Ahn v. Cigna Health & Life Ins. Co., No. 25-1723, __ F.4th __, 2026 WL 1813215 (3d Cir. June 24, 2026) (Before Circuit Judges Hardiman, Scirica, and Ambro)
ERISA is famous for many things, but near the top of the list is its sweeping preemptive force. 29 U.S.C. § 1144 provides that ERISA “shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.”
As Justice Thomas noted in his concurrence in Gobeille v. Liberty Mut. Ins. Co. (2016), ERISA “contains what may be the most expansive express pre-emption provision in any federal statute.” He was not a fan: “Read according to its plain terms, § 1144 raises constitutional concerns.” Justice Thomas worried that ERISA’s “relate to” language, taken to an extreme, might unduly infringe on powers typically reserved to the states.
While Justice Thomas was concerned with structural issues, other Justices have been troubled by remedies. Justice Ginsburg, in her concurrence in Aetna Health Inc. v. Davila (2004), agreed with “the rising judicial chorus urging that Congress and [this] Court revisit what is an unjust and increasingly tangled ERISA regime.” She opined that ERISA’s expansive preemptive scope, combined with a “cramped construction” of its remedies, has resulted in a “regulatory vacuum” in which “virtually all state law remedies are preempted but very few federal substitutes are provided.”
Regardless of how you feel about ERISA preemption, until the Supreme Court (or Congress) changes course, ERISA’s preemptive power will continue to thwart efforts to apply state law in cases involving employee benefits. This week’s notable decision provides yet another example.
The plaintiff in the case is Dr. Jeffrey M. Ahn, an otolaryngologist. He is not part of Cigna Health and Life Insurance Company’s provider network, but some of his patients are insured by Cigna. Dr. Ahn alleges that he submitted claims to Cigna for several of these patients. However, Cigna denied his claims “about 50 times.” In its explanations of benefits (EOBs) Cigna allegedly stated that it “did not pay for services performed by unlicensed providers – i.e., that Dr. Ahn was not licensed to practice medicine.” When Dr. Ahn appealed these claims, “Cigna allowed them in whole, in part, or denied them for a reason unrelated to his licensed status.”
Dr. Ahn was annoyed by Cigna’s insinuation that he did not have a license to practice medicine, so he filed this action in New Jersey state court, asserting claims against Cigna for defamation, defamation per se, and tortious interference. Dr. Ahn contended that the EOBs harmed his professional reputation and interfered with his business relationships.
Cigna removed the case to federal court and moved to dismiss or, alternatively, for summary judgment, citing ERISA preemption. The district court initially found that it was premature to rule on Cigna’s preemption argument because it could not determine from Dr. Ahn’s complaint which of the allegedly defamatory EOBs related to Cigna’s administration of ERISA-governed plans.
The parties thus conducted discovery, after which Cigna once again moved for summary judgment on all of Dr. Ahn’s claims, again relying on ERISA preemption. Dr. Ahn withdrew his defamation and tortious interference claims, leaving only his defamation per se claim.
On this sole remaining claim the district court granted Cigna’s motion. The court found that the plans at issue were all governed by ERISA, and that ERISA preempted Dr. Ahn’s claim. (Your ERISA Watch covered this decision in our March 26, 2025 edition.) Dr. Ahn appealed to the Third Circuit, which issued this published opinion.
The appellate court began by identifying two categories of state laws that ERISA preempts: those that have a “reference to” ERISA plans and those that have an impermissible “connection with” ERISA plans. Cigna relied on the second category, in which a state law “governs…a central matter of plan administration” or “interferes with nationally uniform plan administration.”
The Third Circuit agreed with Cigna that Dr. Ahn’s claim fell within this second category. The court emphasized that “[t]he communication of claim adjudications to plan participants and beneficiaries is a ‘central matter of plan administration.’” ERISA requires plans to “provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial.”
Here, Cigna fulfilled this duty by issuing EOBs. As a result, “statements therein about the reasons for the denial of a claim are inseparable from Cigna’s duty to provide a written explanation of claim denials under ERISA. And any state-law claims challenging the content of such statements would impermissibly allow state law to regulate matters squarely within ERISA’s ‘heartland.’”
In so ruling, the court relied heavily on the Fifth Circuit’s decision in Mayeaux v. Louisiana Health Service & Indemnity Co. (2004), in which that court dismissed a physician’s tort claims, including defamation, that challenged an insurance carrier’s claims handling. Mayeaux held that allowing such claims “would undoubtedly jeopardize the relationships among the traditional ERISA entities, of which the treating physician is not one. These are the sort of claims that go to the very heart of the ERISA administration process.”
Dr. Ahn attempted to distinguish Mayeaux, arguing that “accusing a medical professional of being ‘unlicensed’ does nothing to establish standards of conduct, responsibility and obligation for fiduciaries of employee benefit plans.” However, this was irrelevant to the court: “[T]he relevant inquiry is not whether defaming providers is central to an administrator’s fiduciary duties. It is not. The right question to ask is whether communicating benefits determinations to subscribers and beneficiaries is a central matter of plan administration. It is.”
The Third Circuit further concluded that Dr. Ahn’s claim, if allowed to proceed, would interfere with nationally uniform plan administration. The court noted that one of ERISA’s “principal goals” is “to establish a uniform administrative scheme, which provides a set of standard procedures to guide processing of claims and disbursement of benefits.”
Dr. Ahn’s claim would upset this goal. “Uniformity is impossible if plans are subject to different legal obligations in different states.” The court explained that ERISA provides a civil enforcement mechanism for claims, making state tort claims like defamation “unnecessary and impractical.” Allowing state law tort claims “would require plan administrators and fiduciaries to consider not only ERISA’s requirements but also the common law of each state, undermining the congressional goal of minimizing administrative and financial burdens on plan administrators.”
Dr. Ahn, citing two other Third Circuit cases – Plastic Surgery Ctr., P.A. v. Aetna Life Ins. Co. (2020) and Pascack Valley Hosp., Inc. v. Loc. 464A UFCW Welfare Reimbursement Plan (2004) – attempted to argue that his claim was not preempted because it “neither seeks benefits under an ERISA plan nor requires more than a cursory examination of an ERISA plan.” However, according to the Third Circuit, this approach “offers a mistaken understanding of the governing caselaw.” The court stated that “Plastic Surgery applied the same standards we apply today,” and Pascack Valley “involved a different ERISA preemption provision than this one.”
Thus, for the Third Circuit, this case was a simple one: “ERISA broadly preempts state-law claims. The explanation of benefits forms at issue in this appeal fall well within the scope [of] ERISA preemption. We will therefore affirm the District Court’s summary judgment.”
Below is a summary of this past week’s notable ERISA decisions by subject matter and jurisdiction.
