In recent Employee Retirement Income Security Act of 1974 (ERISA) litigation challenging benefit decisions by plan administrators and fiduciaries, litigants have been pleading closely related claims under multiple ERISA statutory civil remedy provisions. Responding to these attempts, several federal courts of appeals have expanded the types of claims that litigants may bring under ERISA’s “catchall” equitable remedy provision, 29 U.S.C. Section 1132(a)(3).This expansion has drawn scrutiny due to issues related to the appropriate standard of review and the availability and scope of discovery for certain ERISA claims.

CASTILLO v. METROPOLITAN LIFE INSURANCE COMPANY The Court affirmed the dismissal of a suit brought under the Employee Retirement Income Security Act that sought to recover attorney’s fees incurred in an administrative appeal of a benefits determination.Panel: Judges Paez, Bade, and Zouhary (N.D. Ohio), with Judge Bade writing the opinion.Key Highlight: “This appeal requires us to decide whether” 29 U.S.C. § 1132(a)(3) “authorizes an award of attorney’s fees incurred during the administrative phase of the ERISA claims process. We hold that § 1132(a)(3) does not authorize an award of such fees.

Moyleet. al. v. Liberty Mut. Ret. Benefit Plan, et. al., No. 3:10-2179-GPC-MDD (S.D. Cal. Jul. 1, 2013).*BackgroundA class of current and former employees of Golden Eagle Insurance Corporation (“New Golden Eagle”), a subsidiary of Liberty Mutual Group, Inc.,seeking benefits creditfor their years of service with Golden Eagle Insurance Company (“Old Golden Eagle”) prior to its acquisition by Liberty Mutual Insurance Company,brought a lawsuit against the Liberty Mutual Retirement Plan (“Plan”)and its owners, sponsors, and administrators (“Liberty Mutual”),under ERISA asserting a claim for benefits under 29 U.S.C.§ 1132(a)(1)(B), a claim for breach of fiduciary duty under 29 U.S.C.§ 1132(a)(3), and two other claims alleging regulatory violations under ERISA.The dispute centered around whether the Old Golden Eagle employees should be credited for purposes of calculating the pension benefit accrual under the terms of the Plan.

Cyr then approached the long-term disability insurer, Defendant Reliance Standard Life Insurance Company (“Reliance”) about adjusting her disability payments accordingly. Reliance denied the request and Cyr sued Reliance.The specific statute involved, 29 U.S.C. § 1132(a)(1)(B), provides: “A civil action may be brought . . . by a participant or beneficiary . . . to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.”In the district court, Reliance argued that it was not a proper party-defendant under § 502(a)(1)(B) pursuant to prior Ninth Circuit precedent which held that suits under 29 U.S.C. § 1132(a)(1)(B) may only be brought against the plan or plan administrator, but that an ERISA participant or beneficiary could not sue a plan’s insurer for benefits. See, e.g., Ford v. MCI Communications Corp. Health and Welfare Plan, 399 F.3d 1076, 108 (9th Cir. 2005); Everhart v. Allmerica Financial Life Ins. Co., 275 F.3d 751, 754 (9th Cir. 2001); Gelardi v. Pertec Computer Corp., 761 F.2d 1323, 1324 (9th Cir. 1985).

A court in Florida has declined to expand the remedies available under a claim for benefits due under 29 U.S.C. § 1132(a)(1)(B) of ERISA. Keys v. Bell, 2019 U.S. Dist. LEXIS 195505 (M.D. Fla. 2019). The court dismissed the plaintiff’s claim for “equitable estoppel by silence” under that provision of ERISA’s civil remedies.This supports the trend in other courts following the U.S. Supreme Court’s 2011 decision in CIGNA Corp. v. Amara, which marked firm boundaries for litigation of claims under § 1132(a)(1)(B) versus under § 1132(a)(3) of ERISA. Amara strongly signaled that claims under § 1132(a)(1)(B) rise and fall on the terms of the plan and are to be litigated under principles of the law of contracts. Equitable principles (such as estoppel, reformation, and surcharge) are available to provide relief under § 1132(a)(3), but only where the plaintiff can demonstrate a claim under § 1132(a)(1)(B) would provide inadequate relief because of the inequitable conduct of the defendant.Plaintiff Tyrone Keys was an NFL defensive lineman from 1983 until 1989, when he retired because of football-related injuries. Keys par

