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Remedies Under ERISA When a Plan Participant Spends the Proceeds in a Subrogation Case
On Jan. 20, 2016, the United States Supreme Court rendered its decision, in an 8-1 vote, in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, an Eleventh Circuit case in which an ERISA health plan sought to recover medical benefits paid to an injured participant after that participant's personal injury settlement funds had already been spent.
The Supreme Court held that “when a participant dissipates the whole settlement on nontraceable items [such as services or food], the fiduciary cannot bring a suit to attach the participant's general assets under '502(a)(3) [of ERISA] because the suit is not one for 'appropriate equitable relief.'” See Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, 577 U.S., __ No. 14-723, slip op. at 2 (Sup. Ct. Jan. 20, 2016).
The Supreme Court based its decision on its own precedent for the Employee Retirement Income Security Act of 1974 (ERISA), forging no new ground. This holding leaves little recourse for plan sponsors in reimbursement, or subrogation, cases where the plan sponsor, or the third party on behalf of the plan sponsor, does not take steps to recover amounts owed to the plan in a timely fashion.
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