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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. MISSING
Regular Panel Decision

Agway, Inc. Employees' 401(K) Thrift Investment Plan v. Magnuson

This case involves an action brought by Agway, Inc. Employees’ 401(k) Thrift Investment Plan and State Street Bank & Trust Company under ERISA, alleging breaches of fiduciary duties by various parties concerning the Agway pension plan. Defendant Mellon Trust of New England, N.A., a former fiduciary, sought court approval for a tentative settlement agreement with the plaintiffs, which included a bar order preventing non-settling defendants from asserting indemnity or contribution claims against Mellon Trust. The non-settling defendants, including the Committee Defendants, Director Defendants, and PricewaterhouseCoopers LLP, opposed the bar order, arguing it was overbroad. Magistrate Judge Peebles found the proposed bar order overreaches as it purports to restrict contribution and indemnity claims in actions brought by parties other than the plaintiffs, such as the Department of Labor. Consequently, the court denied Mellon Trust's application for settlement approval without prejudice, conditioning approval on either restricting the bar order's scope to the current action or securing the Secretary of Labor's agreement to the judgment credit reduction in any future action.

ERISAFiduciary Duty BreachPension PlanSettlement AgreementBar OrderContribution ClaimsIndemnity ClaimsPartial JudgmentNon-Settling DefendantsProportionate Fault
References
21
Case No. MISSING
Regular Panel Decision
Apr 28, 1987

Save Pine Bush, Inc. v. City of Albany

This case involves appeals concerning a combined declaratory judgment action and CPLR article 78 proceeding initiated by Save the Pine Bush, Inc. and others against the Planning Board of the City of Albany and intervenors State Employees Federal Credit Union (SEFCU) and Madison Avenue Extension Office Park, Inc. (MAEOPI). Petitioners challenged the rezoning and site plan approvals for two commercial projects in the Pine Bush area, alleging violations of the State Environmental Quality Review Act (SEQRA). The Supreme Court annulled the Board's approvals, a decision affirmed on appeal despite the projects' completion, due to the public importance and recurrence likelihood of the environmental issues. The Appellate Division found the Board's approval arbitrary and capricious, as it failed to take a "hard look" at the cumulative environmental impact, specifically regarding the minimum acreage required for the Pine Bush ecology and the Karner Blue butterfly's survival. The court dismissed appeals from motions to reargue, affirming the necessity of addressing the minimum preserve issue for SEQRA compliance.

Environmental Impact ReviewSEQRAPine BushZoningSite Plan ApprovalCollateral EstoppelMootness DoctrineCumulative Environmental ImpactKarner Blue ButterflyType I Action
References
8
Case No. 15-24-00114-CV
Regular Panel Decision
Oct 04, 2024

Cecile Erwin Young, in Her Official Capacity as the Executive Commissioner of the Texas Health and Human Services Commission; Molina Healthcare of Texas, Inc.; And Aetna Better Health of Texas, Inc. v. Cook Children's Health Plan, Texas Children's Health Plan, Superior Health Plan, Inc., and Wellpoint Insurance Company

This case involves an appeal concerning a temporary injunction and the denial of a plea to the jurisdiction issued by the 353rd Judicial District of Travis County. The appellants, including Cecile Erwin Young (Executive Commissioner of HHSC), Molina Healthcare of Texas, Inc., and Aetna Better Health of Texas, Inc., are challenging the lower court's decision. The appellees (Cook Children's Health Plan, Texas Children's Health Plan, Superior Health Plan, Inc., and Wellpoint Insurance Company) had sought to enjoin the Texas Health and Human Services Commission (HHSC) from proceeding with STAR & CHIP and STAR Kids managed care procurements. The core legal arguments revolve around whether HHSC's procurement processes violated Texas law, thereby rendering the intended contract awards unlawful ultra vires acts, and whether the appellees' claims are barred by sovereign immunity or failure to exhaust administrative remedies. The appellants contend that the district court abused its discretion by granting the injunction and denying the plea.

Appellate CourtTemporary InjunctionPlea to the JurisdictionSovereign ImmunityUltra Vires ClaimsProcurement DisputeManaged Care ContractsMedicaidCHIPTexas Health and Human Services Commission
References
95
Case No. MISSING
Regular Panel Decision

In re Robert Plan Corp.

Kenneth Kirschenbaum, the Chapter 7 Trustee for The Robert Plan Corporation and The Robert Plan of New York Corporation, sought court approval for fee awards for himself and his professionals for administering an ERISA plan. The U.S. Department of Labor (DOL) objected, asserting the court lacked jurisdiction to award fees from Plan assets and had specific objections to the reasonableness of the fees. The court affirmed its core jurisdiction over the Trustee's actions as Plan administrator and his professionals' compensation, regardless of whether payments came from Plan or estate assets, citing previous rulings. The court analyzed whether Bankruptcy Code §§ 326 and 330 conflicted with ERISA statutes concerning fiduciary compensation, concluding no substantive conflict existed and the Bankruptcy Code's specific compensation scheme governed. Ultimately, the court largely overruled DOL's objections and granted the fee applications for the Trustee, K & K, Witz, and Whitfield, deeming the requested amounts reasonable and compliant with the Bankruptcy Code. The awards are payable from the Plan's Pguy Account, with any shortfall covered by the Debtors' estate.

