Echague v. Metropolitan Life Insurance

43 F. Supp. 3d 994, 58 Employee Benefits Cas. (BNA) 1413, 2014 U.S. Dist. LEXIS 68642, 2014 WL 2089331
CourtDistrict Court, N.D. California
DecidedMay 19, 2014
DocketCase No. 12-cv-00640-WHO
StatusPublished
Cited by11 cases

This text of 43 F. Supp. 3d 994 (Echague v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Echague v. Metropolitan Life Insurance, 43 F. Supp. 3d 994, 58 Employee Benefits Cas. (BNA) 1413, 2014 U.S. Dist. LEXIS 68642, 2014 WL 2089331 (N.D. Cal. 2014).

Opinion

Re: Dkt. Nos. 92, 103, 104, 107

ORDER GRANTING IN PART PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT; DENYING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT; GRANTING DEFENDANT’S MOTION FOR JUDGMENT AS A MATTER OF LAW; DENYING PLAINTIFF’S MOTION FOR LEAVE TO AMEND

WILLIAM H. ORRICK, United States District. Judge

After being diagnosed with cancer and going on medical leave, Carol Echague sent defendant TriNet Group, Inc. a specific inquiry about her insurance coverage, stating that she did not want any of it to lapse. TriNet responded by referring her to confusing form letters it had already provided that did not specifically address the policies that were in danger of lapsing. Ms. Echague died four months later, and her husband, ' the plaintiff here, then learned that her insurance policies had lapsed. Among several issues, I have to determine whether TriNet breached its fiduciary duty to the Echagues and whether it or any other defendant is liable as a result. I find that TriNet’s insufficient response violated its fiduciary duties under ERISA and GRANT plaintiffs motion on that ground. In all other respects, I GRANT defendants’ motions for summary judgment and judgment on the pleadings.

BACKGROUND

Mr. Echague sues defendants Metropolitan Life Insurance Company (MetLife), TriNet Group, Inc., (TriNet),1 and Pacific Coast Bankers’ Bank (PCBB) for Recovery of Employee Benefits under 29 U.S.C. § 1132(a)(1)(B) and for equitable relief and breach of fiduciary duty under 29 U.S.C. § 1132(a)(3). His wife, Carol Echague, was employed by PCBB.2 PCBB outsourced its payroll and benefits administration to TriNet. TriNet sponsored and made available to PCBB employees two life insurance policies that are relevant to this case: the TriNet Basic Life Insurance Policy and the TriNet Supplemental Life Insurance Policy (Policies). The premiums for the Basic Policy were paid by PCBB. Carol Echague paid the premiums for the Supplemental Policy. As of January 2011, Ms. Echague’s coverage amount was $440,000. Both policies were issued by MetLife.

[1001]*1001Carol Echague was diagnosed with breast cancer and went on a leave of absence as of January 1, 2011. Declaration of Sheryl Southwiek, Exhibit G. PCBB offered to pay Ms. Echague’s “portion of her benefits premiums until the point in time she would need to go onto COBRA.” Declaration of Ernie Echague (Docket No. 109), Ex. 4 at E614. PCBB paid for Ms. Echague’s portions of her health care and life insurance benefits payments through March 81, 2011.

On January 24, 2011, TriNet sent two letters to Ms. Echague. The first letter “RE: Request for Leave of Absence” identified Ms. Echague’s leave as starting on January 1, 2011 and her COBRA effective date as April 1, 2011. Ex. G.3 The letter explained that it was important for Ms. Echague to understand her rights and responsibilities and referred her to “the addendum to the Employee Handbook” or the “TriNet Employee Handbook” for specific information on PCBB’s leave policies and benefits while on leave. Id. The letter noted that the “addendum” could be viewed on TriNet’s “HR passport” website under My Company-> Company Addendum. Id. The letter did not address Ms. Echague’s Basic or Supplemental Life Insurance Policies and did not mention Met-Life, but did address COBRA, disability and other topics.4 For more information Ms. Echague was referred to the “TriNet Employee Handbook” and the “TriNet Signature Benefits Guidebook,” which “could be” found on HR passport, and to the TriNet solutions center’s 800 number. Id.

