The First Circuit determined that plaintiff Michele Terteault’s administrative appeal of an adverse benefits decision was time-barred because she failed to file her appeal within the 180-day deadline that was prescribed in the summary plan description.  Once in court, Terteault argued that the limitations period was not enforceable because the plan document did not expressly reference this deadline to file an appeal and the U.S. Supreme Court previously ruled in Amara that the terms of the SPD do not govern.  The First Circuit concluded that Amara had no application here because in Amara the Supreme Court addressed the legal effect of an SPD when plan documents are silent on the subject.  Here, by contrast, the plan document expressly incorporated the terms of the SPD.  The case is Terteault v. Reliance Standard Life Ins. Co., 2014 WL 4976198 (1st Cir. Oct. 6, 2014).

Proskauer’s Perspective:  While the plan’s deadlines were enforced in this case, best practices dictate clearly setting forth time limitations in the summary plan description and plan documents.