Stiltner v. Beretta USA Corp

CourtCourt of Appeals for the Fourth Circuit
DecidedFebruary 5, 1996
Docket94-1323
StatusPublished

This text of Stiltner v. Beretta USA Corp (Stiltner v. Beretta USA Corp) 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
Stiltner v. Beretta USA Corp, (4th Cir. 1996).

Opinion

PUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

JAMES E. STILTNER, Plaintiff-Appellant,

v. No. 94-1323

BERETTA U.S.A. CORPORATION, Defendant-Appellee.

Appeal from the United States District Court for the District of Maryland, at Baltimore. J. Frederick Motz, Chief District Judge. (CA-92-3507-JFM)

Argued: September 27, 1995

Decided: February 2, 1996

Before ERVIN, Chief Judge, RUSSELL, WIDENER, HALL, MURNAGHAN, WILKINSON, WILKINS, NIEMEYER, HAMILTON, LUTTIG, WILLIAMS, and MICHAEL, Circuit Judges, and PHILLIPS, Senior Circuit Judge, sitting en banc.

_________________________________________________________________

Affirmed by published opinion. Judge Hamilton wrote the majority opinion, in which Judges Russell, Widener, Wilkinson, Wilkins, Nie- meyer and Williams joined. Judge Luttig wrote a separate opinion concurring in the judgment. Senior Judge Phillips wrote an opinion concurring in part and dissenting in part in which Chief Judge Ervin and Judges Hall, Murnaghan and Michael joined. Judge Motz did not participate in this case.

_________________________________________________________________

COUNSEL

ARGUED: Christy Concannon, BAPTISTE & WILDER, P.C., Washington, D.C., for Appellant. Jerrold Alan Thrope, GORDON, FEINBLATT, ROTHMAN, HOFFBERGER & HOLLANDER, Balti- more, Maryland, for Appellee. ON BRIEF: Roland P. Wilder, Jr., Susan Boyle, BAPTISTE & WILDER, P.C., Washington, D.C.; Marc H. Rifkind, SLEVIN & HART, P.C., Washington, D.C., for Appel- lant. Gregory S. Reynolds, GORDON, FEINBLATT, ROTHMAN, HOFFBERGER & HOLLANDER, Baltimore, Maryland, for Appel- lee.

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OPINION

HAMILTON, Circuit Judge:

Appellant, James E. Stiltner (Stiltner), appeals an order granting summary judgment in favor of his former employer, Beretta U.S.A. Corp. (Beretta), on Stiltner's ERISA and state law claims against Beretta. A divided panel of this court affirmed the summary judgment as to Counts I, II, and IV of Stiltner's complaint, but vacated and remanded as to Count III of the complaint. See Stiltner v. Beretta U.S.A. Corp., No. 94-1323 (4th Cir. January 18, 1995) (designated for publication, but not reported). On Beretta's suggestion, we vacated the panel decision and reheard the case en banc . Having considered the briefs and the arguments of the parties, we now affirm in toto the district court's grant of summary judgment.

I.

On November 21, 1988, Stiltner began working as a tool room supervisor for Beretta, a Maryland arms manufacturer. Frank Valorose, a Beretta employee, helped Stiltner obtain the job. Valorose had been Stiltner's manager at Stiltner's former job with FN Manu- facturing (FN).

Stiltner's initial employment status was that of an independent con- tractor. Although he was not entitled to the fringe benefits that regular employees received, Stiltner received free housing from Beretta, as well as an allowance to pay for his COBRA coverage under FN's health insurance plan.1 _________________________________________________________________ 1 Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), employers must offer terminated employees the option of

2 On February 28, 1989, Beretta offered Stiltner a job as a regular employee. The terms of the offer were described in a letter given to Stiltner by Peter Axelrod, Beretta's human resources manager. Stilt- ner and Axelrod reviewed the letter together, and Stiltner signed the letter to indicate that he found the terms of the offer acceptable. Among the benefits described in the letter were the following:

Medical Insurance: Company paid hospitalization and medi- cal insurance for you and your dependents . . . .

Long Term Disability: Pays 60% of salary after six months of disability (after one year of employment). Payable to age 70.

(J.A. 83). Axelrod agreed to make Stiltner's regular employment date retroactive to November 21, 1988, for purposes of his eligibility for vacation and benefits.

Stiltner enrolled in two welfare benefit plans that Beretta provided for its employees. The first of these plans, Beretta U.S.A. Health Plan # 501 (the Health Plan) provided group health insurance for all full- time employees and their eligible dependents. The Health Plan pro- vided that coverage would cease at the end of the month in which an employee stopped active work on a full-time basis.

The second plan, Beretta U.S.A. Life and Disability Plan # 502 (the Disability Plan), provided long-term disability benefits to full-time employees who became disabled after one year of employment. At the time Stiltner enrolled, American Bankers Life Assurance Com- pany (American Bankers) provided the coverage under this plan. American Bankers issued a disability plan insurance policy that expressly excluded coverage for disabilities caused by pre-existing conditions. Although the certificate of insurance/benefits booklet that American Bankers issued to participants in the disability plan clearly disclosed this pre-existing condition limitation, the summary plan description then in effect for the disability plan (the original SPD) did _________________________________________________________________ continuing coverage under the employer's group health plan. 29 U.S.C. §§ 1161, 1163(2).

3 not. Stiltner claims that he did not receive a copy of the certificate of insurance/benefits booklet until after he became disabled.

In February 1990, Beretta changed the insurer of its disability plan to the Guardian Life Assurance Company of America (Guardian). The Guardian policy, like the American Bankers policy, had an express pre-existing condition limitation. The new certificate of insur- ance/benefits booklet issued by Guardian clearly disclosed the pre- existing condition limitation. Beretta sent copies of the new booklet to participating employees, along with a memo entitled "Summary Plan Description Supplement to Certificate for the Beretta U.S.A. Health and Welfare Plans" (the SPD Supplement). The SPD Supple- ment stated that "[t]his supplement and your certificates of insur- ance/benefits booklets constitute the Summary Plan Description as required by [ERISA]." (J.A. 566). Stiltner claims that he did not receive a copy of either the new certificate of insurance/benefits booklet or the SPD Supplement until after he became disabled.

Stiltner suffered from a heart condition when he began working for Beretta. On February 6, 1990, he had a heart attack. After the heart attack, he worked sporadically until June 9, 1990. Since that date, he has not worked for Beretta or anyone else because of his heart prob- lems.

To assist Stiltner in filing a disability insurance claim, Beretta sent Stiltner the new Guardian certificate of insurance/benefits booklet, the original SPD for the Disability Plan, and the SPD Supplement for that plan. Stiltner applied to Guardian for long-term disability benefits under the Disability Plan, and to the Social Security Administration for Social Security disability benefits. Guardian denied Stiltner's claim because his disability arose out of a pre-existing condition.

Beretta attempted to help Stiltner in several ways. First, Beretta wrote Guardian, urging it to reconsider its decision to deny Stiltner's claim for disability benefits. Second, although it was clear that Stilt- ner would never be able to return to work after June 9, 1990, Beretta kept paying Stiltner his full salary until October 1990, when Stiltner began receiving Social Security disability benefits.

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