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employer’s mark was on the plan to such an extent that it was an ERISA plan, which defeated the participant’s plans to receive damages beyond the payment of the claim.

Anderson v. UNUM Provident Corp. 369 F.3d 1257 (11th Cir. 2004).

COBRA Notification

The court held the employer’s COBRA notice was deficient in that it failed to give the number of days to apply for COBRA and said only that it was to be completed as soon as possible. The infraction resulted in the employer having to pay a claim but there was no penalty assessed.

Thomas v. Town of Hammonton, F.3d (3d Cir. 2004).

Retiree Coverages

Court held that retiree benefits were not guaranteed so long as employer had the right to amend or terminate coverage.

International Union of United Automobile Aerospace and Agricultural Implement Workers of America v. Rockford Powertrain, Inc., F.3d (7th Cir. 2004).

SPD-Document Conflict – LTD

The two documents were in conflict on the his/any occupation issue. The classic omission v. conflict issue was at stake. Since the conflict was genuine, the court held that the SPD prevailed, meaning the participant won.

Healy v. Dawn Food Products, Inc. F.Supp.2d (W.D. Ky. 2004).

LTD Claim Denial

This is another dispute involving an employee pay-all but employer-sponsored LTD plan. The participant wished the venue to be a state court but the court held that the employer’s stamp of authority was such as to make it an ERISA plan. Thus the participant had to have his complaint heard in a federal court.

Stern v. Provident Life & Accident Ins. Co., F.Supp. (M.D. Fla. 2004).

Sex Discrimination

Plan, upon denying a claim of a female for contraceptives, was sued for discrimination under these federal laws:

  • Civil Rights Act of 1964

  • Pregnancy Discrimination Act.

© 2004 International Foundation of Employee Benefit Plans, Inc. All rights reserved.

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