Employee Health Insurance and ERISA in California

ERISA pre-empts two categories of state laws. ( Gobeille v. Liberty Mut. Ins. Co. (2016) 577 U.S. 312, 319.) First, ERISA pre-empts a state law if it has a reference to ERISA plans. ( Id. ) To be more precise, where a State's law acts immediately and exclusively upon ERISA plans ... or where the existence of ERISA plans is essential to the law's operation ..., that reference will result in pre-emption. ( Id. at 319-20.)

The court found that ERISA applied when “(1) the state law claims address areas of exclusive federal concern, such as the right to receive benefits under the terms of an ERISA plan; and (2) the claims directly affect the relationship among the traditional ERISA entities—the employer, the plan and its fiduciaries, and the participants and beneficiaries.” ( Id. at pp. 244-245.)

s right to receive benefits under his ERISA plan, nor does it affect the relationship among Defendant, his employer, and his plan.

There are two types of ERISA preemption: “express” preemption under Section 514(a) and “conflict preemption based on Section 502(a). ERISA Section 514(a) expressly preempts “any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.” There are two categories of state law claims that “relate to” an ERISA plan for purposes of Section 514(a): “claims that have a ‘reference to’ an ERISA plan, and claims that have ‘an impermissible ‘connection with’’ an ERISA plan.”

First, TCW argues that all of Lakewoods claims conflict with the federal Employee Retirement Income Security Act ("ERISA") and thus are preempted by that statute. (29 U.S.C. Section 1144(a).) Second, TCW argues that even if Lakewoods claims are not preempted by ERISA, Lakewoods complaint fails to allege sufficient facts to support the claims. Taking the preemption argument first, the Court has determined that Lakewoods claims are not preempted by ERISA.

Defendant demurs the SAC in its entirety on the grounds that Plaintiff’s claims are preempted by ERISA. ERISA: ERISA is a federal law that sets minimum standards for employer sponsored retirement and health plans. “As a part of this integrated regulatory system, Congress enacted various safeguards to preclude abuse and to secure the rights and expectations that ERISA brought into being” including broad preemption provisions. Marshall v. Bankers Life & Casualty Co. (1992) 2 Cal.4th 1045, 1051.

A state law claim “relates to” an ERISA plan if the claim either makes “reference to” or holds a “connection with” an ERISA plan. (California Div. of Labor Standards Enforcement v. Dillingham Constr., N.A., Inc. (“Dillingham”) (1997) 519 U.S. 316, 324.) A state law claim makes “reference to” an ERISA plan if (1) the claim acts “immediately and exclusively” on an ERISA plan or (2) adjudication of the claim requires the existence of an ERISA plan.

Indeed, in a case decided after The Meadows, the Ninth Circuit itself stated that in The Meadows it “recognized that ERISA preempts the state claims of a provider suing as an assignee of the beneficiary’s rights to benefits under an ERISA plan,” but went onto hold “that ERISA does not preempt ‘claims by a third-party who sues an ERISA plan not as an assignee of a purported ERISA beneficiary, but as an independent entity claiming damages,’ because such claims do not ‘relate’ to ERISA preemption.”

Equally concerning, Respondents clearly raised the ERISA jurisdiction issue in their opposition papers and Petitioner failed to address the jurisdictional and preemptions issues in its reply. Instead, Petitioner summarily dismissed ERISA as “irrelevant”. (See Reply, at p. 2.) However contrary to Petitioner’s claims and based upon the plain language of the arbitration provision, whether or not ERISA applies is relevant. (Ibid.)

ERISA preempts each of Plaintiff’s state law causes of action because all of Plaintiff’s allegations necessarily “relate to” an ERISA-governed plan. All of Plaintiff’s allegations concern matters of Plan administration, relationships governed by ERISA, and interpretation of the Plan. Therefore, each cause of action is preempted by ERISA Section 514. Section 514(a) “supersedes any and all state laws insofar as they may now or hereafter relate to any employee benefit plan.” 29 U.S.C. § 1144(a).

ERISA preempts the causes of action because Plaintiff’s causes of action necessarily “relate to” an ERISA-governed plan. The allegations of the Complaint concern matters of Plan administration, relationships governed by ERISA, and interpretation of the Plan. Therefore, the first through fourth causes of action are preempted by ERISA Section 514. Section 514(a) “supersedes any and all state laws insofar as they may now or hereafter relate to any employee benefit plan.” 29 U.S.C. § 1144(a).