Bankruptcy LawERISAChapter 7 TrusteeFee ApplicationPlan AdministrationJurisdictionReasonable CompensationStatutory ConstructionDepartment of LaborFiduciary Duties
References
50
Case No. 07-09-00163-CV
Regular Panel Decision
Mar 12, 2010

Potter County, Texas as Plan Administrator for the Health Benefits Plan for the Employees of Potter County, Texas v. Ronda Tuckness and Michael Tuckness

Potter County, acting as the plan administrator for its employee health benefits plan, appealed an order that denied its plea to the jurisdiction. The underlying lawsuit was filed by Ronda and Michael Tuckness, seeking health care benefits after the County denied Michael Tuckness's claim for back surgery costs due to an occupational injury exclusion. The County contended it was immune from suit. The appellate court found that the County's governmental immunity had not been waived by the requests for declaratory relief, the terms of the health plan contract, or the County's conduct. Consequently, the court reversed the trial court's order and dismissed the Tucknesses' case for lack of subject-matter jurisdiction.

Governmental ImmunityImmunity WaiverDeclaratory JudgmentContract LawHealth BenefitsPlan AdministratorOccupational Sickness/InjuryJurisdictionPlea to JurisdictionInterlocutory Appeal
References
20
Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. MISSING
Regular Panel Decision

Pig Newton, Inc. v. Boards of Directors of the Motion Picture Industry Pension Plan

Plaintiff Pig Newton, Inc. commenced an action against the Boards of Directors of the Motion Picture Industry Pension Plan, Health Plan, and Individual Account Plan, seeking a declaration that certain provisions of the Plans’ Trust Agreements were invalid and unenforceable. The Defendants counterclaimed for delinquent contributions under ERISA. The core dispute revolved around "Controlling Employee Provisions" in the Trust Agreements, which obligated employers to contribute for Controlling Employees for a specified number of hours and weeks regardless of actual hours worked. Pig Newton argued these provisions were invalid, not properly incorporated, or conflicted with collective bargaining agreements (CBAs). The Court, applying federal common law and an arbitrary and capricious standard of review for the Directors' interpretation, found the provisions valid, properly incorporated, and not in conflict with the CBAs, concluding that Szekely (Pig Newton's sole owner) qualified as a Controlling Employee. Consequently, the Court denied Plaintiff's motion for summary judgment and granted Defendants' cross-motion for summary judgment, dismissing Plaintiff's complaint and awarding Defendants the sought-after contributions, interest, auditors’ fees, and liquidated damages.

ERISAMultiemployer PlanPension PlanHealth PlanDeclaratory JudgmentSummary JudgmentTrust AgreementsCollective Bargaining AgreementsControlling Employee ProvisionsDelinquent Contributions
References
44
Case No. MISSING
Regular Panel Decision

Murphy v. Wal-Mart Associates' Group Health Plan

Hazel and Charlie Murphy sued Wal-Mart Associates’ Group Health Plan and Prudential Health Care Plan after the Plan denied coverage for Mr. Murphy's high-dose chemotherapy and autologous bone marrow transplant for Non-Hodgkin’s Lymphoma. The Murphys alleged the Wal-Mart Plan acted arbitrarily and capriciously in denying benefits and their subsequent appeal, and brought state law claims against Prudential. The court found that Wal-Mart Plan's decision was based on medical expert opinions and was not arbitrary and capricious. Furthermore, it determined that ERISA preempted all state law claims against Prudential. Consequently, the court granted summary judgment for both defendants, dismissing the plaintiffs' claims.

ERISAEmployee BenefitsHealth InsuranceSummary JudgmentArbitrary and Capricious StandardMedical NecessityHigh-Dose ChemotherapyAutologous Bone Marrow TransplantNon-Hodgkin’s LymphomaPlan Administrator Discretion
References
28
Case No. MISSING
Regular Panel Decision

Laflamme v. Carpenters Local 370 Pension Plan

Plaintiff Michael LaFlamme initiated a class action against the Carpenters Local #370 Pension Plan and its Board of Trustees, alleging violations of the Employee Retirement Income Security Act (ERISA) concerning the plan's 'freezing rule' for benefit accrual after a 'break in service.' LaFlamme sought a judicial declaration that this rule contravenes ERISA's minimum accrual standards, along with a reformation of the pension plan and recalculation of benefits for all affected class members. The court, presided over by District Judge Hurd, evaluated the motion for class certification under Federal Rule of Civil Procedure 23(a) and (b), finding that the requirements of numerosity, commonality, typicality, and adequacy of representation were met. Consequently, the motion for class certification was granted, establishing a class comprised of all plan participants, active or retired, who experienced a service break resulting in frozen benefit accrual rates. The decision also outlined procedures for providing notice to the newly certified class members, while deferring detailed adjudication of defenses like statute of limitations and exhaustion of remedies to later dispositive motions.

ERISAPension BenefitsClass ActionBenefit AccrualFreezing RuleBreaks in ServiceClass CertificationRule 23(a)Rule 23(b)Federal Civil Procedure
References
49
Case No. MISSING
Regular Panel Decision
Nov 24, 1992

PINE BARRENS v. Planning Bd.

This case addresses whether the State Environmental Quality Review Act (SEQRA) mandates a cumulative impact statement for over 200 proposed development projects in the Central Pine Barrens region of Long Island. The Central Pine Barrens is a vital ecological area, serving as the sole natural source of drinking water for millions and harboring numerous endangered species, leading to various protective legislations. The Court of Appeals reversed the Appellate Division's ruling, determining that a mandatory cumulative impact study under SEQRA is not applicable here because there is no overarching governmental 'plan' for development in the region, only general protective policies. The court emphasized that comprehensive planning for this area should be conducted by the Long Island Regional Planning Board as outlined in ECL article 55, rather than through individual SEQRA assessments. It also noted the significant delay in the Regional Planning Board's action, urging legislative intervention to address this pressing environmental concern.

Environmental LawSEQRACumulative ImpactPine BarrensSuffolk CountyLong IslandAquifer ProtectionLand Use PlanningState Environmental Quality Review ActPlanning Board
References
6
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