Breach of Fiduciary Duty
Third Circuit
Fumich v. Novo Nordisk Inc., CV 24-9158 (ZNQ) (JBD), 2026 WL 1816026 (D.N.J. June 24, 2026) (Judge Zahid N. Quraishi). This putative class action alleges mismanagement in the administration of Novo Nordisk Inc.’s 401(k) Savings Plan by various defendants, which include the company, its board of directors, and the company’s retirement committee. Plaintiffs, who were participants in the plan, allege that the plan’s assets included Schwab Managed Retirement Target Date Funds (TDFs), which underperformed compared to other funds. They also allege that defendants engaged in a prohibited transaction by contracting with Schwab for recordkeeping and administrative (RKA) services, and that those fees were unreasonably high. Plaintiffs’ amended complaint contains three claims for relief under ERISA: (1) breach of the fiduciary duty of prudence against the retirement committee for selecting the Schwab TDFs and failing to minimize recordkeeping fees; (2) failure to monitor other fiduciaries against the company and the board; and (3) prohibited transactions against all defendants. Defendants filed a consolidated motion to dismiss and motion to strike; the motion to dismiss was directed at the first two counts (but only regarding the TDFs, not the RKA fees) while the motion to strike was directed at the third count. Taking plaintiffs’ claims in order, the court first found that plaintiffs failed to allege sufficient facts to show that the committee acted imprudently in selecting the Schwab TDFs. Plaintiffs pointed to comparator funds (the T. Rowe Price Retirement Target Date A Series, the American Funds Target Date R6 Series, the Callan GlidePath Target Date Cl Z Series, and the MFS Lifetime R6 Series) to support their claim, but the court found that these funds were not “meaningful benchmarks” because they were actively managed and had different asset allocations. Furthermore, the court noted that the Schwab TDFs only slightly underperformed plaintiffs’ selected comparators. “These levels of underperformance do not plausibly suggest that Defendants acted imprudently when selecting the Schwab TDFs for the Plan and courts have routinely dismissed claims where the alleged underperformance was minimal, as it is here.” Because count one failed, plaintiffs’ derivative second claim for failure to monitor also failed. As for plaintiffs’ third claim, the court granted defendants’ motion to strike because the claim exceeded the scope of the leave to amend previously granted by the court. The court noted that “Plaintiffs’ initial Complaint did not include a prohibited transaction claim, nor did the Court identify any defects that could be addressed regarding such a claim.” (Your ERISA Watch reported on the court’s previous order in our August 27, 2025 edition.) The claim was thus “unauthorized.” The court “exercise[d] its discretion to strike Count Three of the Amended Complaint without prejudice to Plaintiffs’ right to seek leave to amend their complaint.” As a result, defendants succeeded on all their arguments, although the dismissals were without prejudice.
Ninth Circuit
Dawson-Roberts v. Norman S. Wright Mech. Equip. LLC, No. 26-CV-01171-AGT, 2026 WL 1834788 (N.D. Cal. June 25, 2026) (Magistrate Judge Alex G. Tse). Norman S. Wright Mechanical Equipment LLC offers retirement benefits through an employee stock ownership plan (ESOP), which primarily invests in the company’s stock but also holds other assets in an Other Investments Account (OIA). Between 2021 and 2024, the OIA grew from $4.1 million to $11.9 million, invested entirely in cash equivalents. Christopher Dawson-Roberts, an ESOP participant and former employee of the company, alleges that his ESOP account would be more valuable if the OIA assets had been invested in more appropriate asset classes for long-term retirement savings, such as stocks and bonds. Dawson-Roberts alleges that because of this failure defendants (the company, the governing committee, and the committee members) breached their duties of prudence and loyalty under ERISA. He also alleges a breach of duty of disclosure related to the company’s 2024 conversion from an S-corporation to a limited liability company, which he claims was not communicated to ESOP participants. Defendants filed a motion to dismiss, asserting a host of arguments, which Dawson-Roberts opposed. In this order the court marched briskly through the eight issues raised. First, the court found that Dawson-Roberts had Article III standing to pursue his claims based on a theory of “relative loss,” even if the plan did not suffer an “absolute loss.” Second, the court concluded that Dawson-Roberts plausibly alleged a breach of the duty of prudence. The committee defendants allegedly left the OIA in cash equivalents that earned minimal returns, which was inconsistent with the ESOP’s long-term investment objectives. The court noted that Section 1104(a)(2) (which provides that “an ESOP fiduciary’s investment in the employer’s stock cannot be challenged as imprudent on the basis of insufficient asset diversification”) did not bar a prudence claim because that section “is limited to diversification-based objections to the ‘acquisition or holding’ of ‘qualifying employer securities’ or real property[;] it does not, by its terms, immunize the management of non-employer-security assets such as the OIA from scrutiny[.]” Defendants argued that they had “good reasons for keeping high OIA cash balances,” and the court did not discount them, but “those reasons are more appropriately considered on a full factual record, not on a motion to dismiss.” Third, the court found that Dawson-Roberts plausibly alleged a breach of the duty of loyalty. The committee defendants allegedly managed the ESOP to ease corporate liabilities, rather than in the interest of the participants, by maintaining a large OIA cash balance to relieve the company from its obligation to repurchase shares. Fourth, the court determined that Dawson-Roberts stated a plausible claim under 29 U.S.C. § 1106, as a 2024 transfer of OIA assets constituted a “transaction” under the statute. Fifth, the court ruled that Dawson-Roberts’ allegations were sufficient to state claims against the committee members as individual defendants, as they were plausibly ESOP fiduciaries. Sixth, the court found that Dawson-Roberts plausibly alleged that the company breached its duty to monitor the committee, as it failed to remove or change the committee’s investment decisions despite imprudent investments. Seventh, the court rejected defendants’ argument for dismissal of the co-fiduciary liability claim because, as explained above, Dawson-Roberts had stated actionable underlying claims. Eighth, and finally, the court dismissed Dawson-Roberts’ duty-to-disclose claim, as he did not identify a viable source for the duty related to the corporate conversion. The court noted that ERISA’s fiduciary duties do not apply in “the settlor context,” i.e., decisions regarding the form or structure of the plan. As a result, Dawson-Roberts’ complaint survived defendants’ motion to dismiss almost entirely unscathed; the court even gave him leave to amend the only casualty, his duty-to-disclose claim.
