Phia Group Russo & Minchoff

Summary Plan Description Vs. The Plan: Consequences Of Discrepancies

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 [...]

The PPO Value Proposition: A Roundtable Discussion for Plan Sponsors

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 [...]

Coming Soon: Broader Definition of Fiduciary Under ERISA

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.

Fiduciary Liabilities: Are You Covered?

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, [...]

Blue Cross Accused of Deceptive Practices

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 [...]

Equitable Relief

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 [...]

Indiana Employer Wins Mixed Ruling in Benefits Case

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.

Breach of Duty Suit Announced

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 [...]

Recent U.S. D.O.L. ERISA Claims- Fiduciary Duties at the Forefront

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 [...]

James LaRue v. DeWolff, Boberg & Associates, Inc., et al., 75 U.S.L.W. 3677

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 [...]

Hughes v. Legion Insurance Company 2007 U.S. Dist. Lexis 17255, (US Dist. S.D. TX, 2007)

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 [...]

Don’t Even TRY To Blame Your Lawyer!

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 [...]

Pippin v. Broadspire Services, Inc., 2006 WL 2588009 (W.D. LA, 2006)

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 [...]

Reichert v. Liberty

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 [...]