Gordon & Rees Chicago Team Obtains Complete Dismissal of ERISA and Breach of Fiduciary Duty Lawsuit Against Third-Party Plan Administrator Client

May 2016

Gordon & Rees Chicago Partner Jamey Hiller, Senior Counsel Lindsay Watson, and Associate Marissa Dellacroce, obtained complete dismissal of a federal lawsuit filed against their client (the “Client”) who was the third-party plan administrator of the welfare benefit plan (the “Plan”) at issue.  Plaintiffs brought suit in the United States District Court for the Southern District of Indiana against the Plan and the Client, alleging that the Client wrongfully denied the Plaintiffs coverage for an experimental medical treatment, bronchial thermoplasty. Plaintiffs alleged violations of the Employee Retirement Income Security Act, 29 U.S.C. § 1001 et seq. (“ERISA”) and breach of fiduciary duty for which they sought an order requiring the defendants to approve, and pay for, the medical treatment as well as significant attorneys’ fees and costs.

Gordon & Rees attorneys filed a comprehensive motion to dismiss the complaint pursuant to Federal Rule of Civil Procedure 12(b)(6), arguing that the Client’s role as a third-party plan administrator made it an improper party to the lawsuit. Gordon & Rees successfully argued that the Client was an improper party because the Administrative Services Agreement between the Plan and Client established that the Client was not a fiduciary under ERISA nor were the Plan and the Client “closely intertwined”. Gordon & Rees was able to distinguish the Client’s role as third-party administrator from those cases where the Court found that the third-party administrator exercised enough discretionary authority and control over the plan to bring it within the purview of ERISA. Specifically, Gordon & Rees attorneys detailed the relationship between the Client and the Plan and established that the Client’s role was ministerial in nature, and therefore the Client did not exercise the requisite control to be a fiduciary under ERISA.

Gordon & Rees attorneys obtained a complete dismissal for the Client.