ERISA Watch – February 1, 2016

This week’s notable decision is a discovery order out of the Southern District of Ohio in the matter of Sim v. Reliance Standard Life Ins. Co. The Magistrate Judge presiding over the parties’ discovery dispute permitted the long term disability claimant to pursue substantial discovery into Reliance Standard’s structural conflict of interest. Permissible topics include incentives or reward programs for employees involved in reviewing disability claims, the insurers relationship with vendors who review disability claims and their track records, data on the number of claims received and denials, processes designed to check the accuracy of grants of claims, and much much more. If Reliance Standard operates its claims unit in a manner that ensures fair reviews of disability claims, it has nothing to worry about the plaintiff uncovering… There were a number of other notable decisions this past week so don’t stop reading at the cartoon section. Until next week!

Below is Roberts Disability Law, P.C. summary of this past week’s notable ERISA decisions.

SCOTUS

Complaint did not plausibly allege a breach of fiduciary duty claim related to the purchase and hold of employer’s stock. Amgen Inc. v. Harris, No. 15-278, __S.Ct.___, 2016 WL 280886 (U.S. Jan. 25, 2016) (PER CURIAM). This is the U.S. Supreme Court’s second disposition of this matter involving allegations that defendants breached their fiduciary duties by allowing participants to purchase and hold employer’s stock despite knowing that its price was artificially inflated. The United States District Court for the Central District of California granted the fiduciaries’ motion to dismiss, and the participants appealed. The United States Court of Appeals for the Ninth Circuit reversed and remanded. On remand, the District Court, entered an order dismissing action, and participants again appealed. On denial of petition for rehearing en banc, the Court of Appeals reversed and remanded. The fiduciaries petitioned for certiorari, which the U.S. Supreme Court granted, and then it vacated judgment and remanded it back to the Court of Appeals. The Court of Appeals reversed and remanded. The Supreme Court granted certiorari and held that to state claim for breach of fiduciary duty under ERISA, Plaintiffs were required to plausibly allege that a prudent fiduciary in the same position could not have concluded that alternative action of removing employer’s stock from list of investment options would do more harm than good. The Court examined the complaint and did not find sufficient facts and allegations to state a claim for breach of the duty of prudence. The Court reversed the judgment of the Ninth Circuit and remanded for further proceedings. The Court leaves to the District Court in the first instance whether the stockholders may amend the complaint in order to adequately plead a claim for breach of the duty of prudence guided by the standards provided in Fifth Third Bancorp v. Dudenhoeffer, 134 S. Ct. 2459, 189 L. Ed. 2d 457 (2014).

Second Circuit

Panel denies rehearing in matter where it determined that divorce settlement agreement does not constitute a QDRO. Yale-New Haven Hosp. v. Nicholls, No. 13-4725, __F.3d___, 2016 WL 279354 (2d Cir. Jan. 22, 2016) (Before: KEARSE, STRAUB, and WESLEY, Circuit Judges). In Yale-New Haven Hosp. v. Nicholls, 788 F.3d 79 (2d Cir. 2015), the Second Circuit found that a divorce settlement agreement does not constitute a Qualified Domestic Relations Order (“QDRO”) because the agreement fails to comply with the requirements of 29 U.S.C. § 1056(d)(3)(C). The “substantial compliance” rule announced in Metropolitan Life Insurance Co. v. Bigelow, 283 F.3d 436 (2d Cir. 2002) does not apply to domestic relations orders issued after January 1, 1985. However, the court found that two nunc pro tunc orders constitute valid QDROs that assign funds to the former spouse from the three retirement and pension plans named in the orders. The court rejected the argument that domestic relations orders entered after the death of the plan participant can be QDROs. Because the nunc pro tunc orders do not clearly specify the fourth plan, the court concluded that the orders do not assign funds from that plan to the former spouse. Nicohlls petitioned for a panel rehearing which the panel denied over a dissent by Circuit Judge Wesley. Judge Wesley explained that shortly before its decision, the Supreme Court of Virginia decided substantially the issue presented in this case. In opposing a writ of certiorari in the U.S. Supreme Court, the appellee opposed principally on the ground that the posthumous qualified domestic relations order there assigned to an alternate payee payable lump-sum benefits, as opposed to annuity benefits, and thus no conflict existed between the decision of Supreme Court of Virginia and those of other state supreme courts or federal courts of appeals. Judge Wesley did not comment on the merits of the distinction but noted that Nicholls squarely presents this important ERISA question in the context of annuity benefits.

