Humble Surgical Hospital, LLC v. Connecticut General Life Insurance Company, et al.

This case implicates two important and recurring problems in ERISA litigation. In the decision below, the Fifth Circuit diverged from decisions of this Court and multiple courts of appeals on the standard for reviewing an ERISA administrator’s interpretation of plan language. The Fifth Circuit also deepened a widely acknowledged conflict regarding the statutory penalties for failing to furnish plan documents to ERISA participants. Each distinct question has now squarely divided the lower courts, and this case presents an optimal vehicle for resolving them. The questions presented are:

1. Whether, in reviewing an administrator’s interpretation of plan language, it is automatically “dispositive” that at least two other courts previously upheld a “similar” interpretation (as the Fifth Circuit held below, to the express exclusion of any other “factors”), or whether a reviewing court must consider all the traditional factors required in Firestone’s “combination-of-factors” analysis (as required by multiple courts of appeals and this Court).

2. Whether an entity not explicitly named as the plan “administrator”—but otherwise assuming the administrator’s statutory duties to furnish plan documents—may be subject to ERISA penalties for failing to respond to a proper document request under 29 U.S.C. 1132(c)(1). (I)