The plaintiff-the Pharmaceutical Care Management Association-is a national trade organization representing pharmacy benefit managers. Pharmacy benefit managers act as “middlemen†hired by health benefit providers (such as employers, health maintenance organizations, and public and private …
Although Lumbermens has shown that the Summary Plan Description (“SPDâ€) unambiguously confers upon the Plan administrator discretionary authority to determine eligibility for benefits and to construe the terms of the plan, see Ingram v. Martin …
John Alvis Jackson, Jr. and Larry Andrew Carey (together, the Defendants), were prosecuted in the Western District of Virginia on multiple fraud and theft offenses involving a loss of more than $15 million. U.S. v. …
As the Supreme Court has observed, the plain meaning of the statute should be conclusive except in the rare cases [in which] the literal application of a statute will produce a result demonstrably at odds …
Although we have never addressed the question of derivative standing for ERISA benefits, our sister circuits have consistently recognized such standing when based on the valid assignment of ERISA health and welfare benefits by participants …