Derogatis v. Bd. of Trs. of the Welfare Fund of the Int'l Union of Operating Eng'rs Local 15, 15a, 15C 15D, AFL-CIO
This text of 385 F. Supp. 3d 308 (Derogatis v. Bd. of Trs. of the Welfare Fund of the Int'l Union of Operating Eng'rs Local 15, 15a, 15C 15D, AFL-CIO) is published on Counsel Stack Legal Research, covering District Court, S.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Opinion
McMahon, Chief Judge:
On remand from the Second Circuit, this Court must decide whether the Employee Retirement Income Security Act,
Until recently, monetary compensation was unavailable in an action alleging a violation of section 502(a)(3) of ERISA because such claims were legal rather than equitable in nature. Mertens v. Hewitt Assocs. ,
In this very sad case, operating engineer Frank DeRogatis was diagnosed with terminal cancer. After his diagnosis, Plaintiff Emily DeRogatis received erroneous information about the possible termination of her husband's healthcare benefits from a claims specialist employed by Frank's healthcare plan-the Welfare Fund of the International Union of Operating Engineers Local 15, 15A, 15C & 15D, AFL-CIO (the "Welfare Fund"). Fearing a loss of medical benefits at a time when her husband was hospitalized and dying, she declined to submit an early retirement election that Frank had signed in order to maximize the pension benefit that she would receive after his death. As a result, Emily was not eligible for augmented survivor's benefits under the terms of his pension plan-the Central Pension Fund of the International Union of Operating *312Engineers and Participating Employers (the "Pension Plan").
After Frank's death, Emily brought lawsuits against the Welfare Fund and the Pension Plan,1 in a quest to obtain the augmented benefit that would have been available to her had she submitted Frank's early retirement papers. This Court granted summary judgment in favor of defendants, and DeRogatis appealed. The Court of Appeals affirmed this Court's award of summary judgment in favor of the Pension Plan-the terms of which clearly barred giving Emily the augmented benefit-but concluded that there were genuine issues of material fact about the potential liability of the Welfare Fund for a breach of fiduciary duty based on the actions of its employees. Specifically, the Second Circuit concluded that there were genuine issues of material fact about (i ) whether the trustees were acting as fiduciaries to DeRogatis when a Welfare Fund employee provided erroneous advice to Emily; and, if they were, (ii ) whether the trustees breached those fiduciary duties through a combination of a misleading summary plan description ("SPD") and the erroneous advice. However, the Court of Appeals observed that the Welfare Fund could still obtain summary judgment if it established on remand that DeRogatis was not entitled to equitable relief under the circumstances-an issue that neither party had briefed before this Court in connection with the motions for summary judgment.
Presently before the Court is the Welfare Fund's renewed motion for summary judgment, on the grounds that DeRogatis has no claim for an equitable remedy under the circumstances of this case. Also before the Court is DeRogatis' cross-motion for summary judgment on the issue of whether the Welfare Fund breached its fiduciary duty.
For the reasons that follow, both motions are denied.
BACKGROUND
I. Facts
The Court assumes familiarity with the facts of the case from the Court's previous decisions, DeRogatis v. Bd. of Trs. of the Cent. Pension Fund of the Int'l Union of Operating Eng'rs , No. 13-cv-8788,
Frank DeRogatis was an operating engineer and member of the International Union of Operating Engineers Local 15 ("Local *31315"). The Union provides its members with both medical (welfare) and pension benefits. Medical benefits are administered locally, through the Welfare Fund's New York City-based office. Pension benefits are administered centrally, through the Pension Plan's Washington, D.C. based-office. The two plans have no formal affiliation with each other, except that they both serve Local 15 members.
As the Pension Plan's Washington, D.C.
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McMahon, Chief Judge:
On remand from the Second Circuit, this Court must decide whether the Employee Retirement Income Security Act,
Until recently, monetary compensation was unavailable in an action alleging a violation of section 502(a)(3) of ERISA because such claims were legal rather than equitable in nature. Mertens v. Hewitt Assocs. ,
In this very sad case, operating engineer Frank DeRogatis was diagnosed with terminal cancer. After his diagnosis, Plaintiff Emily DeRogatis received erroneous information about the possible termination of her husband's healthcare benefits from a claims specialist employed by Frank's healthcare plan-the Welfare Fund of the International Union of Operating Engineers Local 15, 15A, 15C & 15D, AFL-CIO (the "Welfare Fund"). Fearing a loss of medical benefits at a time when her husband was hospitalized and dying, she declined to submit an early retirement election that Frank had signed in order to maximize the pension benefit that she would receive after his death. As a result, Emily was not eligible for augmented survivor's benefits under the terms of his pension plan-the Central Pension Fund of the International Union of Operating *312Engineers and Participating Employers (the "Pension Plan").
