Eversheds Sutherland 11th Circuit Business Blog
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“Binding” External Benefit Determinations Might Not Bind Courts Under ERISA

Does ERISA preempt rules that give “binding” effect to benefit determinations made by a plan’s external review panel? Not as long as those determinations don’t actually bind courts, the Eleventh Circuit held in Alexandra H. v. Oxford Health Insurance Inc. Freedom Access Plan, 2016 WL 4361936 (11th Cir. Aug. 16, 2016). The plaintiff in the case was challenging an adverse...