Taking the preemption argument first, the Court's tentative ruling is that the Hospital's claims are not preempted by ERISA. It is salient for the ERISA preemption inquiry that the Hospital is a third-party provider of services to CDI members, outside of the plan's network of providers. Put another way, the Hospital is not a plan participant, an assignee of a participant, or a plan beneficiary. Drawing on a body of ERISA precedent, the Court in Morris Silver M.D., Inc. v.

(Request for Judicial Notice at 3-12:13) ANALYSIS ERISA Section 514(a) preempts Plaintiff’s Causes of Action California courts have yet to address the issue as to whether ERISA section 514 preempts the fair procedure doctrine as applied to ERISA plans.

ERISA does not preempt commonplace lawsuits against ERISA plans for run-of-the-mill state-law claims such as unpaid rent, failure to pay creditors, or even torts committed by an ERISA plan, despite the fact that they obvioulsy affect and involve ERISA plans and their trustees. See Morris B. Silver, MD v. International Longshore and Warehouse Union (2016) 2 Cal.App.5th 793, 802. This case cites from Mackey v. Lanier Collection Agency (1988) 486 U.S. 825, 833.

In opposition, Cross-Complainants argue the Plan does not relate to ERISA. They contend [t]he right to fair procedure is a doctrine that makes no mention of the ERISA statute and applies regardless of whether an ERISA plan is involved. (Opp. 13-15.) This argument fails. When addressing whether a claim relates to ERISA, courts must look to the facts of the claim, not the title of the cause of action. Cross-Complainants are correct that fair procedure is not unique or specific to ERISA.

Patel’s claims are subject to conflict preemption under ERISA. In Port Medical Wellness, Inc. v. Connecticut General Life Ins. Co. (2018) 24 Cal.

It explained that where a State’s law ‘acts immediately and exclusively upon ERISA plans, ... or where the existence of ERISA plans is essential to the law’s operation, ... that “reference” will result in pre-emption.’ [Citation.] Further, a law that does not refer to ERISA plans ‘may yet be pre-empted if it has a “connection with” ERISA plans.’ [Citation.]

Section 514(a) of ERISA preempts state law claims that relate to employee benefit plans. 29 U.S.C. § 1144(a). We have held that ERISA preempts common law theories of breach of contract implied in fact, promissory estoppel, estoppel by conduct, fraud and deceit and breach of contract. Aetna Life Ins. Co. v. Bayona , 223 F.3d 1030, 1034 (9 th Cir. 2000). ERISA preempts the first cause of action because Plaintiffs cause of action necessarily relates to an ERISA-governed plan.

Section 514(a) of ERISA preempts state law claims that relate to employee benefit plans. 29 U.S.C. § 1144(a). We have held that ERISA preempts common law theories of breach of contract implied in fact, promissory estoppel, estoppel by conduct, fraud and deceit and breach of contract. Aetna Life Ins. Co. v. Bayona , 223 F.3d 1030, 1034 (9 th Cir. 2000). ERISA preempts the first cause of action because Plaintiffs cause of action necessarily relates to an ERISA-governed plan.

Patel’s claims are subject to conflict preemption under ERISA. In Port Medical Wellness, Inc. v. Connecticut General Life Ins. Co. (2018) 24 Cal.

Defendants demur on the grounds that Plaintiff Maldonado’s claims are preempted by ERISA because Maldonado is a participant in a group benefit plan which entitled him to bring a claim under ERISA § 502(a), and because of Maldonado’s claims arise from an alleged denial of benefits under the ERISA regulated plan.

among the traditional ERISA entities—the employer, the plan and its fiduciaries, and the participants and beneficiaries.”

ILWU has shown that ERISA preemption might bar Patel’s claims, but the case of Morris B. Silver M.D., Inc. v. International Longshore & Warehouse etc. (2016) 2 Cal. App. 5th 793, 806-08, renders ERISA preemption inapplicable if the reason for non-payment was unrelated to the patients’ eligibility under their plans. Patel fails to allege that the patients were all undisputedly covered but that ILWU failed to pay it for another reason.

Section 514(a) of ERISA preempts state law claims that relate to employee benefit plans. 29 U.S.C. § 1144(a). We have held that ERISA preempts common law theories of breach of contract implied in fact, promissory estoppel, estoppel by conduct, fraud and deceit and breach of contract. Aetna Life Ins. Co. v. Bayona , 223 F.3d 1030, 1034 (9 th Cir. 2000). ERISA preempts the first cause of action because Plaintiffs cause of action necessarily relates to an ERISA-governed plan.

