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Health plans did not violate ERISA, N.J. court rules

TRENTON, N.J.–Six health insurers that allegedly conspired with brokers to steer customers their way in return for hidden commissions did not violate the Employee Retirement Income Security Act, a New Jersey district court judge ruled Monday.

Judge Garrett E. Brown Jr.’s dismissal of the ERISA claims against American International Group Inc., CIGNA Corp., Hartford Financial Services Group, MetLife Inc., Prudential Insurance Co. of America and Unum Corp. is the latest ruling in the ongoing consolidated litigation in New Jersey that stems from industrywide investigations into bid-rigging and client-steering allegations.

Brought on behalf of commercial property/casualty insurance policyholders and employee benefit plan sponsors, the litigation centers on allegations that several dozen insurers and brokers engaged in a conspiracy in which they stifled competition by steering clients and fixing prices in violation of the Racketeer Influenced and Corrupt Organizations Act, the Sherman Antitrust Act and ERISA.

In two separate rulings last year, Judge Brown threw out the RICO and antitrust claims against the insurers and brokers, citing lack of factual evidence (BI, Oct. 1, 2007; Sept. 10, 2007).

Those rulings are now on appeal in the 3rd U.S. Circuit Court of Appeals in Philadelphia.

In his latest ruling, Judge Brown said the plaintiffs were unable to support their claim that the insurers were fiduciaries under ERISA with respect to the employee benefit plans involved in the alleged conspiracy.

Among other charges, plaintiffs alleged that the insurers breached their fiduciary duty by failing to disclose contingent commissions and other types of compensation on Schedule A of Form 5500, which is provided to ERISA plan participants.

While Judge Brown has dismissed all the claims pending in the class actions, there are still a number of individual plaintiffs cases centering on the same issues against the insurers and brokers that were filed in federal courts around the country and subsequently transferred to Judge Brown, noted Mitchell J. Auslander, an attorney with Willkie, Farr & Gallagher in New York, who represents Marsh & McLennan Cos. Inc. in the multidistrict litigation.

Judge Brown noted in his ruling that he will hold a conference call on Jan. 24 to discuss remaining motions and other open issues in the case before the court.

While Judge Brown did not elaborate, Mr. Auslander said the court may address remaining individual policyholder cases.

He noted that most of the defendants and plaintiffs class counsel have taken the position that the individual cases should be stayed pending the appeal in the 3rd Circuit.

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