B-T Dissolution, Inc. v. Provident Life & Accident Insurance

175 F. Supp. 2d 978, 2001 U.S. Dist. LEXIS 23115, 2001 WL 1578939
CourtDistrict Court, S.D. Ohio
DecidedSeptember 4, 2001
DocketC-3-98-225
StatusPublished
Cited by8 cases

This text of 175 F. Supp. 2d 978 (B-T Dissolution, Inc. v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
B-T Dissolution, Inc. v. Provident Life & Accident Insurance, 175 F. Supp. 2d 978, 2001 U.S. Dist. LEXIS 23115, 2001 WL 1578939 (S.D. Ohio 2001).

Opinion

FINDINGS OF FACT AND CONCLUSIONS OF LAW IN SUPPORT OF DETERMINATION THAT INSURANCE POLICIES ISSUED BY DEFENDANTS TO PLAINTIFF STEVEN MATTHEWS ARE NOT GOVERNED BY EMPLOYEE RETIREMENT INCOME SECURITY ACT, 29 U.S.C. § 1001, et seq.

RICE, Chief Judge.

This litigation stems from events surrounding Plaintiff Steven Matthews’ resignation from his position as a managerial employee and minority shareholder of Plaintiff B-T Dissolution, Inc. 1 (“B-T”). After his resignation, Matthews sought to recover disability benefits under separate insurance policies issued to him by Defendants Provident Life and Accident Insurance Company (“Provident”) and Guardian Life Insurance Company (“Guardian”). Provident and Guardian initially paid Matthews’ claims for benefits, but they stopped making the payments after determining that he was not “disabled,” within the meaning of the policies. Matthews subsequently filed suit in state court, asserting claims for breach of contract and bad faith. 2 (Complaint, attached to Notice of Removal, Doc. # 1). The Defendants removed the action to this Court on June 2, 1998, alleging the existence of (1) diversity jurisdiction and (2) federal question jurisdiction, on the basis.that Matthews’ state-law claims are completely preempted by the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001, et seq. The Defendants then moved for summary judgment on Matthews’ state-law claims on the basis of ERISA preemption. (See Doc. # 27, 28).

In a Decision and Entry filed on February 24, 2000, the Court overruled both Motions, finding a genuine issue of material fact as to whether Matthews’ individual Provident and Guardian policies are governed by ERISA. (Doc. # 34). The *980 Court noted that if the policies are not governed by ERISA (i.e., if they are not part of an “ERISA plan”), then his state-law claims against Provident and Guardian will remain viable. On the other hand, the Court recognized that if the two policies are governed by ERISA, then Provident and Guardian will be entitled to summary judgment on Matthews’ state-law claims, as pled. 3 (Id.).

On August 9, 2000, the Court held an oral and evidentiary hearing to resolve the foregoing factual dispute regarding the applicability of ERISA. (See Transcript of Proceedings, Doc. # 108). Having reviewed the evidence presented during that proceeding, the Court now sets forth its Findings of Fact and Conclusions of Law. 4

I. Findings of Fact

At all relevant times, Plaintiff B-T was an “S” corporation, and Plaintiff Matthews was both a shareholder in, and an employee of, the corporation. While a shareholder-employee of B-T, Matthews owned much more than two percent of the company’s stock. He also was the owner and beneficiary of separate disability insurance policies issued by Defendant Provident and Defendant Guardian. Matthews made a personal choice, along with B-T Board member James Bryson, to purchase the *981 Provident and Guardian policies, without B-T promoting the policies or otherwise encouraging him to purchase them. (Transcript, Doc. # 108 at 212-13). The two polices were not part of any B-T “executive salary continuation plan,” as no such plan existed. (Id. at 213-14). Matthews’ Provident and Guardian disability insurance polices were unrelated to any policies, plans or programs that B-T may have played an active role in creating or administering. (Id. at 216-18). In addition, he dealt directly with the two insurance companies on claims-related issues, without assistance from B-T. (Id. at 225).

Despite the fact that Matthews made a personal choice to purchase the two policies, B-T did receive the premium notices for them. (Id. at 183, 226). B-T also wrote checks to Provident and Guardian to pay the policy premiums. (Id. at 116, 146, 183-84, 226). Furthermore, B-T deducted those premium payments on its tax returns and recorded the cost in its financial records as fringe-benefit expenses. (Id. at 30 32, 40,151-152,160). Matthews did not reimburse B-T for the premium expense by writing the company a check. (Id. at 226). Nor did B-T subtract the expense from Matthews’ salary or bonuses as a payroll deduction. (Id. at 226-27). To the contrary, as a result of B-T’s payment of the insurance premiums, Matthews’ gross income actually increased. (Id. at 227). In compliance with IRS Revenue Rule 91-26, 5 the entire cost of the premiums was included in his gross income on his 1994-W-2 form. (Id. at 78-81,159, 208).

In late 1994, Matthews suffered a psychological “breakdown,” and he was unable to continue working for B-T. (Id. at 218). His last day at work was October 31, 1994. (Id.). Matthews subsequently filed his own claims for disability benefits, and he began receiving such benefits under his Provident and Guardian policies. (Id. at 117, 219, 224-25). The disability insurance benefits that he received were not reported by him as taxable income. (Id. at 219-24). Matthews entered into a formal resignation agreement with B-T in January, 1995. (Id. at 218).

II. Conclusions of Law

The sole issue before the Court is whether Matthews’ Provident and Guardian disability insurance policies are part of an “employee welfare benefit plan” that is governed by ERISA. Title 1 of ERISA defines an “employee welfare benefit plan,” as, inter alia, any plan, fund, or program established by an employer to provide disability benefits, through the purchase of insurance or otherwise, to participants or their beneficiaries. 29 U.S.C. § 1002(1). “The existence of an ERISA plan is a question of fact, to be answered in light of all the surrounding circumstances and facts from the point of view of a reasonable person.” Thompson v. American Home Assurance Co., 95 F.3d 429, 434 (6th Cir.1996). When determining whether a welfare benefit plan is an ERISA-governed plan, a court must undertake a three-step factual inquiry. Id. at 434. First, it must apply certain “safe-harbor” regulations established by the Department of Labor to determine whether the plan is exempt from ERISA’s reach. 6

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Bluebook (online)
175 F. Supp. 2d 978, 2001 U.S. Dist. LEXIS 23115, 2001 WL 1578939, Counsel Stack Legal Research, https://law.counselstack.com/opinion/b-t-dissolution-inc-v-provident-life-accident-insurance-ohsd-2001.