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July 2011

Obtained Dismissal Of Erisa Claim Filed By Spouse Of An Electric Power Association Employee

Obtained dismissal of an ERISA claim filed by the spouse of an electric power association (EPA) employee.  The spouse had received approval on two prior occasions for certain medical treatment of her illness, but when the EPA amended its health care plan in 2008, the plan deemed the treatment that she had received in the past to be “experimental” and, therefore, not a covered procedure.  The federal district court judge in the Southern District of Mississippi applied longstanding ERISA law and granted the defendant’s Motion for Summary Judgment, finding that the EPA had the authority to amend its plan despite previously paying for the procedure in question under different plan documents and that, under those amendments, the procedure in question was not a covered procedure under the plan.