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of Texas, Inc. v. Culad, 124 S.Ct. 2488 (2004).

LTD Claim Denial

Employee-pay-all LTD had these employer marks on the plan’s administration:

  • Chose insurer

  • Indicated that it established the plan

  • Was agent for legal service of process

  • Was plan administrator

  • Did numerous administrative functions.

For these reasons, court held the plan was an ERISA plan and that participant’s state law claim was not appropriate.

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

Standard of Review

While court noted the potential conflicted interest with a employer-administered health care plan, it was not harsh with employer because the employer took pains to alleviate the structural conflict of interest.

Stratton v. E.I. DuPont de Nemours & Co., 363 F.3d 250 (3d Cir. 2004).

Retiree Benefit Termination

The participant’s retirement letter said retirees could keep or continue their benefits after they retired. This did not mean that such benefits were vested.

Jones v. American General Life and Accident Ins. Co. 370 F.3d 1065 (11th Cir. 2004).

Legal Action Time Filing Period

Leased employees were not enrolled in 1992 and were told that they were not eligible. It later developed that they were in fact eligible. They began a class action suit effective in

  • 2001.

    The employer argued the suit was time-barred because it should have been filed in

  • 1992.

    The court held against the employer.

Schultz v. Stoner, 308 F.Supp.2d 289 (S.D.N.Y. 2004).

Subrogation

The court denied a subrogation recovery citing the logic of Great-West v. Knudson; i.e., it was a legal and not an equitable recovery.

Professional Claims Management v. Carver, 32 EBC 2537 (6th Cir. 2004).

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

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