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Table of Contents |
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Chapter 1: |
ERISA Causes of Action |
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- Q 1.1 : What are the most common ERISA causes of action?2
- Q 1.2 : What rights or duties are at issue in claims for denial of benefits?3
- Q 1.2.1 : Who are the proper parties in a claim for denial of benefits?4
- Q 1.2.2 : What are common allegations in claims for denial of benefits?4
- Q 1.2.3 : What elements must a plaintiff generally establish in a claim for denial of benefits?5
- Q 1.2.4 : What relief is available for claims for denial of benefits?6
- Q 1.3 : What rights or duties are at issue in breach of fiduciary duty claims?6
- Q 1.3.1 : Who are the proper parties in a claim for breach of fiduciary duty?8
- Q 1.3.2 : What are some common allegations in a claim for breach of fiduciary duty?8
- Q 1.3.3 : What elements must generally be proved to prevail in a claim for breach of fiduciary duty?8
- Q 1.3.4 : What relief is available?9
- Q 1.4 : What rights or duties are at issue in knowing participation claims?10
- Q 1.4.1 : Who are proper parties in claims for knowing participation in a violation of ERISA?10
- Q 1.4.2 : What are common allegations in knowing participation actions?10
- Q 1.4.3 : What elements must a plaintiff generally establish?10
- Q 1.4.4 : What relief is available?11
- Q 1.5 : What rights or duties are at issue in interference claims?11
- Q 1.5.1 : Who are the proper parties for an interference claim?12
- Q 1.5.2 : What are some common types of interference actions?12
- Q 1.5.3 : What elements must a plaintiff generally establish?12
- Q 1.5.4 : What relief is available?13
- Q 1.6 : What common law claims may be made under ERISA?13
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Chapter 2: |
ERISA Actions in Federal Court |
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- Q 2.1 : How does ERISA interact with state and local laws governing contract, employment, insurance, and other areas?18
- Q 2.2 : Does ERISA preempt state laws?18
- Q 2.2.1 : What is the scope of ERISA’s preemption?18
- Q 2.3 : What civil remedies does ERISA exclusively provide?19
- Q 2.3.1 : What does it mean for a state law to “relate” to ERISA?19
- Q 2.3.2 : What does it mean for a state law to “refer” to ERISA?20
- Q 2.3.3 : What does it mean for a state law to have a connection to ERISA?21
- Q 2.3.4 : Which state laws are excepted from ERISA preemption?21
- Q 2.3.5 : Are employer-funded ERISA plans subject to state insurance laws?22
- Q 2.3.6 : What indicates whether a law regulates insurance so as to avoid preemption under ERISA?22
- Q 2.4 : Who has standing to bring an ERISA suit?23
- Q 2.4.1 : Who has standing to sue for monetary relief for breach of fiduciary duty claims?23
- Q 2.4.2 : Who has standing to sue for equitable relief?25
- Q 2.4.3 : What parties have standing to sue based on information requests?25
- Q 2.4.4 : Are any other parties allowed to bring ERISA suits?26
- Q 2.5 : Are ERISA actions in state court subject to removal?26
- Q 2.6 : How does a defendant remove an ERISA case?28
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Chapter 3: |
Class Action Litigation |
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- Q 3.1 : Why would a plaintiff bring a class action in an ERISA case?32
- Q 3.2 : What types of ERISA claims are brought as class actions?33
- Q 3.2.1 : Can a claim for breach of fiduciary duty under ERISA § 502(a)(2) be brought as a class action?33
- Q 3.2.2 : Can a claim for individual relief under ERISA § 502(a)(3) be brought as a class action?33
- Q 3.3 : What are the requirements for the certification of an ERISA class?33
- Q 3.3.1 : What issues or classes can be certified?34
- Q 3.3.2 : When does class certification occur?34
- Q 3.4 : What are the requirements of Rule 23(a)?34
- Q 3.4.1 : What is required under Rule 23(a)(1)?34
- Q 3.4.2 : What is required under Rule 23(a)(2)?35
- Q 3.4.3 : What is required under Rule 23(a)(3)?36
- Q 3.4.4 : What is required under Rule 23(a)(4)?36
- Q 3.4.5 : Is there interplay among the four requirements of Rule 23(a)?37
- Q 3.4.6 : When an ERISA breach of fiduciary duty claim is based upon representations made to beneficiaries, what class certification issues arise under Rule 23(a)?38
- Q 3.4.7 : How do potential defenses affect the requirements of Rule 23(a)?39
- Q 3.5 : What are the requirements of Rule 23(b)?39
- Q 3.5.1 : How can a plaintiff meet the requirements of Rule 23(b)(1) in an ERISA case?40
- Q 3.5.2 : How can a plaintiff meet the requirements of Rule 23(b)(2) in an ERISA case?40
- Q 3.5.3 : How can a plaintiff meet the requirements of Rule 23(b)(3) in an ERISA case?42
- Q 3.5.4 : What is the practical effect of having a class certified under Rule 23(b)(1), 23(b)(2) or 23(b)(3)?43
- Q 3.6 : Are jury trials available in class action cases?43
- Q 3.7 : What unique issues arise in settlement of ERISA class actions?43
- Q 3.7.1 : How effective are releases of liability in class situations?44
- Q 3.7.2 : What exempts class action settlements from ERISA’s prohibited transaction provisions?44
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Chapter 4: |
Fiduciary Duties Under ERISA |
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- Q 4.1 : What does it mean to be a “fiduciary” of an ERISA plan?48