Ninth Circuit
Williams v. Lawrence Livermore Nat’l Security, LLC Benefits & Investment Committee, No. 24-CV-07593-VC, 2026 WL 1865363 (N.D. Cal. June 29, 2026) (Judge Vince Chhabria). Dean Williams had been employed at Lawrence Livermore National Security (LLNS) for more than 30 years when he faced a choice: retire, or enroll in one or both of two disability programs offered by LLNS. He consulted two benefits personnel at LLNS, and based on their advice he chose to enroll in both the traditional long-term disability program and the “Defined Benefit Eligible Disability” program. He alleges he was led to believe by the personnel that enrolling in the second program would result in him receiving pension credit for his time on disability, thereby increasing his pension payments upon retirement. However, this turned out to be incorrect. He thus brought this action against the LLNS Benefits and Investment Committee and related defendants, asserting a claim for breach of fiduciary duty under ERISA based on the misrepresentations. The case proceeded to cross-motions for summary judgment, which the court ruled on in this order. Defendants contended first that the two employees were not acting as fiduciaries when they advised Williams. The court disagreed, noting that the employees “advised Williams on which benefits he should choose and why,” and one of the employees had the title of “Retirement Counselor” (and was later named Delegate of Plan Administrator), which “strongly suggests” that she “was entrusted with discretion, ‘one of the central touchstones for a fiduciary role.’” Defendants further argued that any misrepresentation was not actionable unless it was “accompanied by ambiguous plan language on the same topic.” However, the court emphasized that ERISA imposes a duty on fiduciaries to convey complete and accurate information, regardless of whether the misrepresentation was intentional or inadvertent: “If a fiduciary advises a beneficiary to take a course of action based on the fiduciary’s misunderstanding of the plan, and the beneficiary takes that course of action to their detriment, it’s unclear why it should matter whether the advice was intentionally or inadvertently erroneous, or whether the advice was clearly contrary to the plan or just potentially contrary to the plan.” In any event, the plan language at issue was “embarrassingly ambiguous” because two different provisions explaining pension calculations were in “direct contradiction” of each other. The court characterized defendants’ attempt to harmonize them as “ridiculous.” Next, the court dismissed defendants’ argument that Williams’ reliance on oral misstatements was unreasonable due to his failure to consult written plan documents. The court highlighted that reliance is a context-specific inquiry and found that Williams reasonably relied on the advice given the ambiguous plan language and the fiduciary role of the advisors. Turning to remedies, the court discussed the options of equitable estoppel and surcharge. For equitable estoppel, Williams “must satisfy the traditional requirements for equitable estoppel as well as three ERISA-specific requirements.” The court found the plan terms ambiguous and that the representations were interpretations of the plan rather than amendments or modifications, but noted insufficient evidence regarding the intent requirement. “Specifically, it’s unclear whether [the employees] acted with the intent to induce Williams to enroll in the defined benefit disability program or acted in a way that entitled Williams to believe that their intent was to induce him to enroll in the program.” While the requirements for proving surcharge were not as onerous, the court still noted that there were issues of fact as to whether and how Williams was harmed by the misrepresentations. As a result, regardless of which remedial theory applied, the court ruled that a trial was necessary to establish the amount of compensation Williams could receive.
Class Actions
Third Circuit
Cezus v. Konica Minolta Bus. Solutions U.S.A., Inc., No. CV 21-792 (JXN)(LDW), 2026 WL 1801135 (D.N.J. June 23, 2026) (Judge Julien Xavier Neals). This case has its origins in the merger of Konica and Minolta in 2003. The new company maintained separate offices in Connecticut (Konica) and New Jersey (Minolta) at first. However, in 2016 it decided to consolidate most of its operations in New Jersey, although some jobs in Connecticut would remain. (The company eventually closed the Connecticut office in 2025.) Unsurprisingly, this consolidation resulted in job terminations. The company had a severance plan under which employees terminated due to a reduction in force (RIF) were eligible for severance, but those refusing a transfer were not. Plaintiff James Cezus, who had worked in the Connecticut office for more than 30 years, refused a transfer and was terminated. Cezus made an unsuccessful claim for severance benefits and then filed this putative class action in New Jersey state court, alleging that the company used the relocation “as a guise to conduct a mass layoff without having to pay severance.” He claimed that the company knew most Connecticut employees would not accept a transfer to a facility 123 miles away and that the positions were effectively eliminated, constituting a RIF which entitled him and others to severance benefits under the plan. The company removed the case to federal court, after which Cezus filed a motion to certify a class of employees who were denied severance benefits under the plan. The company opposed the motion, arguing that the relocation was not a RIF, that the plan’s eligibility requirements must be determined individually, and that the class was not clearly defined or ascertainable. (The company did not oppose the motion based on numerosity or adequacy of counsel.) The court granted Cezus’ motion. The court found the class ascertainable because it was narrowly and specifically defined as Connecticut employees who were selected for transfer, did not accept the transfer, were terminated, and were “ineligible for severance benefits under the Plan as an employee ‘who has refused an offer of employment in another division, department, office, or unit of the Company.’” Company records could identify these class members “without extensive and individualized fact-finding or ‘mini-trials.’” The court further determined that the class satisfied the requirements of Federal Rule of Civil Procedure 23(a): numerosity was met because the class included up to 400 members, and no fewer than 100; commonality was satisfied because the case “presents common questions of liability and relief,” such as whether the relocation constituted a RIF; typicality was met because Cezus’ claims were based on the same legal theories and facts as the class; and adequacy was satisfied because Cezus’ interests aligned with the class and counsel was qualified. The court also found certification appropriate under Rule 23(b)(1) because “[i]ndividual cases could produce different interpretations of the Plan and set incompatible standards of conduct for the Plan and its administrator[.]” The court did not address certification under Rules 23(b)(2) or (b)(3) because Rule 23(b)(1) was satisfied. As a result, Cezus’ motion for class certification was granted.
Disability Benefit Claims
Ninth Circuit
Jump v. Unum Life Ins. Co. of Am., No. 25-1021, __ F. App’x __, 2026 WL 1847149 (9th Cir. June 26, 2026) (Before Circuit Judges Wardlaw, Owens, and De Alba). Denise Jump brought this action seeking benefits under an ERISA-governed long-term disability plan. The district court ruled in favor of the plan’s insurer, defendant Unum Life Insurance Company of America, and in this terse memorandum disposition the Ninth Circuit quickly affirmed. The court noted that it “review[s] for abuse of discretion the district court’s denial of benefits under an ERISA plan that grants the administrator discretionary authority… Under this standard, we reverse only when we are convinced that ‘the reviewed decision lies beyond the pale of reasonable justification under the circumstances.’” The appellate court found that the district court did not abuse its discretion by not explaining “why its conclusion differed from that of the Social Security Administration (‘SSA’).” Jump contended that while the district court took judicial notice “of the fact that the SSA awarded benefits,” it “did not delve into the actual reasoning behind the SSA’s decision[.]” However, “such an explanation was not required,” and in any event, “even if the district court wanted to provide a more detailed explanation of why its decision differed from that of the SSA, it could not have; Jump never submitted the SSA’s award notice to the district court.” The court further ruled that the district court did not abuse its discretion by not remanding the matter to Unum for further consideration of the SSA award. The Ninth Circuit noted that the award was issued after Unum’s final decision, so Unum “cannot be faulted for not considering it.” As a result, the judgment in Unum’s favor was affirmed.
