Gruber v. Hubbard Bert Karle Weber, Inc.

159 F.3d 780, 22 Employee Benefits Cas. (BNA) 1857, 1998 U.S. App. LEXIS 27504, 1998 WL 744597
CourtCourt of Appeals for the Third Circuit
DecidedOctober 26, 1998
Docket97-3477
StatusUnknown
Cited by2 cases

This text of 159 F.3d 780 (Gruber v. Hubbard Bert Karle Weber, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gruber v. Hubbard Bert Karle Weber, Inc., 159 F.3d 780, 22 Employee Benefits Cas. (BNA) 1857, 1998 U.S. App. LEXIS 27504, 1998 WL 744597 (3d Cir. 1998).

Opinion

OPINION OF THE COURT

STAPLETON, Circuit Judge:

This is the fourth installment in this lengthy and tortuous insurance saga. The case has come back to us after we dismissed it because the district court had not adjudicated all the claims in one of the actions in the consolidated case. The district court has since issued an order dismissing all ERISA claims, denying appellant’s petition for a declaratory judgment, and entering final judgment pursuant to Rule 54(b) of the Federal Rules of Civil Procedure. We will affirm in part and reverse in part.

I.

The Lake Erie Employers’ Association (“LEEA”) was formed in September 1981 as a non-profit corporation with the stated purpose of “fosterling] and promoting] the mutual interests of those individuals, partnerships, firms, associations, and corporations who are engaged in business in the Northwestern Pennsylvania Area” and “fosterling] and advancing] a mutual cooperation and understanding among such businesses with the other economic entities affecting business in the area.” See LEEA Certificate of Incorporation, at A65. “Any individual, partnership, firm, association, or corporation ... engaged in business in the Northwestern Pennsylvania area employing at least five (5) but less than 150 employees and who is interested in the purposes of the organization” could apply for membership in the association. 1 LEEA Bylaws Art. IV, ¶ 1, at A72. Associate membership was available for businesses having “a demonstrable material interest in the purposes of the organization” but not meeting the membership criteria. Id. ¶ 3, at A72.

LEEA was the brainchild of J. Patrick Karle, one of the principals of the brokerage firm Hubbard Bert Karle Weber, Inc. (“HBKW”). Karle, who also served as President and Chairman of the Board of LEEA, testified that the idea for LEEA arose when HBKW observed the success that large employers had with self-funded health and benefit plans, and concluded that it might be possible for smaller employers to enjoy the same success with a self-funded alternative if they banded together. Karle Dep. of Oct. 7, 1986, at A743-44. He testified that LEEA was formed both to provide small businesses with an alternative health benefit option to that available from Blue Cross/Blue Shield and to serve as a forum where small business people could obtain information about changes in the laws and regulations governing employee benefits. Id. at A751. Toward the latter purpose, LEEA published a newsletter, approximately on a quarterly basis, that discussed changes in benefits law and provisions, as well as other matters that might be of interest to a small business person, such as tax and estate law. In addition, the association held two meetings a year at which legislators and other speakers would discuss topics of interest to the members or local health care providers would describe “wellness programs” that could as *784 sist the employers in the cost-effective provision of health benefits to their employees.

Despite its informational activities, it is clear that LEEA’s primary purpose was the provision of health and other benefits to the employees of its employer-members. The first order of business, after incorporation and the appointment of officers and directors, engaged in by the Board of Directors of LEEA was “a discussion of the need to provide self-insured health benefits and dental benefits for members of [LEEA]” and resolutions “to establish one or several health, dental, and such other benefit plans which shall be offered to the members of this corporation in Pennsylvania, Ohio and New York states” and to establish “the [LEEA] Benefit Trust and the [LEEA] Accident and Health Plan” effective November 1, 1981. Minutes of Meeting of Oct. 8, 1981, at A110-11. In addition, a review of those minutes of later Board meetings that are provided in the record reveals that discussion at the meetings centered almost exclusively on matters related to the various benefit plans administered by LEEA, including plan amendments, rate and billing adjustments, and collection procedures. In addition, there is no indication in the record that LEEA had any members that were not also participants in the LEEA Plan. Indeed, although “[a]ll proceedings in relation to membership applications [were] secret and confidential,” LEEA Amended Bylaws, Art. V, ¶ 2, at A89, there is an implication in the record that membership decisions were based on underwriting considerations.