Select Slip Copy & Not Reported Decisions

Attorneys’ Fees

Second Circuit

Court awards a total of $359,134.77 in attorneys’ fees, costs, and 9% prejudgment interest in matter involving successful LTD litigant. Doe v. Unum Life Ins. Co. of Am., No. 12CIV9327LAKAJP, 2016 WL 335867 (S.D.N.Y. Jan. 28, 2016) (Magistrate Judge Andrew J. Peck). Following a $780,756 judgment in Doe’s favor, the Magistrate Judge issued a report and recommendation that Plaintiff’s motion for attorneys’ fees and cost be granted in part and Plaintiff awarded attorneys’ fees, costs and prejudgment interest totaling $359,134.77 ($219,385.34 in attorneys’ fees, $946.12 in costs and $138,803.31 in prejudgment interest). In granting Plaintiff’s motion, the court rejected Unum’s contention that Plaintiff should not be awarded any fees. The court explained that Plaintiff’s judgment constitutes some degree of success on the merits and that courts in this Circuit routinely award fees to prevailing plaintiffs in ERISA actions based solely on their achieving some degree of success on the merits. The court found that a $600 hourly rate is appropriate for Plaintiff’s attorney, Scott Riemer, and that a $355 hourly rate is appropriate for an attorney with five years of ERISA experience. The court also found an hourly rate of $200 for paralegal work to be reasonable. The court did reduce the time Plaintiff’s attorneys expended on certain tasks. The court did not award approximately 47 hours Reimer’s associate billed on the protective order which Plaintiff filed to preclude Unum’s discovery demands. The court also awarded only $71,271.94 in attorneys’ fees for counsel’s work on the trial briefs, which represents a twenty-five percent reduction in the fees requested. With respect to the preparation of “trial exhibits,” the court found that the billing entries were vague and it could not readily determine how the various aspects of trial exhibit preparation were divided among counsel and staff. To account for this lack of clarity (and the excessive amount of hours involved regardless of the division of labor), the court awarded only $21,413.55 in fees for the trial exhibit preparation, which represents a forty percent reduction in the fees requested. With respect to costs, the court awarded only $946.12 and did not allow $341.63 spent on FedEx and messengers. Lastly, the court awarded prejudgment interest at the rate of 9% simple interest per year on the $780,756 judgment using a midpoint of 721 days after October 24, 2011 (the day Doe was to receive his first benefit payment).

Disability Benefit Claims

Sixth Circuit

Denial of LTD benefits not arbitrary and capricious where medical records did not show that claimant complained of fatigue or cognitive impairment as of the date of disability. Slaton v. Standard Ins. Co., No. 3:14-CV-269, 2016 WL 316864 (S.D. Ohio Jan. 26, 2016) (Judge Walter H. Rice). The court upheld Standard’s decision denying Plaintiff’s long term disability benefit claim, where Plaintiff, a former practicing attorney, claimed to be disabled due to fatigue and cognitive difficulties stemming from multiple sclerosis. Plaintiff needed to submit satisfactory written proof that as of January 1, 2012-the date he claims that he became unable to work full-time – he was “disabled” as that term is defined in the Plan. The court found that there is absolutely no evidence in his medical records that he ever complained about any fatigue or decreased ability to concentrate before March 16, 2012, more than two months later. Absent documentation of such subjective complaints in the record as of the claimed date of disability, the court could not find that Standard acted in an arbitrary and capricious manner in failing to give those complaints more weight, or in failing to order an independent medical examination to better assess Plaintiff’s credibility. The court explained that if there was any evidence that Plaintiff actually experienced fatigue or decreased cognitive ability prior to January 1, 2012, the outcome of this case might be different. However, under the circumstances presented here, the court found that Standard’s decision to deny long term disability benefits was not arbitrary or capricious.