ERISA Preemption “ERISA is a comprehensive federal law designed to promote the interests of employees and their beneficiaries in employee pension and benefit plans.” (Port Medical Wellness, Inc. v. Connecticut General Life Insurance Company (2018) 24 Cal.App.5th 153, 171.) “The purpose of ERISA is to provide a uniform regulatory regime over employee benefit plans.

Seventh and Ninth Causes of Action: ERISA Preemption Preferred next argues that Plaintiff’s claims are also “potentially preempted” by ERISA. (Motion, 9-10.) Preferred argues that while Plaintiff alleges that its own claims are not based on ERISA, Plaintiff failed to affirmatively allege that patient J.O.’s claims do not arise from ERISA. (Id.)

Demurrer to Entire Complaint ERISA Preemption Defendant first demurs to the entire First Amended Complaint on the grounds that the claims are preempted by section 514 of the Employee Retirement Income Security Act of 1974, as amended (ERISA).

to bring the ERISA claims would be seek leave to amend the SAC.

Co. (2018) 24 Cal.App.5th 153 (Port Medical), the Court determined that ERISA preempted the claim. Under ERISA, the insurer must “‘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, written in a manner calculated to be understood by the participant.’” (Silver, supra, 2 Cal.App.5th at p. 808.)

As noted by Defendants, “[i]n evaluating whether a common law claim has ‘reference to’ a plan governed by ERISA, the focus is whether the claim is premised on the existence of an ERISA plan, and whether the existence of the plan is essential to the claim's survival. If so, a sufficient ‘reference’ exists to support preemption.” (Providence Health Plan v. McDowell (9th Cir. 2004) 385 F.3d 1168, 1172.)

It is settled law that Section 1144(a) preempts not only state laws dealing with matters specifically covered by ERISA, but also any state law that purports to regulate, directly or indirectly, the terms and conditions” of ERISA plans. (ERISA § 514, subd. (c)(2), 29 U.S.C. § 1144, subd. (c)(2).)

ILWU has shown that ERISA preemption might bar Shamaan’s claims. The case of Morris B. Silver M.D., Inc. v. International Longshore & Warehouse etc. (2016) 2 Cal. App. 5th 793, 806-08, renders ERISA preemption inapplicable if the reason for non-payment was unrelated to the patients’ eligibility under their plans. However, the court in Port Medical Wellness, Inc. v. Connecticut General Life Ins. Co. (2018) 24 Cal.

There is no longer any mention of the non ERISA plan reimbursement, although the amount of the payment to Valley Children’s matches the amount of the non ERISA plan reimbursement from the petition. The discrepancy must be explained. Pursuant to California Rules of Court, Rule 3.1312, subd. (a) and Code of Civil Procedure section 1019.5, subd. (a), no further written order is necessary.

ILWU has shown that ERISA preemption might bar Shamaan’s claims, but the case of Morris B. Silver M.D., Inc. v. International Longshore & Warehouse etc. (2016) 2 Cal. App. 5th 793, 806-08, renders ERISA preemption inapplicable if the reason for non-payment was unrelated to the patients’ eligibility under their plans. Shamaan fails to allege that the patients were all undisputedly covered but that ILWU failed to pay him for another reason, rendering his claims potentially subject to ERISA preemption.

PR-23-001125 – DISPUTED CLAIM OF MUNOZ, RENAISSANCE – Minor Renaissance Munoz’s Motion to Quash an Erisa Medical Lien – GRANTED AS MODIFIED. Pursuant to its discretion under Probate Code § 3601(a), the Court disallows the ERISA Blue Cross and VA medical expenses as against the minor’s share of the settlement. In doing so, the Court finds it unnecessary to reach the preemption issues presented by the Moving Party or to make a ruling on whether the medical liens should be completely quashed.

The Plaintiff’s claims are not preempted by ERISA. Complete preemption does not apply since Plaintiff is not a participant or beneficiary of the Plan and therefore does not have standing under ERISA § 502(a), 29 U.S.C. § 1132.

ERISA preempts the first through fifth causes of action because Plaintiff’s causes of action necessarily “relate to” an ERISA-governed plan. The allegations concern matters of Plan administration, relationships governed by ERISA, and interpretation of the Plan. Therefore, the first through fifth causes of action are preempted by ERISA Section 514. Section 514(a) “supersedes any and all state laws insofar as they may now or hereafter relate to any employee benefit plan.” 29 U.S.C. § 1144(a).