After Frank's death, Emily brought lawsuits against the Welfare Fund and the Pension Plan,1 in a quest to obtain the augmented benefit that would have been available to her had she submitted Frank's early retirement papers. This Court granted summary judgment in favor of defendants, and DeRogatis appealed. The Court of Appeals affirmed this Court's award of summary judgment in favor of the Pension Plan-the terms of which clearly barred giving Emily the augmented benefit-but concluded that there were genuine issues of material fact about the potential liability of the Welfare Fund for a breach of fiduciary duty based on the actions of its employees. Specifically, the Second Circuit concluded that there were genuine issues of material fact about (i ) whether the trustees were acting as fiduciaries to DeRogatis when a Welfare Fund employee provided erroneous advice to Emily; and, if they were, (ii ) whether the trustees breached those fiduciary duties through a combination of a misleading summary plan description ("SPD") and the erroneous advice. However, the Court of Appeals observed that the Welfare Fund could still obtain summary judgment if it established on remand that DeRogatis was not entitled to equitable relief under the circumstances-an issue that neither party had briefed before this Court in connection with the motions for summary judgment.
Presently before the Court is the Welfare Fund's renewed motion for summary judgment, on the grounds that DeRogatis has no claim for an equitable remedy under the circumstances of this case. Also before the Court is DeRogatis' cross-motion for summary judgment on the issue of whether the Welfare Fund breached its fiduciary duty.
For the reasons that follow, both motions are denied.
BACKGROUND
I. Facts
The Court assumes familiarity with the facts of the case from the Court's previous decisions, DeRogatis v. Bd. of Trs. of the Cent. Pension Fund of the Int'l Union of Operating Eng'rs , No. 13-cv-8788,
Frank DeRogatis was an operating engineer and member of the International Union of Operating Engineers Local 15 ("Local *31315"). The Union provides its members with both medical (welfare) and pension benefits. Medical benefits are administered locally, through the Welfare Fund's New York City-based office. Pension benefits are administered centrally, through the Pension Plan's Washington, D.C. based-office. The two plans have no formal affiliation with each other, except that they both serve Local 15 members.
As the Pension Plan's Washington, D.C. office is not readily accessible to New York City-based members of the Local 15, employees of the Welfare Fund occasionally provide advice related to pension benefits under the Pension Plan. That is what happened in this case.
After Frank DeRogatis was diagnosed with terminal cancer in January 2011, he and his wife Emily met with Patrick Keenan, an office administrator for the Welfare Fund, to learn about Frank's post-retirement options for health benefits and pension benefits. Based on what Keenan told him, Frank then filled out and signed the paperwork to apply for early retirement. He did this because, under the terms of the Pension Plan, the surviving spouse of a retired Local 15 member would receive a higher monthly benefit than the surviving spouse of a member who died while employed. To put numbers on the difference: if Frank died while employed, Emily was entitled to a Preretirement Annuity of $ 787 per month; if he died after retiring, Emily could qualify for a Joint Annuity (the "100% Joint Annuity"), which would pay her as much as $ 1,076 per month. So by retiring, at age 61 instead of waiting until age 62, Frank could leave Emily with a pension benefit worth almost $ 300 more each month.
When Frank was hospitalized with pneumonia in late July 2011, Emily brought the signed retirement paperwork to the local Welfare Fund office for filing. However, before she submitted the paperwork, claims specialist Richard Lopez told her that the DeRogatises would lose their health benefits if Frank retired before reaching the age of 62. This was not correct. What Lopez should have said was that Frank would stop accruing additional health benefits (which were credited to Local 15 members every four months based on hours worked) if he retired early-although since he was dying, not working, this would hardly have mattered. Taking early retirement would not have left Frank without health insurance benefits.
But Emily thought that submitting the early retirement paperwork would jeopardize Frank's access to health insurance. So she did not submit it. Instead, she applied for a short-term disability benefit from the Welfare Fund.
Frank died less than two months later, in September 2011.
In strict accordance with the terms of the Pension Plan, Emily began receiving the lower, $ 787/month Preretirement Annuity. Emily tried to submit Frank's signed retirement papers after his death and contested the Pension Plan's determination. After several unsuccessful rounds of administrative appeals, Emily brought parallel ERISA cases in this Court against both the Pension Plan (13-cv-8788) and the Welfare Fund (14-cv-8863).