- Q 4.2 : How does a person or an entity become a “fiduciary” of an ERISA plan?48
- Q 4.2.1 : What makes someone a “named” or “designated” fiduciary?49
- Q 4.2.2 : What does it mean to function as a fiduciary by exercising discretionary authority or control?49
- Q 4.3 : When is someone a fiduciary for certain purposes or particular actions?49
- Q 4.4 : How many fiduciaries must an employee benefit plan have?51
- Q 4.5 : For what is a fiduciary responsible?51
- Q 4.6 : For what is a fiduciary liable?51
- Q 4.7 : How does a fiduciary terminate its fiduciary status arising from being a named or designated fiduciary?52
- Q 4.7.1 : How does a fiduciary formally terminate its fiduciary status?52
- Q 4.7.2 : How does a fiduciary unequivocally terminate its fiduciary status?53
- Q 4.7.3 : How does a fiduciary ensure that its resignation or termination of fiduciary status is in compliance with plan documents?53
- Q 4.7.4 : What are a fiduciary’s obligations after resigning or terminating its fiduciary status?54
- Q 4.7.5 : Must a resigning fiduciary appoint a successor fiduciary?54
- Q 4.7.6 : Must a resigning fiduciary disclose material information necessary for the protection of the plan upon termination?55
- Q 4.7.7 : Must a resigning fiduciary investigate the successor prior to termination?55
- Q 4.8 : How does a fiduciary terminate its fiduciary status arising from the performance of fiduciary functions?55
- Q 4.9 : Can fiduciary responsibility be waived?56
- Q 4.10 : Can fiduciary responsibility be delegated?56
- Q 4.10.1 : Does the fiduciary have ongoing responsibilities with respect to these delegations?57
- Q 4.11 : What does it mean to be a fiduciary with a duty of loyalty to plan beneficiaries under ERISA?58
- Q 4.11.1 : What is the standard of loyalty required of fiduciaries?58
- Q 4.11.2 : Can a fiduciary have interests adverse to those of plan beneficiaries?58
- Q 4.11.3 : Can an employer-trustee invest trust assets in its own securities?59
- Q 4.11.4 : Can a fiduciary with a conflicting interest ever make decisions that are adverse to the interests of the beneficiaries?59
- Q 4.11.5 : To what extent do fiduciary duties apply during plan creation and amendment?60
- Q 4.12 : What is the duty to disclose information and avoid misrepresentations?61
- Q 4.12.1 : What is “material information”?62
- Q 4.12.2 : Does the duty to disclose information extend to future plans or plan amendments?62
- Q 4.12.3 : Is the duty to disclose violated if no one asks for information specifically?63
- Q 4.12.4 : What information does a fiduciary not have to disclose?64
- Q 4.12.5 : What actions may plan beneficiaries take if this duty is violated?64
- Q 4.13 : What is the duty to manage plan funds in the interests of participants and beneficiaries?64
- Q 4.13.1 : Can a fiduciary ever benefit personally from investment decisions made for the plan beneficiaries?65
- Q 4.13.2 : What should a fiduciary consider when making investment decisions?65
- Q 4.14 : What is the duty of prudence?65
- Q 4.14.1 : How do courts interpret the duty of prudence?66
- Q 4.14.2 : What is the duty to invest prudently and how does it relate to the duty to investigate?66
- Q 4.14.3 : How far must a fiduciary go to satisfy the duty to investigate?67
- Q 4.14.4 : To what extent can a fiduciary rely on expert assistance?67
- Q 4.14.5 : To what extent can a fiduciary rely on non-experts?68
- Q 4.14.6 : How do courts assess the prudence of an investment?69
- Q 4.14.7 : How do courts determine the prudence of loans?69
- Q 4.14.8 : How do courts determine prudent management of Employee Stock Ownership Plans?70
- Q 4.14.9 : May a fiduciary decide to invest in the securities of the plan’s sponsor?70
- Q 4.14.10 : What are the obligations of a fiduciary with respect to sell-back options?71
- Q 4.14.11 : What qualifies as prudent purchasing of annuities in connection with plan termination?71
- Q 4.15 : What is the duty to diversify?72
- Q 4.15.1 : What is the purpose of the duty to diversify?73
- Q 4.15.2 : How can violations of the duty to diversify be challenged?73
- Q 4.15.3 : What assets are subject to the duty to diversify?73
- Q 4.15.4 : Is the final distribution of assets of a plan subject to the duty to diversify?74
- Q 4.15.5 : Are investments in employer securities, including employee stock ownership plans (ESOPs), subject to the duty to diversify?74
- Q 4.15.6 : Are annuities subject to the duty to diversify?74
- Q 4.15.7 : Are real estate and mortgages subject to the duty to diversify?74
- Q 4.15.8 : What is the scope of the duty to diversify?75
- Q 4.15.9 : In a claim for breach of the duty to diversify, what is the plaintiff’s burden?75
- Q 4.15.10 : In defending a claim for breach of this duty, what is the defendant’s burden?75
- Q 4.16 : What is the duty to act in accordance with the documents and instruments governing the plan?76
- Q 4.16.1 : In what circumstances have courts found this duty violated?76
- Q 4.16.2 : When a court finds that this duty was violated, what types of damages are awarded?77
- Q 4.16.3 : How has this duty been construed by courts in claims for improper denial of benefits?77
- Q 4.16.4 : Does this duty change if the plan documents and other ERISA provisions conflict?78
- Q 4.16.5 : If a fiduciary violates other ERISA duties but acts in accordance with the documents and instruments governing the plan, has he violated the duty of loyalty?78
