Negley v. Breads of the World

Court of Appeals for the Tenth Circuit·Decided March 2, 2007·No. 05-1415·Unpublished

Opinion

F I L E D

United States Court of Appeals Tenth Circuit

UNITED STATES CO URT O F APPEALS March 2, 2007

FO R TH E TENTH CIRCUIT Elisabeth A. Shumaker Clerk of Court

SH A U N N N EG LEY , Plaintiff-Appellant,

v. No. 05-1415 (D.C. No. 02-cv-840-ZLW -PAC)

BREA DS OF THE W OR LD (D . Colo.)

M ED ICAL PLA N ; B REA D S O F THE W ORLD, L.L.C., doing business as Panera Bread,

Defendants-Appellees.

OR D ER AND JUDGM ENT *

Before HO LM ES, M cKA Y, and BROR BY, Circuit Judges.

Shaunn Negley appeals the district court’s grant of judgment as a matter of law in favor of Breads of the W orld M edical Plan (BOW Plan or Plan) and Breads of the W orld, L.L.C. (BOW ). W e exercise jurisdiction pursuant to 28 U.S.C. § 1291 and A FFIR M .

*

After examining the briefs and appellate record, this panel has determined unanimously to grant the parties’ request for a decision on the briefs without oral argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore ordered submitted without oral argument. This order and judgment is not binding precedent, except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.

I. Background

M r. Negley began employment with BOW in June 2001. BOW told M r.

Negley his eligibility date for health insurance through the BOW Plan was July 1, 2001. Benefits under the BOW Plan were fully insured by M edical M utual of Ohio (M M O). M M O is not a party to this action. BOW forwarded health plan enrollment materials to M r. Negley on several different occasions at various addresses, but he did not receive the materials until September 28. After submitting his enrollment form to M M O on October 8, M r. Negley was enrolled in the BOW Plan effective November 1, according to the terms of the Plan documents. Based on that effective date, M r. Negley was subject to a preexisting condition exclusion under the Plan for a number of months and, as a result, he incurred medical expenses that were not covered by his health insurance.

M r. Negley filed this lawsuit against BOW and the BOW Plan, seeking damages for his lost medical benefits under § 502(a) of the Employee Retirement Income Security Act of 1974 (ERISA ), 29 U.S.C. § 1132(a). He alleged that BOW , as an ERISA fiduciary, violated its duties to properly transmit health plan enrollment materials to him, to advise him of applicable deadlines for submitting his enrollment materials, and to promptly enroll him in the BOW Plan by submitting those materials to M M O within the deadlines. As a result of BOW ’s alleged breach of fiduciary duty, M r. Negley sought damages, including but not limited to medical and related expenses, as well as costs, attorneys’ fees,

prejudgment interest, statutory penalties authorized by ERISA , and such other and further relief as the district court deemed fit.

M r. Negley’s case was tried to the court in April 2004. Defendants moved for judgment as a matter of law after the close of plaintiff’s evidence and again following the submission of all of the evidence. They argued, in relevant part, that the money damages M r. Negley sought were not recoverable on a breach of fiduciary duty claim under ERISA § 502(a)(3), which provides only for “appropriate equitable relief.” The district court initially denied the motions and proceeded to make oral findings of fact and conclusions of law, concluding that BOW had breached its fiduciary duty by failing to provide complete and accurate information about when M r. Negley’s benefits began under the BOW Plan and the deadlines related to his enrollment. The district court asked the parties to confer and agree on the amount of damages and a manner by which the money could be disbursed directly to M r. N egley’s medical providers, rather than paid to him. The court deferred entry of judgment pending resolution of the damages issues.

W hile the post-trial briefing proceeded, defendants renewed their motions for judgment as a matter of law and submitted supplemental authority, including a Tenth Circuit decision that had issued since the conclusion of the trial: Callery v. United States Life Insurance Co. in the City of New York, 392 F.3d 401 (10th Cir. 2004). Relying on Callery, the district court granted defendants’ motions for judgment as a matter of law and M r. Negley appealed.