Discovery
Second Circuit
David F. v. Cigna Life & Health Ins. Co., No. 3:25-CV-02188 (SRU), 2026 WL 1815680 (D. Conn. June 24, 2026) (Judge Stefan R. Underhill). This action seeks relief under ERISA and the Mental Health Parity and Addiction Equity Act (Parity Act). At issue was a discovery dispute: “Although the parties agree that discovery on the plaintiffs’ ERISA claim will be limited to the administrative record, they disagree on whether limited discovery should be permitted on plaintiffs’ Parity Act claim.” In this brief order the court ruled that it would permit “limited discovery,” noting that “the nature of Parity Act claims is that they generally require further discovery to evaluate whether there is a disparity between the availability of treatments for mental health and substance abuse disorders and treatment for medical/surgical conditions.” The court observed that “information about how insurance companies process treatment limitations will often be in the hands of insurers alone,” and thus, “[i]f claimants were barred from accessing that information via discovery, they would very likely face ‘a serious obstacle’ in bringing ‘meritorious Parity Act claims.’” The court relied on other district court rulings arriving at a similar conclusion. However, the court emphasized that “[i]n submitting discovery requests to the defendants, the plaintiffs must remember not to ‘attempt to obtain indirectly what they cannot obtain directly’ with regard to their ERISA claim.”
Tenth Circuit
Mayor v. Metropolitan Life Ins. Co., No. 1:25-CV-00012-DBB-DAO, 2026 WL 1815564 (D. Utah June 24, 2026) (Judge David Barlow). This is an action for accidental death benefits against Metropolitan Life Insurance Company and two officers of Union Pacific Railroad. The deceased is Casey Mayor, who was employed by the Railroad and covered by its ERISA-governed benefit plan, and the plaintiff is his wife, Nicole Mayor. In December of 2025, defendants filed the administrative record, but Mayor was unhappy with it and responded with a motion objecting to it and requesting additional discovery. As we detailed in our May 20, 2026 edition, the assigned magistrate judge recommended granting Mayor’s motion in part and denying it in part. Mayor filed objections to the magistrate’s ruling, and this order from the district court judge was the result. The court reviewed the magistrate’s non-dispositive ruling under the “clearly erroneous or contrary to law” standard. The court first addressed Mayor’s “primary objection,” which was that the magistrate did not order the production of additional plan documents. The magistrate found her requests “speculative and unnecessary” because she did not demonstrate that “a separate master plan document must exist.” The court agreed, noting that the summary plan description could serve as the required ERISA plan document alongside the insurance policy, consistent with Tenth Circuit precedent. The court noted that Mayor would nevertheless likely obtain the documents she sought, if they existed, because “the magistrate judge still essentially granted Plaintiff’s motion by requiring production of any additional plan documents compiled in the course of denying Ms. Mayor’s claim.” Mayor also objected to the inclusion of an insurance application document in the administrative record. The magistrate allowed it because it was part of the contract and relevant to determining applicable law. The court found no clear error because “the application preceded the relevant policy and could have been considered by MetLife in denying the claim.” Mayor also contended that the application was not properly authenticated, but “Ms. Mayor offers no authority to support her assertion that each document in an ERISA administrative record must be authenticated under oath.” Finally, Ms. Mayor argued that the magistrate improperly treated defendants’ assertions as factual and mischaracterized her discovery requests. The court again found no clear error, as the magistrate independently considered each category of requested discovery and appropriately focused on “principal arguments in favor of that discovery rather than every potential application of the requested category of documents.” As a result, the court overruled Mayor’s objections and upheld the magistrate’s order in full.
ERISA Preemption
Sixth Circuit
Gessford v. July Bus. Servs., Inc., No. CV 5:25-322-KKC, 2026 WL 1834348 (E.D. Ky. June 25, 2026) (Judge Karen K. Caldwell). Doug Gessford filed this action in Kentucky state court against July Business Services, Inc., alleging that July was negligent in the transfer of his retirement funds. Gessford contends that he and his wife initiated an in-service rollover distribution from their 401(k) funds to new IRA accounts, and while July processed Ms. Gessford’s request promptly, thereby allowing her to benefit from favorable market conditions, it delayed processing Mr. Gessford’s request, which caused him to miss out on those conditions, damaging him financially. July removed the case to federal court, alleging ERISA preemption, and Gessford filed a motion to remand, which the court decided in this order. The court applied the Supreme Court’s two-part Davila test to determine whether complete preemption by ERISA was applicable. Under the first prong, the court found that Gessford was not seeking to recover benefits due under the ERISA plan but was instead seeking damages for the alleged negligence of July. The court held that “[w]here a plaintiff includes plan benefits as ‘simply a reference to [the] specific, ascertainable damages [the plaintiff] claims to have suffered as a proximate result of’ a defendant’s tortious conduct, complete preemption under § 1132 does not apply.” Under the second prong of the Davila test, the court determined that Gessford’s claim was based on Kentucky’s “universal duty of care,” which is “independent of ERISA,” because it “is not derived from, nor is it conditioned upon the terms of Gessford’s 401(k) plan.” The court relied on a similar district court case in which that court rejected preemption arguments because the plaintiff “was not seeking benefits from ERISA plan assets directly,” but was instead seeking “monetary damages relative to the diminished value of the benefit she received resulting from the agent’s improper notarization.” Similarly, Gessford sought damages from July directly, not from the 401(k) plan itself. As a result, the court found that Gessford’s claims were not preempted, granted his motion to remand the case back to state court, and denied July’s concurrently filed motion for judgment on the pleadings for lack of jurisdiction.
Eighth Circuit
Flowers v. Caremark PCS Health, LLC, No. 25-3068, __ F.4th __, 2026 WL 1859929 (8th Cir. June 29, 2026) (Before Circuit Judges Gruender, Benton, and Erickson). Kevin Flowers is a participant in an ERISA-governed prescription drug benefit program. The program is administered by the giant pharmacy benefits manager (PBM) Caremark, which maintains a provider network of pharmacies. Flowers alleges in this putative class action that Caremark “covers plan members’ ‘maintenance prescriptions,’ i.e., prescriptions taken regularly for more than ninety days, only if plan members fill those prescriptions ‘at one of its CVS retail pharmacy stores or through its mail-order delivery service.’” According to Flowers this requirement violates two Arkansas statutes: the “Mail Order Provision,” which provides that a pharmacy controlled by a PBM “shall not require that a patient receive his or her prescriptions through home delivery services,” and the “Network Adequacy Provision,” which requires PBMs to provide “[a] reasonably adequate and accessible [PBM] network for the provision of prescription drugs…[with] convenient patient access to pharmacies within a reasonable distance from a patient’s residence.” Caremark moved to dismiss Flowers’ complaint, arguing that he did not adequately plead a violation of the Mail Order Provision, and that both the Mail Order Provision and the Network Adequacy Provision are preempted by ERISA. The district court granted Caremark’s motion, and Flowers appealed. The Eighth Circuit, reviewing the case de novo, “quickly dispense[d]” with Flowers’ Mail Order Provision claim. The court noted that this provision only “prohibits PBMs from requiring that patients receive their prescriptions through home delivery services… But Caremark, as alleged, requires plan members to fill their maintenance prescriptions either by mail or at CVS pharmacies. Therefore, Flowers has not alleged facts sufficient to show that Caremark requires patients to fill prescriptions only through home delivery services.” The court thus turned to Flowers’ claim based on the Network Adequacy provision, which it admitted “is more complicated.” On this issue the court focused on whether ERISA preempted the geographic coverage requirements imposed by the statute’s implementing regulations. (The court followed the parties’ lead on this and thus stated that it would “expressly leave open the question of whether the Network Adequacy Provision, standing on its own or implemented through different regulations, would be preempted by ERISA”.) These regulations required PBMs to ensure that a certain percentage of plan members live within specified distances of a network pharmacy. The Eighth Circuit noted that state laws “relate to” an ERISA plan, and are therefore preempted by ERISA, when the law “has a connection with or reference to such a plan.” The court agreed with Caremark that the geographic coverage requirements had an impermissible “connection with” ERISA plans. Although the requirements “nominally permit PBMs to retain some flexibility to design their networks, the requirements ‘forc[e] … [a] particular scheme of substantive coverage.’” The court stated that ERISA was designed to “minimiz[e] the administrative and financial burden of complying with conflicting directives and ensur[e] that plans do not have to tailor substantive benefits to the particularities of multiple jurisdictions.” However, the requirements “bulldoze through these objectives, requiring PBMs to tailor and retailor their networks – and perhaps even build new brick-and-mortar pharmacies – to comply with a set of exacting particularities.” Flowers argued that the requirements did not “require payment of specific benefits” or “bind plan administrators to specific rules for determining beneficiary status,” but the Eighth Circuit stated that these were only examples of preempted activity and were not an “exhaustive overview…of how state laws might ‘structure benefit plans in particular ways’ and thereby risk running afoul of ERISA… ERISA can also preempt state laws that do not perform these functions.” The court thus affirmed the judgment below, agreeing with the district court that Flowers’ Mail Order and Network Adequacy claims should be dismissed.
