In this appeal, we are asked to decide whether an employee benefit plan participant is required, under the Employment Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1101 et seq., to exhaust an administrative claims procedure that was adopted by his plan only after he had already brought an ERISA action to recover benefits. The district court held that the exhaustion of such remedies was a prerequisite to seeking relief in court, and so dismissed the plaintiffs suit without prejudice. We hold that the exhaustion of such remedies is excused under 29 C.F.R. § 2560.503-1(l). Accordingly, we vacate the decision of the district court, and re
BACKGROUND
While an employee of Sterling Winthrop (“Sterling”), Plaintiff-Appellant Martin Coyne began participating in employer-sponsored benefit plans.
In Coyne’s case, Sterling’s Supplemental Plan promises to make up the shortfall between (a) what the qualified plan actually pays, and (b) the level of regular pension benefits participants tvould receive, but-for the limits placed on qualified plan payouts by the tax code. The Supplemental Plan confers “full power and authority” on the Plan committee to make “binding and conclusive” decisions on benefit claims and all other issues arising under the Plan. Based on estimates from an actuarial consulting firm, Coyne places the pre-tax value of his benefits under the Plan at roughly $11,300 per month.
Coyne started working for Sterling in 1981. He and the company eventually parted ways amid a string of corporate recombinations. As a result, responsibility for Coyne’s benefits under the Supplemental Plan seemed, for a time, to have gotten lost in the shuffle. Sterling was bought by Eastman Kodak Company (“Kodak”) in 1989, at which point Sterling’s retirement programs became part of Kodak’s retirement plan. Sterling changed hands again in 1994, becoming a wholly-owned subsidiary of Defendant-Appellee Bayer Corporation (“Bayer”) through a two-stage, three-firm transaction that also involved SmithKline Beecham. See Eastman Kodak Co. v. STWB Inc.,
Coyne became eligible to receive benefits under the Supplemental Plan on March 1, 2004. Still having heard nothing from Bayer, Kodak paid Coyne’s first month of benefits. Kodak’s controller again contacted Bayer, now seeking indemnification for the payment under the terms of the sale of Sterling to Bayer. Bayer did not respond, and in June 2004 Kodak and Coyne together filed suit in the United States District Court for the Southern District of New York. In the amended complaint,
In its answer, filed October 15, 2004, Bayer alleged that Coyne had failed to exhaust administrative remedies. At a pre-trial conference held the following week, Bayer explained that those administrative remedies consisted of a new claims procedure added to the Plan by “Amendment No. 1” (“Amendment”), which Sterling’s Board of Directors adopted on July 12, 2004. The Amendment was retroactive, and made the claims procedure effective as of January 1, 2004.
Kodak and Coyne moved for summary judgment. Coyne argued that the Amendment had an adverse impact on his vested rights under the Plan, and hence, was invalid under the terms of the Plan, which
Kodak and Coyne filed a notice of appeal, but Kodak subsequently withdrew from the appeal. In response to an inquiry from Coyne, the district court clarified that the administrative claims proceeding was not stayed pending appeal.
DISCUSSION
ERISA requires both that employee benefit plans have reasonable claims procedures in place, and that plan participants avail themselves of these procedures before turning to litigation. See 29 C.F.R. § 2560.503-1 (detailing requirements of claims procedures, including notification of adverse decisions within 90 days and the availability of a full and fair review of the initial determination); see also Jones v. UNUM Life Ins. Co. of Am.,
A. Appellate Jurisdiction
As a threshold matter, Appellees contend that this court lacks jurisdiction to hear Coyne’s appeal, because, they submit, the district court’s order was not a final decision within the meaning of 28 U.S.C. § 1291. Appellees are correct, of course, that “[fjederal appellate jurisdiction generally depends on the existence of a decision by the District Court that ends the litigation on the merits and leaves nothing for the court to do but execute the judgment.” Coopers & Lybrand v. Livesay,
The district court “dismissed [Coyne’s suit] without prejudice to its refiling after Coyne has exhausted the administrative procedure under the amended Plan.” Eastman Kodak,
Appellees argue that Nichols is not controlling. In that case, Appellees observe, the district court’s order “le[ft] the primary responsibility for further action in the hands of Nichols,” who had to take steps to exhaust her administrative remedies before returning to court. Id. at 104. Here, by contrast, the district court jump-started the administrative process without requiring any further action on Coyne’s part, by directing the Plan’s administrator to accept Coyne’s complaint as a claim for benefits. See Nichols,
B. Exhaustion of Administrative Remedies
Having established our jurisdiction, we turn to the principal question in this case: Whether a benefits claimant may be required to exhaust administrative remedies that were adopted only after the claimant has brought an action to recover benefits.
