Employees of Solvay Chemicals, Inc. brought an ERISA claim against the company for what they contended was improper notice with regard to changes in the company retirement program. At one time the company offered a defined benefit plan, but changed it to a "cash balance" plan that required a defined contribution from the company (rather than defined payments to employees). While the Tenth Circuit held that the company violated its notice obligations with regard to preexisting early retirement subsidies, the notice was sufficient in all other respects. As remedy for the defective notice, employees asked that the company revert back to the abandoned defined benefit plan. The district court found that the company's notice failure was not "egregious" to grant the employees' requested relief. The employees appealed the district court's denial of their request. Agreeing that the employees were not entitled to their requested relief, the Tenth Circuit affirmed. View "Jensen, et al v. Solvay Chemicals, Inc., et al" on Justia Law
Petitioner Jose Cardoza brought this lawsuit pursuant to the Employee Retirement Income Security Act of 1974 (ERISA), to challenge United of Omaha Life Insurance Company’s calculation of his long-term disability benefits (LTD benefits). United of Omaha answered, asserting its calculation was appropriate, and counterclaimed, demanding that Petitioner reimburse it for payments of short-term disability benefits (STD benefits) which it claimed were miscalculated. On cross-motions, the district court granted Petitioner's motion for summary judgment and denied United of Omaha’s motion, concluding United of Omaha’s decision to calculate Petitioner's LTD benefits and recalculate his STD benefits as it did was arbitrary and capricious. United of Omaha appealed. Upon review, the Tenth Circuit concluded that the district court erred in granting Petitioner's motion for summary judgment with respect to United of Omaha’s LTD benefits calculation: "[t]he plain language of the long-term disability benefits policy instructed United of Omaha to base its calculation of Cardoza’s LTD benefits on his earnings as verified by the premium it received. Thus, United of Omaha’s decision to do so was reasonable and made in good faith." The district court did not err, however, in granting Petitioner's motion for summary judgment with respect to United of Omaha’s recalculation of his STD benefits and demand for reimbursement "United of Omaha’s decision to recalculate Cardoza’s STD benefits based on his earnings verified by premium rather than his actual earnings was not reasonable." The Court therefore reversed in part, affirmed in part, and remanded the case to the district court for further proceedings. View "Cardoza v. United of Omaha Life Insurance" on Justia Law
Plaintiff-Appellant William Foster sued his former employer, Defendant-Appellee PPG Industries, Inc. (PPG), and Defendant-Appellee the PPG Industries Employee Savings Plan (collectively, Defendants) under the Employee Retirement Income Security Act (ERISA) to recover Plan benefits allegedly due him after Foster’s ex-wife fraudulently withdrew Foster’s entire Plan account balance. The district court upheld the decision of the Plan Administrator, who had determined that the Plan was not liable to reimburse Foster for the fraudulently withdrawn benefits. Foster appealed. Finding no merit to Foster's argument, the Tenth Circuit affirmed the district court. View "Foster v. PPG Industries, Inc., et al" on Justia Law
The district court overturned an employee benefit plan's denial of a former employee's claim for permanent and total disability life insurance benefits. On appeal, Defendant Owens-Illinois Hourly Employees Welfare Benefit Plan contended the district court erred in rejecting Defendant’s argument that the employee was not eligible for this benefit under the Plan’s life insurance coverage provisions because his PTD life insurance claim was not filed until after he retired. Upon review, the Tenth Circuit concluded that the district court should have entered judgment in favor of Plaintiff on the administrative record rather than remanding for further administrative proceedings. The Tenth Circuit therefore remanded the case with directions for the district court to modify its order and enter judgment in favor of Plaintiff. View "Spradley v. Owens-Illinois Hourly Employees Welfare Benefit Plan" on Justia Law
Plaintiff-Appellant Eugene S. appealed a district court's denial of his motion to strike and its entry of summary judgment in favor of Defendant-Appellee Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ). Plaintiff sought coverage for his son A.S.'s residential treatment costs from his employer's ERISA benefits insurer. Horizon's delegated plan administrator originally denied the claim. Having exhausted his administrative appeals, Plaintiff filed suit in district court challenging the denial of benefits. The parties filed cross-motions for summary judgment, but Horizon also filed a declaration that included the terms of Horizon's delegation of authority to the plan administrator to administer mental health claims in a Vendor Services Agreement. Plaintiff moved to strike that declaration as procedurally barred. The district court denied the motion and granted Horizon summary judgment, finding that neither Horizon nor its plan administrator acted in an arbitrary or capricious manner in denying the contested claim. Upon review, the Tenth Circuit found substantial evidence in the record that A.S. did not meet the criteria for residential treatment benefits under the plan, and as such, the plan administrator did not act in an arbitrary or capricious manner in denying Plaintiff's claim. The Court affirmed the district court's judgment. View "Eugene S. v. Horizon Blue Cross Blue Shield" on Justia Law
Posted in: ERISA, Government & Administrative Law, Insurance Law, U.S. 10th Circuit Court of Appeals