Ninth Circuit
Estate of Gilbert Dominguez v. Estes Express Lines, Inc., No. 2:25-CV-10514-DSF-MAR, 2026 WL 1823874 (C.D. Cal. June 24, 2026) (Judge Dale S. Fischer). The complaint in this case alleges that Gilbert Dominguez, a former employee of Estes Express Lines, Inc., was severely injured in 2017 while working at a trucking terminal, and his injuries ultimately led to his death two years later. In 2019, Dominguez’ daughter contacted Estes on behalf of her father’s estate regarding his employment and was informed that he had been terminated due to his inability to return from leave, and that the estate “was not entitled to any back income or funeral costs. Dominguez and his family had been unaware of his termination.” As a result, the estate brought this action against Estes and G.I. Trucking Company, alleging causes of action under California law for wrongful discharge, physical disability discrimination, and negligence, among other claims. Defendants removed the case to federal court based on ERISA preemption, asserting that part of the estate’s case was a claim for $400,000 in ERISA-governed life insurance benefits. The estate filed a motion to remand the case back to state court. The court applied the two-prong Davila test established by the Supreme Court, noting that defendants had failed to do so in their briefing because they had conflated complete preemption (the correct test for determining jurisdiction) and conflict preemption (which is merely an affirmative defense). The court ruled, and the parties stipulated, that the estate “could have brought” a claim under ERISA § 502(a)(1)(B). Thus, the first prong was satisfied. However, the claim that defendants asserted the estate could have brought under ERISA failed under the second prong of Davila. Defendants contended that the estate “is really making a claim that Defendants terminated Dominguez in order not to pay benefits – a claim that falls within the scope of ERISA § 510.” However, “the parties filed a joint stipulation in which the Estate agreed to strike all such references and that it would ‘not seek recovery of any benefits covered by ERISA in this action.’” The court found that after disregarding such allegations there was an independent legal duty implicated by defendants’ actions, separate from any ERISA plan. The estate’s claims were based on state-law duties, such as wrongful termination due to disability, which did not require judicial review of any ERISA plan. “Such claims ‘do not rely on, and are independent of, any duty under an ERISA plan’ and ‘would exist whether or not an ERISA plan existed[.]’” Defendants relied on comments by the estate in the parties’ joint report and its discovery responses which could be interpreted as seeking employee benefits, but the court found that these were irrelevant because the correct focus was on the claims in the estate’s complaint. Thus, in the end, defendants failed to satisfy both prongs of the Davila test, which were required to establish complete preemption and federal jurisdiction. The estate’s motion was granted and the case was remanded to state court.
Exhaustion of Administrative Remedies
Fifth Circuit
Young v. Woman’s Hosp. Foundation, Civ. No. 24-518-SDD-EWD, 2026 WL 1847413 (M.D. La. June 25, 2026) (Judge Shelly D. Dick). Latasha Young was employed by Woman’s Hospital Foundation from 2021 to 2022 and participated in several of the Foundation’s ERISA-governed employee benefit plans, including a long-term disability plan. The plan required proof of loss within 90 days, and any adverse claim decision was required to be appealed to the insurance company administering the plan. After undergoing surgery in 2022, Young alleges that she inquired about her disability benefits and was informed by a human resources employee that she was not eligible. Young filed this action and has amended her complaint twice. Her complaint now contains a claim under 29 U.S.C. § 1132(a)(1)(B), alleging that the Foundation improperly denied her disability benefits, and also includes claims under 29 U.S.C. §§ 1132(a)(3) and 1132(c). These claims assert two exceptions to the plan’s exhaustion requirement: estoppel due to the Foundation’s failure to advise her to review the plan provisions, and a claim that the Foundation’s failure to follow the plan’s procedures should relieve her of the exhaustion requirement. The Foundation filed a motion to dismiss. The court first addressed the Foundation’s argument that Young impermissibly alleged Section 1132(a)(3) and 1132(c) claims, and impermissibly alleged exceptions to exhaustion, because the court did not allow such allegations in its previous ruling dismissing Young’s prior complaint. The court agreed: “The Court did not give Plaintiff leave to allege new legal theories. Nor did Plaintiff file a motion seeking such leave. Additionally, nothing in the record indicates that Plaintiff received Defendant’s written consent for these amendments.” The court thus turned to Young’s 1132(a)(1)(B) claim and the issue of exhaustion. Young admitted that she did not exhaust her administrative remedies, as she did not appeal the denial of her long-term disability benefits to the insurance company, as required by the plan. The court found no applicable exceptions to the exhaustion requirement and concluded that Young’s failure to comply with the plan’s procedures barred her from relief. As a result, the Foundation’s motion was granted and the case was dismissed with prejudice.