- Q 4.16.6 : What should a fiduciary do if the plan documents contain provisions that partially conflict with an ERISA provision?79
- Q 4.16.7 : How have courts construed language in plan documents granting fiduciaries discretionary authority?79
- Q 4.16.8 : Is a grant of discretionary authority in unincorporated trust agreements or other instruments sufficient?79
- Q 4.16.9 : How have courts construed a fiduciary’s authority to interpret and apply trustee-created rules?79
- Q 4.16.10 : What is a fiduciary’s authority to interpret and define ambiguous terms in the plan document?80
- Q 4.16.11 : What actions do not fall within the duty to comply with plan documents?80
- Q 4.16.12 : Which documents and instruments govern the plan?80
- Q 4.16.13 : Can an employee recover promised benefits even if the promise was not contained in a governing document?81
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Chapter 5: |
Breach of Fiduciary Duty Litigation |
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- Q 5.1 : What actions are available for breach of fiduciary duty under ERISA?88
- Q 5.2 : Who may bring a claim for breach of fiduciary duty?89
- Q 5.2.1 : Who is a “participant”?89
- Q 5.2.2 : Who is a “beneficiary”?90
- Q 5.2.3 : Who is a “fiduciary”?90
- Q 5.3 : Who may recover for breach of fiduciary duty?91
- Q 5.4 : What remedies are available for a breach of fiduciary duty under ERISA?91
- Q 5.4.1 : Are compensatory damages recoverable?92
- Q 5.4.2 : Are punitive damages recoverable?92
- Q 5.4.3 : Is restitution available?92
- Q 5.4.4 : Can a fiduciary’s transaction in breach of its fiduciary duties be canceled or avoided?93
- Q 5.4.5 : Can the court impose a constructive trust?93
- Q 5.4.6 : Is an injunction available?94
- Q 5.5 : What is the applicable statute of limitations?94
- Q 5.6 : In what court can an action for breach of fiduciary duty be filed?95
- Q 5.7 : Is a jury trial available?96
- Q 5.8 : When can a § 502(a)(2) action on behalf of the plan be brought?96
- Q 5.8.1 : Who may bring a § 502(a)(2) action?96
- Q 5.8.2 : Who is a proper defendant in a § 502(a)(2) action?96
- Q 5.8.3 : What relief is available in a § 502(a)(2) action?96
- Q 5.9 : When can a § 502(a)(3) action seeking individual relief be brought?97
- Q 5.9.1 : Who may seek individual relief under a § 502(a)(3) action?97
- Q 5.9.2 : Who is a proper defendant in a § 502(a)(3) action?97
- Q 5.9.3 : What relief is available in a § 502(a)(3) action?97
- Q 5.9.4 : What is “other appropriate equitable relief”?98
- Q 5.9.5 : What if relief is available under other ERISA provisions?98
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Chapter 6: |
Stock Drop Litigation |
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- Q 6.1 : What are ERISA “stock drop suits”?102
- Q 6.2 : Which types of ERISA plans are permitted to invest in employer stock?102
- Q 6.3 : Which fiduciary duties apply to fiduciaries of EIAPs and ESOPs?103
- Q 6.4 : What is the duty of loyalty?104
- Q 6.4.1 : When does the duty of loyalty apply?104
- Q 6.4.2 : What facts do plaintiffs typically allege are indicative of a breach of the duty of loyalty?105
- Q 6.5 : What obligations do the duties of prudence and loyalty encompass in stock drop litigation?106
- Q 6.6 : What is the duty to investigate and when does it arise?106
- Q 6.6.1 : When does an ERISA fiduciary have a duty to investigate company affairs affecting stock value?106
- Q 6.6.2 : What does the duty to investigate investment decisions entail?107
- Q 6.7 : What is the duty to monitor?108
- Q 6.7.1 : How broad is the duty to monitor?109
- Q 6.7.2 : What conduct does the duty to monitor require?109
- Q 6.8 : What is the duty to disclose?110
- Q 6.8.1 : How does a claim for breach of the duty to disclose arise?110
- Q 6.8.2 : When does an individual act as a fiduciary?111
- Q 6.8.3 : How broad is the scope of the duty to disclose?112
- Q 6.9 : What is the duty of prudence?114
- Q 6.9.1 : What must a plaintiff show to establish a breach of the duty of prudence?114
- Q 6.10 : What is the Moench presumption?114
- Q 6.10.1 : In what context does the Moench presumption apply?115
- Q 6.10.2 : At what stage of the litigation does the Moench presumption apply?115
- Q 6.10.3 : Which circuits have adopted the Moench presumption?115
- Q 6.10.4 : What must a plaintiff show to rebut the Moench presumption?116
- Q 6.10.5 : To what extent does the language of the plan documents affect the analysis of a duty of prudence claim?118
- Q 6.10.6 : What test do courts use to determine whether a fiduciary acted prudently once the Moench presumption has been rebutted?119
- Q 6.11 : What defenses are available to defendants in stock drop litigation cases?120
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Chapter 7: |
ESOP Litigation |
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- Q 7.1 : What is an ESOP?126
- Q 7.2 : What are common types of litigation that involve ESOPs?126
- Q 7.2.1 : What do plaintiffs typically allege in a claim that an ESOP did not purchase stock for adequate consideration?127
- Q 7.2.2 : What claims do plaintiffs typically assert in “stock drop” litigation involving an ESOP?128
- Q 7.3 : What is a “prohibited transaction”?129
- Q 7.4 : What is “adequate consideration”?129
- Q 7.5 : What does “good faith” mean?130
