Steen v. John Hancock Mutual Life Insurance

106 F.3d 904, 97 Cal. Daily Op. Serv. 926, 97 Daily Journal DAR 1384, 1997 U.S. App. LEXIS 2137, 1997 WL 49963
CourtCourt of Appeals for the Ninth Circuit
DecidedFebruary 10, 1997
DocketNos. 95-15874, 95-16061
StatusPublished
Cited by23 cases

This text of 106 F.3d 904 (Steen v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Steen v. John Hancock Mutual Life Insurance, 106 F.3d 904, 97 Cal. Daily Op. Serv. 926, 97 Daily Journal DAR 1384, 1997 U.S. App. LEXIS 2137, 1997 WL 49963 (9th Cir. 1997).

Opinion

OPINION

WIGGINS, Circuit Judge.

The California Council of Civil Engineers and Land Surveyors (“Cal Council”), an association of California employers engaged in civil engineering and surveying, established a trust fund (“Cal Council Trust”), through which it purchased insurance from John Hancock Mutual Life Insurance Co. (“John Hancock”) to provide health insurance benefits to the employees of its member employers. As part of the insurance agreement, Cal Council and John Hancock established a Rate Stabilization Reserve (“RSR”), administered by Association Administrators & Consultants (“AA & C”), under which an amount equaling twelve percent of the annual premium paid by the Cal Council Trust to John Hancock was to be set aside to offset potential premium increases caused by unforeseen increases in claims paid on the John Hancock policy. Under the agreement, the RSR balance was to be returned to the Cal Council if it withdrew from the insurance agreement after sufficient notice. When John Hancock terminated the agreement, a dispute over the amount due from the RSR to the Cal Council arose.

The Civil Engineers and Land Surveyors of California (“CELSOC”) was created as a result of a merger between the Cal Council and another trade organization of civil engineers and surveyors. CELSOC provides health and welfare benefits to its members’ employees through the CELSOC Trust, the successor in interest to the Cal Council Trust. The Trustees of the CELSOC Trust [908]*908brought several claims in the district court against John Hancock and AA & C seeking recovery of the RSR funds, pursuant to Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001-1461. The district court found that it lacked federal question jurisdiction, based on the collateral estoppel effect of our unpublished opinion in American Institute of Architects Benefit Insurance Trust v. John Hancock Mutual Life Insurance Co., No. 87-6492, 1988 WL 91140 (9th Cir. Aug.29, 1988) (hereinafter “AIA-BIT”). The Trustees appeal. We have jurisdiction under 28 U.S.C. § 1291 and AFFIRM in part and REVERSE and REMAND in part.

FACTS

CELSOC is a trade association of California employers engaged in civil engineering and land surveying. CELSOC was formed as the result of a 1992 merger between two predecessor organizations, the Cal Council and the Consulting Engineers Association of California (“Consulting Engineers”). Each of those organizations had maintained an insurance trust to provide health and welfare benefits to its members’ employees and their dependents. Contributions to the trusts were made by both employers and employees. The Cal Council Trust was one employers organization trust that participated in what is collectively known as the Design Professionals Group Insurance Plan (“DPGIP”).1 As recognized by the district court, “the DPGIP is not itself a legal entity of any kind, but merely a term of convenience for the participating trusts as a group.”

The trusts that participated in the DPGIP all independently purchased insurance from John Hancock for the employer members of their respective regional trade associations. The employers, in turn, provided the insurance as a benefit to their employees. The Cal Council trust and the other DPGIP trusts entered into a Rate Stabilization Reserve Agreement (“RSR Agreement”), negotiated and administered by AA & C. The object of the RSR Agreement was for each participant trust to maintain a balance of twelve percent of its annual premium paid to John Hancock. The RSR was designed to stabilize premium payments by allowing John Hancock to draw from the reserve where there had been a significant increase in benefits paid, instead of increasing the premium rates beyond the rate of inflation for medical and other benefits. AA & C and John Hancock were to assure that any DPGIP trust whose RSR balance fell below twelve percent of the annual premium would make up the shortfall within five years.

This arrangement was terminated when John Hancock withdrew as the insurer for the DPGIP trusts on September 30, 1991. The RSR Agreement contains explicit provisions for the distribution of RSR funds upon the withdrawal of an individual trust, but does not separately provide for the distribution of funds upon termination of the agreement by John Hancock. The CELSOC Trustees allege that at the time of the termination of the RSR Agreement, the Cal Council Trust’s RSR balance was approximately $3,000,000, but that John Hancock only returned $1,310,111.68 as the undisputed sum owed to the Cal Council Trust. The Trustees claim that John Hancock used the balance of the funds in Cal Council’s RSR to offset negative RSR balances of other DPGIP Trusts, and to pay claims that had been incurred under Cal Council’s policy'but not paid prior to John Hancock’s termination of the insurance policy.

On September 23,1993, the CELSOC Life and Health Insurance Plan and the Trustees of the CELSOC Trust filed suit against John Hancock and AA & C seeking declaratory relief, equitable reformation of contract, and imposition of a constructive trust and accounting, based on John Hancock’s breach of fiduciary duty and participation as “parties-in-interest” in prohibited transactions in violation of 29 U.S.C. § 1106. The Trustees alleged that the district court had jurisdiction [909]*909to consider its claims pursuant to 29 U.S.C. § 1132(e)(1), which gives the district court jurisdiction over ERISA claims brought by an ERISA plan “participant, beneficiary, or fiduciary.”

On July 29,1994, pursuant to Fed.R.Civ.P. 12(b)(1), John Hancock moved to dismiss the Trustee’s complaint for lack of jurisdiction, arguing that the CELSOC Plan and the CELSOC Trustees lacked standing to sue under ERISA, and that “the issue of subject matter jurisdiction with respect to the claims presented in [the Trustee’s] complaint has already been litigated and found to be lacking” in the Ninth Circuit’s unpublished 1988 opinion of AIA-BIT. In AIA-BIT, one of the DPGIP participant trusts sued John Hancock, AA & C, and the trustees of the other DPGIP participant trusts seeking the return of more than $2,000,000 from its RSR account, which the parties to the RSR Agreement alleged AIA-BIT had forfeited by voluntarily withdrawing from the RSR Agreement without giving sufficient notice of its intention to withdraw from the agreement. Pursuant to a motion to dismiss brought by the trustees of the other DPGIP participant trusts, including the trustees of the predecessor trusts to CELSOC, and joined in by John Hancock and AA & C, the district court in AIA-BIT dismissed for lack of diversity and lack of a federal question.

On appeal, we affirmed, ruling “that the DPGIP was not an employee welfare benefit plan subject to ERISA jurisdiction,” AIA-BIT, 1988 WL 91140 at **3, and “that the defendants were not fiduciaries, for the purposes of ERISA jurisdiction under 29 U.S.C. § 1132(e)(1).” Id. at **4.

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106 F.3d 904, 97 Cal. Daily Op. Serv. 926, 97 Daily Journal DAR 1384, 1997 U.S. App. LEXIS 2137, 1997 WL 49963, Counsel Stack Legal Research, https://law.counselstack.com/opinion/steen-v-john-hancock-mutual-life-insurance-ca9-1997.