Halo v. Yale Health Plan, Director of Benefits & Records Yale University, 546 F. App'x 2

Tiffany Halo, pro se, sued Yale Health Plan under ERISA Title I seeking benefits denial review and damages; District Court granted defendant’s motion for judgment on the administrative record (treated as summary judgment).
The District Court found insufficient evidence that Halo’s treatment by Dr. D’Amico was emergency/urgent and was unclear whether she exhausted administrative remedies.
Halo filed a detailed opposition memorandum referencing Rule 56 but submitted no supporting affidavits for factual assertions (e.g., emergency treatment, exhaustion).
The Second Circuit queried whether the Vital notice requirement for pro se litigants opposing summary judgment applied and whether civil penalties are available for violations of 29 C.F.R. § 2560.503-1.
The appellate panel found no indication the District Court gave Halo the required Rule 56 notice for pro se litigants and that the record did not show Halo understood the consequences of failing to submit evidentiary materials.
The Court vacated and remanded for further proceedings, directing the District Court to address whether Yale complied with 29 C.F.R. § 2560.503-1 and to consider exhaustion and standard-of-review issues on remand.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether district court had to give Vital notice to pro se plaintiff opposing summary judgment	Halo argued she opposed the motion (filed opposition memorandum referencing Rule 56) and should not be penalized	Yale treated the motion as summary judgment and relied on absence of evidentiary support	Court held Vital notice was required; record shows no such notice and no clear showing Halo understood Rule 56 evidentiary burden, so vacatur warranted
Whether civil penalties are available for violations of 29 C.F.R. § 2560.503-1	Halo (and Secretary of Labor amicus) argued regulatory violations could permit penalties/remedial relief	Yale disputed liability/penalties based on administrative record	Court did not decide on availability of civil penalties (left for remand)
Whether procedural failures affect exhaustion and standard of review (de novo vs. deferential)	Halo argued Yale failed to follow ERISA claims procedures, which could excuse exhaustion and alter standard of review	Yale argued plaintiff failed to exhaust and deferential review applies	Court instructed District Court on remand to determine if Yale violated 29 C.F.R. § 2560.503-1; findings will affect exhaustion and applicable standard of review

Vital v. Interfaith Med. Ctr., 168 F.3d 615 (2d Cir.) (pro se notice requirement re: summary judgment)
McPherson v. Coombe, 174 F.3d 276 (2d Cir.) (requiring clear record that pro se litigant understood summary judgment consequences)
Hernández v. Coffey, 582 F.3d 303 (2d Cir.) (vacatur where pro se litigant lacked notice that affidavits would be last chance to present evidence)
O’Hara v. Nat’l Union Fire Ins. Co., 642 F.3d 110 (2d Cir.) (motions for judgment on administrative record treated as summary judgment)
Davenport v. Harry N. Abrams, Inc., 249 F.3d 130 (2d Cir.) (failure to exhaust may be excused if exhaustion would be futile)
Paese v. Hartford Life & Accident Ins. Co., 449 F.3d 435 (2d Cir.) (exhaustion under ERISA not jurisdictional)
Jones v. UNUM Life Ins. Co. of Am., 223 F.3d 130 (2d Cir.) (federal policy favors exhaustion in ERISA cases)
Nichols v. Prudential Ins. Co. of Am., 406 F.3d 98 (2d Cir.) (procedural compliance can affect standard of review)