II. Discussion

In a trial to the court, a motion for judgment as a matter of law is governed by Fed. R. Civ. P. 52(c). See Nieto v. Kapoor, 268 F.3d 1208, 1217 (10th Cir. 2001) (noting motion for judgment in bench trial is governed by Rule 52(c), rather than Rule 50). On appeal of a Rule 52(c) motion, “[w]e review the district court’s fact findings for clear error and its legal conclusions de novo.” Id.

A. Compensatory D amages

In Callery, we held that compensatory damages are not recoverable under § 502(a)(3). 392 F.3d at 404-06. The district court held that Callery precluded the damages relief sought by M r. Negley in his claim based upon that same ERISA section. M r. Negley contends that the district court failed to properly construe § 502(a)(3) consistent with Congress’s primary intent to provide a set of broad, flexible and comprehensive remedies–what M r. Negley refers to as a safety net that permits make-whole relief. Specifically, he argues that § 502(a)(3) should be interpreted consistent with the principles of trust law, under which equity courts traditionally could remedy a breach of fiduciary duty by ordering the payment of money. Thus, M r. Negley asserts that the district court erred by failing to award damages for his lost medical benefits as appropriate equitable relief under § 502(a)(3). As the district court noted, however, these arguments were thoroughly addressed–and rejected–in this court’s opinion in Callery. W e will not revisit them here.

Nor do we believe the district erred by failing to find Callery factually distinguishable from this case. M r. Negley asserts that the relief the plaintiff sought in Callery was not benefits under the policy, but money damages for the lost opportunity to obtain other coverage. This is a distinction without a difference for purposes of the district court’s ruling.

In Callery we explicitly stated, “To the extent M s. Callery seeks payment of the policy proceeds, such relief is barred under § 502(a)(3).” 392 F.3d at 405. The fact that M r. Negley’s measure of damages w as the value of his lost benefits, rather than the lost opportunity to obtain the same benefits elsewhere, does not change the analysis. He, like the plaintiff in Callery, sought money damages from defendants due to a breach of fiduciary duty. See Calhoon v. Trans W orld Airlines, Inc., 400 F.3d 593, 598 (8 th Cir. 2005) (applying the reasoning of Callery and concluding that plaintiffs, who sought “to recover the equivalent of full plan coverage” due to an alleged breach of fiduciary duty, could not recover under § 502(a)(3); they were not seeking “appropriate equitable relief”).

M r. Negley also argues that the district court erred in holding that monetary relief is never available under § 502(a)(3). But the district court made no such ruling, and in fact it specifically noted that restitution is one remedy a plaintiff could pursue under that section. However, the district court recognized that restitution was not available in this case because M r. Negley did not seek return of any amounts he had paid. Nor did he alternatively seek to recover particular

funds in defendants’ possession. See Callery, 392 F.3d at 406 (noting restitution available under § 502(a)(3) through constructive trust or equitable lien w here money can be traced to particular funds in defendant’s possession).

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

Negley v. Breads of the World, (10th Cir. 2007).

Negley v. Breads of the World (Negley v. Breads of the World) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Tele-Communications, Inc. v. Commissioner
104 F.3d 1229 (Tenth Circuit, 1997)
Adams v. Cyprus Amax Minerals Co.
149 F.3d 1156 (Tenth Circuit, 1998)
Fischer Imaging Corp. v. General Electric Co.
187 F.3d 1165 (Tenth Circuit, 1999)
Stump v. Gates
211 F.3d 527 (Tenth Circuit, 2000)
W.N.J. v. Yocom
257 F.3d 1171 (Tenth Circuit, 2001)
Nieto v. Kapoor
268 F.3d 1208 (Tenth Circuit, 2001)
Patton v. Denver Post Corp.
326 F.3d 1148 (Tenth Circuit, 2003)
United States v. Parker
362 F.3d 1279 (Tenth Circuit, 2004)
Nova Health Systems v. Fogarty
416 F.3d 1149 (Tenth Circuit, 2005)
Noel Reynolds v. George T. Slaughter
541 F.2d 254 (Tenth Circuit, 1976)
Phillips v. Calhoun
956 F.2d 949 (Tenth Circuit, 1992)
Petition of Di Franco
339 F. Supp. 414 (S.D. New York, 1972)
Nechis v. Oxford Health Plans, Inc.
421 F.3d 96 (Second Circuit, 2005)