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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 23 attorneys engaged exclusively in employee benefits, estate planning and employment law. Seven of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

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

   

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

Illinois Office

Tel: (847) 250-1365

Fax: (847) 250-1367

414 West Deerpath Road
Lake Forest, IL  60045  

 

www.wagnerlawgroup.com

 

 

 

 

June 5, 2014

 

 State and Federal Law Alert

 

 

 

Court Rules "Clear Notice" Standard Applies when Plan Administrators Respond to Document Requests from Participants

 

 

 

In Cultrona v. Nationwide Life Insurance Company, the Sixth Circuit Court of Appeals ruled that a "clear notice" standard applies when determining whether a plan administrator should be subject to statutory penalties for failing to timely furnish plan documents requested by a participant. The Sixth Circuit reasoned that the clear-notice standard strikes a fair balance between a participant's right to timely receive plan documents and the statutory penalties facing plan administrators that fail to timely furnish plan documents requested by a participant.

 

Applicable Law. ERISA requires plan administrators to provide, upon receiving written request from a participant, copies of the latest summary plan description, summary annual report, any terminal report, the bargaining agreement, trust agreement, contract, or other instrument used to operate the plan. A plan administrator that fails to furnish such documents within 30 days after a participant's request faces penalties of up to $110 per day for each day past the 30-day response time.

 

Background. In Cultrona, the plaintiff filed a lawsuit against the defendant after it denied her claim under an accidental death plan for which it was plan administrator. During the appeal process, the plaintiff's counsel requested that the defendant, as plan administrator, provide all documents it had reviewed in reaching the decision to deny the claim.

 

The defendant provided some of the requested documents but failed to provide a copy of the actual accidental death policy until seven months after the plaintiff's request. Consequently, the district court awarded the plaintiff $8,910 in statutory penalties (i.e., $55/day) because of the delay. The defendant appealed this penalty assessment to the Sixth Circuit.

 

Sixth Circuit's Decision. The defendant argued that the penalty was not warranted because the plaintiff did not specifically request the policy. It further asserted that the "clear-notice" standard should be applied, thereby requiring participants to provide clear notice to the plan administrator of the information being requested.

 

The Sixth Circuit agreed that the "clear-notice" standard should apply, but found that the defendant should have known that the plaintiff was requesting a copy of the policy. Since it was clear that the policy was part of the defendant's review process, the Sixth Circuit found that the plaintiff had clearly requested it. Accordingly, the Sixth Circuit upheld the lower court's decision to award statutory penalties.

 

Impact of Cultrona. As evidenced by Cultrona, the "clear-notice" standard can be difficult to interpret. Plan administrators should be cognizant that ERISA clearly favors the production of documents when requested, and recognize that even a poorly worded request can serve as the basis for the assessment of statutory penalties.

 

When responding to participants' document requests, plan administrators are advised to provide what is requested, and possibly more. Plan administrators that have questions about how best to respond to a participant's document request are advised to consult with qualified benefits professionals.  

 

 

 

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Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.

 

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.