Groom principal Kara Petteway Wheatley was featured in the Law360 article, “4 ERISA Excessive Health Fee Suits To Watch,” where she examined current excessive health fee cases and how they might hold up in court.
“The J&J complaint and the Wells Fargo complaint are among the first in what may be a potential wave of new litigation against employers alleging ERISA violations because the self-funded plan overpaid for benefits and services,” said Wheatley.
According to Law360, Wheatley said that “the theories behind recently filed health fee cases draw from lawsuits against employers claiming 401(k) plans paid excessive fees and offered imprudent investments. Both types of lawsuits allege employers were required to do more under federal benefits law to keep workers’ employee benefit costs lower.”
“Plaintiffs on the health plan side are trying to translate those theories over from the retirement context, and it remains to be seen how this will all play out,” she noted.
Regarding Knudsen et al. v. MetLife Group Inc., Law360 reported that Wheatley said that “she expects the Third Circuit will join other courts including the Ninth Circuit in upholding dismissal of a case alleging health fees were excessive for lack of standing.”
The outlet further reported that she said that “a ruling in favor of MetLife would ‘pose a significant challenge to plaintiffs who are trying to bring these cases alleging that they were somehow injured by the premiums and out-of-pocket costs they paid for their health insurance coverage and prescription drug benefits.’”
Wheatley, according to Law360, said that “plaintiffs in both the Wells Fargo and J&J suits were ‘narrowly focusing on this cherry-picked list of drugs that their plaintiffs’ lawyers have hand-picked and selected out of the many, many prescription drugs that are covered by the plan.’”
“And they’re trying to extrapolate from that and say that overall, the plan and plan participants paid too much for the cost of prescription drug coverage. I think there are a number of incorrect assumptions and flaws in that argument,” she added.
To read the article, click here.
