Montanile argued, relying on Amara, that the subrogation provision could not be enforced because it appeared only in the SPD. The court first rejected the argument that a document could not be both a written instrument that set forth the plan’s terms, as required by ERISA § 3(a)(1), 29 U.S.C. § 1102(a)(1), and a summary plan description, as required by § 102, 29 U.S.C. § 1022. On this point, the court specifically distinguished Amara.

e individuals listed [29 CFR § 2510.3-3 (c)].Due to the absence of statutory guidance in defining employee under ERISA, plan sponsors have often defaulted to the definition of employee under the Internal Revenue Code of 1986, as amended, which defines an employee as an individual who performs services for the employer as a common law employee [26 CFR § 1.410(b)-9]. The common law employee test is articulated in the Nationwide Mutual Ins. Co. v. Darden decision, and it has been criticized as producing inconclusive results, especially in light of the prevalence of remote workers [503 U.S. 318 (1992)]. The use of the new economic realities test to determine the existence of an employee-employer relationship may simplify the analysis for plan sponsors and provide a more definitive classification.2. Participation EligibilityERISA requires that every plan be established and maintained pursuant to a written instrument which identifies the fiduciaries with the authority to interpret the plan [29 USC §1102]. Plan fiduciaries are required to administer a plan pursuant to its terms, which requires that plan fiduciaries interpret operative terms that govern plan participation eligibility [29 USC 1104(a)(1)(D)]. An employer’s workforce may include independent contractors and employees. However, participation eligibility in employer-sponsored benefit plans is typically limited to employees. In designing employee benefits programs, defining, and properly classifying employees is therefore crucial, because an improper exclusion of an individual from benefit eligibility, based on an incorrect classification, can result in costly litigation and issues with the DOL and Internal Revenue Service (IRS). The plan document, which governs the operation and administration of the plan, should contain a clear definition of employee to ensure operation of the plan consistent with the plan document. Employers should also have a compliance program that considers worker classification. In the event a plan spo

According to the policyholders, both Anthem and Express Scripts had an ERISA-imposed duty, as fiduciaries, to keep drug prices low.There are two kinds of ERISA fiduciaries. A "named" fiduciary, as the name implies, is a fiduciary that is named in an ERISA plan.29 U.S.C. § 1102(a). By contrast, a "functional fiduciary" is not identified by the ERISA plan, but is rather considered a fiduciary "to the extent (i) he exercises discretionary authority or discretionary control respecting management of such plan or exercises any authority or control respecting management or disposition of its assets, . . . or (iii) he has any discretionary authority or discretionary responsibility in the administration of such plan."

Such an approach, it ruled, would undermine plan participants’ and beneficiaries’ ability to rely on plan documents in knowing what authority administrators do and do not have, contrary to ERISA’s requirement that “[e]very employee benefit plan shall be established and maintained pursuant to a written instrument.” 29 U.S.C. § 1102(a)(1). CROSS-PLAN OFFSETTING IS IN TENSION WITH ERISA Second, the court found that the practice of cross-plan offsetting is in some tension with the requirements of ERISA, approaching the line of what is permissible.

An employer that forms an ERISA plan is a named or statutory fiduciary. See 29 U.S.C. § 1102(a). A party not named in a plan can also become a fiduciary if (i) it exercises any discretionary authority or control respecting management of the plan or disposition of its assets, (ii) it renders investment advice for compensation with respect to property of the plan, or (iii) it has any discretionary authority or responsibility in the administration of the plan.

An ERISA plan can have multiple fiduciaries performing different functions. 29 U.S.C. § 1102(a)(1). Plan insurers generally function as decision makers for benefit claims that make them fiduciaries.

7Id. at *21 (citing 29 U.S.C. § 1102(a)(1), ERISA § 402(a)(1), with respect to the fact that an “employee benefit plan shall be established and maintained pursuant to a written instrument”).8Id. at *21 (internal quotation marks omitted).9Id.

The petitioner’s argument, however, failed to consider the well-settled tenet of ERISA that written plan terms must be enforced as written. See ERISA §502(a), 29 U.S.C. §1102(a); Curtiss-Wright Corp. v. Schoonejongen, 514 U.S. 73, 83 (1995). The ERISA-plan language at issue provides that the limitation of actions period is “3 years after the time written proof of loss is required to be furnished according to the terms of the policy.”

In questioning from Justice Ginsburg, the petitioner conceded that ERISA does not have a statutory limitation period for benefit claims but contended that the start date for a limitation period would be controlled by federal law, which would preempt any state law starting the limitation period at an earlier date.The petitioner’s argument, however, failed to consider the well-settled tenet of ERISA that written plan terms must be enforced as written. See ERISA §502(a), 29 U.S.C. §1102(a); Curtiss-Wright Corp. v. Schoonejongen, 514 U.S. 73, 83 (1995). The ERISA-plan language at issue provides that the limitation of actions period is “3 years after the time written proof of loss is required to be furnished according to the terms of the policy.”

The ERISA plan language controls whether a claimant is entitled to benefits and thus, if claimants cannot prove their entitlement to benefits under the plan, they will not prevail under section 502(a)(3). See ERISA § 402, 29 U.S.C. § 1102; Curtiss-Wright Corp. v. Schoonejongen, 514 U.S. 73, 83 (1995). Also, claimants previously faced the unyielding hurdle that the relief sought could not be money damages.