McAfee v. Metropolitan Life Insurance

625 F. Supp. 2d 956, 45 Employee Benefits Cas. (BNA) 2235, 2008 U.S. Dist. LEXIS 100765, 2008 WL 5214643
CourtDistrict Court, E.D. California
DecidedDecember 12, 2008
DocketCIV. 05-00227 WBS KJM
StatusPublished
Cited by3 cases

This text of 625 F. Supp. 2d 956 (McAfee v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McAfee v. Metropolitan Life Insurance, 625 F. Supp. 2d 956, 45 Employee Benefits Cas. (BNA) 2235, 2008 U.S. Dist. LEXIS 100765, 2008 WL 5214643 (E.D. Cal. 2008).

Opinion

MEMORANDUM OF DECISION

WILLIAM B. SHUBB, District Judge.

Plaintiff Ryan McAfee and defendant Metropolitan Life Insurance Company (“MetLife”) dispute the value of plaintiffs performance-based stock options for purposes of calculating his monthly disability benefits. On November 17, 2008, the matter was tried to the court, sitting without a jury. The following memorandum constitutes the court’s findings of fact and con *959 elusions of law pursuant to Federal Rule of Civil Procedure 52(a).

I. Factual and Procedural History

A. Background

Plaintiff was Vice President of Research at PeopleSoft Inc. in Pleasanton, California. (Defs.’ Resp. to PL’s Undisputed Facts 2:3-7.) On October 3, 1999, plaintiff was injured in a fall resulting in the paralysis of the lower half of his body. (PL’s Resp. to Def.’s Undisputed Facts 2:6-9; Compl. ¶ 8.) Despite his injury, plaintiff continued to work remotely from his house in Canton, Ohio, from December 1999 to June 2001. (Supp. Admin. R. (“SAR”) 3044.) He then moved back to California in June 2001 and “worked alternately 2-3 days a week from home and 2-3 days a week in the Pleasanton office.” (Id.) However, due to the physical and mental strain involved, plaintiff stopped working on May 7, 2002. (Id. at 3045, 3416.)

Plaintiff filed a claim for Long-Term Disability (“LTD”) benefits pursuant to PeopleSoft’s employee benefit plan, which was funded and administered by MetLife (id. at 3051-54) and governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001-1461. Plaintiff began receiving payments in November 2002, but MetLife subsequently terminated plaintiffs benefits due to a lack of evidence supporting a “continued disability” as defined by the plan. (SAR 2782-83.) Plaintiff appealed the decision; he argued that he not only qualified for LTD benefits, but also that MetLife was underpaying him by not considering his performance-based stock options in calculating his payment amount. (Id. at 2782-83.)

After plaintiffs appeal, MetLife reinstated plaintiffs LTD benefits but rejected his view that the LTD-benefit calculation should include performance-based stock options. (Id. at 3048.) Under the plan, LTD benefits were based on a claimant’s “predisability earnings,” which were defined as “gross salary or wages from [the] Employer as of the day before ... Disability began,” including “commissions and/or performance bonuses averaged over the previous 12 months.” (Sullivan Decl. Ex. A at 86.)

Plaintiff filed suit under 29 U.S.C. § 1132(a)(1)(B) (Docket Nos. 1, 4), which provides for civil actions to recover disability benefits under an ERISA plan. In its Order dated May 23, 2006, the court concluded that the term “performance bonuses” in the plan “clearly encompasses the incentive stock options at issue here, ... and that [MetLife’s] interpretation to the contrary was unreasonable.” (May 23, 2006 Order 12, 2006 WL 1455431.) The court subsequently remanded the case to MetLife in order to recalculate plaintiffs LTD benefits. (Id. at 14.)

B. Proceedings on Remand

1. Plaintiff’s Proposal

On July 6, 2006, plaintiffs counsel wrote a letter to MetLife with the following proposal to determine the value of plaintiffs stock options:

The income earned from the stock options is reflected on [plaintiffs] W-2 forms as ordinary income and on the Schedule D as long-term capital gain income. The best evidence of the earnings from the stock options are [plaintiffs] W-2’s and income tax return/Schedule D for the relevant period.

(SAR 3302.) This proposal yielded “predisability earnings” of $568,540.26, which included plaintiffs base salary of $175,315.44 and earnings from the exercise of stock options totaling $393,224.82. (Id. at 3418.) According to the terms of the plan, these “predisability earnings” would *960 result in a disability payment of $25,000 per month, less plaintiffs receipt of Social Security income. (Id. at 3302.)

2. Mr. Skwire’s Report

MetLife consulted two experts in order to respond to plaintiffs proposal and calculate plaintiffs benefit payments. The first expert was Daniel Skwire, a principal and consulting actuary at Milliman Inc. (Id. at 3398.) In Mr. Skwire’s report, he discussed at length his belief that stock options were not covered by PeopleSoft’s employee benefit plan. (See generally id. at 3398-3410.) Mr. Skwire ultimately concluded, however, that “[i]f MetLife is required to determine benefits ... as if stock options were included in Predisability Earnings, then it should consider only the option value of stock options granted in the 12 months prior to disability and not the ensuing income pertaining to exercises of those options.” (Id. at 3400.)

Mr. Skwire believed that “performance bonuses averaged over the previous 12 months” did not refer to stock options exercised during that period because employees have complete control over when they exercise their options. In other words, plaintiffs proposal would create a “moral hazard.” (See id. at 3404-05) (“The moral hazard problem is the tendency of individuals to alter their behavior because of insurance.... [T]he insurance itself provide[s] an incentive for the insured to try to collect the benefits.” (quoting Kenneth Black & Harold D. Skipper, Jr., Life and Health Insurance (13th ed. 2000)).) In contrast, Mr. Skwire stated that interpreting the plan to refer to stock options granted did not create a moral hazard “because the granting of options is controlled by the employer, not the employee.” (Id. at 3405.)

3. Dr. Findlay’s Report

The second expert consulted by MetLife was M. Chapman Findlay, Ph.D. At the time of his report, Dr. Findlay was the president and director of Fin Fin Inc. and had previously held positions as Professor and Chairman of the Department of Finance and Business Economics at the University of Southern California. (Id. at 3389-90.) Dr. Findlay’s analysis essentially followed two steps: (1) identifying the relevant stock options and (2) applying the Black-Scholes model to determine their value.

a. Identifying the Relevant Stock Options

Like Mr. Skwire, Dr. Findlay rejected plaintiffs proposal to calculate disability payments using the stock options exercised during plaintiffs final twelve months at PeopleSoft. Instead of addressing the “moral hazard” issue, however, Dr.

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625 F. Supp. 2d 956, 45 Employee Benefits Cas. (BNA) 2235, 2008 U.S. Dist. LEXIS 100765, 2008 WL 5214643, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcafee-v-metropolitan-life-insurance-caed-2008.