Pitsko v. Gordon Food Services, Inc., 3:24-cv-01055

Background

Michael Pitsko was a GFS full‑time commercial driver who enrolled in a Hartford‑administered ERISA Plan providing LTD, STD, and life insurance; he became disabled from a workplace injury in July 2017 and later died in February 2022.
Michael received long‑term disability (LTD) and Social Security Disability (SSD) benefits; his son Jacob received Social Security dependent benefits.
Michael settled a workers’ compensation claim and executed a Separation Agreement retroactively designating November 30, 2017 as his last day of employment; plaintiffs allege ERISA benefits were not terminated by that agreement.
Plaintiffs allege Hartford improperly denied a life‑insurance Waiver of Premium and improperly offset Michael’s LTD by Jacob’s dependent SSD benefits; they also allege failures to provide ERISA notices and plan documents.
GFS and Hartford moved to dismiss under Rule 12(b)(6); the court evaluates (1) the Premium Waiver denial, (2) duplicative fiduciary claims under §502(a)(3), (3) propriety of the dependent‑benefit offset, (4) ERISA preemption of state contract claims, and (5) whether the jury demand should be stricken.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Hartford improperly denied life‑insurance Waiver of Premium	Plaintiffs say Michael met expectations for waiver and Hartford failed to follow ERISA notice/appeal procedures and misapplied Policy language	Hartford contends coverage lapsed for nonpayment (Oct. 29, 2017), Michael was not eligible for waiver until six months after disability, and administrative denials were proper	Denial of dismissal — factual disputes (payment, backdating, timing) preclude resolution on Rule 12(b)(6); Count I (Waiver) survives dismissal
Whether Count II (§502(a)(3) fiduciary claim) is precluded as duplicative of §502(a)(1)(B) benefits claim	Plaintiffs allege breaches (misrepresentations, failure to provide notices, improper administration) distinct from a straight benefits denial	Defendants argue §502(a)(3) is improper where §502(a)(1)(B) provides relief and would prevent double recovery	Denial of dismissal — §502(a)(3) claim may proceed at pleading stage where it alleges distinct equitable relief and whether §502(a)(1)(B) is adequate is unresolved until discovery/summary judgment
Whether Hartford properly offset Jacob’s dependent SSD benefits against Michael’s LTD	Plaintiffs contend dependent benefits belong to the child and cannot be offset against parent’s LTD; claim ambiguity in Policy	Hartford says Policy unambiguously defines “Other Income Benefits” to include dependent SSD benefits and requires offset	Granted dismissal on this claim — Court finds Plan language unambiguous permitting dependent benefit offset; Count III dismissed with prejudice
Whether plaintiffs’ state‑law breach of contract claims are preempted by ERISA	Plaintiffs largely concede ERISA preempts plan‑based state claims but tried to preserve contract claims relating to Jacob’s offsets	Defendants assert §514 preempts any state law claims that relate to the ERISA plan	Granted dismissal — breach claims tied to plan administration are preempted; Count IV dismissed with prejudice
Whether plaintiffs are entitled to a jury trial	Plaintiffs sought a jury but concede no jury right on ERISA claims and argued any remaining state claims might be triable	Defendants move to strike, citing ERISA causes as equitable	Granted — jury demand stricken because remaining claims are ERISA/equitable and the state contract claims were dismissed

Key Cases Cited

Ashcroft v. Iqbal, 556 U.S. 662 (pleading‑stage plausibility standard)
Bell Atl. Corp. v. Twombly, 550 U.S. 544 (pleading‑stage plausibility and Twombly/Iqbal framework)
Varity Corp. v. Howe, 516 U.S. 489 (§502(a)(3) as equitable "catchall" and last‑resort remedy)
In re Unisys Corp. (Long‑Term Disability Plan) ERISA Litig., 97 F.3d 710 (dependent SSD offsets valid where plan language expressly permits)
Lamb v. Connecticut Gen. Life Ins. Co., 643 F.2d 108 (dependent benefit characterization and offset principles)
Heimeshoff v. Hartford Life & Acc. Ins. Co., 571 U.S. 99 (ERISA plan terms govern benefit enforcement)
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (standard of review for plan administrator interpretations)
Pane v. RCA Corp., 868 F.2d 631 (no jury right on ERISA benefit claims; ERISA preemption of parallel state claims)