II. Present Proceedings
A. Procedural History
After discovery, the Court granted summary judgment to the Pension Plan defendants, finding as a matter of undisputed fact that the Pension Plan had not acted arbitrarily or capriciously or breached any fiduciary duty in denying DeRogatis' request for an augmented survivor's benefit after her husband's death.
*314DeRogatis I ,
The Court also granted summary judgment to the Welfare Plan. I concluded that a plan administrator could not be held liable for unintentional misrepresentations made about the plan's operation by Lopez, who was a purely "ministerial" agent and not a fiduciary. DeRogatis II ,
DeRogatis appealed. The Second Circuit affirmed the grant of summary judgment to the Pension Plan, but overturned the grant of summary judgment to the Welfare Plan. DeRogatis IV ,
However, there are three elements to such a claim. The third is whether "appropriate equitable relief" is available. As neither party had briefed this issue in their summary judgment papers, the Second Circuit remanded so this Court could consider in the first instance whether Emily might be entitled to any equitable remedy against the Welfare Fund.
The Court of Appeals directed that, "On remand, the District Court should consider whether Emily will be entitled to a surcharge or some other form of 'appropriate equitable relief' under ERISA section 502(a)(3) if she successfully proves that the Welfare Fund breached a fiduciary duty."
DISCUSSION
I. Legal Standards
A. Summary Judgment
Summary judgment is appropriate only where "there is no genuine dispute as to any material fact and the movant is entitled to a judgment as a matter of law." Fed. R. Civ. P. 56(a). A dispute is "genuine" if "the evidence is such that a reasonable jury could return a verdict for the nonmoving party."
*315Anderson v. Liberty Lobby, Inc. ,
B. ERISA Section 502(a)(3)
ERISA provides, in relevant part, "A civil action may be brought by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter or the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan[.]"
DeRogatis alleges that the Welfare Fund violated its fiduciary duty "to provide complete and accurate information" to plan members. See DeRogatis IV ,
The Court of Appeals concluded that the Welfare Fund was not entitled to summary judgment on the first element, because "a factfinder could reasonably conclude that the Funds performed a fiduciary function when speaking through the Welfare Fund's ministerial employees." Id. at 191 (emphasis omitted). Similarly, the Court of Appeals concluded that the Welfare Fund was not entitled to summary judgment on the second element, because "under Becker , DeRogatis may be able to show a breach [of] fiduciary duty" based on the combination of an unclear SPD and oral misrepresentations from Lopez. Id. at 193.
C. Equitable Relief Under Section 502(a)(3)
Whether the Welfare Fund can obtain summary judgment dismissing the claim against it depends on whether it can establish that no appropriate equitable relief is available to DeRogatis. Id. at 199. "[T]o help frame the District Court's analysis on remand," the Second Circuit laid out the relevant standard:
The Supreme Court has interpreted this provision as making available "those categories of relief that ... were typically available in equity." Amara ,563 U.S. at 439 ,131 S.Ct. 1866 (internal quotation marks and emphasis omitted). In addition to injunctions, plaintiffs asserting a claim under section 502(a)(3) may seek remedies *316such as estoppel, equitable reformation of plan terms, or a monetary "surcharge" to recompense "a loss resulting from a [fiduciary's] breach of duty, or to prevent the [fiduciary's] unjust enrichment."Id. at 440-42 ,131 S.Ct. 1866 . The showing required of a plaintiff proceeding under section 502(a)(3) thus depends in part on the particular form of equitable relief sought. Seeid. at 443-44 ,131 S.Ct. 1866 (noting that "detrimental reliance" is a required element for estoppel, but not for reformation or surcharge).
As the moving party, the Welfare Fund covers the waterfront, and exhaustively argues that no equitable remedy-including injunction, reformation, estoppel, or surcharge-is available to DeRogatis. In her opposition papers, DeRogatis does not address the Welfare Fund's contention that injunction, reformation, or estoppel are not available; this I interpret as a concession that they are not available equitable remedies. Instead, Plaintiff focuses exclusively on the availability of what she wants-which is an additional $ 300 per month-and argues that she is entitled to surcharge the Welfare Fund's trustees because of their employee's error.
I, too, will limit my discussion to the availability of equitable surcharge. See Lykins v. IMPCO Techs., Inc. , No. 15-cv-2102,
D. The Surcharge Remedy Generally
Any discussion of surcharge must begin with the United States Supreme Court's decision in Amara.
