Blake v. H-2A & H-2B Voluntary Employees' Beneficiary Ass'n

952 F. Supp. 927, 1997 U.S. Dist. LEXIS 1049, 1997 WL 40130
CourtDistrict Court, D. Connecticut
DecidedJanuary 10, 1997
Docket3:95CV00399(WWE)
StatusPublished
Cited by5 cases

This text of 952 F. Supp. 927 (Blake v. H-2A & H-2B Voluntary Employees' Beneficiary Ass'n) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blake v. H-2A & H-2B Voluntary Employees' Beneficiary Ass'n, 952 F. Supp. 927, 1997 U.S. Dist. LEXIS 1049, 1997 WL 40130 (D. Conn. 1997).

Opinion

Ruling on Defendants’ Motion for Summary Judgment

EGINTON, Senior District Judge.

This tragic case involves a challenge by plaintiff, now a quadriplegic as a result of a serious automobile accident, to the actions of defendants in amending an employee welfare benefit plan to provide a lifetime cap on medical benefits of $150,000, which did not exist at the time of plaintiff’s accident. Plaintiff claims that the actions of defendants violate the antidiscrimination provisions of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1140, and constitute a breach of the fiduciary duties owed to plaintiff as a plan participant under 29 U.S.C. §§ 1104, 1109, as well as under the terms of the plan and summary plan description.

Pending before the Court is Defendants’ Motion for Summary Judgment (Document # 17). Although plaintiffs case is emotionally compelling, this Court holds, for the reasons set forth below, that defendants are entitled to summary judgment as a matter of law.

I. Facts

Plaintiff Berris Blake is a citizen of Jamaica. During June of 1994, plaintiff was a temporary worker in the United States under the Temporary Foreign Workers Labor Program (the “H-2A Program”).' See 8 U.S.C.A. § 1101(a)(15)(H)(ii)(a) (West 1996 Supp.). He was employed as a tree farm worker by Cappachione Farms in Preston, Connecticut. 1 On June 18,1994, plaintiff was severely injured in an automobile accident in Connecticut, as a result of which he was rendered a quadriplegic. He was hospitalized at the William Backus Hospital in Norwich, Connecticut, for two and one-half *929 months and later received rehabilitative care at Farrlawn Rehabilitation Hospital for approximately one year. In July of 1995, he returned to Jamaica for further rehabilitation.

By virtue of his H-2A worker status, plaintiff was able to participate in the H-2A and H-2B Voluntary Employees’ Beneficiary Association Health and Welfare Plan (“the Plan”), a welfare benefit plan governed by ERISA. The Plan was adopted on December 31, 1992, by defendant H-2A and H-2B Voluntary Employees’ Beneficiary Association as its Sponsor to benefit H-2A and H-2B workers who are sponsored by participating Caribbean countries to work in the United States. Trustees of the Plan are Vincent Morrison, who resides in Kingston, Jamaica, and Anthony Irons, who is also the Permanent Secretary-Ministry of Labour, in Jamaica.

The Plan is administered by defendant West Indies Central Labour Organisation (‘WICLO”), an unincorporated organization established by the governments of the Caribbean participating countries to monitor the welfare of their workers while they are in the United States. 2 The Plan provides life, accidental death and dismemberment benefits; accident and sickness benefits; hospital benefits, surgical expense benefits, medical expense benefits and drug and medicine benefits for members of the H-2A and H-2B Voluntary Employees’ Beneficial Association who elect coverage. (Section 1.3 of the Plan).

Since the commencement of the Plan, every eligible H-2A and H-2B worker has elected to be covered by the Plan, including plaintiff. To receive coverage each participant must make a weekly contribution of $4.80.

Prior to and at the time of plaintiff’s accident, the Plan did not have a cap on the dollar amount of medical coverage which it would provide to Plan participants. 3 The Plan did, however, limit the payment of hospital, surgical, medical, and drug and medicine benefits to those expenses incurred during a thirteen-week period of disability. (Sections 8.4, 9.4, 10.4, and 11.3 of the Plan). Furthermore, any benefits under the Plan would terminate upon a participant’s leaving the United States. The Plan also provided for continuation coverage if elected by a participant, which plaintiff through his attorney elected. 4 (Section 16.1 of the Plan).

On September 22, 1994, the Plan was amended by the Trustees, Mr. Morrison and Mr. Irons, to provide a cap of $150,000 on the amount of all medical benefits that could be paid over the lifetime of any one individual. 5 *930 The amendment was effective October 1, 1994, and applied to medical expenses incurred after September 30, 1994. In determining whether the cap had been reached, however, the amendment provided that benefits paid both before and after September 30, 1994, were to be taken into account. See Note 5, supra. Furthermore, the cap applied to all types of Plan benefits in the aggregate, such that for example hospital and surgical expense benefits, medical expense benefits, and drug and medicine expense benefits would be added together to determine whether the cap had been reached. Id. Additionally, the amendment applied to every Plan participant irrespective of illness.

The Plan was amended pursuant to Section 15.1 of the Plan which provides in relevant part:

Section 15.1 Amendment. This Agreement may be amended at any time and from time to time by a written instrument signed by the Trustees____ The instrument of amendment shall specify its effective date and amendments may be made effective retroactively. This Agreement also may be terminated at any time by the Trustees.

As a result of his accident, plaintiff incurred medical bills of $191,134 as of September 30, 1994, which were paid by the Plan. However, plaintiff has incurred substantial additional medical bills of $206,-105.94, 6 which defendants have refused to pay, citing the $150,000 lifetime cap on benefits which plaintiff had already exceeded as of September 30,1994.

These facts are not disputed. In dispute, however, are the facts relating to defendants’ motivation in adopting the cap and whether defendants attempted to force plaintiff to return to Jamaica so as to deprive him of Plan benefits.

Defendants claim that their motivation in adopting a lifetime benefits cap was purely financial and was in no way designed to penalize plaintiff. While this Court has no difficulty in accepting defendants’ assertion that their motivation was financial, more problematic is their motivation vis-a-vis the plaintiff. Defendants assert that the idea for amending the Plan was conceived prior to plaintiff’s accident and arose out of a concern for the financial condition of the Plan. They assert that the Plan was losing money and the only two options available were to increase the workers’ contributions, 7 which they chose not to do, or to establish a benefits cap. They admit, however, that plaintiff was the first Plan participant to have medical bills in excess of $150,000.

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Bluebook (online)
952 F. Supp. 927, 1997 U.S. Dist. LEXIS 1049, 1997 WL 40130, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blake-v-h-2a-h-2b-voluntary-employees-beneficiary-assn-ctd-1997.