less favorably than somatic health problems. Read More

The ERISA benefit fund cannot collect unpaid contributions from the employer corporation's officers and directors. Read More

A medical provider may generally only sue for payment as an assignee of the plan beneficiary to whom the provider gave services, and such a suit must be brought under ERISA, not state law—including any tag-along claims for unfair competition, interference with contract and the like. Read More

District court should review ERISA plan administrator’s eligibility determination de novo since a California statute, which is not preempted by ERISA, bans clauses granting an insurer discretion to determine eligibility for policy benefits.  Read More

Though the employee generally bears the burden of proving his eligibility for benefits under an ERISA plan, the plan or employer when proof is, or should be, in the employer’s records.  Read More