Tess Gee commented on the remaining issues that religiously-affiliated hospitals must address following the Supreme Court ruling that extends ERISA’s religious exemption to church-affiliated benefit plans, even if the hospital is not church-established. The ruling is a significant victory for the hospitals and holds that a "church plan" need not be established by a church – which was the issue that unified the three different cases challenging the ERISA exemption.  But the litigation isn't over, given remaining issues that pose individual questions with respect to the hospitals and the plans’ internal benefit committees, Gee said. While it's now clear that a plan needn't be established by the church to qualify for the exemption, the key issue now is whether the plan is maintained by a “principal purpose organization.” Terms like "organization," "administration or funding," "controlled by," "associated" and "principal purpose or function" will require a separate analysis probing their legal interpretation, as well as the structure of an organization’s internal plan committee and its operation, members, functions and relationship to the church, Gee said. "Further," she added, "this analysis will be unique for each 'organization.' Justice Kagan made quite clear the interpretation of these terms 'are not before us and nothing we say in this opinion expresses a view of how they should be resolved.'"