Bartlett v. Martin Marietta Operations Support, Inc. Life Insurance Plan

38 F.3d 514, 1994 WL 562157
CourtCourt of Appeals for the Tenth Circuit
DecidedOctober 14, 1994
DocketNos. 93-1276, 93-1278
StatusPublished
Cited by2 cases

This text of 38 F.3d 514 (Bartlett v. Martin Marietta Operations Support, Inc. Life Insurance Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bartlett v. Martin Marietta Operations Support, Inc. Life Insurance Plan, 38 F.3d 514, 1994 WL 562157 (10th Cir. 1994).

Opinion

ROSZKOWSKI, Senior District Judge.

This is an appeal from the district court’s award of summary judgment in favor of the plaintiff. The judgment awarded $150,000.00 in life insurance proceeds plus attorney’s fees to the plaintiff resulting from her husband’s death. The defendant appeals the entire judgment, while the plaintiff has filed a cross-appeal challenging the amount of attorney’s fees awarded as less than the amount requested by the plaintiffs counsel. As the insurance policy was part of an employee benefit plan, the district court had jurisdiction under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. This court has jurisdiction pursuant to 28 U.S.C. § 1291. For the reasons stated herein, we affirm in part, reverse in part, and remand the case to the district court.

I.

The plaintiff, Maxine Bartlett, is the widow of Frank Bartlett. Mr. Bartlett was hired by the defendant’s predecessor company, G.E. Operations Support (“GEOS”), in February of 1990. He was hired as a civilian employee of its subsidiary, Operation and Maintenance Service, Inc. (“OMS”). He was hired as a [516]*516regular full-time employee and had a normal work week of forty hours.

In mid-1990, GEOS decided to change its benefits plan for employees to a cafeteria plan. In the fall of 1990, as part of the change in the benefits plan, a presentation was given to the employees, describing the flex benefits program. The employees were then asked to make an individual election of benefits under the new plan. At that time, there was no summary plan description detailing the qualifications on the benefits. A flex benefits workbook was given to the employees at the presentation. The workbook states:

Who is eligible?
All regular full-time employees of OMS are eligible to participate in the flexible benefits program. You are considered a full-time employee if you are regularly scheduled to work 40 hours in a week, usually consisting of five work days (or a full-time schedule in effect for your work location.) A complete description of the Flexible Benefits Program is contained in insurance contracts and legal documents on file in the Human Resources Department. Should any questions arise about the nature and extent of your benefits, the formal language of those documents, and not the informal wording of the Workbook, will govern.1

Employees were informed that their choices would be effective beginning January 1,1991. On November 4, 1990, Frank Bartlett filled out the OMS Flexible Benefits Enrollment/Change Form, indicating an election of Option A, which provided $150,000.00 in life insurance benefits.

Sometime previous to submitting the benefits election form, Mr. Bartlett began to experience severe stomach pain. He sought medical attention for his condition and was scheduled for diagnostic surgery. November 10,1990 was the last day Mr. Bartlett reported to his regular job with OMS. By November 13, 1990, Mr. Bartlett was informed that he had a terminal, inoperable colon cancer. Except for a one day release for Christmas, Mr. Bartlett was continuously hospitalized from November 13, 1990 to January 8, 1991.

After he was hospitalized, GEOS placed Mr. Bartlett on a medical leave of absence and received disability benefits. On January 8, 1991, Mr. Bartlett was released from hospitalization, after his doctors decided that there was no hope of arresting his condition. Mr. Bartlett received home nursing care and died at home on January 17, 1991. The plaintiff states that from November 13, 1990 to his death on January 17, 1991, Mr. Bartlett never returned to work and was physically incapable of doing so.

Following Mr. Bartlett’s death, the plaintiff made a demand on the policy for $150,-000.00. The plan administrator determined that Mr. Bartlett had not qualified for coverage under the new plan, but remained covered under the old plan, which provided for $20,000.00 in benefits. The plan administrator determined that the flex plan took effect for “active employees” only. He stated that “Mr. Bartlett went on medical leave of absence on November 10, 1990, and never returned to active status or the active payroll, and therefore never became eligible for the plan_” Docket Entry 34, Appellee’s Appx. p. 34.

This reasoning for the denial is based on the summary plan description for the flex plan, which defined eligibility for “regular full-time active employees.” The summary plan description, however, was not printed until after Mr. Bartlett’s death, and therefore never available to Mr. Bartlett. The material available consisted of the plan workbook, handed out to employees. The workbook did not include “active” in defining eligibility for a regular full-time employee.

The plaintiff then filed suit in the state court, claiming the $150,000.00 policy was in effect when Mr. Bartlett died. The defendant removed the cause to the United States District Court for the District of Colorado under ERISA In ruling on cross-motions [517]*517for summary judgment, the district court granted the plaintiffs motion. The district court found the workbook was the governing plan as of January 1, 1991 and determined that even though Mr. Bartlett was on medical leave, he was still a regular full-time employee. The district court applied a de novo standard of review, finding that as of January 1, 1991, there was no discretionary language for the plan administrator to interpret, until the plan summary was printed in March, after Mr. Bartlett’s death.

The district court also awarded the plaintiff a reduced attorney’s fee, finding the requested fees to be unreasonable. The plaintiff appeals that portion of the judgment, while the defendant has appealed the entire judgment.

II.

Appellate review of summary judgment is de novo. Awbrey v. Pennzoil Co., 961 F.2d 928, 930 (10th Cir.1992). The issue before the court is to determine whether the district court properly determined that Mr. Bartlett satisfied the plan’s eligibility requirements for the new life insurance benefits.

If an employee benefits plan gives the administrator or fiduciary officer discretionary authority to determine plan eligibility or to construe the terms of the plan, the court must review that decision under an arbitrary and capricious standard of review. Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989); Winchester v. Prudential Life Insurance Co. of America, 975 F.2d 1479, 1483 (10th Cir.1992). Absent such discretionary authority, the court reviews the plan administrator’s decision de novo. Firestone, 489 U.S. 101, 109 S.Ct. 948; Winchester, 975 F.2d at 1483. Here, the district court made a de novo review of the plan administrator’s denial of death benefits, after determining there was no discretionary authority reserved to the plan administrator in the plan workbook.

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Bluebook (online)
38 F.3d 514, 1994 WL 562157, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bartlett-v-martin-marietta-operations-support-inc-life-insurance-plan-ca10-1994.