Pleading Issues & Procedure
Second Circuit
Rajappan v. Bloomberg L.P., No. 26-CV-785 (GHW) (BCM), 2026 WL 1803704 (S.D.N.Y. June 23, 2026) (Magistrate Judge Barbara Moses). In this putative class action Rajkumar Rajappan alleges that defendants – Bloomberg L.P., The Bloomberg Investment Committee, and The Bloomberg Retirement Plan Committee – breached their fiduciary duties under ERISA by retaining two “serially underperforming funds” in Bloomberg’s 401(k) plan for over ten years. Defendants contend that Rajappan lacks standing to challenge one of the funds because he never invested in it, and furthermore, “offers only ‘[h]indsight-based performance criticisms and cherry-picked alternatives’” and thus fails to state a plausible claim for imprudence. However, the merits of these claims were not decided in this motion; instead, the motion on the table was by defendants to stay discovery pending the outcome of their motion to dismiss. (Also pending was a motion by Rajappan for leave to amend his complaint to add a new plaintiff who had invested in both challenged funds.) The court granted defendants’ motion to stay, addressing three factors: “(1) the breadth of discovery sought, (2) any prejudice that would result, and (3) the strength of the motion.” On the first factor, the court noted that “it is fairly clear that discovery will likely involve voluminous document production and review.” Furthermore, “[i]n putative class actions under ERISA, discovery is often one-sided.” However, if defendants’ motion were to be granted, “there will be no need for discovery, and if it is granted in part…the discovery burden will be significantly reduced. In these circumstances, a stay of discovery would help avoid ‘burdensome efforts that could be unnecessary … and [may] waste [] precious resources.’” Thus, the first factor weighed in favor of a stay. The court also found that the second factor favored a stay because “plaintiff has not identified any specific prejudice that he will suffer if discovery is delayed.” Plaintiff did not assert that any particular evidence was “crucial,” and “it is well-settled that ‘the general notion that the passage of time will create prejudice’ is an insufficient basis on which to resist a discovery stay.” The court was satisfied that defendants would preserve all relevant evidence and thus plaintiff “should suffer ‘no prejudice’ from the stay.” On the third factor, “it appears to this Court that defendants’ pending motion to dismiss the [first amended complaint] raises ‘substantial arguments for dismissal.’” The court noted that case law frowned on claims relying heavily on “after-the-fact allegations” about a decrease in an investment’s value, and noted that “plaintiff pleads that the challenged funds underperformed their disclosed benchmarks by only 0.67% (on an average annual basis)[.]” Thus, the court found that defendants had a “substantial argument” in favor of dismissal, even if “plaintiff has also ‘raised significant opposition.’” Thus, “[on balance…’the scales tip in favor of a discovery stay.’” As a result, defendants’ motion was granted and discovery will be put on hold until the court rules on defendants’ motion to dismiss.
Fourth Circuit
Trader v. Savage, No. CV 25-975-BAH, 2026 WL 1811525 (D. Md. June 24, 2026) (Judge Brendan A. Hurson). The plaintiff in this case is Virginia Trader and the defendants are William Savage, III, Diamond State Meats LLC (DSM), Savage Poultry, Inc., and the VIP 401k Plan. It is difficult to tell from this decision exactly what claims Trader has brought, but two things are clear: Trader’s claims arise under ERISA and Savage Poultry has entered bankruptcy and taken the VIP 401k Plan with it. In this order the court addressed the bankruptcy and various discovery disputes. First, the court examined a “Joint Motion to Dismiss” filed by DSM and Savage, seeking to dismiss Savage Poultry and the VIP 401k Plan from the case with prejudice due to the bankruptcy stay. The court quickly denied this motion on procedural grounds because DSM and Savage “do not have standing to seek dismissal of the other defendants.” The court noted that Savage Poultry itself had only requested a stay, not dismissal. DSM and Savage contended that the plan was not a “true party” because it was a retirement plan, but the court disagreed, explaining that retirement plans are often proper defendants in ERISA actions. Thus, the claims against Savage Poultry and the plan remained stayed, not dismissed. Regarding the discovery issues, the court granted Trader’s motion to extend the discovery deadline for a deposition of a Merrill Lynch representative, and partially granted defendants’ motions to extend the discovery deadline. The court engaged in some finger-wagging on this issue, noting that “the parties do not appear to have strictly complied with the Court’s Local Rules requiring conference of counsel before seeking extensions of time.” Indeed, the parties’ filings were “ridden with errors and typos reflecting that the respective author took little to no time to contemplate whether the filing was appropriate or helpful, also contain competing and repetitive accusations of bad faith against opposing counsel.” The court ordered the attorneys to behave in the future or “the Court will consider appropriate sanctions to deter such behavior in the future.” Finally, the court addressed a discovery dispute concerning questions about damages, restitution, and attorney’s fees which arose during Trader’s deposition. The court found that the attorney-client privilege does not extend to billing records and expense reports, but the relevance of such information was questioned. The court concluded that Trader’s fee agreement with her counsel was not relevant to establishing liability on her ERISA claims and declined to order that her deposition be reconvened for this purpose. As for damages and restitution, the court noted that it did not have the deposition transcript and “the dispute has not been adequately raised in the parties’ joint status reports… To the extent any dispute remains, counsel are directed to the Court’s informal discovery dispute procedure.”
Fifth Circuit
Hawkins v. Wells Fargo Bank, N.A., No. 3:26-CV-00026, 2026 WL 1862614 (S.D. Tex. June 18, 2026) (Magistrate Judge Andrew M. Edison). Patrick Sean Hawkins was employed by Wells Fargo Bank and was a participant in the bank’s ERISA-governed short-term disability benefit plan. Hawkins alleges that in 2024 he became unable to perform his job duties due to severe work-related stress, anxiety, and symptoms associated with attention-deficit/hyperactivity disorder. He submitted a claim to the plan’s administrator, Lincoln National Life Insurance Company, but Lincoln denied it, contending that the medical evidence did not support a disabling impairment as of the claimed date. Hawkins thus brought this pro se action against Wells Fargo, the plan, and Lincoln, alleging two claims for relief. Count 1 is for wrongful denial of benefits under ERISA § 502(a)(1)(B), while Count 2 is under ERISA § 502(a)(3), which provides for “appropriate equitable relief.” Hawkins pleaded Count 2 as an alternative claim, “which he asserts only ‘to the extent the Court determines that relief under § 502(a)(1)(B) is unavailable, incomplete, or inadequate.’” Defendants filed a motion to dismiss Count 2, arguing that Hawkins’ claim for equitable relief was duplicative of his claim for benefits in Count 1. The motion was assigned to a magistrate judge, who recommended in this ruling that defendants’ motion be granted. The court relied on Fifth Circuit authority, which “has explained that ‘a claimant whose injury creates a cause of action under ERISA § 502(a)(1)(B) may not proceed with a claim under ERISA § 502(a)(3).’” The court stated that § 502(a)(3) is a “catchall” provision meant to offer equitable relief for injuries not adequately remedied by other sections of ERISA. Because Hawkins’ alleged injury – a wrongful denial of benefits – could be addressed under § 502(a)(1)(B), he could not simultaneously pursue a claim under § 502(a)(3). Hawkins argued that his § 502(a)(3) claim was not duplicative because it sought unique equitable remedies, such as a surcharge against fiduciaries and injunctive relief for compliance with ERISA’s procedural requirements. The court was unconvinced, finding that these remedies essentially sought the same outcome as the § 502(a)(1)(B) claim: “the value of his benefits.” The court emphasized that it “must focus on the substance of the relief sought and the allegations pleaded, not on the label used.” The court further rejected Hawkins’ argument that his claim was valid because it was pleaded in the alternative: “True, alternative pleading is allowed in most civil cases. But ERISA is different. Section [502](a)(3) is a catch-all provision.” The court thus recommended that because Hawkins’ alleged injuries could be addressed through his claim under § 502(a)(1)(B), his § 502(a)(3) claim should be dismissed.