- Q 7.6 : How are pension plans able to invest in employer securities in light of the prohibited transaction restrictions?131
- Q 7.6.1 : Can an ESOP own assets other than the employer’s stock?131
- Q 7.6.2 : Can an ESOP sell the employer’s stock?132
- Q 7.7 : How do courts determine whether it is imprudent to continue investing in employer stock?132
- Q 7.7.1 : Does a significant downward trend in the employer’s stock render it imprudent for a fiduciary to continue to invest in, or offer as an option investment in, the employer’s stock?133
- Q 7.8 : What are “unusual circumstances” that may result in a duty to sell the employer’s stock?133
- Q 7.8.1 : Does the employer have to be on the brink of collapse before a fiduciary will be required to sell the employer’s stock?134
- Q 7.9 : With respect to public companies, is the fiduciary required to consider any factors beyond the public price?134
- Q 7.10 : What other claims are typically brought related to ESOPs?134
- Q 7.10.1 : Under ERISA, how may a fiduciary be protected from liability for plan losses?134
- Q 7.10.2 : Have courts rejected indemnification claims made by ESOP fiduciaries?135
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Chapter 8: |
Cash Balance Plan Litigation |
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- Q 8.1 : What is a cash balance plan?140
- Q 8.2 : What are the potential litigation risks posed by moving from a traditional pension plan to a cash balance plan?141
- Q 8.3 : What are the most common ERISA claims relating to cash balance plans?142
- Q 8.4 : What are courts doing with ERISA age discrimination claims against employers that convert to cash balance plans?142
- Q 8.5 : What legislative action has been taken to combat anti-discrimination claims arising from cash balance plan conversions?143
- Q 8.6 : How does the anti-cutback rule apply to conversions to cash balance plans?143
- Q 8.7 : What is wearaway and what are its effects?144
- Q 8.7.1 : What are the statutory and regulatory requirements related to wearaway?145
- Q 8.7.2 : How are courts treating wearaway claims by plaintiffs?145
- Q 8.7.3 : What is the interplay between wearaway and ERISA’s anti-cutback rule?146
- Q 8.8 : What is the “whipsaw” calculation and how does it apply to cash balance plans?146
- Q 8.8.1 : What are courts doing with the “whipsaw” dilemma?148
- Q 8.8.2 : What are the remedies for improper whipsaw calculations?148
- Q 8.8.3 : What is the “normal retirement age” for purpose of the whipsaw calculation?149
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Chapter 9: |
Prohibited Transaction Litigation |
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- Q 9.1 : What is a prohibited transaction?152
- Q 9.2 : Who is considered a party in interest?153
- Q 9.3 : Which types of transactions between a plan and a party in interest are prohibited?153
- Q 9.4 : Is a transaction still prohibited if a party-in-interest relationship ends before the dispersal of funds in connection with a potential loan?154
- Q 9.5 : What level of intent is required for a fiduciary to be liable for a prohibited transaction?155
- Q 9.5.1 : What additional level of intent is required for a fiduciary to be liable for a transfer of plan assets for the benefit of a party in interest?155
- Q 9.6 : Can a prohibited transaction occur if a third party was involved?155
- Q 9.7 : What constitutes prohibited “self-dealing” by a plan fiduciary?156
- Q 9.8 : Does good faith, legitimate business purpose or lack of harm cure an otherwise prohibited transaction?157
- Q 9.9 : Are there any exemptions from ERISA’s prohibited transaction bar?158
- Q 9.10 : What are statutory exemptions?158
- Q 9.10.1 : What types of prohibited transactions are subject to statutory exemptions?158
- Q 9.10.2 : What is considered a reasonable contract or arrangement entitled to relief under the statutory exemption?158
- Q 9.11 : What are class exemptions?159
- Q 9.11.1 : What types of prohibited transactions are subject to class exemptions?159
- Q 9.12 : What are individual exemptions?159
- Q 9.13 : How may fiduciaries have personal liability held liable for prohibited transactions under ERISA? [ED? Please confirm title?]160
- Q 9.14 : What penalties can the Department of Labor and the IRS assess for non-exempt prohibited transactions? [ED? Please confirm title?]160
- Q 9.15 : What are the private remedies available for a violation of prohibited transaction provisions that cause a loss of money or assets?160
- Q 9.16 : What are the private remedies available for a violation of prohibited transaction provisions that do not cause a loss of money or assets?161
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Chapter 10: |
401(k) Fee Litigation |
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- Q 10.1 : What is 401(k) fee litigation?166
- Q 10.2 : Who are the typical plaintiffs in 401(k) fee litigation?167
- Q 10.3 : Do plaintiffs need to establish standing in fee litigation cases?167
- Q 10.3.1 : How do plaintiffs establish standing in fee litigation cases?167
- Q 10.3.2 : Can a named plaintiff establish standing on behalf of a class of past or future participants?168
- Q 10.4 : Who are the typical defendants in 401(k) fee litigation?168
- Q 10.4.1 : Who are typical corporate defendants in 401(k) fee litigation?168
- Q 10.4.2 : Who are typical individual defendants in 401(k) fee litigation?168
