Agosto v. ACADEMIA SAGRADO CORAZON

739 F. Supp. 2d 90, 2010 U.S. Dist. LEXIS 101049, 2010 WL 3733989
CourtDistrict Court, D. Puerto Rico
DecidedSeptember 27, 2010
DocketCivil 08-2392 (FAB)
StatusPublished

This text of 739 F. Supp. 2d 90 (Agosto v. ACADEMIA SAGRADO CORAZON) is published on Counsel Stack Legal Research, covering District Court, D. Puerto Rico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Agosto v. ACADEMIA SAGRADO CORAZON, 739 F. Supp. 2d 90, 2010 U.S. Dist. LEXIS 101049, 2010 WL 3733989 (prd 2010).

Opinion

OPINION AND ORDER

BESOSA, District Judge.

Before the court are four motions for summary judgment: defendant Academia Sagrado Corazoris first and second motion, third party defendant Humana’s motion, and plaintiffs motion for partial summary judgment. For the reasons set forth, the Court DENIES defendant ASC’s motions; DENIES defendant Humana’s motion; and DENIES plaintiffs motion.

DISCUSSION

I. Procedural History

On December 18, 2008, plaintiffs Ramon L. Agosto (“Agosto”), Dinah L. Rios-Santiago (“Rios”), Isabel Santos-Pantoja (“Santos”), and Maria V. Tirado-Gonzalez (“Tirado”) (collectively referred to as “plaintiffs”) 1 filed a complaint, (Docket No. 1), alleging a violation of their right to be notified of continuance of health coverage under the Consolidated Omnibus Budget Reconciliation Act (“COBRA”). See 29 U.S.C. § 1166. The complaint names Academia Sagrado Corazón (“ASC”), a private school located in San Juan, Puerto Rico, as the defendant. The complaint alleges that ASC failed to notify plaintiffs of their COBRA rights at the time they commenced employment and at the time their employment was terminated.

On May 16, 2009, defendant ASC filed a motion for summary judgment asking the Court to dismiss the claims against it because ACS did not act as group health plan or as plan administrator, because ACS fulfilled all duties requested within reasonable diligence, and because plaintiffs did not request any COBRA benefits nor did they exhaust administrative remedies before commencing litigation. (Docket No. 11.) Plaintiffs opposed the motion on June 19, 2009, alleging that ACS did not deny that it failed to provide the requisite notice required under COBRA, nor did it provide evidence of the plan under which another party would be identified as being liable, (Docket No. 18), to which the movants replied on July 13, 2009 (Docket No. 22).

Defendant ASC then filed an answer to the complaint and a third party complaint against Humana Insurance of Puerto Rico, Inc. (“Humana”), Ceridian Corporation (“Ceridian”), and Triple-S Management Corporation (“TSM”) on October 2, 2009 (Docket No. 31). 2 In its complaint against Humana, ASC alleges that Humana was the party liable for failing to provide continuation coverage notice to plaintiffs. (Docket No. 31.) On March 9, 2010, Humana filed a motion for summary judgment, alleging that it did not act as the plan administrator or the plan sponsor under the plan. (Docket No. 70.) ASC opposed the motion on April 15, 2010 (Docket No. 77), to which the third party defendant replied on May 3, 2010 (Docket No. 82).

On April 20, 2010, plaintiffs filed a motion for partial summary judgment, alleging that plaintiffs were entitled to the *93 imposition of statutory penalties for defendants’ failure to provide notification of continuation coverage after plaintiffs’ termination, (Docket No. 79), to which ASC filed an opposition on May 25, 2010 (Docket No. 87). Subsequently, ASC filed a second motion for summary judgment on July 26, 2010, reiterating the arguments raised in its initial motion and requesting dismissal of the plaintiffs’ claim for damages incurred through medical bills, (Docket No. 88), to which plaintiffs filed an opposition on August 9, 2010 (Docket No. 91).

II. Uncontested Facts

Agosto, Rios, Santos, and Tirado were all employed by ASC for the school year commencing in August 2007 and ending in May 2008 (Docket Nos. 14-8, 14-9, 14-10, 14-11). In January of 2008, ASC entered into an agreement with Humana to provide group health plan coverage to ASC’s employees. (Docket No. 11-5.) Around this time, Mr. Reinaldo Morales (“Principal Morales”), the principal at ASC, convened a personnel meeting to announce the coverage of the new health plan to employees. (Docket No. 11-5.) ASC does not allege that written notice regarding continuation coverage was provided to covered employees at this time, or at any other time during their employment. (See Docket No. 11-5.) The plaintiffs were covered by the group health plan administered by Humana for the months of February 2008 through June 2008. (Docket No. 14-18) (showing Invoice of ACS to Humana for the months mentioned). In May of 2008, plaintiffs’ employment with ACS was terminated. (Docket No. 18-2.) On May 19, 2008, ACS sent Humana a notice for cancellation of health coverage for Rios, Santos, Agosto, and Tirado. (Docket Nos. 14-2, 14-3, 14^4, 14-5.) ACS did not send a notice to plaintiffs regarding their right to continuation coverage after their termination. (See Docket No. 11-3.) In August of 2008, all plaintiffs started working for another employer, Academia San Jorge, another private school in the San Juan area. (Docket Nos. 11-3,18-3.)

III. Exhaustion of Remedies

ACS asks the Court to read into the ERISA requirements, under which COBRA claims are considered, that plaintiffs must exhaust administrative remedies before commencing litigation. (Docket 11-2.) See 29 U.S.C. §§ 1132(a),(c); 1133; see also Morales-Cotte v. Cooperativa de Ahorro y Credito Yabucoeña, 73 F.Supp.2d 153 (D.P.R.1999). The Court finds that such a reading is not appropriate. See Morales-Cotte, 73 F.Supp.2d at 159-60. Morales-Cotte holds that where a plaintiff is bringing suit for a violation of COBRA’s notification and continuing coverage requirements, exhaustion of administrative remedies is not required when plaintiffs claim is based on a statutory violation of ERISA, as distinguished from a situation where plaintiff is claiming rights under the terms of a group health plan. Morales-Cotte noted that although the First Circuit Court of Appeals has not definitively ruled on the issue, other circuits have. The majority position, which Morales-Cotte adopted, “holds that where ... a plaintiff brings an action under ERISA for a statute-based claim, the plaintiff is not first obligated to pursue administrative remedies before seeking relief in the federal courts.” Id. This Court adopts the position of Morales-Cotte, and finds that exhaustion of administrative remedies in this case is not required.

LEGAL STANDARDS AND ANALYSIS

I. Summary Judgment Standard

The Court’s discretion to grant summary judgment is governed by Rule 56 of *94 the Federal Rules of Civil Procedure. The Rule states, in pertinent part, that the court may grant summary judgment only if “the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(c);

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Bluebook (online)
739 F. Supp. 2d 90, 2010 U.S. Dist. LEXIS 101049, 2010 WL 3733989, Counsel Stack Legal Research, https://law.counselstack.com/opinion/agosto-v-academia-sagrado-corazon-prd-2010.