As an initial matter, it is not actually apparent from the allegations in the pleading that ERISA is implicated here. Plaintiff does not allege facts about Defendant or the plan it administers from which the Court can conclude ERISA applies. This is true irrespective of Plaintiff’s anticipatory allegation that its claims do not arise under ERISA, which allegation is accompanied by citations to legal authority. (Compl., ¶ 22.)

A non-ERISA plan paid $3,959. See item 13b(2)(e). There was a negotiated reduction of $2,649. See item 13b(2)(f)(ii)(B). It appears that there is to be a reimbursement to a non-ERISA plan in the amount of $1,310, although it is unclear because box that is supposed to contain the total reimbursement amount is left blank. The medical liens total $1,950. See item 13b(5). These two figures do not total $4,599. It is unclear where the remaining $1,339 comes from.

Here, plaintiff avers that it is a fiduciary under ERISA, and that it has an obligation to ensure the proper disbursement of death benefits. Plaintiff brought this action in interpleader to fulfill that obligation. In other words, plaintiff is an ERISA fiduciary who filed an interpleader action for the purpose of enforcing the terms of the plan.

Here, plaintiff avers that it is a fiduciary under ERISA, and that it has an obligation to ensure the proper disbursement of death benefits. Plaintiff brought this action in interpleader to fulfill that obligation. In other words, plaintiff is an ERISA fiduciary who filed an interpleader action for the purpose of enforcing the terms of the plan.

Because their state law claims do not relate to the right to receive benefits under an ERISA plan, but are based on alleged independent oral agreements, their claims are not preempted by ERISA. See Providence Health Plan v.

(B) ERISA Preemption The Corrigan Defendants asserts that the court lacks jurisdiction over plaintiffs’ claims against them because they are preempted by ERISA. The Corrigan Defendants base this argument upon “conflict preemption” pursuant to ERISA section 514(a) (29 U.S.C. § 1144(a)). (Reply, p. 8.) In support of their argument, the Corrigan Defendants cite Dearth v. Great Republic Life Ins. Co. (1992) 9 Cal.App.4th 1256 (Dearth) and Hollingshead v. Matsen (1995) 34 Cal.App.4th 525 (Hollingshead).

Defendants demur to the Complaint and each cause of action on the ground that the Employee Retirement Income Security Act (ERISA) Section 514(a) preempts all state law causes of action. 29 USC § 1144(a); Blue Cross of Cal. v. Anesthesia Care Assocs. Medical Grp., Inc. , 187 F.3d 1045, 1051 (9 th Cir. 1999). Section 514(a) of ERISA preempts state law claims that relate to employee benefit plans. 29 U.S.C. § 1144(a).

The ERISA issue should be set for hearing, which, in the absence of concession by the trust beneficiaries to the position of the surviving spouse, the court would like fully briefed by counsel with applicable federal statutory and case law. gmr

Demurrer The demurrer of the defendant to the First Amended Complaint is SUSTAINED without leave on the ground the three causes of action (quantum meruit, breach of oral contract, and promissory estoppel) are pre-empted by ERISA. (See Port Wellness Medical, Inc. v. Connecticut General Life Ins. Co. (2008) 24 Cal.App.5th 153.) Case Management Conference The Case Management Conference is OFF CALENDAR. Notice The defendant shall give notice and prepare the appropriate order/judgment.

Defendants demur to the Complaint and each cause of action on the ground that the Employee Retirement Income Security Act (ERISA) Section 514(a) preempts all state law causes of action. 29 USC § 1144(a); Blue Cross of Cal. v. Anesthesia Care Assocs. Medical Grp., Inc. , 187 F.3d 1045, 1051 (9 th Cir. 1999). Section 514(a) of ERISA preempts state law claims that relate to employee benefit plans. 29 U.S.C. § 1144(a).

. --- ERISA Preemption – Defendant contends that the instant action is preempted entirely by ERISA, and argues ERISA is the exclusive remedy of Plaintiff in securing its rights under the healthcare plan by and between Defendant and Patients KM and NW. While the parties address the finer points of ERISA preemption under Federal caselaw, the Court is bound by the 2016 California Second District Court of Appeal decision Morris B. Silver M.D., Inc. v. International Longshore & Warehouse etc. (2016) 2 Cal.