In Cigna Corp. v. Amara ,
Since Amara , circuit courts have allowed beneficiaries to proceed against fiduciaries for monetary compensation under a "make whole" theory. In Kenseth v. Dean Health Plan, Inc. ,
Similarly, in McCravy v. Metropolitan Life Ins. Co. ,
Similarly, in Gearlds v. Entergy Servs., Inc. ,
Since Amara , district courts in this circuit have also recognized that surcharge is one of the "remedies generally available under § 502(a)(3), even if the practical result of entering such relief is a monetary payment." Amara v. CIGNA Corp. ,
E. Requirement To Show Harm and Causation
"[T]o obtain relief by surcharge" for misrepresentations by plan fiduciaries, a "beneficiary must show that the violation injured him or her." Amara ,
On Amara 's remand from the Supreme Court, my Connecticut colleague, Judge Janet Bond Arterton, elaborated on the "harm and causation" standard. Amara II ,
Amara II explains that, for beneficiaries seeking monetary surcharge against fiduciaries on a "make whole" theory of relief, "actual harm" may consist of either: (i ) "detrimental reliance," Amara II ,
To show causation, detrimental reliance is "sufficient but not necessary." Amara II ,
In this case, Emily relied to her detriment on representations made by a Welfare Fund employee about the potential loss of her husband's health benefits and declined to submit his early retirement papers. She also argues that the fiduciary breach caused her to lose almost $ 300 each month since her husband's death in pension benefits-benefits she would have received had she followed Frank's instructions and submitted his early retirement papers-which means she is arguing "but-for" factual causation. It appears, then, that Emily may be entitled to equitably surcharge the Welfare Fund under either theory.
Amara II notwithstanding, the Welfare Fund moves for summary judgment, arguing that DeRogatis is not entitled to equitable relief, because (i ) the relief she seeks is not traceable to particular assets of the Welfare Fund; (ii ) payment to DeRogatis would be inconsistent with the terms of the Welfare Fund Trust Agreement and so would cause the Trustees to breach their fiduciary duty to the members; and (iii ) surcharge cannot be a "standalone" remedy.
Each of these arguments lacks merit.
F. Surcharge Does Not Require Traceability
Despite the overwhelming similarity between the facts of this case and the facts in Kenseth , Gearlds , and McCravy , the Welfare Fund first argues that the relief DeRogatis seeks is not "equitable," because it is not traceable to specific assets or property in the Welfare Fund trust, which has no funds attributable to the pension benefit in question. (Mem. of Law in Supp. of the Local 15 Welfare Fund Defs.' Mot. for Summ. J. ("Br."), Dkt. No. 88 at 4-5.)
The *319Welfare Fund relies on Cent. States, Se. & Sw. Areas Health & Welfare Fund v. Gerber Life Ins. Co. ,
Relatedly, the surcharge remedy, as understood by the Amara court in the ERISA context, requires neither unjust enrichment nor the loss of "particular" plan funds, as would previously have been required to surcharge a trustee. See Gabriel v. Alaska Elec. Pension Fund ,
DeRogatis does not seek "restitution" of anything. Nor does "surcharge" under Amara require DeRogatis' injury to be traceable to any particular Welfare Fund assets. Therefore, the Welfare Fund is not entitled to summary judgment on this ground.
G. Neither the Trust Agreement Nor McCutchen Bars DeRogatis From Seeking Relief
The Welfare Fund next argues that DeRogatis cannot use the surcharge theory to seek compensation for lost pension benefits because the Welfare Fund Trust Agreement allegedly prohibits Fund assets from being used for anything other than the payment of healthcare benefits for its members. (Br. at 7-8.) Its argument depends, in large part, on dicta from US Airways, Inc. v. McCutchen ,
In McCutchen , the plaintiff, an employee of US Airways, was injured in a car crash that was wholly the fault of another driver.
US Airways sued McCutchen to recover its $ 67,000 outlay for medical expenses, relying on the following plan provision:
If [US Airways] pays benefits for any claim you incur as the result of negligence, willful misconduct, or other actions of a third party, ... [y]ou will be required to reimburse [US Airways] for amounts paid for claims out of any monies recovered from [the] third party, including, but not limited to, your own insurance company as the result of judgment, settlement, or otherwise.
The Supreme Court held that the plain terms of the plan barred McCutchen from raising these equitable defenses.
The Welfare Fund submits that these same principles should preclude DeRogatis from seeking what are essentially pension benefits, but paid out of the Welfare Fund. They argue that certain paragraphs of the Welfare Fund Trust Agreement constitute a de facto contract between plan beneficiaries and trustees that limits recovery to medical benefits. They identify two provisions of the Trust Agreement that (allegedly) prohibit the trustees of the Welfare Fund from using the fund's assets for anything other than member healthcare benefits:
WHEREAS: The Union, the Associations and the Employers desire to establish a Trust under which the moneys paid on account of medical and hospital care and related benefits will be held in a trust fund to be known as the WELFARE FUND OF THE INTERNATIONAL UNION OF OPERATING ENGINEERS, LOCAL UNIONS 15, 15A, 15C, 15D, AFL-CIO (hereinafter referred to as the "Welfare Fund"), and to designate trustees to receive, hold, administer and disburse said moneys and other properties owned by the Welfare Fund, and to define the powers, duties and responsibilities of the Trustees;
(Steinberg Decl. Ex. A at 2.)