Plaintiff Dennis Carter began working as a directional driller at Pathfinder Energy Services, Inc., in December 2004. Two years later, declining health had caused a reduction in Plaintiff's workload. Pathfinder fired Plaintiff for "gross misconduct" based primarily on an altercation that he had had with a coworker and his language and attitude during a conversation with his supervisor. Plaintiff sued Pathfinder in federal district court, alleging that Pathfinder had violated his rights under the Americans with Disabilities Act (ADA) and the Employee Retirement Income Security Act (ERISA). He also alleged that Pathfinder had breached his implied-in-fact employment contract. The district court granted summary judgment in favor of Pathfinder on all three claims. Upon careful review, the Tenth Circuit reversed the district court’s grant of summary judgment on Plaintiff's ADA claim, but affirmed the grant of summary judgment on the remaining claims. Specifically, the Tenth Court held that "[a] reasonable jury could conclude that [Plaintiff] has made out a prima facie case of discrimination and has established that Pathfinder’s asserted justification for his firing was pretextual. At this stage of the case, that is enough." The Court remanded the case for further proceedings on the ADA claim. View "Carter v. Pathfinder Energy" on Justia Law
Plaintiff Steven Lucas filed suit against Liberty Life Assurance Company of Boston (Liberty Life), asserting that the company violated the Employee Retirement Income Security Act of 1974 (ERISA) when it denied his claim for long term disability benefits. Finding that the denial of benefits was not arbitrary and capricious, the district court entered judgment in favor of Liberty Life. Plaintiff appealed the district court's decision. Plaintiff was an employee of the Coca-Cola Company. Liberty Life both administered and insured Coca-Cola's long-term disability benefits plan. Under the plan, it has discretionary authority to determine eligibility for benefits. Plaintiff suffered a work-related injury requiring spinal surgery and, after a short period back on the job, stopped working. He filed a claim for long-term disability benefits in August 2005. In September 2007, Liberty Life terminated Plaintiff's benefits after determining that he was not eligible for continued benefits under the "any occupation" provision: while he might not be capable of performing his own occupation, he was capable of performing some occupation comparable to his former position. Plaintiff filed an administrative appeal with Liberty Life, but the company upheld the denial of benefits. Upon review, the Tenth Circuit concluded that Liberty Life's decision was supported by substantial evidence, and that Plaintiff failed to show that it was arbitrary and capricious. Accordingly, the Court affirmed the district court's decision. View "Lucas v. Liberty Life Assurance Company" on Justia Law
Posted in: ERISA, Injury Law, Insurance Law, Labor & Employment Law, U.S. 10th Circuit Court of Appeals
Petitioners Wayne Tomlinson, Alice Ballesteros and Gary Muckelroy appealed the dismissal of their claims against El Paso Corporation and the El Paso Pension Plan (collectively "El Paso") brought under the Age Discrimination in Employment Act (ADEA) and the Employee Retirement Income Security Act (ERISA). Plaintiffs' claims concern "wear-away" periods that occurred during El Paso's transition to a new pension plan. They contended that the wear-away periods violated the ADEA's prohibition on age discrimination and the anti-backloading and notice provisions of ERISA. The trial court found that El Paso's transition favored, rather than discriminated against, older employees; and the plan was frontloaded rather than backloaded. Accordingly, the Tenth Circuit's review concluded that ERISA did not require notification of wear-away periods so long as employees were informed and forewarned of plan changes. The Court affirmed the lower court's decision dismissing Petitioners' claims. View "Tomlinson v. El Paso Corp." on Justia Law
Posted in: Civil Rights, Class Action, ERISA, Labor & Employment Law, U.S. 10th Circuit Court of Appeals
The Plaintiffs in this action were participants and beneficiaries of a life insurance plan offered by Defendant Qwest Communications International. In 2007, Plaintiffs filed a lawsuit against Qwest, arguing that the Plan made certain changes in violation of ERISA. The district court granted summary judgment in favor of Qwest. Plaintiffs raised seven issues on appeal to the Tenth Circuit, the sum of which was that the Plan misrepresented certain changes that unreasonably impacted employees' retirement benefits. Upon careful consideration of the arguments and applicable legal authority, the Tenth Circuit found that any misrepresentations were not material or in violation of ERISA. The Court affirmed the district court's grant of summary judgment in favor of the Plan.
The employee attempted to enroll in his employer's ERISA-regulated health care plan. The employer deducted premiums, but did not enroll the employee, who subsequently left the company and fell ill. The employee won $157,182 plus attorney fees under ERISA, then filed state law claims of fraud, misrepresentation, and breach of contract, which the employer removed to federal court. The district court denied remand and dismissed the claims as res judicata. The Tenth Circuit ordered remand to state court, holding that the state law claims are not completely preempted by ERISA and that the federal court did not have jurisdiction over those claims. While he was employed by the company, the employee would have had standing, under ERISA, to challenge the actions underlying the state claims; at the time he filed the suit, he did not have standing. Having already won an ERISA award, the employee no longer qualified as a former employee with a colorable ERISA claim.