ERISA Preemption CHPC’s assertion that the Employment Retirement Income Security Act of 1974 (ERISA) preempts both causes of action in the cross-complaint are also unfounded. The Employee Retirement Income Security Act of 1974 (ERISA) section 514 expressly preempts “any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.” (29 U.S. 1144(a); Port Medical Wellness, Inc. v.

The Court granted the demurrer on the ground that Plaintiff’s complaint referenced California’s Knox-Keene act which is preempted by ERISA. In opposition to Plaintiff’s Combined Motion to Compel Further, one of Defendant’s principal objections was that the discovery was related to ERISA issues. The Court finds that the October 13 Order properly denied Plaintiff’s Combined Motion. Defendant’s ERISA objections were valid because at the time the Complaint was preempted by ERISA.

“Accrual of an ERISA action is a question of federal law, and thereunder an ERISA claim ‘accrues either at the time benefits are actually denied, or when the insured has reason to know that the claim has been denied.’” Wise v. Verizon Communis. Inc. (9th Cir. 2010) 600 F. 3d 1180, 1188. In Wise, the court determined that the “fourth letter triggered [participant’s] ERISA claim because only after receiving this letter was she informed that no further internal appeals were possible.” Id.

While it appears to the court that it may have concurrent jurisdiction to hear a matter which involves the federal ERISA statutes, the numerous references by the moving party to federal court cases raise the possibility of removal of this case to federal court.

Code §17200 et seq. is not preempted by ERISA. When liberally construed, the allegations are not entirely dependent upon Explanations of Benefits, but refer to other behaviors as well. Under these circumstances, Morris B. Silver M.D. Inc. v. International Longshore & Warehouse (2016) 2 Cal.App.5th 793, does not require a finding of federal preemption. b) The Court finds that, when liberally construed, the pleading sufficiently alleges the claims for punitive damages (Civ.

THE DEFINITION OF "REGULATION" IS UNDER CALIFORNIA LAW; THE DEFINITION OF "STATE LAW" IS UNDER ERISA. 5.) THE COURT DID NOT MAKE FACTUAL FINDINGS. 6.) THE COURT PROPERLY REJECTED PLAINTIFF'S REQUEST FOR JUDICIAL NOTICE. 7.) AS A MATTER OF LAW, DEFENDANT WAS OBLIGATED TO WITHDRAW THE ENTIRE POLICY UNDER INSURANCE CODE SECTION 10291.5. 8.) THE REFERENCE TO CIVIL CODE SECTION 1654 WAS NOT ERRONEOUS. =(302/PJM/PB)

While not all of the claims will involve complicated legal issues, those involving ERISA do constitute complicated legal issues. All of these cases should be handled by one judge to avoid inconsistent rulings. To assign these matters to one general civil department would be burdensome on the court. There will no doubt be numerous pleading challenges and dispositive motions to contend with, not to mention the probability of protracted discovery disputes and a lengthy trial.

While not all of the claims will involve complicated legal issues, those involving ERISA do constitute complicated legal issues. All of these cases should be handled by one judge to avoid inconsistent rulings. To assign these matters to one general civil department would be burdensome on the court. There will no doubt be numerous pleading challenges and dispositive motions to contend with, not to mention the probability of protracted discovery disputes and a lengthy trial.

Medicare... and ERISA" matters. The arbitration clause of the on-line contract is not in capital letters as set forth in the statute; and is not in "at least 10-point bold face red type" as required by statute. So §1295 is clearly not an applicable exemption here and MP knows it is not an applicable exemption here. The court system does not have the resources to re-hear all previously adjudicated motions where the claimed "new law" is so clearly inapplicable.

ERISA The references to ERISA are inapposite to this complaint. ERISA is a comprehensive federal statutory scheme designed to promote the interests of employees and their beneficiaries in employee benefit plans. (See generally Carpenters So. Cal. Admin. Corp. v. El Capitan Development Co. (1991) 53 Cal.3d 1041, 1047.) The allegations of the complaint and all judicially noticeable facts do not support any argument that the alleged insurance plans are subject to ERISA.

Nowhere in the Complaint do the allegations specifically implicate ERISA. One of the cases relied on heavily by Defendant, Port Medical Wellness, Inc. v. 2|Page Connecticut General Life Ins. Co., (2018) 24 Cal. App. 5th 153, which was decided on summary judgment, noted that conflict preemption is an affirmative defense. [A] demurrer based on an affirmative defense will be sustained only where the face of the complaint discloses that the action is necessarily barred by the defense. (Heshejin v.

