“In 2018, the Third Circuit held in American Orthopedic & Sports Medicine v. Independence Blue Cross Blue Shield, that “anti-assignment clauses in ERISA-governed health insurance plans as a general matter are enforceable.” 890 F.3d 445, …
The Court is obliged to dismiss this action because Plaintiff has ultimately pleaded himself out of court. . . . Notably, Defendant has not pleaded that Plaintiff, in seeking to recoup and recouping the overpayments, …
“EBSA regional offices conduct investigations of retirement and health plans to detect and correct violations of Title I of ERISA and related criminal laws. EBSA investigators identified 4,273 violations in the 1,411 investigations closed in …
“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 …
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 …
In the case at bar, Plaintiff is no longer a participant in Defendant’s ERISA plan and he does not allege a wrongful withholding of benefits. . . . Plaintiff does not claim that Defendant promised …
The make-whole rule provides that an insurer cannot enforce its subrogation rights unless and until the insured [i. e., Farie] has been made whole by any recovery, including any payments from the insurer.” Copeland Oaks …
May an attorney be held liable for aiding and abetting a fiduciary breach? A recent law review article raises the issue and advocates the view. The article isn’t written for an ERISA audience, but it …
Tenet alleges that it provided approximately $ 241,000 worth of medical services to Sylvester based on UniCare’s representation that Sylvester was covered under the Plan. . . . Pursuant to the Managed Care Agreement, UniCare …
Estoppel under ERISA is an equitable doctrine of the federal common law of contracts designed to enforce ERISA and the agreements made under it. Armistead v. Vernitron, 944 F.3d 1287, 1298 (6th Cir. 1991). There …