9th Cir.;
15-55880

The court of appeals reversed a judgment. The court held that a lack of clarity in a statement of modifications to a retiree health plan violated the disclosure requirements of the Employment Retirement Income Security Act of 1974 (ERISA).

Linda King, whose husband was a retired United Parcel Service of America, Inc. (UPS) employee, participated in a welfare benefit plan administered by Blue Cross and Blue Shield of Illinois for UPS and the UPS Health and Welfare Plan for Retired Employees. In November 2012, Mrs. King suffered a back infection that required immediate surgery and extensive post-surgery rehabilitative care. After initially approving her treatment as medically necessary, defendants denied her claim for benefits because Mrs. King exceeded her plan's $500,000 lifetime benefit maximum. In May 2013, Mrs. King sued defendants for breaching breached the her retiree plan contract and their fiduciary duties in violation of ERISA. In December 2014, Mrs. King died and her husband Gary substituted in as plaintiff.