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June 13 — The Third Circuit rejected a man's attempt to receive health insurance coverage through his husband's employer-sponsored plan ( Sacchi v. Luciani , 2016 BL 187382, 3d Cir., No. 15-1453, unpublished 6/13/16 ).
The court explained that the man had no standing to bring a lawsuit under the Employee Retirement Income Security Act because he wasn't a beneficiary or participant in his husband's health plan.
According to the U.S. Court of Appeals for the Third Circuit, it's “beyond dispute” that only participants and beneficiaries in ERISA-governed plans can sue for benefits. Further, the man's claim that he would have been a beneficiary but for the employer's wrongful conduct was belied by the fact that the man's husband “did not in fact elect coverage for him when given the opportunity,” the Third Circuit explained.
The court's unpublished June 13 opinion affirms a 2015 decision by a New Jersey federal judge.
The man seeking benefits under his husband's plan was represented by his husband, Stephen J. Simoni, and the law firm Jardim Meisner & Susser.
Simoni, who is both a nurse and an attorney, filed a similar lawsuit on his own behalf against the hospital that previously employed him.
Although that case remains pending, a district judge in 2014 denied Simoni's request to add his husband as a plaintiff, reasoning that the husband lacked standing under ERISA.
Judge Marjorie O. Rendell wrote the decision. Judges Michael A. Chagares and Patty Shwartz joined the decision.
Fox Rothschild represented the health plan.
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Text of the decision is at http://www.bloomberglaw.com/public/document/Sacchi_v_Luciani_No_151453_2016_BL_187382_3d_Cir_June_13_2016_Cou.
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