- Q 10.4.3 : What particular issues relating to board committee and officer defendants arise in 401(k) fee litigation?169
- Q 10.4.4 : Who are typical service provider defendants in 401(k) fee litigation?169
- Q 10.4.5 : What particular issues relating to service provider defendants arise in 401(k) fee litigation?169
- Q 10.5 : What are the typical claims brought in fee litigation?170
- Q 10.5.1 : How have plaintiffs alleged that defendants paid excessive fees?170
- Q 10.5.2 : How have plaintiffs alleged that defendants failed to capture revenue streams?171
- Q 10.5.3 : How have plaintiffs alleged claims for imprudent decision-making?171
- Q 10.5.4 : How have plaintiffs alleged that defendants engaged in prohibited transactions and breached the duty of loyalty?172
- Q 10.5.5 : How do plaintiffs bring claims for failure to disclose or misrepresentation of excessive fees?172
- Q 10.5.6 : How have plaintiffs framed claims against defendants for holding excessive cash positions in company stock funds?173
- Q 10.6 : What type of relief do plaintiffs seek in fee litigation cases?173
- Q 10.7 : What standards do courts use in determining if defendants paid excessive fees?174
- Q 10.8 : How have courts adjudicated claims alleging the failure to disclose certain fee arrangements?176
- Q 10.9 : What is the applicable statute of limitations in fee litigation cases?176
- Q 10.10 : Does ERISA’s safe harbor provision apply in fee litigation cases?177
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Chapter 11: |
Litigation to Recover Benefits Due Under a Plan |
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- Q 11.1 : Can a plan participant file a civil claim seeking benefits under an ERISA plan?182
- Q 11.1.1 : Under what circumstances do such claims typically arise?183
- Q 11.1.2 : What kinds of relief are available to a successful claimant?183
- Q 11.2 : Who can bring claims for benefits?183
- Q 11.2.1 : Who is a “participant”?183
- Q 11.2.2 : Who is an “employee”?184
- Q 11.2.3 : Who is a “beneficiary”?184
- Q 11.2.4 : May benefits available under an ERISA plan be assigned, and does an assignee have standing to bring a claim for benefits?184
- Q 11.3 : Which provision discusses jurisdiction and venue for claims for benefits?185
- Q 11.4 : Does ERISA require exhaustion of claims review procedures as a prerequisite to bringing a claim for benefits?185
- Q 11.4.1 : Are there any exceptions to the exhaustion requirement?186
- Q 11.5 : Does ERISA address a participant’s or beneficiary’s entitlement to insurance proceeds?186
- Q 11.6 : What other kinds of claims may accompany a claim seeking benefits?186
- Q 11.7 : Who may be sued in an action seeking ERISA benefits?187
- Q 11.7.1 : May a party other than an ERISA plan properly be named a defendant in a claim for benefits action?187
- Q 11.7.2 : What is a “plan administrator”?188
- Q 11.7.3 : May a party other than the designated plan administrator be sued as a de facto plan administrator in a benefits action?188
- Q 11.8 : What standard of review applies to a district court’s review of a plan administrator’s interpretation of plan terms?189
- Q 11.9 : What damages are available to a claimant in a benefits action?189
- Q 11.9.1 : Are claimants also entitled to additional relief, including consequential and punitive damages?190
- Q 11.9.2 : Have district courts subsequent to Ingersoll-Rand Co. expanded the scope of available remedies?191
- Q 11.9.3 : What kinds of relief are included in the equitable relief available in a benefits action?191
- Q 11.10 : In a benefits action, under what circumstances is a party entitled to an award of costs and attorney’s fees?192
- Q 11.10.1 : Do courts consider whether the offending party has prevailed in the litigation in deciding to award attorney’s fees?192
- Q 11.10.2 : Do courts consider the degree of bad faith or frivolity in deciding whether to award attorney’s fees?192
- Q 11.10.3 : Do courts consider whether the party has been successful in the litigation in deciding to award attorney’s fees?192
- Q 11.11 : What type of retirement income benefits can form the basis of a claim for benefits under ERISA?193
- Q 11.12 : What is a defined benefit plan?193
- Q 11.12.1 : What are the characteristics of a defined benefit plan?194
- Q 11.12.2 : When can a participant or beneficiary bring a claim for benefits under a defined benefit plan?195
- Q 11.13 : What is a defined contribution plan?195
- Q 11.13.1 : What are the characteristics of a defined contribution plan?196
- Q 11.13.2 : When can a beneficiary bring a claim for benefits under a defined contribution plan?197
- Q 11.14 : What type of welfare benefits can form the basis of a claim for benefits under ERISA?197
- Q 11.15 : What standards of review do courts apply to an administrator’s decision denying benefits?198
- Q 11.15.1 : How do courts determine which standard of review applies to a particular administrative decision?198
- Q 11.15.2 : How do courts determine whether a benefit plan gives the administrator discretionary authority?199
- Q 11.15.3 : Must the plan contain an express grant of discretion to warrant deference to the administrator’s decision?199
- Q 11.15.4 : What must a plan say to confer discretion or the plan administrator?199
- Q 11.15.5 : Must discretion be granted to a plan administrator or fiduciary in a particular plan document?200