Eighth Circuit

Claim denial under stringent definition of disability must be upheld, even if illusory. Anderson v. Sappi Fine Paper N. Am., No. CV 14-428 ADM/LIB, 2016 WL 335861 (D. Minn. Jan. 27, 2016) (Judge Ann D. Montgomery). The court granted summary judgment to Defendant on Plaintiff’s claim seeking disability retirement benefits. Plaintiff has a well-documented history of bilateral clubfeet and injuries to her shoulder, knees, hands, wrists, ankles, and feet. She continued to work at Sappi’s industrial paper mill as a carton line operator by “suck[ing] it up” and dealing with the pain. However, following a foot injury, combined with her long-term feet and knee problems, Plaintiff had to stop work altogether because she could not stand or walk for any significant period. The Social Security Administration found her disabled under its rules. She applied for disability retirement benefits, which Defendant denied. Under the Plan, an individual is entitled to disability retirement benefits if they have a “Total and Permanent Disability,” which is defined as: a physical or mental disability as a result of which a Member is wholly and continuously unable to engage in any occupation or perform any work for any kind of compensation of financial value …. Defendant denied Plaintiff’s claim upon finding that since she was able “to engage in any occupation or perform any work for any kind of compensation of financial value,” she was not entitled to disability retirement benefits. Plaintiff argued that Defendant’s promise to pay disability benefits is illusory because nobody is able to demonstrate they meet the Plan’s definition of disabled. The court found that Plaintiff’s contention has merit but that rewriting a single provision in an otherwise enforceable contract is not recognized in the Eighth Circuit. Although exceedingly difficult to meet, the law does not compel Defendant to have a more favorable definition of disabled nor does the law does not even require Defendant to have a plan at all. The court acknowledged that this result may seem harsh considering the extent of Plaintiff’s well-documented, multiple medical conditions and amazing perseverance to work through her pain to stay employed at the mill for over thirty years, but Defendant’s stringent definition of disability is permissible. Since Plaintiff did not meet her burden in establishing disability, the court could not overturn Defendant’s denial.

Discovery

Sixth Circuit

Court permits substantial conflict of interest discovery in LTD case. Sim v. Reliance Standard Life Ins. Co., No. 1:15-CV-390, 2016 WL 319868 (S.D. Ohio Jan. 26, 2016) (Magistrate Judge Karen L. Litkovitz). In this matter involving a denial of long term disability benefits, Plaintiff moved for discovery and to supplement the administrative record. The court found that discovery is warranted in this case given the structural conflict of interest (Reliance served as both the Plan administrator and the payor of benefits) and because Defendants’ finding that Plaintiff was not totally disabled is contrary to the Social Security Administration’s finding that plaintiff was totally disabled. The court found the following topics within the permissible scope of discovery:

•· Incentive, bonus, or reward programs or systems, formal or informal, for any employees involved in any meaningful way in reviewing disability claims;

•· Policies, informal or formal, that reward claims denials;

•· Contractual connections and the historic relationship between Reliance and the reviewers, vocational professionals, and/or vendors utilized in Plaintiff’s claim;

•· Financial payments made annually to the reviewers, vocational professionals, and/or vendors utilized in Plaintiff’s claim;

•· Data regarding the number of claim files sent to the reviewers, vocational professionals, and/or vendors utilized in Plaintiff’s claim, and the number of denials which resulted;

•· Data regarding the number of times Reliance vocational professionals, employees, vendors, reviewers, and/or personnel classify a regular occupation as sedentary, found disability claimants able to work at a sedentary occupation, or found claimants to be not disabled from their regular occupation or any occupation;

•· Data regarding the number of claims received by legacy employees of the Plan, and the number of denials;

•· Documentation of administrative processes designed to check the accuracy of grants of claims;

•· Policies and procedures regarding the processing and adjudication of claims, and the gathering of claims information, and to ensure the fair and proper administration of Plaintiff’s claim;

•· An explanation of the factual basis of Reliance’s defenses;

•· Information regarding Plaintiff’s duties at the time he became disabled; and

•· A specimen application for benefits, to include the Employer Section.

Based on the court’s ruling that Plaintiff is entitled to discovery of those portions of the claims manual and other statements of guidance upon which Defendants relied, the court denied Plaintiff’s motion to supplement the record as moot. The court explained that it will consider any such documents that Plaintiff presents as evidence of Defendants’ conflict of interest or bias and it is inappropriate for portions of the claims manual and statements of guidance upon which Defendants did not rely to be made part of the administrative record.

