Gamble v. Group Hospitalization & Medical Services, Incorporated

38 F.3d 126, 18 Employee Benefits Cas. (BNA) 2290, 74 A.F.T.R.2d (RIA) 6686, 1994 U.S. App. LEXIS 29354
CourtCourt of Appeals for the Fourth Circuit
DecidedOctober 21, 1994
Docket94-1020
StatusPublished

This text of 38 F.3d 126 (Gamble v. Group Hospitalization & Medical Services, Incorporated) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gamble v. Group Hospitalization & Medical Services, Incorporated, 38 F.3d 126, 18 Employee Benefits Cas. (BNA) 2290, 74 A.F.T.R.2d (RIA) 6686, 1994 U.S. App. LEXIS 29354 (4th Cir. 1994).

Opinion

38 F.3d 126

74 A.F.T.R.2d 94-6686, 18 Employee Benefits Cas. 2290

Joseph P. GAMBLE, Plaintiff-Appellant,
v.
GROUP HOSPITALIZATION & MEDICAL SERVICES, INCORPORATED,
Excess Benefit Plan; Group Hospitalization &
Medical Services, Incorporated,
Supplemental Executive
Retirement Plan,
Defendants-
Appellees.

No. 94-1020.

United States Court of Appeals,
Fourth Circuit.

Argued July 12, 1994.
Decided Oct. 21, 1994.

ARGUED: Anthony John Trenga, Hazel & Thomas, P.C., Alexandria, VA, for appellant. Stephen Michael Sayers, Hunton & Williams, Fairfax, VA, for appellees. ON BRIEF: Attison L. Barnes, III, Hazel & Thomas, P.C., Alexandria, VA, for appellant. Robert J. Stoney, Hunton & Williams, Fairfax, VA, for appellees.

Before NIEMEYER, MICHAEL, and MOTZ, Circuit Judges.

Affirmed by published opinion. Judge NIEMEYER wrote the opinion, in which Judge MICHAEL and Judge MOTZ joined.OPINION

NIEMEYER, Circuit Judge:

When Joseph P. Gamble retired under pressure on November 12, 1992, as president and chief executive officer of Group Hospitalization and Medical Services, Inc. ("Group Hospitalization"), he became entitled to a pension of $115,641 from a tax-qualified pension plan, an additional benefit of $192,348 per year from an excess benefit plan, and yet an additional benefit of $25,000 per year from a supplemental excess benefit plan. Because of large financial losses then being sustained by Group Hospitalization, the insurance commissioners in Virginia and the District of Columbia instructed Group Hospitalization not to make the payments to Gamble from the two excess benefit plans. When Group Hospitalization honored the direction and refused to make payment to Gamble of the excess benefits, paying him only the pension, he filed suit under the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. Sec. 1001 et seq., alleging that the excess benefit plans were "employee pension benefit plans" covered by ERISA and that he is entitled to payment as a participant and beneficiary of the plans. He sued the plans under 29 U.S.C. Sec. 1132 for recovery of past payments, a declaratory judgment that he is entitled to future payments, and an injunction mandating their payment. He also sued for attorney's fees under 29 U.S.C. Sec. 1132(g)(1).

Following discovery, Gamble filed a motion for summary judgment for an award of benefits, contending that ERISA preempts any state agency's direction not to pay, and Group Hospitalization filed a cross-motion for summary judgment to dismiss the complaint, contending that the court lacked subject matter jurisdiction because the plans were excess benefit plans exempted from ERISA's coverage. The resolution of the jurisdictional issue is significant to the parties because they both believe that if the plans are covered by ERISA, ERISA's preemptive force would deny the state insurance commissioners' efforts to challenge the legitimacy of payments based on possible executive mismanagement.

The district court denied Gamble's motion for summary judgment without prejudice to his pursuing claims for benefits under state law and dismissed the action on the ground that the excess benefit plans were not covered by ERISA and therefore claims against the plan could not rely on federal jurisdiction granted by ERISA. Limiting our consideration to the narrow jurisdictional issue, we affirm.

* Group Hospitalization is a District of Columbia corporation that provides a variety of health insurance services and includes, as one of its divisions, Blue Cross Blue Shield of the National Capital Area. At the time Gamble retired as president and chief executive officer of Group Hospitalization, Group Hospitalization and its affiliates had sustained millions of dollars of losses and were the subject of an investigation by the United States Senate. Peter Homick, who had been appointed Group Hospitalization's interim president, testified that when he took over Group Hospitalization in 1993 the corporation was not just bleeding financially, "it was massive[ly] hemorrhaging."

In order to save the company from financial ruin, Group Hospitalization was compelled in August 1992 and again in February 1993 to enter into consent orders, first with the Virginia State Corporation Commission (Bureau of Insurance) and later with the District of Columbia Insurance Administration. The orders subjected Group Hospitalization to substantial regulatory control by the two commissioners, and limited Group Hospitalization's ability to enter into contracts or transactions or to dispense funds without the explicit authorization of the commissioners.1

Upon his retirement in November 1992, Gamble became eligible to receive a pension from Group Hospitalization's tax-qualified pension plan, and excess benefits of $192,348 per year from the corporation's Excess Benefit Plan and $25,000 per year from a Supplemental Executive Retirement Plan ("SERP"). These two plans had been established by Group Hospitalization to supplement payments from its tax-qualified pension plan which were limited in 1984 by I.R.C. Sec. 415, placing a statutory dollar maximum on contributions and benefits to participants in plans which receive special tax treatment. After Group Hospitalization had made one payment to Gamble under these plans, the insurance commissioners of Virginia and the District of Columbia directed Group Hospitalization not to make any further unfunded "excess benefit" payments to Gamble and another high level former executive of Group Hospitalization. Group Hospitalization accordingly refused to make further payments to Gamble and requested that Gamble return the one payment that had been made to him in December 1992, stating that the request was "based solely on [Group Hospitalization's] desire to remain in compliance with the Consent Order entered into with the Virginia State Corporation Commission, Bureau of Insurance."

In his complaint, Gamble alleged that the two excess benefit plans constitute "employee pension benefit plans" as defined by ERISA and that Gamble is a participant and beneficiary under the plans and entitled to payment in accordance with the plans' terms. He contended that as of the filing of the complaint he had, despite demands, received "neither the overdue payments nor the requested assurances" that he is entitled to payment. He demanded judgment for payment in an amount equal to past payments plus interest, a declaratory judgment that he is entitled to future payments, an injunction that the plans be ordered to make future payments, and attorney's fees.

On cross-motions for summary judgment, the court dismissed the case for lack of subject matter jurisdiction, concluding that both plans were created and maintained for the sole purpose of providing benefits in excess of the limitations imposed by I.R.C. Sec. 415 and were therefore exempted from ERISA's coverage. The court entered judgment in favor of the plans without prejudice to Gamble's right to pursue the claims under state law. This appeal followed.

II

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38 F.3d 126, 18 Employee Benefits Cas. (BNA) 2290, 74 A.F.T.R.2d (RIA) 6686, 1994 U.S. App. LEXIS 29354, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gamble-v-group-hospitalization-medical-services-incorporated-ca4-1994.