Johnson v. Chicago Plastering Institute Health and Welfare Fund

341 F. Supp. 2d 1011, 33 Employee Benefits Cas. (BNA) 2851, 2004 U.S. Dist. LEXIS 21018, 2004 WL 2378362
CourtDistrict Court, N.D. Illinois
DecidedOctober 19, 2004
Docket04 C 2176
StatusPublished
Cited by1 cases

This text of 341 F. Supp. 2d 1011 (Johnson v. Chicago Plastering Institute Health and Welfare Fund) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. Chicago Plastering Institute Health and Welfare Fund, 341 F. Supp. 2d 1011, 33 Employee Benefits Cas. (BNA) 2851, 2004 U.S. Dist. LEXIS 21018, 2004 WL 2378362 (N.D. Ill. 2004).

Opinion

MEMORANDUM OPINION AND ORDER

CONLON, District Judge.

This case involves a group of employees (“the participants”) who received health coverage from the Chicago Plastering Institute Health and Welfare Fund (“Plasterers fund” or “Plasterers plan”). After a vote to switch bargaining representatives, the participants obtained coverage from the Masons Health and Welfare Fund, Local 56 of DuPage County (“Masons fund” or “Masons plan”) while maintaining coverage under the Plasterers plan. Each plan’s coordination of benefits provision provides it is secondary to the other. The funds dispute which fund is primarily liable for payment of the participants’ health care claims from the period of overlapping coverage. Jeff Johnson, et al, (“plaintiffs”), as trustees and fiduciaries of the Masons fund, sue Richard Dahm, et al., (“defendants”), trustees and fiduciaries of the Plasterers fund, under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(3); see also Winstead v. J.C. Penney Co., Inc. Voluntary Employees Beneficiary Assoc., 933 F.2d 576, 578-80 (7th Cir.1991) (ERISA fund may sue another fund to enforce its plan provisions). Plaintiffs seek to enforce the Masons plan’s coordination of benefit provision. Cross-summary judgment motions are before the court.

BACKGROUND

The material facts are undisputed. The Masons and Plasterers plans are self-insured welfare benefit plans under ERISA, 29 U.S.C. § 1002(1). Masons Facts at ¶¶2-3, 7-8. The Plasterers fund is a third-party beneficiary of a collective bargaining agreement between the Journeymen Plasterers Protective and Benevolent Society of Chicago, Local No. 5 (“Local 5”) and signatory employees. Plasterers Facts at ¶ 9. The Plasterers fund provides health benefits to eligible plaster employees and their beneficiaries; once employees become eligible, the coverage year runs from April 1st through March 31st of the year of eligibility. Id. at ¶¶ 11-13. An employee becomes eligible for coverage by the plan if 1200 contribution hours are reached in a given year. Id. at ¶ 13. The Masons fund similarly provides health benefits to eligible plasterers and their beneficiaries pursuant to collective bargaining agreements between Local 56 of the International Union of Bricklayers and Allied Craftworkers (“BAC 56”) and various employers. Id. at ¶ 15. Many plastering employers were signatories to both the Local 5 and BAC 56 collective bargaining agreements. Id. at ¶ 16.

In 2001, BAC 56 began an organizing campaign to become the exclusive bargaining representative of plastering employees in the Chicagoland area. Id. at ¶ 17. BAC 56 worked to convince plastering employees of dual-signatory employers to vote for BAC 56 and against Local 5 in National Labor Relations Board elections. Id. In any election BAC 56 won, the employer no longer had an obligation to contribute to the Plasterers fund pursuant to the Local 5 agreement. Id. at ¶ 18. The Masons fund sought to expand its number *1013 of participants and supported BAC 56’s campaign. Id. at ¶¶ 20, 26. BAC 56’s campaign was successful and in 2002 some employees voted to certify BAC 56 as their exclusive collective bargaining representative. Id. at ¶ 36. In addition, some employees opted to switch from the Plasterers fund to the Masons fund and all employer contributions on their behalf went to the Masons. Id. at ¶ 37. Specifically, seven participants and their beneficiaries obtained coverage under the Masons plan between April and August 2003. Masons Facts at ¶¶ 58-60. The coverage lasted through March 31, 2004 or later. Id. at ¶ 61. Pursuant to the eligibility provision of the Plasterers plan, the participants also remained covered by the Plasterers through March 31, 2004. Id. at ¶¶ 59, 63; Plasterers Facts at ¶ 39.

A. The Plasterers Plan

Faced with the loss of participants due to the BAC 56 campaign, and the resulting loss of their contributions, in 2002 the Plasterers plan was amended to read:

Notwithstanding any other provision of the plan, effective February 1, 2002, if an Employee covered by the plan is covered by any other group health plan as a result of work he or she performed pursuant to a collective bargaining agreement, this plan will only provide secondary coverage for such Employee and any eligible Dependents. The other group health plan will be the primary coverage.

Id. at ¶ 40. The amended language represents the Plasterers plan’s terms governing coordination of benefits and applies only when an employee’s coverage by another plan begins subsequent to the commencement of the employee’s coverage by the Plasterers plan. Masons Facts at ¶¶ 22-23. The purpose of the coordination of benefits provision is to save money for the Plasterers fund. Id. at ¶ 27.

B. The Masons Plan

The Masons plan states:

Effective December 1, 1991, The Plan has been designed to be a secondary payer to all other health coverage... If an employee or dependent is covered by another self-insured medical plan which provides that it is secondary to all other policies, then this Plan will pay only 50% of the covered expenses that otherwise will be payable under this Plan.

Id. at ¶ 14. The following amendment was approved:

If an employee or dependent is covered by another medical plan which provides that it is secondary to all other policies, then this Plan, in compliance with applicable law governing cases where both plans claim secondary status, without waiving its secondary status, will pay only 50% of the covered expenses that otherwise will be payable under this Plan. The Trustees further clarify that since January 1,1991, these coordination of benefit rules provide that this plan is secondary if an employee or dependent is covered by another medical plan that provides that it is secondary to all plans of the type of this Plan, such as any plan that provides that it is secondary for an employee or dependent who is covered by any other group health plan as a result of work an employee performs pursuant to a collective bargaining agreement. Again, in compliance with applicable law governing cases where both plans claim secondary status, this Plan, without waiving its secondary status, will also pay only 50% of covered expenses otherwise payable under this Plan.

Id. at ¶ 15. The January 1, 1991 date in the amendment was an error; the correct date was December 1, 1991. Id. at ¶ 16. The purpose of the coordination of benefits provision is to limit the Masons fund’s *1014 costs of providing health care benefits to participants and beneficiaries. Id. at ¶ 17.

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341 F. Supp. 2d 1011, 33 Employee Benefits Cas. (BNA) 2851, 2004 U.S. Dist. LEXIS 21018, 2004 WL 2378362, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-chicago-plastering-institute-health-and-welfare-fund-ilnd-2004.