ERISA Preemption

Ninth Circuit

In matter involving cyberattackers and personal health information, court denies reconsideration of decision denying motion to remand. In re Anthem, Inc. Data Breach Litig., No. 15-CV-04739-LHK, 2016 WL 324386 (N.D. Cal. Jan. 27, 2016) (Judge Lucy H. Koh). In this putative class action against Defendants related to cyberattackers unauthorized access to Anthem’s data systems and Plaintiffs’ personal health information, the court had previously denied Plaintiffs’ motion to remand, finding that Plaintiffs’ claims were subject to ERISA complete preemption. Plaintiff’s moved for leave to file a motion for reconsideration, which the court denied. Plaintiffs contend that the court’s decision denying remand was grounded on the mistaken predicate that Plaintiffs have not challenged the documentation submitted by Defendants showing that Plaintiffs received health benefits during the relevant time period as dependent beneficiaries of employer sponsored ERISA plans. And, based on this mistaken finding, the court erroneously concluded that Plaintiffs could have brought their claims under ERISA § 502(a), 29 U.S.C. § 1132(a). The court rejected Plaintiffs’ arguments. First, Plaintiffs conceded that they received benefits under an ERISA plan and that they had standing to bring their claims under ERISA § 502(a). Second, Plaintiffs’ challenges to some of the documents submitted by Defendants do not clear the bar necessary for leave to file a motion for reconsideration since Plaintiffs do not challenge the fact that Plaintiffs were enrolled in an ERISA plan. The court found that Defendants sufficiently demonstrated that Plaintiffs were covered under an ERISA plan during the relevant time period and Plaintiffs have not shown a manifest failure by the court to consider material facts or dispositive legal arguments.

Proposed amended complaint alleging misrepresentation about participation in employee benefit plans is not preempted by ERISA. Roberts v. Daymon Worldwide Inc., No. 15-CV-00774-WHO, 2016 WL 301997 (N.D. Cal. Jan. 25, 2016) (Judge William H. Orrick). Plaintiff moved to amend his complaint, which arises from his termination by Defendants, to add two causes of action for intentional and negligent misrepresentation related to statements Defendants made to him about his participation in the 401(k) plan and Employee Stock Ownership Plan (ESOP). Defendants opposed the motion, in part arguing that the amendment would be futile because Plaintiff’s proposed new claims are preempted by ERISA Section 514(a). The court disagreed and permitted Plaintiff to amend his complaint. In finding that Plaintiff’s claims are not preempted by ERISA, the court reasoned that ERISA does not purport to regulate the broad spectrum of unlawful employment practices that may be committed by employers. Further, Plaintiff’s claims do not concern the need for unifying plan administration or standardizing the regulations applicable to all plan beneficiaries; nor do they arise out of Defendants’ administration of the 401(k) Plan or the ESOP. Instead, Plaintiff alleges that Defendants made false statements about the compensation Plaintiff could expect as a result of the sale of Omni Pacific. As such, the allegations are based on a common law duty to refrain from providing false statements, a duty that arises independently from any obligation ERISA may impose on Defendants. They also do not duplicate, supplement, or supplant the ERISA civil enforcement remedy.

Medical Benefit Claims

Tenth Circuit

Health plan administrator’s interpretation of “area” to mean “state” is not arbitrary and capricious but residential treatment exclusion violates Parity Act. F. v. Sinclair Servs. Co., No. 2:14-CV-00505-RJS, 2016 WL 309787 (D. Utah Jan. 25, 2016) (Judge Robert J. Shelby). Plaintiffs sued Defendants Sinclair Services Company and Sinclair Services Company Point of Service Basic Plan after Sinclair’s Plan Administrator denied Plaintiffs’ claim for benefits relating to long-term residential treatment services rendered to their minor daughter, N.F., for depression in the State of Texas. For claims incurred before January 1, 2013, the Administrator denied the claims on the basis that the Basic Plan does not provide benefits for care or services received from non-network providers. The denial turned on the Administrator’s interpretation of the Use of Network Providers During Travel provision. Under that provision, the Plan provides benefits “if a participant travels to obtain care to an area where a network provider is available … [and] utilizes a network provider …. For this purpose, the Plan Administrator interprets area to mean a state. The court found that the general term “area” is undefined, ambiguous, and susceptible to two or more reasonable interpretations as used in the Plan. Because the Administrator’s interpretation of “area” to mean a state is consistent with a reasonable person’s understanding of the term, and even though the Administrator operates under a conflict of interest, the court concluded the Administrator’s claim denial based on that interpretation was not arbitrary and capricious. With respect to claims on or after January 1, 2013, the court concluded that the 2013 amendment to the “Plus Plan” excluding benefits for residential treatment violates the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. The Plus Plan provides no benefits for services received at a residential treatment facility. Prior to the amendment, residential treatment benefits were available for only mental health conditions. Thus, when it eliminated coverage for residential treatment services, it necessarily imposed a treatment limitation that applies only with respect to mental health conditions. The court found that this violates the plain language of the Parity Act.

