Steigleman v. Symetra Life Insurance Company

District Court, D. Arizona·Decided November 9, 2023·No. 3:19-cv-08060·Unknown

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

9 Jill M Steigleman, No. CV-19-08060-PCT-ROS

10 Plaintiffs, ORDER

11 v.

12 Symetra Life Insurance Company,

13 Defendant. 14 15 The Ninth Circuit concluded there was a dispute of fact whether Plaintiff Jill 16 Steigleman’s “long-term disability policy was part of an ‘employee welfare benefit plan’ 17 under the Employee Retirement Income Security Act (ERISA).” Steigleman v. Symetra 18 Life Ins. Co., 2022 WL 912255, at *1 (9th Cir. 2022). After a bench trial, almost all the 19 facts are undisputed. To the extent there are factual disputes, the Court makes the factual 20 findings set forth below. Based on those factual findings, the Court concludes Steigleman’s 21 disability coverage was part of an employee welfare benefit plan established or maintained 22 by an employer. 23 BACKGROUND1 24 Steigleman was an insurance agent who sold insurance products issued by Farm 25 Bureau Financial Services. From 2008 to 2018, Steigleman owned and operated the 26 Steigleman Insurance Agency (“Agency”). During that period, the Agency always had one 27 or two employees but, at times, as many as four. (Doc. 216 at 89-91). When she

28 1 The parties stipulated to much of the relevant background. (Doc. 193). Those stipulations are accepted and, to the extent relevant, incorporated into this Order. 1 established the Agency, and throughout its existence, Steigleman was a member of The 2 Agents Association (“TAA”). TAA is a nonprofit organization formed by Farm Bureau 3 agents to represent their common interests to the management of Farm Bureau. (Doc. 216 4 at 124). 5 At all times relevant to this suit a company named “mgc Group” was TAA’s 6 insurance broker. In that role, mgc Group offered what both parties identify as “benefits” 7 to TAA members and their staff. (Doc. 222 at 5) (TAA offered “group benefits); (Doc. 8 223 at 4) (TAA offered “TAA Plan benefits”). Those benefits consisted of various types 9 of insurance coverages, such as long-term disability, short-term disability, and life 10 insurance. The coverages mgc Group offered through TAA were from a variety of 11 insurance companies, including Defendant Symetra Life Insurance Company that offered 12 long-term disability coverage. Some of the coverages were only available to TAA 13 members (i.e., Steigleman) while others were available to TAA members as well as their 14 staff and families (i.e., the Agency’s staff and their families). (Doc. 223 at 4). The TAA 15 coverages had eligibility requirements, such as employment by a TAA member for a 16 minimum amount of time or working a minimum number of hours per week. Steigleman 17 did not have any direct control over TAA’s eligibility requirements, and she did not impose 18 unique eligibility requirements on the Agency’s staff. 19 Based on Steigleman’s membership in TAA, the Agency’s employees were eligible 20 to enroll in TAA’s coverages. (Doc. 216 at 95). The Agency used some of those TAA 21 coverages in offering its employees a “benefits package.”2 Steigleman believed offering a 22 benefits package was important both for recruiting and retaining qualified employees. 23 (Doc. 216 at 100). Steigleman viewed offering the Agency’s employees the coverages 24 handled by TAA “as a way of having less administrative duties so that [she] could just run

