Schmidt v. Overland Xpress, LLC

CourtDistrict Court, S.D. Ohio
DecidedMay 28, 2021
Docket1:12-cv-00397
StatusUnknown

This text of Schmidt v. Overland Xpress, LLC (Schmidt v. Overland Xpress, LLC) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schmidt v. Overland Xpress, LLC, (S.D. Ohio 2021).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF OHIO WESTERN DIVISION

Tobi Schmidt, : : Plaintiff, : Case No. 1:12-cv-397 : v. : : Judge Michael R. Barrett Overland Xpress, LLC, et al., : : Defendants. :

OPINION AND ORDER This matter is before the Court on Defendants Jason Brown’s and Terese Brown’s Motion for Summary Judgment (Doc. 78) and Plaintiff Tobi Schmidt’s Motion for Judgment (Doc. 79) on her claims against Defendant Overland Xpress, LLC (“Overland”) only. I. Background A. Factual History The factual background of this case was set forth in detail in the Court’s September 28, 2020 Opinion and Order (Doc. 69) denying summary judgment to Plaintiff Tobi Schmidt. A summary will be presented here. Schmidt was employed by Overland from August 2010 until December 13, 2011. Defendant Jason Brown was the CEO of Overland, and Defendant Terese Brown was the Chief Human Resources Officer for the company. (Doc. 58-1, PageID 980.) Pursuant to her employment, Schmidt became a covered person under a contract between Overland and Humana Health Plan of Ohio, Inc. (“Humana”) providing medical benefits insurance coverage. (Doc. 25-1, PageID 431; Doc. 25-3, PageID 539.) Overland was identified as the sponsor of Group Plan No. 712609 (“the Plan”) under the contract. (Doc. 25-2, PageID 433.) Humana was the named administrator of the Plan with discretionary authority over coverage and benefits: With respect to paying claims for benefits or determining eligibility for coverage under a policy issued by Humana, Humana as administrator for claims determinations and as ERISA claims review fiduciary, shall have full and exclusive discretionary authority to: • Interpret plan provisions; • Make decisions regarding eligibility for coverage and benefits; and • Resolve factual questions relating to coverage and benefits. (Doc. 25-4, PageID 687.) Schmidt asserts that she was wrongly denied more than $150,000 in medical benefits under the Plan during the term of her employment. (Doc. 58-1, PageID 983; Doc. 58-8, PageID 991–1002.) The parties’ dispute centers on Schmidt’s eligibility for medical benefits coverage when she took a disability or medical leave of absence from work. The Employee Handbook provided to Schmidt by Overland stated that benefits were provided to employees regularly scheduled to work full time “subject to the terms, conditions, and limitations of each benefit program.” (Doc. 62-1, PageID 1064.) It further provided that certain benefits were not provided to employees who were regularly scheduled to work part time less than twenty-eight hours per week. (Id.) The Employee Handbook did not address the benefit eligibility of employees taking medical or disability leaves of absence. On the other hand, the Plan provided coverage to employees who “were in active status

for the employer on a full-time basis.” (Doc. 25-3, PageID 539, 543.) It further stated that employees were “deemed to be in active status if an absence from work is due to sickness or bodily injury, provided the individual otherwise meets the definition of employee.” (Id., PageID 536.) Coverage under the Plan terminated upon the occurrence of defined conditions, including on “the date [the employee] has terminated employment” or “the date he or she is no longer qualified as an employee.” (Doc. 25-2, PageID 500.) Being placed on medical leave was not one of the defined conditions for termination of coverage.

The Plan required Overland and the employee to notify Humana as to “any change of eligibility, including lack of eligibility, of any covered person.” (Id.) Read in context within the “Termination of coverage” provision, this section required Overland and the employee to inform Humana when an employee had “terminated employment with the employer.” (Id.) The Plan also prohibited Overland from “discharge[ing] or otherwise discriminat[ing] against a plan participant in any way to prevent the participant from obtaining a benefit.” (Doc. 25-4,

PageID 701.) Schmidt agreed to take a leave of absence from her employment with Overland starting on April 4, 2011 due to ongoing medical issues related to a heart problem. Of note, Schmidt contends that she only agreed to take leave after receiving the following assurance from Jason Brown:

Jason told me that I was required to begin a medical leave on that day. He further stated that Overland would continue to pay my health insurance premiums while I was on medical leave and that if Overland was unable to pay for the medical insurance, he personally would insure [sic] that the company would provide a COBRA notification or a state extension for the medical benefits along with short term and long term disability for me. (Doc. 58-1, PageID 981.) On April 6, 2011, Terese Brown erroneously told Humana that Schmidt had resigned her employment two days earlier, and Humana immediately terminated Schmidt’s medical benefits coverage under the Plan effective April 4. (Doc. 57-1, PageID 941.) Schmidt sought state continuation of medical benefits while she was on leave, and the Browns fulfilled their role in the application process, but she was ineligible under state law. (Doc. 62-1, PageID 1088.) On the other hand, Schmidt was eligible for and received short-term disability benefits while she was on medical leave. (Doc. 58-3, PageID 985, 987.)

Schmidt remained on leave of absence until December 13, 2011. Jason Brown terminated Schmidt’s employment effective that day after, he alleges, she made threatening social media posts against Overland and two executive employees. (Doc. 25-5, PageID 716.) B. Procedural Posture Schmidt filed this suit against Overland, the Browns, and Humana. While this litigation was pending, in or about late 2015, Humana conducted an administrative appellate review of

the denial of benefits to Schmidt, including a review of her medical records. (Doc. 38.) Thereafter, Schmidt voluntarily dismissed her claims against Humana on March 31, 2017. (Doc. 53.) The following claims asserted in the First Amended Complaint remain against Overland and the Browns: Count One—ERISA, 29 U.S.C. § 1132(a)(1)(B); Count Two—ERISA Request for Injunctive and Other Appropriate Relief, 29 U.S.C. § 1132(a)(3); Count Three—ERISA Interference with Plaintiff’s Benefit Rights, 29 U.S.C. § 1140; Count Four—Disability Discrimination in violation of Ohio Revised Code chapter 4112; and Count Five—Fraud. (Doc. 25, PageID 421–426.) Schmidt moved for summary judgment as to Counts One, Four, and Five only following the initial discovery period. (Doc. 58.) The Browns, representing themselves pro se, opposed the motion. Overland, because it was not represented by counsel, did not file a brief in opposition. The Court denied summary judgment to Schmidt on Count One because genuine issues of fact remained in dispute and on Counts Four and Five because the state law claims appeared to be preempted by ERISA. (Doc. 69.) Thereafter, the Court gave the parties leave to

conduct additional discovery and to file additional motions for summary judgment. The Browns, pro se, now move for summary judgment on Counts One through Five. Schmidt also moves for judgment, but only against Overland on the sole basis that Overland failed to retain counsel. The motions are fully briefed and ripe for adjudication. II. Standard of Review Federal Rule of Civil Procedure 56(a) provides that summary judgment is proper “if the

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Bluebook (online)
Schmidt v. Overland Xpress, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schmidt-v-overland-xpress-llc-ohsd-2021.