Professional Documents
Culture Documents
Retirement & Welfare Benefits: Securing The Right To Deferred and Contingent Benefits
Retirement & Welfare Benefits: Securing The Right To Deferred and Contingent Benefits
Moeller v. Bertrang
Further alleged conditions: (1) no moonlighting in similar work; (2) continued service until retirement at 62.
Pension: provides retirement income or results in deferral of income for periods extending to termination of covered employment or beyond.
Things That Look Like ERISA Plans But Arent ERISA Plans
One-shot transaction v. ongoing administration.
ERISA Problems
Employer begins reduction in force, and offers 1 weeks pay for each year of employment to each employee accepting voluntary layoff. ERISA plan? Employer announces annual bonus plan based on employee salary and annual corporate profit. ERISA plan? Employee handbook describes sick leave policy providing pay for up to 10 days of absence due to sickness. ERISA plan?
Employee handbook describes disability policy, providing pay for up to six months of pay at 60% of regular pay, provided employee is still an employee.
ERISA does not require an employer to offer a pension, or to maintain a pension it has!
ERISA does not require an employer to offer health insurance or to maintain insurance for employees!
HIPAA
Administrator is fiduciary.
Required written explanation of decision and internal appeal.
An ERISA plan?
Administrators duty in deciding claims under this model? Appropriate level of judicial review?
The Administrator: Agent for Employer? Or for Beneficiaries?
The problem of conflict of interest: How does it affect judicial review? Factors affecting severity of the conflict of interest?
Will a manager/administrator remember who he serves?
Did VP of Human Resources have discretion to interpret the documents? Conflict of interest?
Negligent counseling?
Duty to help maximize benefits, avoid inadvertent loss of benefits? Reasons for or against duty?
Transfers for able-bodied to report in 14 days (Mich. to NC) with no seniority, though local workforce insufficient to satisfy labor needs.
More likely claims: Restrictive transfer policy; ADEA, ADA and NLRA claims.
Discriminatory Coverage
SELECTED EMPLOYEES
Independent contractors?
No non-discrimination rules for welfare benefits.
Early equal access theory: No discrimination if men & women covered for same conditions.
How does plan cover other temporarily disabling conditions? Compare with pregnancy.
Saks
Franklin Covey
Assisted Reproduction,
Prevented Reproduction, &
v.
Assisted Intercourse
Must the Health Plan Pay?
Court: PDA protects only conditions related to pregnancy and unique to women.
Maybe his condition required her surgical impregnation.
Entitled to equal participation. But must the employer pay for wheelchairs?
Lawful
Complete preemption: non-application of wellpleaded complaint rule if claim is within the scope of ERISAs enforcement provisions.
Aetna v. Davila
Good news: The plan says youre well enough to go home. Bad news: The plan says youre well enough to go home.