Published by The Pellegrin Firm August 13, 2019

This question is one of the “labyrinthine complexities” of ERISA law and practice, as stated by the New Orleans-based U.S. Court of Appeals for the Fifth Circuit in last year’s decision, Manuel v. Turner Indus. Grp., L.L.C., 905 F.3d 859 (5th Cir. 2018).

Fiduciary claims under ERISA § 502(a)(3) can give a separate and alternate ground for recovery to claimants, separate from claims for improperly withheld benefits under the plan. However, as stated in Manuel, ERISA § 502(a)(3) claims can only be maintained when those claims could not have been brought as claims for unpaid benefits under ERISA § 502(a)(1)(b). For example, the court in Manuel held that claims raising “problematic administrative procedures,” such as asserting new grounds for denial late in review or failing to identify an independent medical reviewer, can properly be raised under ERISA § 502(a)(1)(b) and thus the district court was correct to dismiss such claims brought under § 502(a)(3).

However, the Manuel court found that the district court was wrong to dismiss a § 502(a)(3) claim for deficiencies in the Summary Plan Description (“SPD”), in particular the allegation that the SPD did not contain a reference to the pre-existing condition exclusion. This claim is more of a claim for detrimental reliance due to a faulty SPD under ERISA, and not a claim for benefits under § 502(a)(1)(b). The court of appeal did not say that the plaintiff could or would ultimately prevail on such a claim, but it held the district court should have more fully considered it.