BOARD OF TRUSTEES, OF THE UAW GROUP HEALTH & WELFARE PLAN v. ACOSTA

CourtDistrict Court, D. New Jersey
DecidedApril 14, 2023
Docket2:14-cv-06247
StatusUnknown

This text of BOARD OF TRUSTEES, OF THE UAW GROUP HEALTH & WELFARE PLAN v. ACOSTA (BOARD OF TRUSTEES, OF THE UAW GROUP HEALTH & WELFARE PLAN v. ACOSTA) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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BOARD OF TRUSTEES, OF THE UAW GROUP HEALTH & WELFARE PLAN v. ACOSTA, (D.N.J. 2023).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

: BOARD OF TRUSTEES, OF THE UAW : GROUP HEALTH & WELFARE PLAN, et : Civil Action No. 14-6247 (JXN) (CLW) al : Plaintiffs, : : OPINION v. : : SERGIO ACOSTA, et al : Defendants. : : :

NEALS, District Judge: This matter comes before the Court on the motion by Defendant Sergio Acosta for reconsideration of the Court’s Opinion and Order [ECF Nos. 199, 200] granting the motions to dismiss his Counterclaim and Third-Party Complaint. The Court has carefully considered the parties’ submissions and decides the matter without oral argument under Federal Rule of Civil Procedure 78(b) and Local Civil Rule 78.1(b). For the reasons stated herein, Acosta’s motion for reconsideration [ECF No. 203] is GRANTED in part and DENIED in part. I. FACTUAL BACKGROUND As the parties are intimately familiar with the facts of this case, the Court will only address those relevant to the present motion. This action involves a dispute surrounding the allegedly fraudulent administration of health insurance benefits to ineligible participants under the Plan. The facts as alleged in the Third Amended Complaint (“TAC”) are summarized as follows. The Plan was created on or about January 1, 2001, via an Agreement and Declaration of Trust (“Trust Agreement”) by and between the Union and various employers who employed individuals represented by the Union. See TAC ¶ 1, ECF No. 81. The Trust Agreement was enacted for collective bargaining purposes, specifically to provide health benefits to eligible employees of the Participating Employers, the Plan, and the Union as permitted under the Employee Retirement Income Security Act (“ERISA”) as well as Section 302(c)(5) of the Labor Management Relations Act of 1947 (“Section 302(c)(5)”). Id. ¶¶ 1, 15.

Two Trustees administer the Plan pursuant to the Trust Agreement and Section 302(c)(5), one of whom is appointed by the Union (“Union Trustee”). Id. ¶ 2. Defendant Sergio Acosta served as the Union Trustee from January 1, 2001, through approximately November 1, 2011. Id. ¶ 5. In this role, Acosta assumed and carried out various responsibilities such as (i) determining individuals’ eligibility for benefits under the Plan, (ii) reporting the identity of eligible participants and beneficiaries to the Plan’s group insurance providers, (iii) negotiating insurance contracts, and (iv) collecting contributions to the Plan and paying its expenses. Id. ¶¶ 2, 6, 7. Under the Trust Agreement and pertinent collective bargaining agreements, Participating Employers must submit contributions and deductions to the Plan as well as “accurate remittance reports” at least once per month. Id. ¶ 18. Furthermore, the Union must “remit contributions to the Plan on behalf of its

employees” at a rate, frequency, and manner equivalent to other Participating Employers. Id. From January 2001 until October 2011, Defendant Lawrence Ackerman was the chief executive officer of Atlantic Business Association, Inc. (“ABA”) and Atlantic Medical Association, Inc. (“AMA”). Id. ¶ 8. Ackerman formed these companies “for the purpose of deriving monetary gain by deceiving and fraudulently inducing the Plan, the Employer Trustee, and the Plan’s health insurance underwriters . . . to provide medical insurance coverage to individuals who were not employees of ABA and AMA . . ..” To perpetrate this fraudulent scheme, Ackerman “solicited Acosta to cause the Plan to enter into a participation agreement with [the] ABA effective January 1, 2004[.]” Id. ¶ 26. Thereafter, Ackerman solicited Acosta again on at least two more occasions to have Acosta “prepare and execute a collective bargaining agreement between the Union and ABA” and “to prepare and execute a similar agreement between the Plan and AMA[.]” Id. ¶¶ 27-28. “ABA and AMA never employed any individuals nor engaged in any legitimate business operation that would have required employees.” Id. ¶ 30.