- Q 11.16 : What factors do courts take into consideration when applying a de novo standard of review?202
- Q 11.17 : What determinations are subject to de novo review by courts?202
- Q 11.18 : What interpretive principles do courts use when interpreting ERISA plan documents?203
- Q 11.18.1 : Can courts consider extrinsic evidence when construing plan language?204
- Q 11.19 : When do courts apply an abuse of discretion standard of review to an administrator’s or fiduciary’s decision?204
- Q 11.19.1 : What factors do courts consider when applying the abuse-of-discretion standard of review?205
- Q 11.19.2 : What is the scope of evidence considered under the abuse-of-discretion standard of review?205
- Q 11.19.3 : When can a court remand a case for further administrative review?206
- Q 11.19.4 : What showing do courts require to sustain a denial of benefits?206
- Q 11.19.5 : What standard does a court apply in a deferential review of a plan administrator’s decision?206
- Q 11.19.6 : When is a plan administrator’s decision “reasonable”?207
- Q 11.19.7 : How does a court evaluate the “reasonableness” of a plan administrator’s decision?207
- Q 11.19.8 : What impact does a conflict of interest have on the evaluation of a fiduciary’s duties?209
- Q 11.19.9 : What constitutes a conflict of interest?209
- Q 11.19.10 : How does a conflict of interest impact the standard of review applied by the court?210
- Q 11.19.11 : What is the sliding scale standard?211
- Q 11.19.12 : What is the modified sliding scale standard?211
- Q 11.19.13 : What is the reasonableness approach?212
- Q 11.20 : Do courts impose a “treating physician rule” on administrators?213
- Q 11.21 : What is anti-cutback litigation?214
- Q 11.21.1 : What is ERISA’s anti-cutback provision?214
- Q 11.21.2 : How is a claim for violation of ERISA’s anti-cutback provision pled?215
- Q 11.21.3 : Who are proper parties in an anti-cutback claim?215
- Q 11.21.4 : What remedies are available for violation of ERISA’s anti-cutback provision?215
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Chapter 12: |
Multiemployer Plan Litigation |
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- Q 12.1 : What is a multiemployer plan?224
- Q 12.1.1 : What factors are relevant to determining whether a multiemployer plan is established for a substantial business purpose?225
- Q 12.1.2 : What kinds of plans may be structured as multiemployer plans?225
- Q 12.2 : How are multiemployer plans controlled and administered?226
- Q 12.3 : What claims may be brought against a participating employer in a multiemployer plan?226
- Q 12.4 : Which statutes govern multiemployer plans?226
- Q 12.5 : How are multiemployer pension plans funded?227
- Q 12.6 : What requirements does the Labor Management Relations Act impose on multiemployer plans?228
- Q 12.7 : How does ERISA apply to multiemployer plans?228
- Q 12.8 : What is the result of an employer’s exit from a plan?229
- Q 12.8.1 : What types of withdrawal exist?230
- Q 12.8.2 : What is complete withdrawal?230
- Q 12.8.3 : What is partial withdrawal?230
- Q 12.8.4 : Does the suspension of contributions constitute withdrawal?230
- Q 12.8.5 : Is the sale of stock considered an employer withdrawal?230
- Q 12.9 : How does the plan sponsor respond to an employer’s withdrawal?231
- Q 12.9.1 : How is the employer’s withdrawal liability calculated?231
- Q 12.10 : How does an employer respond to the plan sponsor’s imposed withdrawal liability?232
- Q 12.11 : Are withdrawal disputes subject to mandatory arbitration?232
- Q 12.11.1 : What deference is given to the plan sponsor’s decision during arbitration?233
- Q 12.12 : When must the withdrawing employer begin to make payments?234
- Q 12.12.1 : Who is responsible for liability payments?234
- Q 12.13 : What judicial review is available?235
- Q 12.13.1 : What remedies exist for collecting contributions?235
- Q 12.14 : What private causes of action exist for plan participants and beneficiaries?236
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Chapter 13: |
Managed Care Plan Litigation |
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- Q 13.1 : What is an ERISA managed care plan?240
- Q 13.1.1 : What is utilization review?240
- Q 13.1.2 : What advantages do managed care plans offer over traditional benefits plans or fee-for-service arrangements?241
- Q 13.1.3 : What are some common criticisms of managed care plans?241
- Q 13.2 : When are employer-sponsors of managed care plans subject to ERISA liability?241
- Q 13.2.1 : When is an employer-sponsor of a managed care plan also considered the plan administrator?242
- Q 13.2.2 : Can an employer sponsoring a managed care plan be liable as an ERISA fiduciary if the employer is not formally designated as the plan administrator?243
- Q 13.2.3 : For what acts is an employer who is also a plan administrator subject to liability as an ERISA fiduciary?243
- Q 13.3 : Under what circumstances may an employer-administrator have obligations to plan beneficiaries under ERISA?244
- Q 13.4 : What are an employer-administrator’s obligations when denying or terminating healthcare coverage?244
- Q 13.4.1 : What information should be included in a denial/termination notice?244
- Q 13.4.2 : What happens if a qualified beneficiary does not receive adequate notice?245