In this case, three classes of plaintiffs who were denied coverage for various mental health services under their ERISA health benefit plans brought suit against claims administrator United Behavioral Health (UBH). They alleged, among other things, that UBH had improperly denied benefits in violation of ERISA, 29 U.S.C. § 1132(a)(1)(B), and asserted a claim for equitable relief under ERISA, 29 U.S.C. § 1132(a)(3).The plaintiffs alleged that internal guidelines UBH used in making coverage determinations were inconsistent with plan terms because they failed to ensure coverage for all treatment consistent with generally accepted standards of care (GASC). According to the plaintiffs’ interpretation of plan terms, this narrowed the scope of coverage under their plans. UBH disagreed. While the exact language of the roughly 3,000 ERISA plans at issue varied, UBH, acting with discretion to interpret plan terms in administering claims, read the plan provisions as requiring as a precondition of coverage that treatment be consistent with GASC.The district court certified three classes with respect to the ERISA denial-of-benefits claim without requiring the plaintiffs to show that putative class members would be entitled to benefits had UBH not used its internal coverage guidelines in making their benefits determinations. To sa

After receiving notice from Castillo's former employer that he received pension benefits in the form of an IRA rollover at the outset of his disability, MetLife determined this was an offset under the Plan that reduced his monthly benefits and resulted in a significant overpayment. Castillo retained counsel to represent him during the administrative review process, which resulted in a reversal of MetLife's decision and the payment of all benefits due to Castillo.Castillo nonetheless sued MetLife for breach of fiduciary duty and sought to recover the attorneys' fees he incurred during the administrative review process as a surcharge under 29 U.S.C. § 1132(a)(3). Even though he obtained all benefits due to him under the terms of the Plan, Castillo argued he was entitled to "make whole" equitable relief under the U.S. Supreme Court's decision in CIGNA Corp. v. Amara, 563 U.S. 421 (2011).

The Fifth Circuit becomes the first federal court of appeals to recognize a remedy for a plan's failure to notify a COBRA participant of the termination of a health-care plan under 29 U.S.C. § 1166(a)(4): award of a civil penalty under 29 U.S.C. §§ 1132(a)(1)(A) and 1132(c)(1).Hager v. DBG Partners, Inc., No. 17-11147 (5th Cir. Sept. 6, 2018): The district court in this case, days away from a bench trial, sua sponte dismissed this case because in concluded that the participant had no remedy against a defunct plan.Hager, a one-time CFO of the defendant, was terminated and elected to receive COBRA continuation coverage from his former employer. Not quite a year into the coverage, the employer terminated the plan and supposedly sent notice to the participants.

According to 29 U.S.C. § 1132(c)(1)(B) of ERISA, it is within a court’s discretion to award a penalty of up to $110 per day based on an administrator’s failure to comply with a plan participant’s or beneficiary’s request for plan documents. Citing to Law v. Ernst & Young, 956 F.2d 364 (1st Cir. 1992), some have argued that this statute applies to plan insurers acting as de facto plan administrators even though they are not named as such.

The U.S. Court of Appeals for the Fourth Circuit rejected the requested relief because the relief sought was not "equitable" in nature and the suit did not seek relief on behalf of the plan. The decision of the appeals court denying the plaintiff's request follows traditional legal analysis in ERISA cases under ERISA provision 29 U.S.C. § 1132(a)(2), which authorizes recovery of "any losses to the plan." LaRue v. DeWolff, Boberg & Associates, Inc., No. 06-856.