Provider Claims

Third Circuit

Assignment of benefits sufficient to confer standing notwithstanding patients’ ultimate responsibility to pay. Garden State Pain and Radiology, P.C. v. Horizon Healthcare Services, Inc., et al., No. 15-2878 (KSH)(CLW), 2016 WL 347315 (D.N.J. Jan. 28, 2016) (Judge Katharine S. Hayden). Garden State has its patients sign the following Assignment of Benefits (AOB):

For the professional or healthcare expense benefits allowable and otherwise payable to me under my current insurance policy as payment toward the total charges for the professional services rendered. THIS IS A DIRECT ASSIGNMENT OF MY RIGHTS AND BENEFITS UNDER THIS POLICY. This payment will not exceed my indebtedness to the above-mentioned assignee, and I have agreed to pay, in a current manner, any balance of said professional service charges over and above this insurance payment.

The court found the above AOB sufficient to confer derivative standing under § 502(a). The court found that patients’ ultimate responsibility to pay the balance of the charges to the medical providers does not undercut the validity of the assignment. The court denied Horizon’s motion to dismiss as to Garden State but granted it with prejudice as to Mann Anesthesia because it did not provide the court with a copy of the AOB it required patients to sign.

Seventh Circuit

Provider lacks standing under ERISA where health plan did not give written consent to provider’s assignment as required by the plan. University of Wisconsin Hospitals and Clinics Authority v. Aetna Life Insurance Company, et al., No. 14-CV-779-WMC, 2016 WL 305062 (W.D. Wis. Jan. 25, 2016) (Judge Williams M. Conley). Plaintiff UWHCA operates a hospital in Dane County and is the putative assignee of its patient, Buckingham, who received medical treatment for complications arising from a surgery for which she had only been discharged less than a week before. UWHCA attempted to precertify the follow-up treatment with Aetna, the claims administrator for Buckingham’s health plan. Aetna denied Plaintiff’s request for precertification and then issued a notice indicating that it was denying payment on UWHCA’s claim for “failure to follow contractual notification requirements.” UWHCA appealed multiple times from the denial of benefits but Aetna ultimately upheld its original decision denying benefits. On summary judgment, the court found it undisputed that Aetna did not give written consent to Plaintiff’s assignment as required by the Plan. Accordingly, Plaintiff does not have standing under ERISA despite that the Plan allows for direct payment to medical providers. The court distinguished Kennedy v. Conn. Gen. Life Ins. Co., 924 F.2d 698 (7th Cir. 1991) as merely recognizing that the possibility of direct payment may be enough to make a claim colorable for the purpose of establishing subject matter jurisdiction at the motion to dismiss stage. The court found that Kennedy does not hold out the possibility of direct payment overriding an otherwise valid and unambiguous anti-assignment clause and, in fact, instructs the court to strictly enforce the terms of ERISA plans. The court concluded that since Plaintiff makes no other argument challenging the validity of the anti-assignment clause or Aetna’s ability to enforce that clause, the court cannot reach the merits of Plaintiff’s claims for coverage. The court granted summary judgment in favor of Defendants but denied Defendants attorneys’ fees.

Provider presents colorable claim for benefits where health plan contemplated assignment with consent of administrator and allows direct payment to medical care provider. Univ. of Wisconsin Hosps. & Clinics Auth. v. Aetna Health & Life Ins. Co., No. 15-CV-286-WMC, 2016 WL 305063 (W.D. Wis. Jan. 25, 2016) (Judge William M. Conley). Defendants moved to dismiss Plaintiff’s ERISA claim on the basis that the Plan’s restrictions on assignments prohibit Plaintiff from pursing these claims. Defendants characterize the restriction as an “anti-assignment” but the court found that the relevant assignment provision does not prohibit assignments. In another case involving the same parties and same claims, where the court granted Defendants’ motion to dismiss, the plan expressly provided that “coverage and your rights under this Aetna medical benefits plan may not be assigned.” Here, an assignment is actually contemplated, albeit only with the consent of Aetna. The court found that the assignment provision, coupled with the provision allowing direct payment to the medical care provider, presents a “colorable claim” for benefits that is sufficient to satisfy subject matter jurisdiction. Whether Aetna withheld consent (and whether that withholding was proper) is a merits issue, which the court cannot decide on the pleadings alone. The court denied Defendants’ motion to dismiss but cautioned Plaintiff to consider whether it has a viable claim in light of court’s concurrent decision on a motion for summary judgment in University of Wisconsin Hospitals and Clinics Authority v. Aetna Life Insurance Company, et al., No. 14-CV-779-WMC, 2016 WL 305062 (W.D. Wis. Jan. 25, 2016), at least without Aetna’s consent or an amendment substituting the true plaintiff in interest.

