⁍ A divided federal appeals court revived a New York family’s lawsuit against Microsoft and its delegated ERISA plan administrator, Premera Blue Cross, for denying coverage for their teenage daughter’s long-term psychiatric treatment at a residential facility in Utah.

⁍ In a 2-1 split, the 10th U.S. Circuit Court of Appeals said a federal judge in Salt Lake City gave too much deference to Premera’s coverage determination based on a ‘discretionary authority’ clause in a plan document that the parents ‘had no way of knowing … even existed

– A divided federal appeals court on Friday revived a New York family’s lawsuit against Microsoft Corp. and its delegated plan administrator, Premera Blue Cross, for denying coverage for their teenage daughter’s long-term psychiatric treatment at a residential facility in Utah. In a 2-1 split, the 10th US Circuit Court of Appeals said a federal judge in Salt Lake City gave too much deference to Premera’s coverage determination based on a ‘discretionary authority’ clause in a plan document that the parents ‘had no way of knowing … even existed.’


Source: https://www.reuters.com/article/divided-10th-circ-revives-lawsuit-over-m/divided-10th-circ-revives-lawsuit-over-microsoft-blue-cross-erisa-plan-idUSL2N2EW00S