Provider Claims
Second Circuit
Rowe Plastic Surgery of N.J., LLC v. Aetna Health & Life Ins. Co., No. 22-CV-4755 (MKB), 2026 WL 1847285 (E.D.N.Y. June 26, 2026) (Judge Margo K. Brodie). Rowe Plastic Surgery of New Jersey, LLC and its principal, Dr. Norman Maurice Rowe, are frequent litigants, and this is one of their many lawsuits against Aetna Health and Life Insurance Company. (The court noted that plaintiffs had filed “approximately thirty nearly identical lawsuits in the Southern and Eastern Districts of New York alleging that Aetna breached an oral agreement to pay for a surgery”). This dispute is based on Aetna’s allegedly “late, reduced, and unreasonable payment” for a bilateral breast reduction surgery performed in 2021 on a patient insured by Aetna. Plaintiffs contend that they sought and obtained a network exception from Aetna and relied on a representation of reimbursement at the 90th percentile of reasonable and customary rates. However, Aetna paid $90,844.28, which was “far below” the 90th percentile. Plaintiffs filed this action in New York state court asserting claims for breach of contract, promissory estoppel, unjust enrichment, and violation of New York’s Prompt Pay Law. Aetna removed the case to federal court based on ERISA preemption, after which plaintiffs filed an amended complaint including claims of fraud, fraud by omission, and fraudulent inducement. Aetna filed a motion to dismiss, arguing that plaintiffs improperly added new claims without court permission, the fraud claims failed to state a claim, and ERISA preempted plaintiffs’ claims. The court agreed with Aetna that plaintiffs’ new complaint exceeded the scope of the court’s leave to amend by adding new claims of fraud and fraud by omission without seeking permission. Although these claims were based on the same underlying facts as the fraudulent inducement claim, they were not authorized by the court’s previous order. The court also agreed that ERISA preempted plaintiffs’ claims. Plaintiffs contended that the complaint “pleads a classic rate-of-payment, not right-to-payment, dispute,” but the court disagreed. The court found that the claims were inseparable from the patient’s ERISA-governed plan because the alleged misrepresentations and network exceptions were tied to the plan’s terms. The court further found that plaintiffs’ claims were directed at rectifying a wrongful denial of benefits under an ERISA-regulated plan. The court also rejected plaintiffs’ argument that Aetna’s pre-surgery representations and network exceptions created an independent legal duty outside the ERISA plan. According to the court, the call transcript between plaintiffs and Aetna did not support an independent promise to reimburse at a specific rate, and the network exception did not provide a specific reimbursement rate. Thus, plaintiffs’ claims were centered on the plan and ERISA preempted them. The court therefore granted Aetna’s motion to dismiss.
Retaliation Claims
Fifth Circuit
Salazar v. Lockheed Martin Corp., No. 4:25-CV-1364-P, 2026 WL 1800303 (N.D. Tex. June 12, 2026) (Magistrate Judge Jeffrey L. Cureton). Marc Gabriel Salazar was employed by Lockheed Martin Corporation from 2016 until 2022. Salazar is unhappy about how his employment ended and has filed this pro se action against Lockheed alleging the following claims: (1) interference in violation of the Family Medical and Leave Act (FMLA); (2) retaliation in violation of the FMLA; (3) wrongful termination; (4) breach of contract/seniority rights; (5) interference in violation of ERISA; and (6) negligent misrepresentation. The operative pleading is Salazar’s third amended complaint, which Lockheed moved to dismiss. Meanwhile, Salazar moved for leave to file a fourth amended complaint. The motions were referred to the assigned magistrate judge, who issued this report and recommendation. The magistrate ruled that Salazar’s FMLA claims for interference and retaliation were time-barred by the two-year statute of limitations, as he filed the lawsuit nearly three years after his termination. Furthermore, the magistrate noted that FMLA violations must be “willful” in order to support a cause of action, and Salazar’s allegations “are consistent with a negligent, not a willful, violation of the FMLA.” Next, the magistrate determined that Salazar failed to state a claim for ERISA interference because he did not allege “specific discriminatory intent” by Lockheed to interfere with his benefits. The magistrate noted that “a global reading” of Salazar’s complaint “shows that Plaintiff is alleging that he was wrongfully terminated for taking FMLA, not for the purpose of interfering with his ERISA benefits.” Salazar’s allegations regarding how Lockheed incorrectly documented his seniority, which affected his benefits, were insufficient because “more than simply alleging an employer acted to deprive an employee of benefits is required” to state a claim for ERISA interference. In any event, Salazar’s ERISA claim was time-barred by the two-year statute of limitations because he was aware of the alleged interference at the time of his termination in 2022. Salazar’s remaining claims fared no better. The magistrate concluded that Salazar’s wrongful termination claim was not viable because “there is no common law cause of action for workplace discrimination or retaliation” and Salazar did not identify a statutory or constitutional violation. He also could not sue for breach of contract because he did not allege the existence of a valid contract. Salazar relied on “the CBA and company policies, which constitute a contract,” so the magistrate construed his claim as arising under the Labor Management Relations Act. However, Salazar did not allege that he had exhausted any grievance procedures, or that his union had breached any duty of fair representation. The magistrate also rejected Salazar’s negligent misrepresentation claim, noting that this claim was absent in his proposed fourth amended complaint, which the magistrate interpreted as abandonment. Finally, the magistrate considered Salazar’s pro se status and his request to file a fourth amended complaint, but concluded that “Plaintiff has already been given the opportunity to file three amended complaints,” and his proposed complaint “suffer[s] from the same defects as set forth above.” As a result, the magistrate concluded that amendment would be futile. He recommended that Lockheed’s motion to dismiss be granted with prejudice and that Salazar’s motion to amend be denied.
