Ariana M. v. Humana Health Plan of Texas, Inc.

Section 502(g)(1) of the Employee Retirement Income Security Act of 1974 (“ERISA”) provides that “[i]n any action under this subchapter * * * by a participant, beneficiary or fiduciary, the Court in its discretion may allow a reasonable attorney’s fee and costs of the action to either party.” 29 U.S.C. 1132(g)(1). This Court, in Hardt v. Reliance Standard Life Ins. Co., 560 U.S. 242 (2010), held that to be eligible for an award of attorney’s fees under this statutory provision, an applicant need not be a “prevailing party,” id. at 252, but rather need only achieve “some success on the merits.” Id. at 256. Petitioner Ariana M. was a beneficiary under an ERISA-covered healthcare plan insured and administered by Respondent Humana Health Plan of Texas, Inc. (“Humana”). She sought, to no avail, benefits under the plan covering mental health treatment that she underwent in 2013. In 2018, after a district court in Texas and a panel of the Fifth Circuit upheld Humana’s denial of her claim under a deferential standard of review, Petitioner obtained a favorable decision from the en banc Fifth Circuit reversing its decades-old precedent and remanding her claim to the district court for de novo consideration of Respondent’s denial. On remand, the district court again concluded that Respondent correctly denied Petitioner’s claim for benefits, and denied Petitioner’s request for attorney’s fees for the work leading up to the en banc decision. The Fifth Circuit affirmed. The question presented is whether a beneficiary achieves “some success on the merits” for purposes of a fee award under ERISA Section 502(g)(1) when she obtains a significant legal victory that increases the likelihood of a favorable benefits determination and that benefits other plan participants and beneficiaries, regardless of whether benefits are ultimately awarded. (i)