Lou v. Accenture United States Group Health Plan

CourtDistrict Court, N.D. California
DecidedMarch 14, 2024
Docket4:22-cv-03091
StatusUnknown

This text of Lou v. Accenture United States Group Health Plan (Lou v. Accenture United States Group Health Plan) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lou v. Accenture United States Group Health Plan, (N.D. Cal. 2024).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 ALBERT B. LOU, Case No. 22-cv-03091-HSG

8 Plaintiff, ORDER GRANTING THE ACCENTURE DEFENDANTS’ 9 v. MOTION FOR SUMMARY JUDGMENT, DENYING PLAINTIFF’S 10 ACCENTURE UNITED STATES GROUP MOTION FOR SUMMARY HEALTH PLAN, et al., ADJUDICATION, AND 11 TERMINATING AS MOOT BLUE Defendants. CROSS BLUE SHIELD ILLINOIS’ 12 MOTION FOR SUMMARY JUDGMENT AND PLAINTIFF’S 13 REQUEST FOR JUDICIAL NOTICE

14 Re: Dkt. Nos. 51, 68, 69, 59

15 16 Pending before the Court is a motion for summary adjudication filed by Plaintiff, Dkt. No. 17 51, as well as cross-motions for summary judgment filed by Defendants Accenture LLP and 18 Accenture U.S. Group Health Plan, Dkt. No. 68, and by Health Care Service Corporation d/b/a 19 Blue Cross Blue Shield of Illinois, Dkt. No. 69. The Court held a hearing on the motions, Dkt. 20 No. 82, as well as an evidentiary hearing. Dkt. Nos. 90 (minutes), 93 (transcript). For the reasons 21 described below, the Court GRANTS Accenture and the Plan’s motion, DENIES Plaintiff’s 22 motion, and TERMINATES AS MOOT BCBSIL’s motion and Plaintiff’s Request for Judicial 23 Notice, Dkt. No. 59. 24 I. BACKGROUND 25 From April 2019 to December 15, 2022, Albert Lou (“Plaintiff”) was employed by 26 Accenture LLP (“Accenture”) as a Managing Director. Dkt. No. 83 (“Joint Statement”) ¶ 1. By 27 virtue of his employment with Accenture, Plaintiff was eligible to enroll in the Accenture United 1 employees, retirees, and eligible dependents. Id. ¶ 5. Plaintiff enrolled himself and his daughter, 2 A.L., in health benefits through the Plan, selecting the preferred PPO Plan administered by Blue 3 Cross and Blue Shield of Illinois (“BCBSIL”). Id. ¶ 6. During his employment with Accenture, 4 Plaintiff filed claims for coverage of in-home skilled nursing care for A.L., who suffered from a 5 rare genetic disorder known as Aromatic L-amino Acid Decarboxylase Deficiency and had a 6 variety of complex medical needs. Dkt. No. 24 (“FAC”) ¶ 7. BCBSIL paid out certain claims for 7 coverage of A.L.’s in-home care, but not others. Joint Statement ¶ 8. To address the allegedly 8 wrongful denial of claims for A.L.’s care, Plaintiff filed this lawsuit against Accenture, the Plan, 9 and BCBSIL (collectively, “Defendants”) on May 26, 2022 pursuant to the Employee Retirement 10 Income Security Act of 1974 (“ERISA”). Dkt. No. 1. 11 In November 2022, Accenture notified Plaintiff that his employment would be terminated 12 as part of a group layoff. Joint Statement ¶¶ 10–11. In connection with his termination, 13 Accenture provided Plaintiff a draft “Separation Agreement (General Release and Waiver of 14 Claims)” (“Separation Agreement”) on November 14, 2022 for his review. Id. ¶ 11; Hearing 15 Exhibit (“Hrg. Ex.”) 1 at 92–99.1 Per Accenture’s LLP Leadership Separation Benefits Plan (“the 16 Separation Plan”), the draft Separation Agreement offered Plaintiff six months’ salary, a variable 17 cash benefit based on his years of service, a $12,000 COBRA payment, and outplacement services 18 to support his job search. Joint Statement ¶¶ 9, 12. The draft Separation Agreement also included 19 a General Release and Waiver of Claims, and provided Plaintiff 45 days to review and sign. Id. ¶¶ 20 13–14; Hrg. Ex. 1 at 92. 