Contrary to Plaintiff’s claims, workers’ compensation, unemployment benefits and ERISA claims are not subject to arbitration. (Mercuro v. Superior Court (2002) 96 Cal. App. 4th 167, 176.) Plaintiff’s other arguments are unavailing as Plaintiff presents no evidence, not even her own declaration, to support any of her unconscionability claims. Moreover, the arbitration agreement meets the requirements of Armendariz v. Foundation Health Psychcare Services, Inc. (2000) 24 Cal. 4th 83.

We have held that ERISA preempts common law theories of breach of contract implied in fact, promissory estoppel, estoppel by conduct, fraud and deceit and breach of contract. Aetna Life Ins. Co. v. Bayona , 223 F.3d 1030, 1034 (9 th Cir. 2000). However, here, the causes of action are not preempted because ERISA does not preempt claims by a third-party suing an ERISA Plan not as the assignee of a Plan member, but as an independent entity.

Plaintiff's claims are not preempted by ERISA because they allege a 10-year failure to create an IRA as promised, and expressly disclaim any relief relating to an IRA that was later created; defendant cites no case finding preemption in this scenario. As to wrongful termination, no authority is cited for the notion that a complaint to the Labor Commissioner or a third party is required. The remainder of plaintiff's claims are properly pled.

ILWU has shown that ERISA preemption bars Patel’s claims, all of which are based on Patel seeking payment for benefits provided to patients under an employee benefit plan. In addition, the 2nd cause of action for breach of oral contract fails to allege sufficient facts that would establish an oral contract, or the terms of the contract.

Totten deals with state court jurisdiction to seek repayment under a specific federal act, i.e. the ERISA. Totten did not issue a blanket holding that all lienholders would not have standing to challenge the reduction of the liens under Civil Code Section 3333.1. Regardless of whether Totten applies, the lienholders now have notice and have not objected. The motion is GRANTED. A proposed order was lodged with the Court and will be executed.

PR-23-001125 – DISPUTED CLAIM OF MUNOZ, RENAISSANCE – Minor Petitioner’s Motion to Quash an Erisa Medical Lien – HEARING CONTINUED, on the Court’s motion.

ERISA and IRC §401(a)(13) ERISA provides that "[e]ach pension plan shall provide that benefits provided under the plan may not be assigned or alienated." 29 USC §1056(d)(1), see also IRC §401(a)(13). Although Debtor Lampel and James B.

As to the definition of the class, there is no doubt that plaintiff intended to define the class as excluding policies covered by ERISA. Defendant's request to take judicial notice is denied. Any party who contests a tentative ruling must send an email to contestdept302tr@sftc.org with a copy to all other parties by 4pm stating, without argument, the portion(s) of the tentative ruling that the party contests.

First, Petitioner asks for a reimbursement to a Non-ERISA insured plan in the amount of $829.16 in paragraph 13b(2)(c), but does not account for this payment in any other portion of the petition. As such, the Court cannot ascertain whether this medical expense is to be paid from the gross settlement or not. Second, Petitioner has failed to submit a proposed order granting the petition and a proposed order depositing the net settlement into a blocked account.

Cal. 2015) 144 F.Supp.3d 1097, 1114 ("An ERISA plan administrator abuses its discretion when it strays from the plain terms of the plan"); Tapley v. Locals 302 and 612 of Intern. Union of Operating Engineers-Employers Const.

Thus, for example, Defendants’ argument that some of the patients’ claim are barred by ERISA fails. The evidence shows that Defendants’ most recent listing of alleged ERISA plan members identifies, at most, only 87 ERISA plan beneficiaries out of the 123 members involved in this lawsuit. PAMF 3. (1) Breach of Implied-in-fact Contract “[A]n implied-in-fact contract entails an actual contract, but one manifested in conduct rather than expressed in words.” (Maglica v. Maglica (1998) 66 Cal.App.4th 442, 455.)

If approved, $60,000.00 will be used to pay medical expenses paid by a non-ERISA insured plan, $250,000.00 will be used to pay attorneys’ fees, and $17,250.00 will be used to pay for costs associated with this suit, leaving a balance of $672,750.00 for Claimant.

"C") cover, inter alia, any of either D's misrepresentations, wilful misconduct, gross negligence, waste, misapplication or misappropriation of funds, misuse of insurance proceeds or security deposits, breach of environmental warranties, mechanic's lien obligations, failures to enforce lease terms, breach of ERISA warranties, and bankruptcy expenses.

