Sikora and Associates v. Storey

311 F. App'x 568
CourtCourt of Appeals for the Fourth Circuit
DecidedApril 16, 2008
Docket07-1402
StatusUnpublished
Cited by95 cases

This text of 311 F. App'x 568 (Sikora and Associates v. Storey) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sikora and Associates v. Storey, 311 F. App'x 568 (4th Cir. 2008).

Opinion

Affirmed by unpublished PER CURIAM opinion.

Unpublished opinions are not binding precedent in this circuit.

PER CURIAM:

When their health insurance provider, Fidelity Group, Inc. (“Fidelity”), failed to compensate Linda Brown and Beth Abernathy for medical costs, they brought ERISA claims against both Fidelity and their employer, Sikora and Associates, Inc. (“Sikora”), for breach of fiduciary duty. Sikora, in turn, brought a variety of third-party claims under state law against Bob Storey, who Sikora alleged was the alter ego of Fidelity. In its amended complaint, Sikora asserted ERISA as the basis of federal jurisdiction under 28 U.S.C. § 1331 (2000) and claimed supplemental jurisdiction for its state-law claims. The district court granted summary judgment to Sto-rey, finding that Sikora lacked standing to bring an action against him under ERISA. The court also declined to exercise supplemental jurisdiction over the state law claims, which it dismissed without prejudice. Sikora appeals. We affirm.

I.

In 1999, Sikora secured group health insurance for its employees from Magna Corporation. At that time, Bob Storey ran Magna; in 2000, he incorporated the Fidelity Group and converted the Sikora’s ERISA plan from the Magna Plan to the Fidelity Group Plan. In May 2000, Sikora employees began complaining that Fidelity was failing to pay health care claims; by August 2000, all benefit payments ceased. On March 26, 2001, Fidelity formally notified Sikora that the plan was terminated effective March 16, 2001. Sikora immediately secured another insurance provider.

On February 25, 2004, two Sikora employees, Brown and Abernathy, filed an ERISA action against Fidelity and Sikora, seeking benefits due under their ERISA group health plan. Sikora filed an answer, cross-claim, and third-party complaint, pleading diversity jurisdiction as the basis for third-party claims against Storey and others for failure to pay benefits, breach of obligations to Sikora, fraud, and negligent misrepresentation under state law. Storey moved to dismiss Sikora’s complaint for lack of personal jurisdiction as well as improper joinder of parties under Rule 14. The district court denied Storey’s motion for lack of personal jurisdiction, but granted the Rule 14 motion, permitting Sikora leave to amend its complaint.

Sikora then filed an amended answer and cross-claim, eliminating reliance on diversity jurisdiction and asserting ERISA as the basis for federal jurisdiction. Shortly thereafter, Brown and Abernathy settled their claims with Sikora and named Sikora as assignee for their ERISA bene *570 fits. After completing discovery, Storey moved for summary judgment. The district court granted Storey’s motion, reasoning that Sikora lacked standing to bring the ERISA claim. The court then declined to exercise supplemental jurisdiction over Sikora’s state law claims, which it dismissed without prejudice.

II.

Only “participants,” “beneficiaries,” or “fiduciaries” may bring civil actions under ERISA. 29 U.S.C. § 1132(a) (2000); see also Franchise Tax Bd. v. Constr. Laborers Vacation Trust, 468 U.S. 1, 21, 103 S.Ct. 2841, 77 L.Ed.2d 420 (1983) (noting that “[t]he express grant of federal jurisdiction in ERISA is limited to suits brought by certain parties ... as to whom Congress presumably determined that a right to enter federal court was necessary to further the statute’s purposes”). Sikora contends that the district court erred in finding that it lacked standing to assert its claims under ERISA. Sikora asserts standing under ERISA on two independent grounds. First, Sikora argues that, as the assignee of Brown and Abernathy, it stands in their shoes as participant and beneficiary of the ERISA plan, thereby possessing derivative standing. Second, Sikora alleges that it assumed the responsibility of a fiduciary under the ERISA plan and therefore can bring claims pursuant to § 1132(a). We briefly discuss each argument in turn.

A.

Although we have never addressed the question of .derivative standing for ERISA benefits, our sister circuits have consistently recognized such standing when based on the valid assignment of ERISA health and welfare benefits by participants and beneficiaries. See City of Hope Nat Med. Ctr. v. HealthPlus, Inc., 156 F.3d 223 (1st Cir.1998); I.V. Servs. of America, Inc. v. Trustees of the American Consulting Engineers Council Ins. Trust Fund, 136 F.3d 114 (2d Cir.1998); Cagle v. Bruner, 112 F.3d 1510 (11th Cir.1997); Lutheran Med. Ctr. v. Contractors, Laborers, Teamsters and Engineers Health & Welfare Plan, 25 F.3d 616 (8th Cir.1994); Cromwell v. Equicor-Equitable HCA Carp., 944 F.2d 1272 (6th Cir.1991); Kennedy v. Conn. Gen. Life Ins. Co., 924 F.2d 698 (7th Cir.1991); Hermann Hosp. v. MEBA Medic. & Benefits Plan, 845 F.2d 1286 (5th Cir.1988); Misic v. Building Serv. Employees Health & Welfare Trust, 789 F.2d 1374 (9th Cir.1986).

These cases represent a careful balance of competing concerns, in part grounded on the recognition that extending derivative standing to health care providers serves to further the explicit purpose of ERISA in a number of distinct ways. See, e.g., Misic, 789 F.2d at 1377 (noting that extending derivative standing to health care providers “results in precisely the benefit the trust is designed to provide and the statute is designed to protect,” while also “making it unnecessary for health care providers to evaluate the solvency of patients before commencing medical treatment” or forcing patients to “pay potentially large medical bills and await compensation from the plan”).

The district court seemed to believe that courts have permitted “assignment of benefits under ERISA only where the claimant is a health care provider” (emphasis added). In fact, entities other than healthcare providers have been permitted derivative standing as ERISA assignees. See Tango Transp. v. Healthcare Fin. Servs., 322 F.3d 888, 893-94 (5th Cir.2003) (holding that a collection agency possessed derivative standing as an assignee of a healthcare provider, who itself possessed derivative standing as an assignee of the beneficiary of the ERISA plan); Yampol v. Mut. Life Ins: Co. of N.Y.,

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311 F. App'x 568, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sikora-and-associates-v-storey-ca4-2008.