21 Following receipt of the draft Separation Agreement and related materials, Plaintiff 22 communicated numerous times with Alexis Quach, an HR Partner for Accenture, and Erin Evans, 23 Accenture’s West Technology Human Resources Lead, in an effort to, among other things, 24 exclude his ERISA claims from the Separation Agreement’s General Release. Joint Statement ¶¶ 25 20–31. Accenture never agreed to revise the language of the General Release, or to make either of 26 Plaintiff’s other two proposed revisions concerning the amount of his severance payout and his 27 1 COBRA premium. On February 24, 2023, after numerous extensions, Plaintiff signed the 2 Separation Agreement as originally offered. Id. ¶ 32; Hrg. Ex. 7. A day after doing so, Plaintiff 3 emailed Accenture articulating both his “understanding that the release contained in the severance 4 does not cover [this] lawsuit, or any claims against the health plan, or its claims administrator” and 5 his intent to dismiss “Accenture itself” from the lawsuit. Joint Statement ¶ 34. Because 6 Defendants viewed dismissal against the BCBSIL and the Plan as also warranted, they declined to 7 stipulate to only Accenture’s dismissal. Id. ¶¶ 36–38. 8 On June 19, 2023, Plaintiff filed a motion for summary adjudication on two issues. Dkt. 9 No. 51. His motion argues first that he did not release his ERISA claims when he signed the 10 Severance Agreement, and second that he is entitled to benefits for A.L.’s care under 29 U.S.C. § 11 1132(a)(1)(B) and (a)(3). Dkt. No. 51 (“Lou MSA”). Defendants Accenture and the Plan 12 (collectively, the “Accenture Defendants”) filed a cross-motion for summary judgment, arguing 13 that Plaintiff had released his ERISA claims and that his motion consequently must be denied. 14 Dkt. No. 68 (“Accenture MSJ”). Defendant BCBSIL also filed a cross-motion for summary 15 judgment, contending that because Plaintiff lacked standing and BCBSIL correctly administered 16 the Plan, it was entitled to judgment in its favor. Dkt. No. 69 (“BCBSIL MSJ”). The parties 17 appeared on October 19, 2023 for a hearing on the motions, at which point the Court took them 18 under submission. See Dkt. No. 82. On February 26, 2024, the Court held an evidentiary hearing 19 concerning the Separation Release that Plaintiff signed, and heard testimony from plaintiff witness 20 Albert Lou and defense witness Erin Evans. See Dkt. Nos. 90 (minutes), 93 (transcript). 21 II. LEGAL STANDARD 22 Summary judgment is proper when a “movant shows that there is no genuine dispute as to 23 any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). 24 A fact is “material” if it “might affect the outcome of the suit under the governing law.” Anderson 25 v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). And a dispute is “genuine” if there is evidence 26 in the record sufficient for a reasonable trier of fact to decide in favor of the nonmoving party. Id. 27 But in deciding if a dispute is genuine, the court must view the inferences reasonably drawn from 1 Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587–88 (1986), and “may not weigh the evidence 2 or make credibility determinations,” Freeman v. Arpaio, 125 F.3d 732, 735 (9th Cir. 1997), 3 overruled on other grounds by Shakur v. Schriro, 514 F.3d 878, 884–85 (9th Cir. 2008). If a court 4 finds that there is no genuine dispute of material fact as to only a single claim or defense or as to 5 part of a claim or defense, it may enter partial summary judgment. Fed. R. Civ. P. 56(a). 6 III. DISCUSSION 7 Before reaching the substantive question of Plaintiff’s entitlement to medical benefits 8 under the Plan, the Court must consider whether Plaintiff released his ERISA claims against some 9 or all Defendants when he signed the Separation Agreement in February 2023. Both Plaintiff and 10 the Accenture Defendants argue that this question can be resolved in their favor on summary 11 judgment. See Lou MSA at 21–26; Accenture MSJ at 13–22.

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Bluebook (online)
Lou v. Accenture United States Group Health Plan, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lou-v-accenture-united-states-group-health-plan-cand-2024.