In October 2011, “Horizon notified the Plan that ABA/AMA Enrollees were not active, full-time bargaining unit employees covered by legitimate collective bargaining agreement with Union and therefore were not eligible for the Plan’s coverage.” Id. ¶ 38. As a result, “Horizon demanded that the Plan reimburse it for losses incurred in providing coverage to the ABA/AMA Enrollees totaling $5,632,774.” Id. ¶ 39. Following Horizon’s discovery of the ABA/AMA scheme, Acosta resigned as a Trustee and a third-party was retained as Administrative Manager of the Plan. Id. ¶ 50. The Administrative Manager discovered that the Union was not paying any contributions for the Union enrollees. Id. ¶ 52. In fact, the Administrative Manager determined that the Union had never contributed to the Plan for the cost of the Union enrollees’ coverage. Id. Acosta allegedly knew that the Union failed

to meet its remittance obligations to the Plan from January 1, 2001, through March 2012, resulting in $720,000 in losses. Id. ¶ 53. As a Trustee and Plan Administrator, Acosta was responsible for ensuring that the Plan made systematic, reasonable, and diligent efforts to collect contributions owed to the Plan by the Union On January 9, 2017, “Ackerman and Acosta were indicted by a Grand Jury in the District of New Jersey for two counts of conspiracy: one to defraud Horizon and one to defraud the Plan through the ABA/AMA scheme[.]” Id. ¶ 42. Nearly a year later, Acosta pled guilty to one count of embezzlement from an employee benefit plan and admitted to withholding the premiums the Union owed to the Plan for the Union enrollees. Id. ¶ 53. Plaintiffs initiated this matter on October 9, 2014. Shortly thereafter, the case was administratively terminated pending an investigation in a parallel criminal case involving Defendants Acosta and Ackerman. See ECF Nos. 73, 76. In August 2020, Plaintiffs reopened this case and filed the TAC, which lodges six counts. ECF Nos. 78, 81. As to Acosta, Plaintiffs allege

breach of fiduciary duties under the Trust Agreement and ERISA, causing losses due to the coverage of ABA/AMA Enrollees (Count I); and breach of the Trust Agreement and ERISA withholding of contributions owed for union enrollees (Count II). ECF No. 81 ¶¶ 59–71. On September 18, 2020, Acosta filed a motion to dismiss the TAC, which was ultimately denied by this Court in an Opinion and Order issued March 26, 2021. See ECF Nos. 118, 119.1 On April 16, 2021, Acosta timely filed an Answer, Separate Defenses, Designation of Trial Counsel, Crossclaim, Counterclaim, and Third-Party Complaint. See ECF No. 125. In his Counterclaim, Acosta seeks indemnification and “contribution from the [Plaintiff Trustees] with respect to any damages that the Court might award pursuant to [Count II of the TAC].” Id. at 20 ¶¶ 16-18.2 On June 24, 2021, Plaintiffs moved to dismiss Acosta’s Counterclaim, arguing that

ERISA contains no implied right of contribution or indemnification. See ECF No. 150-1. In his Third-Party Complaint against the Union, Acosta similarly seeks to “recover contribution, indemnification, or both, in the event that the Court determines that he is in any way liable to the Plan.” ECF No. 125 at 22 ¶ 10. The Union has moved to dismiss the Third-Party Complaint, contending that “the Courts within the Third Circuit, as well as Courts in other circuits, have overwhelming[ly] found that contribution or indemnification was not a remedy under ERISA,

1 The Honorable Susan D. Wigenton, U.S.D.J., specifically rejected Acosta’s argument that he cannot be held liable under Count II. See ECF No. 118 at 9-10. 2 For sake of clarity, when citing to the parties’ motion papers, the Court cites to the page number listed in the ECF header. federal common law or otherwise, where a non-fiduciary participated in a fiduciary breach.” ECF No. 165-1 at 8.

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BOARD OF TRUSTEES, OF THE UAW GROUP HEALTH & WELFARE PLAN v. ACOSTA, Counsel Stack Legal Research, https://law.counselstack.com/opinion/board-of-trustees-of-the-uaw-group-health-welfare-plan-v-acosta-njd-2023.