Lou v. Accenture United States Group Health Plan

District Court, N.D. California·Decided March 14, 2024·No. 4:22-cv-03091·Unknown

Opinion

ALBERT B. LOU, Case No. 22-cv-03091-HSG

Plaintiff, ORDER GRANTING THE ACCENTURE DEFENDANTS’ v. MOTION FOR SUMMARY JUDGMENT, DENYING PLAINTIFF’S HEALTH PLAN, et al., ADJUDICATION, AND TERMINATING AS MOOT BLUE Defendants. CROSS BLUE SHIELD ILLINOIS’ JUDGMENT AND PLAINTIFF’S REQUEST FOR JUDICIAL NOTICE

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

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

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

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