Cox v. GRAPHIC COMMUNICATIONS CONFERENCE

603 F. Supp. 2d 23, 2009 U.S. Dist. LEXIS 25469, 2009 WL 763400
CourtDistrict Court, District of Columbia
DecidedMarch 25, 2009
DocketCivil Action 08-873 (CKK)
StatusPublished
Cited by6 cases

This text of 603 F. Supp. 2d 23 (Cox v. GRAPHIC COMMUNICATIONS CONFERENCE) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cox v. GRAPHIC COMMUNICATIONS CONFERENCE, 603 F. Supp. 2d 23, 2009 U.S. Dist. LEXIS 25469, 2009 WL 763400 (D.D.C. 2009).

Opinion

MEMORANDUM OPINION

COLLEEN KOLLAR-KOTELLY, District Judge.

Plaintiff Madeline M. Cox brings the above-captioned action to challenge the denial of her health care benefits from the Graphic Communications National Health and Welfare Fund (the “Fund”), following her retirement from Graphic Communications Conference of the International Brotherhood of Teamsters (her “Employer”). Plaintiffs three-count Complaint alleges that the denial of her benefits constituted a breach of contract and a violation of Section 502(a)(1)(B) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), and that the actions of George Tedeschi, President of her Employer, constituted an interference with her right to benefits in violation of Section 510 of ERISA, 29 U.S.C. § 1140. Plaintiff has asserted these claims against her Employer, Mr. Tedeschi (in his individual and official capacities), the Fund, and the Fund’s Board of Trustees.

Defendants have responded with a Motion to Dismiss, or in the alternative, Motion for Summary Judgment, which the Court shall construe as one for summary judgment. Both parties have attached to their filings various declarations and exhibits outside the scope of the Complaint and have submitted statements of material fact pursuant to Local Civil Rule 7(h)(1) (“[e]ach motion for summary judgment shall be accompanied by a statement of material facts” and “[a]n opposition to such a motion shall be accompanied by a separate concise statement”). 1 After thoroughly reviewing the parties’ submissions in connection with Defendants’ Motion for Summary Judgment, including the attachments thereto, and all relevant case law and applicable statutory authority, the Court shall GRANT Defendants’ [7] Motion for Summary Judgment, for the reasons that follow.

I. BACKGROUND

Plaintiff worked at her Employer 2 for over thirty-two years as an Executive Secretary to the President and Executive Assistant to the President. 3 Defs.’ Stmt. ¶ 1. *25 The Employer participated in an employee benefits plan administered by the Fund and provided eligible retirees with Employer-paid health insurance until age sixty-five. Defs.’ Stmt. ¶¶ 5, 8. On March 6, 2006, Plaintiff informed Mr. Tedeschi, President of the Employer, that she intended to retire as of March 31, 2006, and expected the Employer to continue paying for her health insurance. Id. ¶ 3. Mr. Te-deschi explained that the Employer would not pay for Plaintiffs health insurance because she was retiring at fifty-five years old, id. ¶ 2, and “it was the policy of the Employer that health care premiums would not be paid on behalf of employees who left employment prior to age [sixty]....” 4 /!!:. ¶ 4.

Plaintiff retired on March 31, 2006. Defs.’ Stmt. ¶ 1. Consistent with Mr. Te-deschi’s representations to Plaintiff, the Employer submitted a “Termination and Change Form” to the Fund indicating that Plaintiff retired on March 31, 2006, and advising that her coverage should terminate effective April 1, 2006. 5 Id. ¶ 27. On April 7, 2006, the Fund sent Plaintiff a “Termination of Health Insurance Coverage” notice informing her that “[she] and [her] spouse/dependents [were] no longer eligible to be covered under the [Fund]” as of April 1, 2006. Defs.’ Mot., Ex. B-8 at 1 (4/7/06 Termination of Coverage Notice).

Of central significance to this case is a document called the Summary Plan Description (“SPD”), which the Fund distributes to its participants and which Plaintiff received. Defs.’ Stmt. ¶¶21, 22. The SPD describes specific procedures available to challenge a partial or complete denial of coverage, which require a plan participant to (1) submit a claim for coverage within one year of incurred expenses, and if the claim is denied, (2) file an appeal to the Fund’s Board of Trustees within 120 days of the denial:

Time Limit for Filing Claims
All claims must be submitted to the Plan within one year following the date on which the expenses were incurred. No Plan Benefits will be paid for any claim not submitted within this period.
Review Procedure if Your Claim Is Denied
The Administrator will notify you in writing within 90 days of receipt of the claim if payment of your claim is denied in whole or in part. It will explain the reasons why, with reference to the Plan provisions on which the denial was based
You will be told what steps you may take to submit your claim for review and reconsideration.
Your request for review or reconsideration must be made in writing to [the *26 Fund], within 120 days after you receive notice of denial.

Defs.’ Mot., Ex. B-2 at 46-47 (SPD) (emphasis in original omitted). Although the Fund also provides participants with a “Plan Document” containing a description of these procedures, Defs.’ Stmt. ¶ 13, Plaintiff did not receive a copy of that document. 6 See Pl.’s Resp. Stmt. ¶ 11; Defs.’ Resp. Stmt. ¶ 11.

On April 2, 2007 (ie., more than 120 days but less than one year after Plaintiffs health insurance was terminated), Plaintiffs attorney submitted a “Notice of Claim of Plan Benefits” to the Fund asking that the Fund to reinstate Plaintiffs insurance coverage. Pl.’s Opp’n, Ex. B-9 at 1 (4/2/07 Letter from G. Bohn to the Fund). The Fund responded on April 17, 2007, indicating that Plaintiff was ineligible for coverage under the plan:

[a]s of April 2006, [Plaintiff] was dropped from the eligibility report provided to the Plan by her [Employer], The [Employer] further notified the Plan that under the plan of benefits negotiated between the [Employer] and the collective bargaining representative, [Plaintiff] was not entitled to health care benefits following her termination of employment. Further, no premium payments have been received on her behalf since that date.

Pl.’s Opp’n, Ex. A-ll at 2 (4/17/07 Letter from M. Ganzglass to G. Bohn). The letter also stated that the Fund forwarded Plaintiffs notice “to the [Employer] with a request for an explanation of the determination that [Plaintiff] was no longer eligible for coverage under the Plan,” and that once the Fund received a response, it would “respond to [the] April 2nd letter [sent by Plaintiffs attorney].” Id.

The Fund did not respond further. On June 8, 2007, Plaintiffs attorney sent the Fund a letter explaining that two months had elapsed and the Fund had not provided a further explanation. Id., Ex. A-12 at 1 (6/8/07 Letter from G. Bohn to the Fund).

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Cite This Page — Counsel Stack

Bluebook (online)
603 F. Supp. 2d 23, 2009 U.S. Dist. LEXIS 25469, 2009 WL 763400, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cox-v-graphic-communications-conference-dcd-2009.