Harding v. Provident Life & Accident Insurance

809 F. Supp. 2d 403, 2011 U.S. Dist. LEXIS 93622, 2011 WL 3652534
CourtDistrict Court, W.D. Pennsylvania
DecidedAugust 19, 2011
DocketCivil Action No. 11-481
StatusPublished
Cited by9 cases

This text of 809 F. Supp. 2d 403 (Harding v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harding v. Provident Life & Accident Insurance, 809 F. Supp. 2d 403, 2011 U.S. Dist. LEXIS 93622, 2011 WL 3652534 (W.D. Pa. 2011).

Opinion

MEMORANDUM OPINION

NORA BARRY FISCHER, District Judge.

I. INTRODUCTION

In this case, the parties dispute whether a long-term disability plan purchased by Plaintiff Theresa Harding (“Plaintiff’ or “Harding”) from Defendant Provident Life and Accident Insurance Company of America (“Provident”) constitutes an ERISA1 plan, thereby preempting Plain[406]*406tiffs state law claims for breach of contract, bad faith and unfair trade practices against Provident and Defendant Unum Group (“Unum”) (collectively, “Defendants”).2 This dispute was initially presented by way of a motion to dismiss under Rule 12(b)(6) filed by Defendants. (Docket No. 5). However, because the parties presented evidence outside the pleadings in support of their respective positions, including affidavits and documentary evidence, the Court entered an Order converting Defendants’ motion to dismiss to a motion for summary judgment pursuant to Rule 12(d) of the Federal Rules of Civil Procedure. (Docket No. 16). The parties have not objected to this procedure nor have they submitted any further evidence after being notified of the Court’s conversion of the motion to a motion for summary judgment. Upon consideration of all of the parties’ submissions and for the reasons outlined herein, Defendants’ motion for summary judgment [5] is GRANTED.

II. FACTUAL BACKGROUND

Unless otherwise specified, the facts of record are uncontested. Viewed in the light most favorable to Plaintiff, they are as follows. See Watson v. Abington Twp., 478 F.3d 144, 147 (3d Cir.2007).

A. Plaintiff’s Background

Plaintiff was formerly the Controller for Secón Corporation (“Secón”), a real estate company in the Pittsburgh area. (Harding Affidavit Mill, Docket No. 11-1 at 2); see also http://www.seconcorp.com (last visited 8/9/11). Among her duties at Secón, Plaintiff prepared certain forms, in-eluding IRS Form 5500, to ensure that Secon’s employee benefit plans complied with the requirements of ERISA. (Id.). To this end, Plaintiff prepared ERISA compliance documents for Secon’s health insurance plan, an AFLAC plan, and a Provident short-term disability plan. (Harding Affidavit 6/8/11, Docket No. 15-1 at 9). Plaintiff declares that these plans were all part of the Secón Corporation Flexible Benefits Plan and each of these plans were offered to all employees. (Id.).

B. Relationship Between Insurance Agent Angiulli and Secón Corporation

John M. Angiulli is an insurance agent with Angiulli & Associates who was authorized to sell disability policies on behalf of Provident in March of 1999. (Docket Nos. 5-7 at 2,11 at 4). Angiulli sold Secón its short-term disability plan as part of its Secón Corporation Flexible Benefits Plan, which Secón actively set up as an ERISA plan. (Docket No. 15 at 3^1). In March 1999, Angiulli gave a presentation to Secón employees about purchasing individual long-term Provident Disability Income Policies (“long-term disability policies”). (Docket Nos. 11-1 at 2, 4; 15-1 at 9, 27). Secón employees were not required to purchase these policies and some employees declined to purchase long-term disability policies. (Id.). Luana Sevick, the present Controller at Secón, states that the employees who purchased the long-term disability policies understood that: the policies were individually owned; Secón did not manage them; each individual’s premium would be sent by Secón to Provident [407]*407after being deducted from their paychecks; and, they would be a granted a small discount on the premiums as a result of this payment arrangement between Provident and Secón.3 (Sevick Letter May 3, 2011, Docket Nos. 11-1 at 6, 15-1 at 13).

Plaintiff and Anguilli do not believe that the individual policies were ever made a part of an ERISA plan. (Angiulli Affidavit 5/4/H, Docket Nos. 11-1 at 4, 15-1 at 27; Harding Affidavit April 4, 2011, Docket No. 11-1 at 2). Neither Angiulli nor the Plaintiff, who was Controller of Secón at the time, performed any direct action (i.e. filing an IRS Form 5500) to formally make the long-term disability policies that were purchased by Secón employees part of an ERISA plan.4 (Id.). Likewise, Secon’s present Controller, Luana Sevick, asserts that the long-term disability policies were never formally made an ERISA plan by Secón. (Sevick Affidavit May 3, 2011, Docket Nos. 11-1 at 7, 15-1 at 12). However, Secón formally complied with ERISA regulations to make, establish or administer a number of employee benefit plans, thereby making these plans ERISA-compliant, including an AFLAC plan, employees’ health insurance, and a UNUM short-term disability plan.5 (Harding Affidavit [408]*408June 8, 2011, Docket No. 15-1 at 9).6

C. Payment Arrangement Between Secón and Provident

It is undisputed that Secón acted as an intermediary between its employees and Provident such that the employees’ premiums were deducted from their respective paychecks and paid to Provident by Secón. (Docket Nos. 1-1 at ¶ 5; 5-2 at ¶ 7,11-1 at 6). For example, the record includes a premium notice sent by Provident to Secón on August 6, 1999 (due date August 26, 1999) detailing the premiums due for each employee and specifically noting Plaintiffs monthly premium ($26.23) and policy number (7160082). (Docket No. 1-1 at 49-50). In this correspondence, the Total Premium on the invoice for the listed Secón employee group was $248.98. (Id. at 50). On at least one occasion, Secón paid Provident three times the monthly premium amount due by the employee group as evidenced by a check from Secón to Provident for $746.94, which is exactly three times the monthly payment typically due from the Secón employee group (i.e., $248.98 x 3 = $746.94). (Id. at 51-52).

D. Employer Discount Group Arrangement between Secón and Provident

Employees of Secón Corporation who purchased long-term disability insurance through Provident received a twenty-percent Salary Allotment Discount. (Docket No. 1 at ¶ 14). The evidence is undisputed that the Secón employees would not have received the discount if they were not part of the employer discount group. To this end, Sevick, Secon’s Controller, admits that “[t]he employees understood ... that they would receive a small discount based on the fact that the premium would be a direct deduction from their paycheck, and forwarded by Secón Corporation to Unum Provident.” (Sevick Letter 513/11, Docket Nos. 11-1 at 6, 15-1 at 13 (emphasis added)). Likewise, a representative of Provident, Devra J. Kotel, an I.D. Chief Underwriter, declares that “Ms. Harding received this Policy by virtue of her employment at Secón at a 20% premium discount, as part of a Risk Group of eligible Secón Employees.” (Kotel Affidavit, Docket No. 5-2 at ¶¶ 1, 4 (emphasis added)).

This risk group arrangement is also evidenced by two faxes which originated from John Angiulli’s office. (Docket Nos. 5-7 at 2).

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Cite This Page — Counsel Stack

Bluebook (online)
809 F. Supp. 2d 403, 2011 U.S. Dist. LEXIS 93622, 2011 WL 3652534, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harding-v-provident-life-accident-insurance-pawd-2011.