Participant May Get Relief He Didn’t Even Ask For in Retiree Medical Case

In this case, a company allegedly terminated a retiree’s medical benefits after it realized that it had mistakenly covered him. The retiree claimed that the company had used the promise of medical benefits to induce him to take early retirement. He also claimed that he waived other coverage due to the company’s promises of medical coverage. The retiree sued for past and future medical expenses.

The lower court had dismissed the case as they said that the retiree only sought money damages, which were not available to him.

The 5th Circuit Court of Appeals disagreed with the lower court and said that the retiree might be eligible for a monetary payment. It found that the U.S. Supreme Court’s decision in Cigna Corp. v. Amara expanded the type of relief available to potentially include “surcharge”, a type of monetary relief available historically.

The Circuit Court held that even though the retiree didn’t ask for surcharge, he might be entitled to it because he asked to be “made whole”. The case was sent back to the lower court to decide whether the retiree is entitled to this type of relief.

The case is important because it provides additional circumstances under which participants may be entitled to receive money from benefit plans.

Gearlds v. Entergy Service