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Seventh Circuit Affirms ERISA Fund’s Denial of Out-of-Network Medical Treatment

Seventh Circuit Affirms ERISA Fund’s Denial of Out-of-Network Medical Treatment

In Est. of Gifford v. Operating Eng’rs 139 Health Benefit Fund, No. 23-3356, __F.4th__, 2025 WL 79102 (7th Cir. Jan. 13, 2025), the Seventh Circuit Court of Appeals affirmed the…

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Tenth Circuit Finds Plaintiffs Lack Standing to Bring Parity Act Claim and Affirms Award of ERISA Statutory Penalties Against Health Insurance Company

The Tenth Circuit Court of Appeals recently decided S. v. Premera Blue Cross, No. 22-4056, __F.4th__, 2024 WL 4356319 (10th Cir. Oct. 1, 2024), a case involving claims for mental…

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Third Circuit Upholds Dismissal of Putative ERISA Class Action Alleging MetLife Unlawfully Kept $65 Million in Drug Rebates for Its Own Benefit

In Knudsen v. MetLife Grp., Inc., No. 23-2420, __F.4th__, 2024 WL 4282967 (3d Cir. Sept. 25, 2024), Plaintiffs are former employees of MetLife Group, Inc. and participants in the MetLife…

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Fifth Circuit Orders United Healthcare to Pay for Minor’s Partial-Hospitalization Treatment for Anorexia Nervosa

In Dwyer v. United Healthcare Ins. Co., No. 23-50439, __F.4th__, 2024 WL 4230125 (5th Cir. Sept. 19, 2024), the Fifth Circuit reversed the district court’s judgment in favor of United…

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Eighth Circuit: ERISA Health Plan’s Counterclaim Seeking Equitable Right to Settlement Funds Does Not Establish Subject-Matter Jurisdiction in Federal District Court

In Kellum v. Gilster-Mary Lee Corp. Grp. Health Benefit Plan, No. 23-2765, __F.4th__, 2024 WL 3930833 (8th Cir. Aug. 26, 2024), a dispute where a self-funded health plan removed an…

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Seventh Circuit Holds State Law Claims Seeking Payment and Penalties for Unpaid Medical Bills from Self-Funded Health Plan Are Preempted by ERISA

In Carnes v. HMO Louisiana, Inc., No. 23-2903, __F.4th__, 2024 WL 3873528 (7th Cir. Aug. 20, 2024), Plaintiff-Appellant Carnes appealed the district court’s dismissal of his lawsuit against Defendant HMO…

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