Compliance Stuff

On March 5, 2019, Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California issued his opinion in  Wit v. United Behavioral Health , in which he attempted to significantly change how Employee Retirement Income Security Act (ERISA)–governed health plans were administered, particularly third-party administrators’ reliance on medical necessity guidelines and the application of the abuse of discretion standard. The Ninth Circuit ultimately reversed the portions of the decision that were the most troublesome for ERISA plans and third-party administrators. In  K.K.; I.B. v. Premera Blue Cross , issued on February 6, 2025, the Ninth Circuit provided another indication that the approach taken by the district court in the  Wit  matter is in the past. There, the Ninth Circuit affirmed the district court’s grant of summary judgment in favor of the ERISA plan administrator and the self-funded plan. Quick Hits On February 6, 2025, the Ni...

Employee Retirement Income Security Act has protected benefits since 1974 WASHINGTON  – The U.S. Department of Labor today announced the launch of a  webpage that marks the 50th anniversary  of the  Employee Retirement Income Security Act  and reflects on the landmark law’s impact on the retirement security of America’s workers.  The webpage traces the history of ERISA and its protections of the health, retirement savings and other benefits plans of America’s workers. It also details how the department’s  Employee Benefits Security Administration  assists retirement plan beneficiaries and their families in claiming their benefits or reporting violations.  Signed in September 1974, ERISA was designed to protect the interests of employee benefit plan participants and their beneficiaries and has evolved to meet the changing retirement and healthcare needs of workers and their families. “The Employee Income Retirement Security Act became law on L...

  On Labor Day 50 years ago, President Gerald Ford signed the Employee Retirement Income Security Act (ERISA) into law. ERISA , a long time in the making, has had notable successes—but also has led to much litigation and perhaps even contributed to the decline of pension plans. Congress drafted and revised the law after Studebaker closed its plant in South Bend, Ind., in 1963 and left many employees without the pensions they had been promised. ERISA has “accomplished much of what it set out to do,” said Lou Mazawey, an attorney with Groom Law Group in Washington, D.C. “Without ERISA, there would be far fewer workers with retirement savings and far fewer workers with robust health insurance,” said Juliana Reno, an attorney with Venable in New York City. However, ERISA also has become a weapon for plaintiffs’ attorneys to wield against retirement plan administrators and others in court. “We have seen in the past 10 years an explosion of litigation challenging the fees and investment...