No. 18-1033

W. A. Griffin v. United Healthcare of Georgia, Inc., et al.

Lower Court: Eleventh Circuit
Docketed: 2019-02-07
Status: Denied
Type: Paid
Tags: administrative-appeals anti-assignment co-fiduciary-liability document-request erisa erisa-co-fiduciary-liability erisa-document-production-requests ERISA-governed-plan erisa-welfare-plan-administration fiduciary-duty georgia-mandatory-assignment-of-benefits-statute plan-administrator provider-anti-assignment provider-anti-assignment-clauses retroactive-assignment statute-of-limitations-for-erisa-penalties statutory-penalties
Key Terms:
ERISA
Latest Conference: 2019-04-12
Question Presented (AI Summary)

Whether plan administrator waived anti-assignment provisions, ERISA-co-fiduciary-liability, retroactive-assignment-validity, statutory-penalties-limitations

Question Presented (from Petition)

QUESTIONS PRESENTED 1. Whether or not a plan administrator and/or plan fiduciary of an ERISA governed welfare benefit plan waived the rights to assert provider antiassignment provisions when plan fiduciaries failed to notify the provider of the anti-assignment : provision during the administrative appeals process. 2. Whether or not a plan administrator is liable for statutory penalties under ERISA co-fiduciary principles if its designated claims fiduciary failed to provide document request, refused to provide : the address and/or contact information for the plan admininistrator upon request, and failed to forward the document request to the plan administrator upon request *Recently, the 11 th circuit has suggested that the State of ; Georgia does not have a mandatory provider assignment of benefit statue that expressly prohibits provider anti-assigment clauses in health plans. See Georgia § 33-24-54. See Griffin v. Focus Brands, Inc., 635 Fed. Appx. 796 (2015); Additionally, even if the State of Georgia has a mandatory assignment of benefit statue, the 11 Circuit has stated that it would not be preempted by ERISA. See Griffin v. Inc.686 Fed.Appx. 820, 11th Cir.(Ga.), Apr. 27, 2017. As such, the question in this petition focuses on conduct that waives provider anti-assignment provisions in plan documents. ii QUESTIONS PRESENTED ; 3. Whether or not a retroactive assignment of benefit is valid to bring claims for statutory penalties and breaches of fiduciary duty if it was obtained prior to litigation from an provider assignee or party authorized to make ERISA document requests. 4, Whether or not a claim for statutory penalties , pursuant to 29 U.S.C. 1132 (c)(1) for failure to produce documents upon written request is subject to one year statue of limitations under Georgia OCGA § 9-3-28 or twenty year statue of limiations for aggrieved parties under OCGA 9-3-22. . a ‘ : iii

Docket Entries

2019-04-15
Petition DENIED.
2019-03-27
DISTRIBUTED for Conference of 4/12/2019.
2019-01-23
Petition for a writ of certiorari filed. (Response due March 11, 2019)

Attorneys

W. A. Griffin
W. A. Griffin — Petitioner
W. A. Griffin — Petitioner