The second letter was a “FMLA/CFRA Notice” informing Ms. Echague about her rights under the federal Family and Medical Leave Act (FMLA) and the California Family Rights Act (CFRA). Southwiek Deck, Ex. H. The letter explained how the FMLA/CFRA leave would work and discussed the payment of health benefits during the leave. Id. The letter also stated that if “a portion of your paycheck normally goes to pay for certain voluntary expenses, such as additional GVUL life or AFLAC, you will need to make payment directly to the providers of these benefits during your- leave. If you need contact information, refer to www.hrpassport.com or call the TriNet Solution Center at 1-800-638-0461.” Id. The letter did not mention MetLife or the Basic or Supplemental Insurance Policies.

On February 22, 2011, Ms. Echague sent an email to TriNet employee Nisha Berr-ios and PCBB HR representative Ker-ianne Hohener.5 The email read, “I don’t want any insurance to lapse so can you please let me know which ones I need to continue to pay right after March on my own. These might include any supplemental insurance. Also, I would like some information on where to send these payments. If you are not the right individual who can assist me, kindly direct me to the right individual.” Echague Deck, Ex. 6 at E00624. In response, Ms. Berrios, simply resent Ms. Echague copies of the two January 24, 2011 letters. Id. at E00623. Ms. Berrios did not provide Ms. Echague with any details regarding which benefit payments she would need to take over as of [1002]*1002March 31st, and did not provide any information on where to send those benefit payments.

The only further communications between the Echagues and TriNet prior to Ms. Echague’s death, were April 1st and April 4th emails between plaintiff and Ms. Berrios from TriNet regarding whether the Echague’s could secure COBRA coverage for a week, while the Echagues’ health care coverage was transferred from PCBB/TriNet to plaintiffs employer’s plan. Echague Deck, Ex. 8 at E00715-716.

Ms. Echague’s leave of absence from PCBB was extended through August 31, 2011. Echague Deck, Ex 9 at E00613. She died on June 23, 2011.

On June 27, 2011, TriNet notified Mr. Echague by letter that a group life insurance claim had been submitted on his behalf. It requested additional information from him. It mentioned, for the first time, that MetLife was the administrator of the life insurance Policies. Echague Deck, Ex. 10 at E0061. In July 2011, plaintiff was informed that the life insurance claim was denied by MetLife for nonpayment of premiums. Plaintiff forwarded the email regarding the denial to TriNet and appealed the denial with MetLife. Echague Deck, Exs. 11 & 12. In his appeal, plaintiff argued that neither he nor his wife had been informed that the policies were at risk of terminating and that neither he nor his wife received notice from anyone that PCBB was no longer making premium payments. Id., Ex. 12 at E00604.

According to TriNet and PCBB, the ERISA Plan at issue is “The TriNet Employee Benefit Insurance Plan Section, 125, Section 1209.” Southwick Deck ¶ 4. The Plan is a cafeteria-type plan which provided employees of PCBB with a number of health and welfare benefits to choose from. The Basic and Supplemental Life Insurance Policies at issue were offered under the Plan. Id. ¶ 5. TriNet acts as the “Plan Administrator” for the Plan and the Policies, and MetLife is the “Claims Administrator” under the Policies. Id.

TriNet employee Sheryl Southwick testified that the ERISA-required Summary Plan Description (SPD) for the Plan is the “TriNet Signature

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Bluebook (online)
43 F. Supp. 3d 994, 58 Employee Benefits Cas. (BNA) 1413, 2014 U.S. Dist. LEXIS 68642, 2014 WL 2089331, Counsel Stack Legal Research, https://law.counselstack.com/opinion/echague-v-metropolitan-life-insurance-cand-2014.