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Category: Health Insurance

Your ERISA Watch – Fifth Circuit Denies Attorneys’ Fees to Plaintiff for en banc Success Changing Judicial Standard of Review

This week’s notable decision is another terrible decision for ERISA plan participants out of the Fifth Circuit Court of Appeals:  Ariana M. v. Humana Health Plan of Texas, Inc., No. 18-20700, __F.App’x__, 2019 WL 5866677 (5th Cir. Nov. 8, 2019)…

Your ERISA Watch – District Court Finds Oxford’s Denial of Teen’s Residential Treatment Arbitrary and Capricious Due to Reliance on UBH Guidelines

For those of us waiting for a court to follow the reasoning in the remarkable Wit v. United Behavioral Health, 2019 WL 1033730 (N.D. Cal. Mar. 5 2019) decision earlier this year, we got it last week with the decision…

Your ERISA Watch – Second Circuit Holds Breach of Contract Claims for Retiree Medical Coverage Not Preempted by ERISA

This week’s notable decision is an unpublished ERISA preemption decision in Abernethy v. EmblemHealth, Inc., No. 19-422, __F.App’x__, 2019 WL 5302825 (2d Cir. Oct. 21, 2019), where the Second Circuit revived the state law claims retired officers brought against EmblemHealth…

Your ERISA Watch – Ninth Circuit Holds that Hawaii Statutes Restricting Insurers’ Subrogation Recovery Rights Are Saved from ERISA Preemption

This week’s notable decision is Rudel v. Hawai’i Management Alliance Association, No. 17-17395, __F.3d__, 2019 WL 4302895 (9th Cir. Sept. 11, 2019), where the Ninth Circuit made three significant determinations with respect to ERISA preemption of state laws regulating insurance. …

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