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June 2016 Archives

Can a Discounted Premium Bill Create an ERISA Plan?

The recent case of Gooden v. Unum Life Ins. Co. of Am., 2016 WL 3059752 (E.D. Tenn. March 30, 2016) involved a familiar scenario - whether a "list bill" arrangement constitutes an ERISA plan.  The plaintiff was a physician who worked for a clinic in Florida between 1987 and 2007.  In 1991, an insurance broker sold several individual disability income policies to some of the physicians who worked at the clinic, including Dr. Gooden.  However, the individual doctors purchased their own policies - the clinic itself had no involvement whatsoever.  However, because more than three of the doctors participated, Unum set up a "FlexBill" which offered premium discounts of approximately 15% since a single bill was sent to the clinic and the physicians paid their premiums through payroll deductions. 

Insurers Must Evaluate Cognitive/Mental Demands of An Occupation

DeBofsky, Sherman & Casciari attorneys Mark DeBofsky and Martina Sherman recently won the case of Wonsowski v. United of Omaha Life Ins. Co., 2016 WL 3088141 (N.D. Ill. June 2, 2016) following a bench trial before Magistrate Judge Geraldine Soat Brown in the federal court in Chicago.  The case involved Shellie Wonsowski, who had worked as a mechanical engineer before becoming disabled on account of symptoms of idiopathic gastroparesis.  Although Wonsowski initially qualified for benefits, United terminated her benefit payments after concluding she was capable of returning to her regular occupation, which was classified as requiring sedentary exertion.

DeBofsky, Sherman & Casciari, PC