- Q 13.5 : What are an employer-administrator’s obligations when considering amendments to a managed care plan?245
- Q 13.6 : What are an employer-administrator’s obligations upon termination of employment?246
- Q 13.6.1 : What is COBRA?246
- Q 13.6.2 : What is a “qualifying event”?246
- Q 13.6.3 : How should a discharged employee be notified of his or her COBRA rights?246
- Q 13.6.4 : What information should a COBRA notice contain?247
- Q 13.6.5 : What happens if a qualified beneficiary does not receive adequate notice?249
- Q 13.7 : Do courts apply more stringent standards when reviewing decisions made by employers acting as plan administrators, as opposed to decisions made by non-administrator employers?249
- Q 13.8 : Can a non-administrator employer be held liable for the actions or decisions of the managed care plan or administrator chosen by the employer?249
- Q 13.8.1 : Is an employer-sponsor acting as an ERISA fiduciary when selecting a managed care plan?250
- Q 13.8.2 : Does ERISA protect an employer-sponsor alleged to be liable for the actions of a managed care plan or administrator?250
- Q 13.8.3 : How can an employer-sponsor protect itself against possible liability for the actions of a managed care plan or administrator?252
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Chapter 14: |
Discrimination and Interference with Benefits Rights Litigation |
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- Q 14.1 : What provision of ERISA permits claims for discrimination or interference with benefits?256
- Q 14.2 : Who are the appropriate parties to a suit under § 510?257
- Q 14.2.1 : Who are proper defendants in an action under § 510?258
- Q 14.2.2 : Who is a proper plaintiff in an action under § 510?258
- Q 14.3 : What types of conduct are prohibited by ERISA § 510?259
- Q 14.4 : Are state law employment actions relating to benefits under an ERISA plan preempted by ERISA?260
- Q 14.5 : What is the applicable statute of limitations for a § 510 claim?261
- Q 14.6 : What are the elements of an action under ERISA § 510?262
- Q 14.6.1 : What is the direct evidence framework?263
- Q 14.6.2 : What is the indirect or McDonnell Douglas framework?263
- Q 14.6.3 : How does a plaintiff establish a prima facie case?264
- Q 14.6.4 : How does a defendant rebut the initial presumption of discrimination?264
- Q 14.6.5 : How does the plaintiff show that a proffered legitimate non-discriminating reason is pretextual?265
- Q 14.7 : What remedies are available to a plaintiff under ERISA § 510?267
- Q 14.8 : How does ERISA’s anti-retaliation provision relate to other federal discrimination statutes?267
- Q 14.8.1 : How does ERISA § 510 interact with the ADEA?268
- Q 14.8.2 : How does ERISA § 510 interact with the ADA?269
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Chapter 15: |
Litigation of Claims Arising Under Federal Common Law |
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- Q 15.1 : How does federal common law provide guidance to courts applying ERISA?274
- Q 15.2 : What justifies the federal judiciary’s power to develop federal common law, preempting state law, in ERISA cases?274
- Q 15.3 : What principles of law have courts looked to in developing ERISA federal common law?275
- Q 15.3.1 : How has trust law played a role in the development of ERISA federal common law?275
- Q 15.3.2 : How has agency law played a role in the development of ERISA federal common law?275
- Q 15.3.3 : How has contract law played a role in the development of ERISA federal common law?276
- Q 15.4 : What federal common law theories of liability do ERISA participants or beneficiaries most frequently raise?276
- Q 15.5 : Is a claim for restitution a permissible federal common law theory?276
- Q 15.5.1 : Are claims for restitution “at law” permissible?276
- Q 15.5.2 : What distinguishes restitution “at law” from equitable restitution?277
- Q 15.5.3 : Can non-fiduciary employers recover amounts mistakenly contributed to ERISA plans under a theory of restitution?277
- Q 15.5.4 : What factors do courts consider in balancing equities to decide whether to order restitution in a mistaken contribution case?278
- Q 15.5.5 : May non-fiduciary employers recover funds mistakenly contributed to ERISA plans under a theory of restitution?279
- Q 15.6 : Is a claim for rescission a permissible federal common law theory?279
- Q 15.7 : Are claims for indemnification or contribution permissible federal common law theories?280
- Q 15.8 : Is a claim for estoppel a permissible federal common law theory?280
- Q 15.8.1 : Can an estoppel theory be used to enforce oral representations about a plan?281
- Q 15.8.2 : Can an estoppel theory be used to enforce written representations about a plan?281
- Q 15.8.3 : Is a claim for estoppel treated differently in the context of a welfare benefit plan versus a pension plan?281
- Q 15.9 : Is a claim for prejudgment interest a permissible federal common law theory?282
- Q 15.9.1 : Are pension beneficiaries entitled to interest for denial of benefits where the benefits are later restored without resort to litigation?282
- Q 15.10 : Are principles of waiver permissible under federal common law?283
- Q 15.11 : What standard of review do courts apply when evaluating a plan administrator’s decision?283
- Q 15.12 : Does federal common law permit the parties to a welfare benefit plan to determine when benefits vest or terminate?284
