Justia U.S. 6th Circuit Court of Appeals Opinion Summaries

The district court certified a class action and a proposed class in an action under the Employee Retirement Income Security Act, 29 U.S.C. 1001. The suit claimed that Blue Cross breached its fiduciary duty by imposing and failing to disclose an other-than-group subsidy and that the OTG subsidy violated Mich. Comp. Laws 550.1211(2). The state insurance commissioner took the position that state law allows the assessment and that revenue it generates funds Medigap coverage. The Sixth Circuit reversed, holding that the class action is not the superior method of adjudication (Federal Rule of Civil Procedure 23(b)(3)) and prosecuting separate actions does not present the risk of inconsistent adjudications (FRCP 23(b)(1)(A)). ERISA fiduciary status is a crucial threshold factual issue specific to every class member, requiring the court to make individualized determinations. Resolution of the legality of the subsidy before that determination would also mitigate the state's concerns about stopping collection of the fee. Potential awards at stake would not preclude individual class members from seeking relief and there was no evidence that individual litigation would create a risk of inconsistent adjudications that would establish incompatible standards of conduct for the defendant.

The employee failed to provide information requested to supplement his request for leave under the Family and Medical Leave Act (FMLA), exhausted his vacation time, was discharged for insubordination, and applied for benefits through a plan covered by the Employee Retirement Income Security Act, 29 U.S.C. 1001. The administrator denied the claim because the plan specifically excludes discharge for insubordination. A review committee affirmed. The district court entered summary judgment upholding the denial. The Sixth Circuit affirmed, holding that the administrator was not required to go beyond the language of the plan and determine whether the termination violated FMLA. The administrator did not have the ability to resolve the FMLA claim between the employee and employer and it is irrelevant that the review committee made some effort to consider the FMLA issue.