The purposes of the Trust Fund shall be to provide, pursuant to the Welfare Plan, medical care, hospital care, life insurance, disability and sickness benefits, and all other kindred benefits, *321for the Employees eligible thereto hereunder.
(Id. at 6, Article III.)2 (Br. at 8.)
But nothing in the Fund Agreement prohibits the imposition of a surcharge on the Fund's Trustees. As a matter of simple fact, the Trust Agreement does not require that every dollar collected be spent on medical benefits; otherwise, the Fund could not administer itself-rent space, pay its employees, keep the lights on. (See, e.g., id. at 11, Art. VI, First, (i) (property taxes); id. at 12, Art. VI, First, (o) (administrative staff).) Moreover, the Trust Agreement authorizes the use of trust funds to indemnify its trustees. (Id. at 22, Art. XI, Sixth.) The trustees would surely apply for indemnification if they were to be surcharged because of the bad advice given by a subordinate to a member, and the Fund is permitted to pay such indemnification. That alone disposes of the Fund's argument that the trustees would be diverting funds from an allowable use to one that is not authorized.
McCutchen is not to the contrary. McCutchen was not an equitable case at all; it was a simple contract case, as the Supreme Court held, and under the plain terms of the contract, the company had an equitable lien on any recovery McCutchen might get from anyone in connection with his accident, whether by suit or by allowed insurance claim, up to $ 67,000. McCutchen ,
H. Surcharge Does Not Require an Injunction
Finally (albeit for the first time in reply), the Welfare Fund argues that courts in this circuit do not recognize a standalone surcharge remedy; rather, to constitute an equitable remedy, the surcharge must be accompanied by an injunction. (Reply Mem. of Law in Further Supp. of the Local 15 Welfare Fund Defs.' Mot. for Summ. J., Dkt. No. 95 at 2-7.) The Welfare Fund relies on the following language from New York State Psychiatric Ass'n ,
This is weak sauce. There is no indication that the Second Circuit, with this one phrase, meant to restrict the scope and availability of ERISA's surcharge remedy. Rather, it was describing the types of relief available, and it viewed those types as disjunctive: "And so we hold that to the extent Denbo seeks redress for United's past breaches of fiduciary duty or seeks to enjoin United from committing future breaches, the relief sought would count as 'equitable relief' under § 502(a)(3)."
Additionally, if the unavailability of injunctive relief ruled out surcharge as a matter of law, the Court of Appeals-which *322plainly ruled that injunctive relief was not available to DeRogatis-would have had no need to remand the case to this Court so that I could engage in the meaningless exercise of deciding whether surcharge was available.
To bolster its argument that the Second Circuit does not recognize a standalone surcharge remedy, the Welfare Fund also relies on other cases, principally Central States v. Gerber Life Ins. Co. ,
The facts of Curran v. Aetna Life Ins. Co. , No. 13-cv-00289,
Finally, and somewhat perplexingly, the Welfare Fund cites D'Iorio v. Winebow, Inc. ,
In short, there is simply no support for the proposition that injunctive relief is a necessary prerequisite to seeking surcharge.
II. DeRogatis' Cross-Motion for Summary Judgment Is Denied
DeRogatis cross-moves for summary judgment on the second element of her claim for breach of fiduciary duty, on the basis of footnotes in the Second Circuit's opinion. (Mem. of Law in Opp. to the Mot. for Summ. J. Filed by the Local 15 Welfare Fund Defs., Dkt. No. 94 at 15-17.) Her motion is denied. In every section of the opinion, the Court of Appeals was careful to phrase its conclusions in the patois of Rule 56, finding specifically with regards to the breach element that:
• it was "at least questionable whether the SPD clearly alerts participants to the consequences of early retirement for their health benefits," and
• "whether the [Welfare] Fund's various communications with the DeRogatises exacerbated the lack of clarity inherent in the SPD and thereby provided the DeRogatises with materially misleading information ... presents a genuine dispute of material fact."
DeRogatis IV ,
CONCLUSION
For the reasons stated above, the Welfare Fund's motion for summary judgment and DeRogatis' cross-motion for summary judgment are both denied.
The Clerk of Court is respectfully requested to close the motions at Dkt. Nos. 86 and 91.
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