The District Court has already held that these claims are preempted by ERISA and cannot be maintained. In addition, plaintiff fails to state facts sufficient to allege the causes of action she asserts, and her claims are barred by the statute of limitations. Despite this court previously ruling that plaintiff’s intentional and negligent misrepresentation claims improperly assert alleged misrepresentations of future facts rather than present or existing facts, plaintiff still alleges only future facts.

The Health Net I opinion includes the following language: “While it is true that the first cause of action in Wachtel sought damages only under ERISA section 502(a)(1)(B), the allegations of the first cause of action were incorporated into the second, which sought relief under ERISA section 502(a)(3) for breach of HN’s fiduciary duties.

Although the documents attached to the FAC state that the Workforce Reduction Plan is a "welfare benefit plan for purposes of ERISA" (FAC, Ex. A at p. 17), plaintiff has neither pled nor sought recovery for a claimed violation of her ERISA pension rights. See Karambelas v.

As an initial matter, Defendant argues that this action is preempted by section 514, subdivision (a) of the Employee Retirement Income Security Act of 1974, commonly known as ERISA. Defendant is incorrect. ERISA does not preempt claims by health care providers for payment. (See Blue Cross of California v. Anesthesia Care Associates Medical Group, Inc ., 187 F.3d 1045, 1054 (9th Cir. 1999).) Defendant does not address this case in its reply brief.

The Court notes that upon review of the 27 parties’ Income and Expense Declarations, neither party currently works for the type of employer 28 whose retirement plans would not be covered under ERISA (and thus would need to be joined to 29 the action). Petitioner also did not include any retirement plans in her Community Property 1 Declaration filed 7/23/2021.

In an objection filed April 18, 2017 decedent's son, Jeff Taylor, alleges that there may be no assets to probate given ERISA rules and possible Heggstad authorization. Objector alleges that if anyone should be "executor," it should be him. Also on April 18, 2017, Objector and Kerry Nelson filed a cross-petition for probate set for hearing on May 18, 2017, seeking their joint appointment as co-executors without bond.

The parties have settled for $600,000, with a breakdown as follows: Medical expenses: $198,021.00 (total medical expenses) [$98,021.00 (amount paid by ERISA self-funded plan) + $100,000 (amount paid by Petitioner)] Attorney’s fees: $153,874.81 Expenses: $87,167.42 Balance: $160,936.77 The court has reviewed the petition and finds the settlement to be fair and reasonable.

The petition states the minor incurred $30,000 in medical expenses for emergency treatment and surgery to correct the damage, which was paid by a non-ERISA self-funded plan that is not requesting reimbursement. However, the petition states that Medi-Cal paid $1,078.41 for medical expenses and has agreed to accept $1,078.41 in full satisfaction of its lien rights. There are copies of the bills substantiating the claimed medical expenses are attached to the petition as required by Local Rule 7.10.12A.(6).

The parties settled for $15,000, with a breakdown as follows: Medical expenses: $2,133.24 ($3,817 (total medical expenses) - $1,683.76 (amount paid by non-ERISA insured plan) Attorney’s fees: $3,750 Expenses: $435 Balance: $8,681.76 The court has reviewed the petition and finds the settlement to be fair and reasonable. Petitioner and counsel have an agreement for attorney’s fees, (Exh. 3), and counsel has submitted a declaration in support of the requested fees. (Petitioner Blanchard Decl. ¶ 8.)

QDROS Are Not Transfers under the UVTA QDROs are only applicable to ERISA qualified pension plan.

Plaintiff’s motion for summary adjudication of the fifteenth and sixteenth affirmative defenses regarding ERISA and Medicare is granted. Unlike as to the seventh affirmative defense, Kaiser has neither adduced any facts, nor explained any legal theory, suggesting how the claims in this case might be preempted as these affirmative defenses suggest.

On August 8, 2016, the executor demurred to the §850 petition on grounds of federal ERISA preemption. In the exercise of its discretion and in the interests of justice, on October 6, 2016, this court stayed probate court proceedings pending litigation of a lawsuit in the United States District Court, Southern District of California, case 16CV0460L WVG, filed by the creditor's claimant's Thomas Ford, Thomas F. Ford DDS and Ronald Hempel against both executor and the Association of Civil Employers, Inc.

. $662.64 of the $5,662.64 amount is to be paid to a private health insurance or a self-funded plan under a Non-ERISA self-funded plan. $5000 of the $5,662.64 amount is to be paid to West Los Angeles Chiropractic located at 11340 W. Olympic Blvd., Ste. 165, Los Angeles, CA 90064. No attorney’s fees or costs are to be taken from the gross settlement.

