bhoffman | July 19, 2010
www.seethebenefits.com
There is a well-known saying among baseball fans that the “tie goes to the runner.” This is true under one baseball rule that provides that a batter is out if he or the base is tagged before he reaches first. It is not true, however, under another rule that provides that a runner is out [...]
Adam V. Russo | April 20, 2010
Introduction
Over the course of the past several years, the value proposition of Preferred Provider Organizations (PPOs) has come under increasing scrutiny. Many have thought that if price can be controlled, health care costs can be controlled or at least mitigated. The truth is that health care costs are an intricate and complex balancing act between [...]
Adam V. Russo | December 28, 2009
Worried the current regulation may limit investment advice, Labor Department hopes to amend definition by June
by Jessica Toonkel Marquez, Investment News www.investmentnews.com
The Labor Department is planning to expand its definition of fiduciary under ERISA — a move that would have implications for all financial advisers that work on retirement plans.
Adam V. Russo | November 23, 2009
With lawsuits piling up against pension plan sponsors, individual fiduciaries would do well to protect themselves against financial risks, experts say.
Randy Myers – CFO.com | US
November 19, 2009
If you are a fiduciary for your employer’s retirement savings plan, you already know that life isn’t getting any simpler. Lawsuits against plan fiduciaries are on the upswing, [...]
Adam V. Russo | August 11, 2009
by Tim Hull, Courthouse News Service, www.courthousenews.com
LOS ANGELES (CN) – A federal accuses Blue Cross of a wide-ranging scheme to underpay claims from out-of-network hospitals. Methodist Hospital of Southern California claims Blue Cross refuses to let it transfer patients from emergency rooms, then underpays the hospital and sticks patients with hefty bills, falsely claiming the [...]
Adam V. Russo | July 28, 2009
In Administrative Committee of the Wal-Mart Stores, Inc. v. Gamboa, 479 F.3d 538 (8th Cir. 2007), an ERISA plan administrator brought suit seeking equitable reimbursement from a plan participant who had received a settlement from a tortfeasor. Although the reimbursement provision was contained in an SPD for a health plan, the employer had no formal [...]
Adam V. Russo | May 28, 2009
by Fred Schneyer of PLANSPONSOR, www.plansponsor.com
An Indiana manufacturer has received a mixed ruling from a federal judge in a lawsuit alleging its misdeeds in the handling of its benefits program constituted a fiduciary breach.
Adam V. Russo | July 29, 2008
The Brualdi Law Firm, P.C. has issues a press release regarding suit they have filed against Lehman Brothers Holdings, Inc. for potential violations of ERISA. The suit concerns Lehman Brother’s 401(k) plan, which comes within the purview of ERISA. Brualdi, representing members of the Plan, assert that Lehman Brothers and other administrators of the Plan [...]
Adam V. Russo | March 14, 2008
Roy F. Harmon III has posted recent U.S. Department of Labor legal endeavors regarding employee benefit plans on his Health Plan Law blog (http://healthplanlaw.com/). In recent months, most legal controversies regarding ERISA plans have related to plan administration and violations of fiduciary duty. Whether it is an individual plan member suing to enforce plan terms [...]
Adam V. Russo | July 18, 2007
On June 18, 2007, the United States Supreme Court granted a writ of certiorari to hear the appeal of this Fourth Circuit case. Their ruling will once again affect the application of ERISA. Plaintiff (employee LaRue) alleged that the administrator had failed to invest his funds as instructed, resulting in a loss. He sought monetary [...]
Adam V. Russo | April 4, 2007
This case arose from a Plan’s failure to add an employee’s dependents to an ERISA welfare benefit plan. As a benefit of employment, the employer offered its employees health insurance. Under the Plan, the employer was both a “participant” and the “Plan Administrator.” Employees were instructed to direct their inquiries about the Plan to their [...]
Adam V. Russo | April 4, 2007
In this case, a TPA was sued by their clients (employers and those employer’s employees), for mishandling their plans’ funds. The TPA trustees in turn hoped to sue their attorney, claiming that their attorney should have notified them of the fund management issues and improper expenditures. The court found that the attorney did not have [...]
Adam V. Russo | April 4, 2007
In this case, an employee stopped working due to a medical condition and began receiving disability benefits from her employer’s self funded ERISA plan. After two years the case was reassessed, the TPA terminated the benefits. The insured filed suit against the TPA, seeking both payment of past claims and re-instatement of future benefits. The [...]
Adam V. Russo | April 4, 2007
Section 502(a)(3)(B) of ERISA permits a fiduciary to bring a civil action “to obtain equitable relief to enforce the terms of the plan”. To obtain this “equitable relief,” the basis for the fiduciary’s claim and the relief it seeks must be equitable in nature. Importantly, a fiduciary cannot seek to impose personal liability, as that [...]
