Metaxas v. Gateway Bank F.S.B.

CourtDistrict Court, N.D. California
DecidedMarch 31, 2022
Docket3:20-cv-01184
StatusUnknown

This text of Metaxas v. Gateway Bank F.S.B. (Metaxas v. Gateway Bank F.S.B.) 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
Metaxas v. Gateway Bank F.S.B., (N.D. Cal. 2022).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 POPPI METAXAS, Case No. 20-cv-01184-EMC (DMR)

8 Plaintiff, ORDER ON JOINT DISCOVERY 9 v. LETTER

10 GATEWAY BANK F.S.B., et al., Re: Dkt. No. 60 11 Defendants.

12 The parties filed a joint discovery letter brief in which Plaintiff Poppi Metaxas moves to 13 supplement the administrative record. [Docket No. 60 (Jt. Letter).] This matter is suitable for 14 resolution without a hearing. Civ. L.R. 7-1(b). For the following reasons, the motion is denied. 15 I. BACKGROUND 16 This is an action for supplemental retirement benefits pursuant to the Employee Retirement 17 Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a). Metaxas filed this case against her 18 former employer Defendant Gateway Bank, F.S.B. (“Gateway”) and the Gateway Bank 19 Supplemental Executive Retirement Plan (“the Plan”). She alleges that she worked as the 20 President and CEO of Gateway Bank and that she became “totally disabled under the terms of the 21 plan” due to “prolonged sickness” and other “acute and chronic medical problems.” Compl. ¶¶ 7- 22 10. She filed a claim for disability and termination benefits on March 23, 2013, which Defendants 23 denied on February 25, 2016. Id. Metaxas appealed the denial on August 15, 2016, and “sent 24 defendants additional documentation of her disability” with her appeal. Defendants upheld the 25 decision to deny benefits on May 22, 2017. Id. at ¶¶ 12, 13. Metaxas filed the complaint on 26 February 17, 2020 seeking relief under ERISA §§ 502(a)(1)(B), (a)(3). See 29 U.S.C. §§ 27 1132(a)(1)(B), 1132(a)(3). 1 undersigned. [Docket Nos. 38, 44.] Because the motion implicated the appropriate standard of 2 review of the underlying determination, the Honorable Edward M. Chen ordered the parties to 3 brief the issue and subsequently held that “Defendants’ decision to deny benefits to Plaintiff . . . is 4 reviewed for abuse of discretion.” [Docket No. 58.] The undersigned then ordered the parties to 5 meet and confer regarding Metaxas’s request to supplement the administrative record and to file a 6 joint letter on any remaining disputes. [Docket No. 59.] The parties filed the instant joint letter in 7 which Metaxas moves to supplement the administrative record with four categories of documents. 8 Exhibit 1 to the joint letter comprises a table of contents and the 215 pages of documents Metaxas 9 seeks to add to the administrative record. [Docket No. 60-1 (Supp. A.R.).] 10 II. LEGAL STANDARD 11 ERISA allows a participant in an employee benefit scheme to bring a civil action to 12 recover benefits due under the terms of a plan. 29 U.S.C. § 1132(a)(1)(B). As previously noted, 13 Judge Chen determined that he must apply the abuse of discretion standard in this case, which 14 means that the court’s review is limited to the record before the plan administrator. Jebian v. 15 Hewlett-Packard Co. Employee Benefits Org. Income Prot. Plan, 349 F.3d 1098, 1110 (9th Cir. 16 2003) (citation omitted). “In the ERISA context, the ‘administrative record’ consists of ‘the 17 papers the insurer had when it denied the claim.’” Montour v. Hartford Life & Acc. Ins. Co., 588 18 F.3d 623, 632 n.4 (9th Cir. 2009) (quoting Kearney v. Standard Ins. Co., 175 F.3d 1084, 1086 (9th 19 Cir. 1999)). 20 Courts have determined that ERISA and its regulations determine the scope of the 21 administrative record. See Nguyen v. Sun Life Assurance Co. of Canada, No. 3:14-cv-05295 JST 22 (LB), 2015 WL 6459689, at *3-4 (N.D. Cal. Oct. 27, 2015). Under ERISA, “every employee 23 benefit plan shall . . . afford a reasonable opportunity to any participant whose claim for benefits 24 has been denied for a full and fair review by the appropriate named fiduciary of the decision 25 denying the claim.” 29 U.S.C. § 1133(2); see also 29 C.F.R. § 2650.503(h)(1) (“a claimant shall 26 have a reasonable opportunity to appeal an adverse benefit determination to an appropriate named 27 fiduciary of the plan”). ERISA regulations state that claimants must be provided access to “all 1 “[w]hether a document, record, or other information is relevant to a claim for benefits shall be 2 determined by reference to paragraph (m)(8) of this section . . .” See 29 C.F.R. § 2650.503- 3 1(h)(2)(iii). In turn, 29 C.F.R. § 2650-503-1(m)(8) provides that “[a] document, record, or other 4 information shall be considered ‘relevant’ to a” claim if it:

5 (i) Was relied upon in making the benefit determination;

6 (ii) Was submitted, considered, or generated in the course of making the benefit determination, without regard to whether such document, 7 record, or other information was relied upon in making the benefit determination; 8 (iii) Demonstrates compliance with the administrative processes and 9 safeguards required pursuant to paragraph (b)(5) of this section in making the benefit determination; or 10 (iv) In the case of a group health plan or a plan providing disability 11 benefits, constitutes a statement of policy or guidance with respect to the plan concerning the denied treatment option or benefit for the 12 claimant’s diagnosis, without regard to whether such advice or statement was relied upon in making the benefit determination. 13 14 29 C.F.R. § 2650.503-1(m)(8). Materials that fall into one of the foregoing categories should be 15 considered “part of the administrative record.” Nguyen, 2015 WL 6459689, at *3-4. 16 In addition, 29 U.S.C. § 1024(b)(4) mandates that upon request, plan administrators must 17 provide participants with certain foundational plan documents:

18 The administrator shall, upon written request of any participant or beneficiary, furnish a copy of the latest updated summary[ ] plan 19 description, and the latest annual report, any terminal report, the bargaining agreement, trust agreement, contract, or other instruments 20 under which the plan is established or operated. . . . 21 29 U.S.C. § 1024(b)(4). The Ninth Circuit narrowly construes the disclosures required by this 22 section; it has interpreted “other instruments under which the plan is established or operated” to 23 mean “documents that are similar in nature to the documents specifically listed” in section 24 1024(b)(4). Hughes Salaried Retirees Action Comm. v. Adm’r of Hughes Non-Bargaining Ret. 25 Plan, 72 F.3d 686, 691 (9th Cir. 1995). Therefore, section 1024(b)(4) requires a plan 26 administrator to give participants “documents that provide individual participants with information 27 about the plan and benefits.” See id. at 690; see also Curtiss-Wright Corp. v.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
Metaxas v. Gateway Bank F.S.B., Counsel Stack Legal Research, https://law.counselstack.com/opinion/metaxas-v-gateway-bank-fsb-cand-2022.