. $662.64 of the $5,662.64 amount is to be paid to a private health insurance or a self-funded plan under a Non-ERISA self-funded plan. $5000 of the $5,662.64 amount is to be paid to West Los Angeles Chiropractic located at 11340 W. Olympic Blvd., Ste. 165, Los Angeles, CA 90064. No attorney’s fees or costs are to be taken from the gross settlement.

RELAVANCE OF FEDERAL LAW UNDER ERISA This case concerns the duties of the trustee of the UCRP under California law. The USRP plan administrator owes a fiduciary duty to the plan itself regarding the management of plan assets and the competent administration of the plan itself. (California Constitution, Art. 16, § 17.) This responsibility is similar, if not identical, to the responsibilities of plan administrators under ERISA, which is the federal law regulating private sector pensions.

RELAVANCE OF FEDERAL LAW UNDER ERISA This case concerns the duties of the trustee of the UCRP under California law. The USRP plan administrator owes a fiduciary duty to the plan itself regarding the management of plan assets and the competent administration of the plan itself. (California Constitution, Art. 16, § 17.) This responsibility is similar, if not identical, to the responsibilities of plan administrators under ERISA, which is the federal law regulating private sector pensions.

Storke Housing Investors (2003) 31 Cal.4th 1157, the California Supreme Court considered whether workers could seek unpaid contributions to their retirement plan through a mechanics lien or whether the issue was preempted by the Employee Retirement Income Security Act of 1974 (ERISA).

However, the Petition is defective because there is no evidence regarding the medical expenses paid by a non-ERISA insured plan with an expected reimbursement of $1,063.10 after a negotiated reduction of $1,042.86. The unopposed Petition to approve minor’s compromise is DENIED without prejudice.

Nor is such a claim preempted by ERISA; the new cause of action is not entirely dependent upon Explanations of Benefits, but refers to other behaviors as well. Under these circumstances, Morris B. Silver M.D. Inc. v.

However, there is no evidence that Claimants mothers employers ERISA health insurance plan agreed to reduce the amount requested for reimbursement by $2,213.44. The unopposed Petition to approve minors compromise is CONTINUED to December 10, 2021, for Petitioner to obtain proof of the negotiated reduction. Per California Rules of Court, Rule 7.952, Petitioner and Claimant must appear at the hearing, unless the Court finds good cause to excuse their appearance.

Item 13b(2)(c) is checked, indicating that a Non-ERISA insured plan paid medical expenses, but Item 13a(1) and 13b(2)(e) state that $0 were paid. Item 14a and b are both blank. But, both Items 15a, 15b(2), and 15b(3) are checked, indicating Petitioner has paid or become obligated to pay for “attorney’s fees included in the total fee amount shown in Item 14a” and “other expenses included in the total shown in item 14b” in the amount of $1,375. Also, Items 17a and 17c are blank. Item 16 is blank.

However, there is no evidence that Claimants mothers employers ERISA health insurance plan agreed to reduce the amount requested for reimbursement by $2,213.44. The unopposed Petition to approve minors compromise is CONTINUED to December 10, 2021, for Petitioner to obtain proof of the negotiated reduction. Per California Rules of Court, Rule 7.952, Petitioner and Claimant must appear at the hearing, unless the Court finds good cause to excuse their appearance.

Third, Daie claimed that Bailey failed to explain that the ERISA-qualified annuities might not be appropriate because he already maintained tax-deferred accounts. The Arbitrator determined that this was false or clearly erroneous because the annuities were purchased with funds rolled over from other ERISA-qualified accounts and Daie expressly advised Bailey that he had no need to access the funds invested in the annuities for a minimum of 10 years.

The contract indicates in the second paragraph and in section III "General Provisions" that it is a plan services and fee agreement under which the Defendant provided record keeping and consulting services to the Plaintiff so that the Plaintiff could comply with its responsibilities under a pension plan, under the Internal Revenue Code, and under ERISA.

There was an additional issue of ERISA preemption which is not raised here, but no preemption was found under either Cal/OSHA or ERISA. The Oakland Ordinance at issue there was quite similar to §5.49.04: “A. Purpose.

Plaintiffs seek to omit references to defendant’s theft of profit sharing plan funds, as these are ERISA claims within the exclusive jurisdiction of the federal court. Plaintiffs have filed a federal court action. There is no prejudice to defendant in permitting the amendment.