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ERISA Benefits Litigation

Employee Retirement Income Security Act (ERISA) benefits litigation is a complex, ever-evolving area of the law. In this dynamic environment, the U.S. Supreme Court regularly hears and rules on ERISA cases that affect fundamental aspects of ERISA litigation. Members of Robinson+Cole’s ERISA Benefits Litigation Team are at the forefront of ERISA law. We understand the federal and state ERISA regulations and how they evolve. Additionally, we frequently track the ERISA activity of all the U.S. Courts of Appeals.

Our Services

Robinson+Cole is one of the few firms in the Eastern United States with a specific team of lawyers and nonlawyer professionals who focus on advising and defending employers, plans, and insurers in connection with claims for employee welfare benefits, including the following:

  • Federal appeals shaping ERISA procedures governing insured benefit claims
  • Complex health care issues involving ERISA
  • Claim procedures to ensure that claim fiduciaries comply with ERISA regulations
  • Payor/provider disputes
  • Provider de-listing disputes
  • Pharmacy benefit manager (PBM) antitrust claims
  • Nonparticipating provider reimbursement claims
  • Behavioral health claim disputes, including claims alleging violations of federal and state mental health parity and addiction equity laws

Our wide spectrum of clients includes the following:

  • Insurance companies providing life, health, disability, and accidental death and dismemberment (AD&D) coverage
  • Health maintenance organizations (HMOs)
  • Preferred provider organizations (PPOs)
  • Third-party administrators (TPA)
  • PBMs
  • Managed behavioral health care claim administrators
  • Chiropractic health care claim administrators
  • Self-funded plan sponsors

In particular, we have represented claim administrators and plan sponsors in class actions alleging breaches of ERISA fiduciary duty, violations of mental health parity laws, improper offsets against benefits for Social Security disability income benefits, and third-party tort settlements.

Experience


ERISA + Health + Benefits Insurance: Coverage Termination

Robinson+Cole defended a manufacturer in a case brought by 11 retired employees who claimed that employer's termination of their health benefit coverage violated ERISA because such benefits were contractually vested. Robinson+Cole avoided all deposition discovery by persuading plaintiff's counsel to engage in a voluntary document exchange. Based on such informal discovery, we then moved for summary judgment on all of plaintiffs' subsequent claims. The court granted the motion for summary judgment, which resulted in significant litigation cost savings for employer and eliminated potential liability to hundreds of other retirees.

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ERISA + Health + Benefits Insurance: Mental Health Claim

Represented health insurer acting as third-party administrator in a claim for mental health benefits. Successfully obtained summary judgment on behalf of health insurer by demonstrating that insurer was not a plan administrator and did not act as a fiduciary to the plaintiff, and thus was not a proper defendant in the plaintiff's ERISA action.

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Breach of Fiduciary Duty

Successfully defended a municipality, city council members, and retirement board members against a breach of fiduciary duty claim by certain employees, their union, and retirees contesting the legality of an ordinance amending a benefit fund to create an account to pay the cost of retiree health benefits. Prevailed on a motion to dismiss on grounds that the plaintiffs lacked standing due to lack of actual or imminent harm.

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