Research revealed no relevant case law addressing Oregon’s specific regulation. However, several circuits, including the Ninth, Seventh, and Sixth Circuit Courts of Appeals, have held that similar state bans on discretionary language in ERISA plans …
EBSA investigators determined that, over a 10-year period from 2008 to 2017, Gnass converted $52,753 of participant contributions to his own use. During this period, he should have also remitted $25,252 to the plan as a …
“Before the Court is Defendants Cigna Healthcare Inc., Cigna Health and Life Insurance Co., Connecticut General Life Insurance Co., and Cigna Healthcare of Arizona’s (collectively, “Cigna”) Motion to Dismiss. In October 2018, PSCC received a …
Through this matter, Plaintiffs are attempting to stop Defendants allegedly improper practice of underbilling for chiropractic services that Plaintiffs provided to their patients. Presently before the Court are motions to dismiss the First Amended Complaint …
ERISA preempts state law that “relate[s] to any employee benefit plan.”[2] 29 U.S.C. § 1144(a). Plaintiff asserts his claims under a disability policy that, according to Plaintiff, is not subject to ERISA regulation. . . …
Defendants have refused, despite numerous requests, to reimburse the Plan forbenefits the Plan paid on Heafner’s behalf out of Settlement Funds he received in connection withthe Accident. Defendants’ actions violate the terms of the Plan. …
It is well-established that Congress intended ADA and ERISA claims to be arbitrable. See, e.g., Simon v. Pfizer Inc., 398 F.3d 765, 774-75 (6th Cir. 2005) (collecting cases to support ERISA claims are subject to …
“Express Scripts moves for summary judgment on Henkel’s claim for breach of fiduciary duty. Henkel alleges that Express Scripts breached its fiduciary duty not only by failing to adhere to the coverage criteria in the …
By the statute’s terms, only a “participant or beneficiary” may bring a claim. Pascack Valley Hosp. v. Local 464A UFCW Welfare Reimbursement Plan, 388 F.3d 393, 400 (3d Cir. 2004). Nonetheless, a healthcare provider may …
“The description for each of these emails is either “Redacted portion reflecting confidential attorney-client communications with BCBSM Legal Department regarding MLR issues” or “Email reflecting confidential attorney-client communications with BCBSM Legal Department regarding MLR issues.” …