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The Wagner Law Group

The Wagner Law Group is a nationally recognized practice in the areas of ERISA and employee benefits, estate planning, employment, labor and human resources and  investment management.

 

 

Established in 1996, The Wagner Law Group is dedicated to the highest standards of integrity, excellence and thought leadership and is considered to be amongst the nation's premier ERISA and employee benefits law firms. The firm has six offices across the country, providing unparalleled legal advice to its clients, including large, small and nonprofit corporations as well as individuals and government entities worldwide. The Wagner Law Group's 28 attorneys, senior benefits consultant and three paralegals combine many years of experience in their fields of practice with a variety of backgrounds. Seven of the attorneys are AV-rated by Martindale-Hubbell and six are Fellows of the American College of Employee Benefits Counsel, an invitation-only organization of nationally recognized employee benefits lawyers.  Seven of the firm's attorneys have been named to the prestigious Super Lawyers list for 2016, which highlights outstanding lawyers based on a rigorous selection process.

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Boston 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110

 

Washington, D.C.

Tel: (202) 969-2800

  Fax: (202) 969-2568

800 Connecticut Ave., N.W.

Suite 810

Washington, D.C. 20006

 


Palm Beach Gardens 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

Tampa

Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 

 

San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

300 Montgomery Street

Suite 600

San Francisco, CA 94104

 

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
25 W. Moody Avenue
St. Louis, MO  63119

 

 

www.wagnerlawgroup.com

 

 

 

August 3, 2017

 

 Health and Welfare Law Alert

 

 

 

  Fifth Circuit Finds SPD to be Official Welfare

Plan Document 

 

 

 

The Fifth Circuit Court of Appeals, in Rhea v. Alan Ritchey, Inc. Welfare Benefit Plan, has confirmed that a welfare benefit plan's summary plan description ("SPD") could serve as the official plan document. In making this ruling, the Fifth Circuit expressly rejected the plaintiff's assertion that the Supreme Court's decision in CIGNA Corp. v. Amara requires ERISA-covered plans to maintain an official plan document and SPD as separate documents.

 

Background. In Rhea, a beneficiary under an ERISA-covered welfare benefit plan received a settlement in connection with injuries she incurred from medical malpractice. The plan at issue operated using a single instrument as the plan document and SPD. This document contained a provision that required reimbursement of any benefits paid by the plan to a beneficiary in the event that a third party paid a settlement to the beneficiary for causing the injuries.

 

In accordance with the plan's reimbursement provision, the plan sought reimbursement from the beneficiary for the benefits paid. The beneficiary responded by refusing to reimburse the plan, claiming that the reimbursement provision was invalid because it was not contained in an enforceable plan document. Specifically, the beneficiary argued that the document was unenforceable because it referenced an official plan document, which the plan did not have.

 

The plan obtained a favorable judgment against the beneficiary from the district court assigned to review the matter. In turn, the beneficiary appealed the adverse decision to the Fifth Circuit.

 

Fifth Circuit. In reviewing the matter, the Fifth Circuit rejected the beneficiary's contention that a single document could not serve as both the plan's SPD and the official plan document. The court noted that the document contained all of the elements required by ERISA and, that unlike the facts in Amara, there was no conflict between the document and other written information concerning the plan. Accordingly, the Fifth Circuit affirmed the lower court's decision in favor of the plan sponsor.

 

Takeaway for Plan Sponsors. Rhea confirms that courts will enforce an SPD as the official plan document if it contains all of the elements required under ERISA and does not conflict with any other plan-related documents. In view of this fact, plan sponsors must be sure that their SPDs provide accurate descriptions of the plans' benefits and meet ERISA's requirements so that they can limit liability where applicable.

 

Despite this decision, the SPD and the plan generally should be separate documents because they serve conflicting purposes. An SPD must provide information about the plan in language that can be understood by the average participant while the plan document must contain all legal detail needed to establish and maintain the employee benefit plan.

 

Rhea v. Alan Ritchey, Inc. Welfare Benefit Plan is available at:

 

 

 

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This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.