It is also clear that LEEA and HBKW, the brokerage firm, were closely interrelated. As we have noted, the idea for LEEA came from an HBKW principal. LEEA’s Board of Directors, which conducted all of LEEA’s business and affairs, originally consisted of the five principals of HBKW, who were also the incorporators and officers of LEEA. In October 1982, four of the HBKW principals resigned — although Karle remained as Chairman — and four new employer-member directors joined the Board. However, the bylaws, as amended in December 1982, provided that the four former directors, who remained officers of LEEA, would be “ex-officio members of the Board of Directors by virtue of the independent management functions which they perform for the Corporation- The ex-officio members shall have equal standing and authority with the other members of the Board.” LEEA Amended Bylaws, Art. VII, ¶ 1, at A90.

HBKW and LEEA entered into an Administrative Agreement on October 31, 1981, under which LEEA appointed HBKW the Administrative Agent of the LEEA Plan and Benefit Trust. Under the agreement, HBKW received fees from LEEA in exchange for HBKW’s maintaining records and processing claims in connection with the LEEA Plans. LEEA business was conducted out of the offices of HBKW, and LEEA and HBKW had the same address. There was no separately designated office space for LEEA within the HBKW offices, and LEEA had no employees during most of its existence.

In 1985, LEEA became insolvent, and the Plan and Trust were terminated. This prompted employer-members and employee beneficiaries (and their dependents) of the LEEA Plan to file two suits against HBKW, HBKW’s principals, and the officers and directors of LEEA. The complaints, which were consolidated in a single class action, alleged violations of fiduciary duty and other obligations under ERISA and state law breaches of contract, fiduciary duty, and duty of care.

Appellants Western World Insurance Co. and Tudor Insurance Co. (collectively, “Western World”) had issued directors’ and officers’ liability insurance policies to the officers and directors of LEEA. After the lawsuits were filed, Western World filed a declaratory judgment action seeking a declaration that it was not liable under those policies. It relied primarily on a policy exclusion for claims arising under ERISA. 2 This declaratory *785 judgment action was consolidated with the class action for all purposes.

In response to a motion by Western World for summary judgment, the district court entered an order declaring that its ERISA policy exclusion was valid and that the policy did not, therefore, cover claims arising out of ERISA.

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Related

Lucy Dunne v. Elton Corp
Third Circuit, 2024
Robert Gruber, Theresa Penza, on Behalf of Themselves and All Others Similarily Situated Including Their Dependents Glenwood Beer Distributors, Inc. Beechwood Industries, Inc., on Behalf of Themselves and All Other Employers Similarily Situated Ralph Genovese Al Chaney Brian Miller, Representative Employee Paramount Lists, Inc., as a Representative Employer v. Hubbard Bert Karle Weber, Inc. John Gordon J. Patrick Karle Richard McClure Ronald D. Maxwell Timothy Mehl William M. Hilbert J. Boyd Bert, Jr. C. John Weber, III Buckley Hubbard Buckley Hubbard, Iii, Individually and as Duly Elected Members of the Board of Directors of Leea And/or Officers of Leea v. Pennsylvania Insurance Guaranty Association, Third-Party (d.c. Civil No. 85-00063e). Western World Insurance Company, Inc. And Tudor Insurance Company v. Buckley Hubbard, Jr. Buckley Hubbard, III J. Boyd Bert, Jr. J. Patrick Karle C. John Weber John Gordon Richard McClure Ronald D. Maxwell Timothy Mehl William Hilbert Hamot Medical Center of the City of Erie, Pennsylvania, Individually and on Behalf of All Others Similarly Situated St. Joseph Riverside Hospital Robert Gruber, Individually and on Behalf of All Others Similarly Situated and Glenwood Beer Distributors, Inc. Individually and on Behalf of All Others Similarly Situated Erie Indemnity Company Industrial Insurance Company Pennsylvania Insurance Guaranty Association Lexington Insurance Company v. Saint Vincent Health Center, (Intervenor in District Court) (d.c. Civil No. 87-00213e) Western World Insurance Company, Inc. And Tudor Insurance Company
159 F.3d 780 (Third Circuit, 1998)

Cite This Page — Counsel Stack

Bluebook (online)
159 F.3d 780, 22 Employee Benefits Cas. (BNA) 1857, 1998 U.S. App. LEXIS 27504, 1998 WL 744597, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gruber-v-hubbard-bert-karle-weber-inc-ca3-1998.