- Q 15.13 : What are the limitations on the development and use of federal common law in ERISA cases?284
- Q 15.13.1 : Can courts develop federal common law that is inconsistent with ERISA’s language?284
- Q 15.13.2 : Can courts develop federal common law when ERISA is silent on an issue?285
- Q 15.14 : Do courts, by use of federal common law, permit legal remedies?285
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Chapter 16: |
Affirmative Defenses to ERISA Claims |
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- Q 16.1 : What affirmative defenses are available to defend against an ERISA claim?290
- Q 16.2 : What is the § 404(c) safe harbor provision?290
- Q 16.2.1 : How does a plan qualify under § 404(c)?291
- Q 16.2.2 : Does § 404(c) apply to a fiduciary’s decisions about which options to offer?292
- Q 16.3 : Is a fiduciary’s delegation of a fiduciary function an affirmative defense to a breach of fiduciary duty claim based on the performance of that function?292
- Q 16.4 : What affirmative defenses apply when a fiduciary is accused of engaging in of the prohibited transactions in ERISA § 406?293
- Q 16.5 : What is the statute of limitations period for an ERISA claim?294
- Q 16.5.1 : What is the statute of limitations period for an action for breach of fiduciary duty?294
- Q 16.5.2 : What is the statute of limitations period for an action for wrongful denial of benefits under § 502(a)(1)(B)?295
- Q 16.5.3 : What is the statute of limitations period for actions alleging interference with benefits in violation of § 510?296
- Q 16.6 : Can an ERISA claim be waived?297
- Q 16.7 : Who has standing to sue under ERISA?298
- Q 16.8 : Is failure to exhaust administrative remedies an affirmative defense to an ERISA claim?299
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Chapter 17: |
Limitations on Actions Under ERISA |
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- Q 17.1 : May employers condition the receipt of employee benefits on a waiver of ERISA rights and claims?306
- Q 17.1.1 : What factors determine the enforceability of a waiver of benefits?306
- Q 17.1.2 : What constitutes a knowing and voluntary waiver?307
- Q 17.1.3 : Is any single factor in the knowing and voluntary test dispositive?308
- Q 17.1.4 : When can a participant waive his or her spouse’s rights to pension death benefits arising under an ERISA plan?308
- Q 17.1.5 : Does ERISA’s anti-alienation provision bar waivers of pension benefits?308
- Q 17.1.6 : May employees waive prospective ERISA claims?309
- Q 17.1.7 : How do courts interpret the terms of a waiver?309
- Q 17.1.8 : Can a party bring an ERISA claim after signing a waiver?310
- Q 17.1.9 : Can a party bring a claim on behalf of a plan after signing a waiver?310
- Q 17.2 : Can an employer compel arbitration of employee benefits disputes?310
- Q 17.2.1 : What factors determine the enforceability of a mandatory arbitration policy?311
- Q 17.3 : What is the statute of limitations for benefits claims?312
- Q 17.3.1 : Is a contractual limitations period limiting the time to bring a lawsuit benefits claim enforceable?313
- Q 17.3.2 : What constitutes a “reasonable” limitations period?313
- Q 17.4 : What is the statute of limitations for breach of fiduciary claims?313
- Q 17.4.1 : What constitutes actual knowledge for purposes of running the statute of limitations?313
- Q 17.4.2 : Is there a different statute of limitations in a case of fraud or concealment?314
- Q 17.4.3 : Do federal equitable tolling principles apply?315
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Chapter 18: |
Special Considerations for ERISA Litigation |
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- Q 18.1 : Is there a right to a jury trial under ERISA?320
- Q 18.1.1 : How do courts determine if a plaintiff seeks a legal or equitable remedy?320
- Q 18.1.2 : Is a claim for money damages a legal remedy?320
- Q 18.2 : Does the right to a jury trial depend on which ERISA cause of action is being pled?321
- Q 18.2.1 : Is a jury trial available for a cause of action brought under ERISA § 502(a)(1)(B)?321
- Q 18.2.2 : What happens when a plaintiff brings ERISA claims and other claims that give rise to a jury right in the same lawsuit?322
- Q 18.3 : Is a jury trial available for a cause of action brought under ERISA § 502(a)(2)?322
- Q 18.4 : Is a jury trial available when the cause of action is brought under ERISA § 502(a)(3)?323
- Q 18.5 : Does an attorney-client privilege exist between a plan fiduciary and an attorney who provides legal advice?323
- Q 18.6 : Are there ERISA-specific limitations or exceptions to the attorney-client privilege or other situations where the privilege might not attach?324
- Q 18.6.1 : Is the fiduciary exception a waiver of the attorney-client privilege?324
- Q 18.6.2 : Are there limits on when the fiduciary exception applies?325
- Q 18.6.3 : Are certain legal communications excluded from the fiduciary exception based on their substance?326
- Q 18.6.4 : Does the fiduciary exception apply to the work product doctrine?327
- Q 18.7 : Is fee-shifting available in ERISA lawsuits?327
- Q 18.8 : Must a party prevail in the litigation to recover its fees?328
- Q 18.9 : In practice, which parties are mostly likely to receive a fee award?328
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Index |
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