Andrew J. Marciella v. The Prudential Insurance Company of America

30 F.3d 134, 1994 U.S. App. LEXIS 27268, 1994 WL 376868
CourtCourt of Appeals for the Sixth Circuit
DecidedJuly 18, 1994
Docket93-3559
StatusUnpublished

This text of 30 F.3d 134 (Andrew J. Marciella v. The Prudential Insurance Company of America) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Andrew J. Marciella v. The Prudential Insurance Company of America, 30 F.3d 134, 1994 U.S. App. LEXIS 27268, 1994 WL 376868 (6th Cir. 1994).

Opinion

30 F.3d 134

NOTICE: Sixth Circuit Rule 24(c) states that citation of unpublished dispositions is disfavored except for establishing res judicata, estoppel, or the law of the case and requires service of copies of cited unpublished dispositions of the Sixth Circuit.
Andrew J. MARCIELLA, et al., Plaintiffs-Appellants,
v.
The PRUDENTIAL INSURANCE COMPANY OF AMERICA, et al.,
Defendants-Appellees.

No. 93-3559.

United States Court of Appeals, Sixth Circuit.

July 18, 1994.

Before: GUY and NELSON, Circuit Judges, and LIVELY, Senior Circuit Judge.

PER CURIAM.

This is an appeal from a summary judgment for the defendant insurance company in a purported class action brought by participants (and dependents or designated beneficiaries thereof) in a single-employer welfare benefit plan. The insurance company had contracted with the plan sponsor, the company by which the participants were employed, to pay group life and health insurance benefits in accordance with the contract of insurance. The employer--which ultimately went into bankruptcy--stopped paying insurance premiums when it became financially embarrassed. Several months thereafter it stopped making payments to a self-insurance fund from which some of the benefits were supposed to come, and it failed to remit premiums paid by employees who, when they lost their jobs, elected to purchase their own health care continuation coverage pursuant to the Consolidated Omnibus Budget Reconciliation Act ("COBRA"), 29 U.S.C. Secs. 1161 et seq. The employer also failed to give retired employees proper notice of their right to elect continuation coverage under COBRA. Although the employer gave notice of conversion rights under the life insurance coverage, finally, it failed to advise of the time limits within which such rights were to be exercised.

The plaintiffs contend that the insurance company was a co-fiduciary under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. Secs. 1001 et seq. As such, the plaintiffs say, the insurance company had a fiduciary duty to make sure that the obligations of the employer and the trustees of the plan were fulfilled. The insurance company having violated its own fiduciary obligation in this respect, the plaintiffs assert, it should have made the plan whole and should have honored benefit claims that it would not otherwise have been obligated to pay.

The plaintiffs claim standing to enforce the asserted fiduciary obligation under Sec. 502(a)(2) of ERISA, 29 U.S.C. Sec. 1132(a)(2), which authorizes participants and beneficiaries, among others, to bring an action for appropriate relief under Sec. 409 of the Act, 29 U.S.C. Sec. 1109. Section 409 provides that a fiduciary whose breach of duty results in loss to the plan shall be liable to make good the loss.

The district court concluded as a matter of law that there had been no breach of duty on the part of the defendant insurance company with regard to the giving of notice about continuation and conversion rights. The court further concluded that any claim for breach of fiduciary duty under ERISA could only be brought on behalf of the plan, as opposed to individual participants and beneficiaries. The relief sought by the latter would not benefit the former, the court decided, and judgment was therefore rendered in favor of the insurer. In addition, the court dismissed for want of prosecution claims asserted by the plaintiffs against "unknown" trustees of the plan.1 The court's disposition of the case made it unnecessary to decide the class certification issue.

We find no abuse of discretion in the dismissal (which was without prejudice) of any claims against the plan and the unknown trustees. Upon de novo review, moreover, we conclude that the insurance company was entitled to summary judgment. We shall therefore affirm the judgment of the district court in its entirety.

* The plan sponsor, an office furniture manufacturer known as GF Corporation (formerly The General Fireproofing Co.), established the Group Health and Life Insurance Plan for Hourly and Retired Employees of GF Corporation pursuant to a collective bargaining agreement with Local 1617 of the United Steelworkers of America. The plan, of which GF was the administrator as well as the sponsor, covered unionized employees and retirees at a GF facility located in Youngstown, Ohio. The Prudential Life Insurance Company of America, the principal defendant herein, wrote group insurance (term life, accidental death and dismemberment, hospital expense, surgical expense, hospital medical expense, and major medical expense) for those covered by the plan.

Prudential and GF had a "minimum premium" arrangement for the group health coverage. Under this arrangement GF was to make monthly deposits into an account, called the PruMarc Account, on which Prudential would draw in order to pay current health insurance claims up to an agreed maximum. Although Prudential handled the paperwork, GF was a self-insurer with respect to such health care claims. Prudential undertook to use its own funds for payment of health care claims in excess of the agreed maximum, and GF was not a self-insurer with respect to the remaining coverage specified in the plan. Coverage not funded through the PruMarc Account was known as "Column I" coverage. Premiums for Column I coverage were payable on a monthly basis.

GF paid no Column I premiums after December 31, 1989. For the first three months of 1990, however, GF continued to make deposits into the PruMarc Account.

On February 15, 1990--two weeks after the Column I premium for January had become past due--GF closed the Youngstown plant and laid off all its hourly-paid employees. GF gave COBRA notices to the active employees at this point, advising them of their right to purchase continuing medical coverage, but never sent such notices to the retired employees. GF did negotiate a retiree health plan with the union, however, and letters were sent to the retirees urging them to take advantage of it. (Most did not do so.)

On April 18, 1990, GF filed for protection under Chapter 11 of the Bankruptcy Code. In a letter dated May 8, 1990, GF advised Prudential that all insurance coverage was terminated at the time of filing. Prudential took this to mean that GF had canceled its group insurance policy effective at midnight on April 17, 1990.

Prudential promptly sent GF a letter acknowledging cancellation as of April 17 and noting that covered employees had certain rights to convert their insurance coverage to individual policies. The letter told GF that it should send conversion notices to the affected individuals. GF did so by letter dated May 11, 1990; the letters were technically deficient, however, in that they failed to inform participants of the time limits for conversion.

Before describing the lawsuit that followed these events, we shall pause to give a somewhat more detailed account of the vicissitudes of the insurance coverage during the first part of 1990.

A. Health Insurance.

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30 F.3d 134, 1994 U.S. App. LEXIS 27268, 1994 WL 376868, Counsel Stack Legal Research, https://law.counselstack.com/opinion/andrew-j-marciella-v-the-prudential-insurance-company-of-america-ca6-1994.