25 2 During her deposition, Steigleman described her Agency as offering its employees a “benefits package.” (Doc. 216 at 98). At trial, Steigleman testified her previous use of the 26 term “benefits package” was based on TAA’s description of the various coverages. (Doc. 216 at 99). It appeared Steigleman believed it was detrimental to her position to refer to 27 the TAA coverages as the Agency’s “benefits package,” but Steigleman’s testimony established she viewed the Agency as providing a group of benefits to its employees. Thus, 28 Steigleman’s attempt at trial to avoid using the term “benefits package” was not convincing. 1 [her] insurance agency.” (Doc. 216 at 104). Steigleman agreed she was “essentially” 2 delegating administration of the employees’ coverages to TAA. (Doc. 216 at 105). 3 Steigleman’s testimony regarding the handling of the Agency’s benefits package 4 was contradictory and, at times, not credible. Steigleman tried to claim she “wasn’t 5 involved at all” in assessing the quality of the coverages offered by TAA. (Doc. 216 at 6 100). But TAA offered a type of medical coverage that Steigleman concluded was “not 7 good insurance.” (Doc. 216 at 96). Thus, Steigleman opted to obtain medical coverage 8 for the Agency’s employees not through TAA but through Blue Cross Blue Shield. (Doc. 9 216 at 95). As for the other coverages available through TAA, such as long-term disability, 10 Steigleman agreed she could have obtained those coverages through alternatives other than 11 TAA, but she chose not to do so. (Doc. 216 at 100-101). Based on her in-court testimony, 12 including demeanor, the Court concludes it is more likely than not that Steigleman—a 13 long-time professional in the insurance industry—assessed the quality of all the coverages 14 offered by TAA and concluded the non-medical coverages offered by TAA were of 15 sufficient quality for the Agency to offer to purchase for its employees. 16 At trial Steigleman attempted to distance the Agency from any involvement in the 17 TAA benefits by testifying she would inform employees “that anything they received when 18 they got their e-mail [from TAA offering coverages], I would pay for the policy.” (Doc. 19 216 at 102). Based on her opting to obtain medical coverage through Blue Cross Blue 20 Shield, but also informing the employees they could purchase any of the other coverages 21 offered, the offer by Steigleman and the Agency to pay for the TAA coverages was 22 effectively an endorsement of the non-medical coverages offered by TAA. 23 As of 2009, two employees of the Agency were enrolled in short-term disability, 24 dental, and vision coverage through TAA. (Doc. 193 at 5-6). As of 2017, two different 25 Agency employees were enrolled in short-term disability, long-term disability, dental, and 26 vision coverage through TAA. In 2017, TAA also offered critical illness/cancer, accident, 27 and telehealth coverage that the Agency’s employees could have selected. (Doc. 193 at 6). 28 As of 2017 Steigleman was enrolled in long-term disability, excess disability, long term 1 care, critical illness/cancer, dental, vision, and telehealth coverage through TAA. (Doc. 2 193 at 6). Steigleman has offered no plausible explanation why her employees in 2009 and 3 2017 selected almost exactly the same list of coverages while declining others.3 4 Both in 2009 and in 2017, coverages beyond those selected by the Agency’s 5 employees were available. According to Steigleman, the Agency would have paid 100% 6 of the premiums on the employees’ behalf. It is implausible the employees would have 7 gone through the TAA application on their own and selected almost identical sets of 8 coverages, despite knowing they could enroll in all of the available coverages and that the 9 Agency would pay all the premiums. It is more probable than not Steigleman conveyed to 10 her employees which coverages would be paid for by the Agency and which would not. 11 The employees then selected the coverages that would not cost them anything and declined 12 those coverages where they would have to pay. This conclusion is supported by 13 Steigleman’s trial testimony regarding which premiums the Agency would pay. 14 When asked why the Agency’s employees did not select all the available coverages 15 if the Agency had agreed to pay all the premiums, Steigleman stated her staff were making 16 relatively low salaries and likely did not have “the money to go buy everyone in their family 17 long-term care [insurance].” (Doc. 216 at 106).

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

Steigleman v. Symetra Life Insurance Company, (D. Ariz. 2023).

Steigleman v. Symetra Life Insurance Company (Steigleman v. Symetra Life Insurance Company) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Donya Leigh Anderson v Unum Provident Corp.
369 F.3d 1257 (Eleventh Circuit, 2004)
Fort Halifax Packing Co. v. Coyne
482 U.S. 1 (Supreme Court, 1987)
Pegram v. Herdrich
530 U.S. 211 (Supreme Court, 2000)
Charles Schwab & Co., Inc. v. Debickero
593 F.3d 916 (Ninth Circuit, 2010)
Kevin McCann v. Unum Provident
907 F.3d 130 (Third Circuit, 2018)
Daniel Warmenhoven v. Netapp, Inc.
13 F.4th 717 (Ninth Circuit, 2021)
Delaye v. Agripac, Inc.
39 F.3d 235 (Ninth Circuit, 1994)
Velarde v. Pace Membership Warehouse, Inc.
105 F.3d 1313 (Ninth Circuit, 1997)
Waks v. Empire Blue Cross/Blue Shield
263 F.3d 872 (Ninth Circuit, 2001)
Blau v. Del Monte Corp.
748 F.2d 1348 (Ninth Circuit, 1984)
Kanne v. Connecticut General Life Insurance
867 F.2d 489 (Ninth Circuit, 1988)