Retiree Medical

Sixth Circuit

Court reaffirms summary judgment in favor of retirees on post-Tackett reconsideration. United Steel v. Kelsey-hayes Co., No. 4:11-CV-15497, 2016 WL 337467 (E.D. Mich. Jan. 28, 2016) (Judge Gershwin A. Drain). In this matter involving a class of retirees affected by Defendants’ decision to discontinue group coverage insurance for eligible retirees and spouses, age 65 and older, and replace it with health reimbursement accounts, the court previously granted Plaintiffs’ Motion for Summary Judgment and denied Defendants’ Motion for Summary Judgment. One year later, the Sixth Circuit affirmed the court’s judgment but then vacated its opinion and remanded the case back to district court for reconsideration in light of the Supreme Court’s decision in M & G Polymers USA, LLC v. Tackett, 135 S. Ct. 926 (2015). Defendants filed a Renewed Motion for Summary Judgment and Plaintiffs filed a Brief in Support of Reaffirmation of Summary Judgment and Permanent Injunction. The court reaffirmed its prior award of summary judgment to Plaintiffs. Although Defendants argued that vesting must now be established by unequivocal, explicit language within the CBA, the court found that the Supreme Court did not adopt this standard in Tackett. Relying on the ordinary principles of contract interpretation to determine whether the contracts in question created vested rights, the court concluded that the parties’ contracts unambiguously demonstrated intent to provide for vested healthcare benefits for retirees, beyond the duration of the CBAs, and the court need not consider extrinsic evidence. The court declined to address Plaintiffs’ preclusion arguments, because doing so to these pre-Tackett decisions may run the risk of perpetuating the now invalid Yard-Man inference. Similarly, the court declined to apply the Carbon Fuel doctrine (which stands for the proposition that judicial interpretations of CBA terms become part of those terms in later CBAs, if not altered by the parties’ agreement), since prior cases may have been tainted by the Yard-Man inference.

Statute of Limitations

First Circuit

Section 204(h) and 402 claims not time-barred at motion to dismiss stage. White v. Jerome A. Chase, Jr., No. CV 15-40013-TSH, 2016 WL 347040 (D. Mass. Jan. 27, 2016) (Judge Timothy S. Hillman). The court considered Defendant’s objections to the Magistrate Judge’s report and recommendation denying Defendant’s motion to dismiss as to the following counts in Plaintiffs’ First Amended Class Action Complaint: (1) Improper, Untimely and Inadequate Notice under ERISA Section 204(h), 29 U.S.C. § 1054(h)(“Section 1054(h)) (Count I), as the result of the Defendant terminating/amendment of the Plan without proper notice; and (2 ) violation of ERISA Section 402, 29 U.S.C. § 1102 (“Section 1102”), as the result of Defendant implementing the Plan termination “without written Plan Document.” The court found that the Amended Complaint cannot fairly be read to assert claims for benefits under Counts I and II, and it declined to adopt the reasoning of the Magistrate Judge in finding that those claims are timely. But, since the Amended Complaint alleges that Plaintiffs never received notice of the 2007 Plan amendment, they never received copies of the Summary Plan Description, and the amendments were implemented without written “Plan Document,” the court cannot find at this stage of the proceedings that the claims are time barred, regardless of what limitations period applies. Instead, the court will reconsider this issue on summary judgment on a more factually developed record. For these reasons, the court denied Defendant’s motion to dismiss these two counts.

* Please note that these are only case summaries of decisions as they are reported and do not constitute legal advice. These summaries are not updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The cases reported above were handled by other law firms but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us. Case summaries authored by Michelle L. Roberts, Partner, Roberts Disability Law, P.C., 1050 Marina Village Pkwy., Ste. 105, Alameda, CA 94501; Tel: 510-230-2090.