Severance Benefit Claims
Ninth Circuit
Foley v. Wells Fargo & Co., No. 25-CV-04795-EMC, 2026 WL 1805741 (N.D. Cal. June 23, 2026) (Judge Edward M. Chen). Terence Foley was a senior systems quality assurance analyst at Wells Fargo & Company. He contends in this action that because of a change in his work location he is entitled to benefits under Wells Fargo’s ERISA-governed severance plan. Foley worked remotely from his home in Union City, California but in September of 2024 he was informed that he would need to return to Wells Fargo’s office in Concord, California, which he claimed was more than 40 miles away. Wells Fargo denied his claim, determining that the distance was 33.1 miles, based on a computer-based mapping tool (Bing Maps API). This difference was crucial because the plan only paid benefits for a “qualifying event,” which included a “substantial position change,” which in turn included “a change to an Employee’s current position…that results in [e.g.] [a] change in work location beyond a Reasonable Commute Distance,” defined as “40 miles one way, using a mapping resource for this information, as determined by the Participating Employer.” Foley appealed the decision, arguing that the actual commute exceeded 40 miles, but Wells denied the appeal, maintaining that the shortest driving distance did not exceed 40 miles. Foley thus filed this action, asserting four claims for relief: (1) recovery of employee benefits under 29 U.S.C. § 1132(a)(1)(B), (2) inadequate notice and reasons for denial in violation of 29 U.S.C. § 1133(2), (3) failure to establish and maintain reasonable claims procedures in violation of 29 C.F.R. § 2560.503-1(b), and (4) failure to provide specific reasons for denial in violation of 29 C.F.R. § 2560.503-1(h)(3). The case proceeded to cross-motions for judgment. Wells Fargo argued, and Foley “essentially concede[d],” that his last three claims should be dismissed because they were not independent remedial bases. Thus, “the only question for the Court is whether Mr. Foley should prevail on his first cause of action under § 1132(a)(1)(B) – i.e., is he entitled to severance benefits because the change to his job resulted in a ‘Reasonable Commute Distance’ that exceeded 40 miles?” The court applied the abuse of discretion standard of review because the severance plan unambiguously provided discretion to the plan administrator. Foley argued for de novo review, citing procedural violations, but the court found no wholesale and flagrant violations of procedural requirements that would warrant such a shift. The court noted that Wells Fargo provided sufficient information about the mapping tool it used, and ruled that the lack of specific route documentation did not constitute a procedural violation. In applying abuse of discretion review, the court acknowledged Wells Fargo’s conflict of interest, but noted that “there do not appear to be any real procedural irregularities or violations,” and “there is no real indication that Wells’s actions here were in fact dictated or influenced by self-interest. There is no evidence, e.g., of malice, self-dealing, or a parsimonious claims-granting history.” The only possibly relevant irregularity was a difference in the language between the 2025 and 2026 summary plan descriptions, but the 2026 SPD was not in the record, did not govern Foley’s claim, and in any event there was “no clear inconsistency” between the two SPDs. Thus, the court’s review was “at best slightly informed” by Wells Fargo’s structural conflict of interest. As for the central merits question, Foley argued that “‘commute’ cannot simply mean distance but must also take into account, in particular, time.” However, the court found that Wells Fargo’s interpretation of “Reasonable Commute Distance” as the shortest driving distance was reasonable and consistent with the plan’s terms, which defined “commute” as “measured in miles.” The court emphasized that using the shortest driving distance was “perfectly logical” because such a standard “was objective and amenable to uniform and consistent application, free from subjective judgments and ever-changing variables.” As a result, the court concluded that Wells Fargo did not abuse its discretion in denying Foley’s claim for severance benefits.
Venue
Eighth Circuit
Delaney v. Metropolitan Life Ins. Co., No. 4:26-CV-00039-ACL, 2026 WL 1832389 (E.D. Mo. June 24, 2026) (Magistrate Judge Abbie Crites-Leoni). George Delaney worked for Consolidated Edison, Inc. (ConEd) for approximately 40 years and was covered by a ConEd-sponsored group life insurance policy insured by Metropolitan Life Insurance Company with a face value of approximately $404,000. George died in 2016, and his ex-wife, Maura, died only eight days later. The plaintiff in this action, Andrew Delaney, is the son of George and Maura and contends that a New York court, at the time of his parents’ divorce, “issued a binding order dated October 8, 1985, awarding all of Mr. Delaney’s life insurance policies to Maura T. Delaney and directing that she be designated as beneficiary.” Nevertheless, Andrew alleges that only $192,792.91 was paid to Maura Delaney, while $211,207.09 was distributed to eight other individuals “based on a Con Edison beneficiary designation form.” Andrew filed this pro se action against MetLife and ConEd under ERISA, contending that “Defendants knew or should have known that the beneficiary form conflicted with a valid domestic relations order that had been judicially affirmed.” At issue in this order were Delaney’s two motions to proceed in forma pauperis, which were referred to the assigned magistrate judge. The court granted Delaney’s second motion (and denied the first as moot) and waived his filing fee. The court noted that Delaney was “an active litigant in many cases across the country,” but, “[l]iberally construing the allegations of the Complaint and assuming Plaintiff’s assertions as true that he has standing to bring this suit,” the court found that the case was properly brought under ERISA. However, the court flagged the issue of venue. The court stated that an ERISA action may be brought “where the plan is administered, where the breach took place, or where a defendant resides or may be found.” The court noted that the transactions at issue took place in New York, where George Delaney was employed and where the ERISA plan was administered, not in Missouri. Therefore, the court issued an order to show cause why the case “should not be dismissed for lack of proper venue. Specifically, Plaintiff should inform the Court of all other litigation that has occurred on the current claims before the Court and provide case numbers and citations. This includes any Court proceedings concerning the administration of the estates of George and Maura Delaney, that occurred following their 2016 deaths, and any legal matters filed concerning the distribution of the life insurance proceeds at issue.”
Eleventh Circuit
Hughes v. Truist Bank, Inc., No. 1:25-CV-04667-SDG, 2026 WL 1849942 (N.D. Ga. June 26, 2026) (Judge Steven D. Grimberg). Anthony Hughes was employed by Truist Bank, Inc. and was a participant in its ERISA-governed accidental death and dismemberment (AD&D) benefit plan, which was insured by Hartford Life and Accident Insurance Company. Hughes alleges that he elected the maximum AD&D coverage for his wife, amounting to ten times his annual salary, or $830,000. His wife died in May 2024, but Hughes only received half of the elected amount, or $415,000. He then brought this action against Truist and Hartford under ERISA seeking the remainder. The defendants could not agree on how to proceed. Truist filed a motion to transfer venue to the Western District of North Carolina based on a forum selection clause in the summary plan description (SPD), and while Hughes did not oppose this motion, Hartford did on the ground that it was not a signatory to the SPD. Instead, Hartford filed a motion to dismiss for failure to state a claim. The court declined to rule on Hartford’s motion, finding instead that transfer was appropriate. The court reasoned that forum-selection clauses are generally enforceable in federal courts, and the burden is on the party opposing the clause to demonstrate inconvenience. Because Hughes did not oppose the enforcement of the clause, the court found transfer appropriate. However, this decision “leaves open the question of how to handle Hughes’s claims against Hartford,” which objected to the transfer. The court applied the “closely related doctrine,” which allows a forum-selection clause to be enforced against non-signatories. Under the doctrine, “the party must be closely related to the dispute such that it becomes foreseeable that it will be bound.” The court determined that Hartford was “closely related” to the dispute because its interests were “sufficiently derivative of Truist’s interest” in avoiding the additional payment to Hughes. “After all, had Truist not contracted with Hartford…to issue the AD&D policy under the Plan, Hartford…would not have any connection to Hughes’s dispute with Truist.” Furthermore, it was foreseeable that Hartford would be bound by the forum-selection clause because the SPD included the certificate of insurance issued by Hartford, and its representatives signed the certificate. As a result, “the SPD’s forum-selection clause can be enforced against the non-signatories and this action should be transferred in full. The ‘interest of justice’ is better advanced by transferring all claims, rather than by dividing them between two district courts. Truist’s motion was thus granted, and Hartford’s was denied without prejudice.