Eisnaugle v. John Deere Health Care, Inc.

10 F. App'x 401
CourtCourt of Appeals for the Eighth Circuit
DecidedJune 14, 2001
Docket00-3568
StatusUnpublished

This text of 10 F. App'x 401 (Eisnaugle v. John Deere Health Care, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Eisnaugle v. John Deere Health Care, Inc., 10 F. App'x 401 (8th Cir. 2001).

Opinion

PER CURIAM.

Plaintiff Edmund B. Eisnaugle filed suit against Defendant John Deere Health Care, Inc. (“JDHC”) alleging (1) breach of fiduciary duty and estoppel under ERISA; (2) fraudulent misrepresentation; (3) negligent misrepresentation; and (4) breach of contract. Eisnaugle appeals from the District Court’s 2 entry of summary judgment in favor of JDHC and the Court’s denial of his cross-motion for summary judgment. We affirm.

Background

JDHC began affiliating with physicians in the 1990’s through a division of JDHC called Physician Practice Management. The physicians’ practices were incorporated as professional corporations and generally used the words “Cornerstone Group” as part of their corporate name. As a result of an affiliation, JDHC would provide a physician’s practice with management and administrative services, including paying the physician’s salary and benefits. JDHC would not, however, acquire any ownership interest in the practice or become the employer of the physician. JDHC would merely enter into a “management agreement” with the incorporated practice in exchange for a fee.

After an initial contact, JDHC sent Dr. Edmund Eisnaugle draft documentation by which JDHC proposed to affiliate with a practice that Eisnaugle would incorporate under the name Cornerstone Medical *403 Group of Waverly, P.C. (“CMG Waverly”). On October 30, 1996, Dr. Eisnaugle incorporated CMG Waverly. On the same day, JDHC and CMG Waverly entered into a Management Agreement. As part of the Management Agreement, JDHC and CMG Waverly executed a borrowing agreement under which JDHC would loan funds to CMG Waverly to cover working capital and CMG Waverly agreed to repay those loans on demand with interest. CMG Waverly executed an employment agreement with Eisnaugle under which CMG Waverly agreed to pay Eisnaugle a salary and to provide him with benefits. Dr. Eisnaugle’s salary and benefits were negotiated by JDHC prior to and in conjunction with the Management Agreement.

Kevin Pitzer, an employee of JDHC, was authorized to offer the salary and benefits package to Eisnaugle which included short-term and long-term disability insurance. When discussing the benefits proposal, Pitzer told Eisnaugle that he was eligible for disability coverage on his employment date of January 1, 1997 provided he completed and submitted all the applications. Pitzer did not tell Eisnaugle that he would have to qualify or be approved for the disability insurance. Pitzer was not aware that anyone told Eisnaugle he would have to qualify or be otherwise approved for the disability insurance. Under the Management Agreement, CMG Waverly could not secure payroll and benefits administration from anyone other than JDHC.

Katherine Pearson, also an employee of JDHC, coordinated Eisnaugle’s enrollment for disability insurance. On December 13, 1996, she sent Eisnaugle the proper enrollment forms with instructions to complete them and return them to her. Eisnaugle completed his enrollment for disability insurance under CNA’s Income Protection Plan on December 18, 1996. Pearson acknowledged receipt of the enrollment forms on December 20,1996. She checked the forms and forwarded them to All Staff, a benefits administration company hired by JDHC to provide employee benefits administration for affiliate practices. On January 16, 1997, Pearson sent Eisnaugle a note stapled to a Certificate of Insurance for Group Long Term Disability. Eisnaugle assumed that his benefits were effective on January 1,1997.

Dr. Eisnaugle developed vision problems and first saw an opthamologist in October, 1997. His vision had decreased to the point that the doctor advised him it was not safe for him to drive by himself. The Social Security Administration found Eisnaugle disabled due to dementia and statutory blindness with an onset date of October 20, 1997. Eisnaugle claims that he sent Katherine Pearson a letter on October 29, 1997, notifying her of his disability. Pearson denies receiving this letter.

On November 12, 1997, Jon Chapman and George Dellos of JDHC met with Eisnaugle to discuss termination of the relationship between JDHC, CMG Waverly, and Eisnaugle. Chapman gave Eisnaugle a proposed Settlement Agreement and Release which provided for termination of the Management Agreement and dissolution of CMG Waverly. JDHC made several propositions to Eisnaugle, including an offer to continue paying his salary and bonus payments through December 31,1997. JDHC also agreed to forgive a debt of $215,000 incurred by CMG Waverly since January 1, 1997. In exchange, the release portion of the Settlement Agreement provided in part that JDHC, CMG Waverly, and Eisnaugle would mutually and forever release and discharge each other from any and all claims known or unknown.

Eisnaugle took a copy of the Settlement and Release to his attorney, Jay Roberts, for advice before signing the document. *404 Roberts wrote Dellos on November 14, 1997 advising of his understanding of the offer. Roberts also raised the need to discuss health care coverage in the Settlement: ‘You must know of the extreme health problems that he, Sandy, and the family have had that would make it virtually impossible for them to gain health coverage in the future.”

After receiving the letter, Dellos contacted Eisnaugle. Dellos told Eisnaugle that he had received a letter from Roberts and asked Eisnaugle about Roberts’ role in the settlement negotiations. Eisnaugle allegedly indicated that JDHC should not be concerned about the letter and that he was interested in a cash payment under the Settlement and Release Agreement.

JDHC prepared a second proposed Settlement Agreement. The release language was identical to the original Settlement Agreement. The second Agreement terminated all previous agreements between the parties as of November 18, 1997, provided Eisnaugle with salary and bonus through December 31, 1997, a cash payment of $85,000, and COBRA health insurance benefits beginning January 1, 1998. Under the Agreement, Dr. Eisnaugle was required to assume responsibility for the health insurance payments. Disability benefits were never discussed. Dr. Eisnaugle signed the second Settlement Agreement and Release (the “Settlement Agreement”) on November 18, 1997 against the advice of his counsel.

By letter dated December 31, 1997, Eisnaugle’s attorney, Jay Roberts, informed JDHC that Eisnaugle intended to make a disability claim. William Zessar, General Counsel for JDHC, responded by letter dated February 17, 1998 that Eisnaugle’s application for disability coverage was never forwarded by All Staff to CNA, and that Eisnaugle did not meet the eligibility requirements for disability benefits because he had not been a “full time” employee. According to the record, Eisnaugle did not work 30 hours per week performing the duties of his “regular occupation” during 1997 as required to be considered a “full time” employee under the CNA policy.

On March 23, 1998, Roberts again wrote to Zessar regarding Dr. Eisnaugle’s health insurance. Zessar responded two days later with information that Eisnaugle had not submitted an application for COBRA health insurance and he had not paid the premium within the appropriate time period. Roberts wrote to Zessar again stating, “[Eisnaugle] has made every reasonable effort to have health insurance and assert his rights under COBRA.

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Bluebook (online)
10 F. App'x 401, Counsel Stack Legal Research, https://law.counselstack.com/opinion/eisnaugle-v-john-deere-health-care-inc-ca8-2001.