Bayer insists that the retroactive Amendment that added the claims procedure is valid under the terms of the Plan, and hence, may be applied to Coyne. Coyne gives a number of reasons why he was not required to exhaust the claims procedure. First, he argues that administrative remedies are “deemed exhausted” pursuant to a Department of Labor regulation. 29 C.F.R. § 2560.503-1(i) provides that where a plan fails to establish or follow ERISA-compliant claims procedures, “a claimant shall be deemed to have exhausted the administrative remedies available under the plan”; accordingly, the claimant is, without more, allowed to bring a suit to recover benefits. Second, Coyne argues that the Amendment adversely affects his rights — and is therefore invalid under the Plan’s terms. This is so, Coyne contends, because the change permits the Plan’s administrator, rather than a court, to make a benefit determination in the first instance, and such a determination is subject only to deferential “arbitrary and capricious” review in the courts. On a related note, after oral argument Coyne submitted a letter, pursuant to Federal Rule of Appellate Procedure 28(j), drawing our attention to a recent decision of this court, Gibbs v. CIGNA Corp.,
We are persuaded that 29 U.S.C. § 2560.503-l(i) controls the outcome here, and so we do not reach Coyne’s other arguments. First, however, we note that Bayer objects to Coyne’s present reliance on the regulation, as Coyne failed to raise it before the district court. It is true that this court ordinarily will not hear arguments not made to the district court. See, e.g., Pulvers v. First UNUM Life Ins. Co.,
The “deemed exhausted” provision reads in full:
In the case of the failure of a plan to establish or follow claims procedures consistent with the requirements of this section, a claimant shall be deemed to have exhausted the administrative remedies available under the plan and shall be entitled to pursue any available remedies under section 502(a) of the Act on the basis that the plan has failed to provide a reasonable claims procedure that would yield a decision on the merits of the claim.
29 C.F.R. § 2560.503 — 1(Z ).
Bayer’s argument is not expressly foreclosed by the language of the regulation. The regulation provides that administrative remedies are deemed exhausted “[i]n the case of the failure of a plan to establish or follow [ERISA-compliant] claims procedures”; it does not indicate what the relevant timeframe is, nor what happens when a plan changes procedures. In theory at least, the later adoption of remedies with retroactive effect could undo the earlier exhaustion. But as a practical matter, this interpretation of the regulation is a nonstarter, for reasons given by Coyne as well as by amici curiae the Secretary of Labor and the AARP. On such a reading, the regulation would be worse than ineffectual: it would create perverse incentives for plans not to meet their obligations under
It is hard to imagine that this is the result that the Secretary of Labor had in mind in promulgating 29 C.F.R. § 2560.503-1(0- We need not tax our imaginations, though, because the Secretary of Labor has made her views clear, in her amicus brief and through her appearance (by counsel) at oral argument. The Secretary confirms that “nothing in the claims regulation permitted Bayer to effectively ‘undeem’ exhaustion by enacting, for the first time, procedures that complied with the claims regulation after Coyne filed suit and after failing to offer an appropriate procedure in the many months preceding Coyne’s lawsuit.” Sec. of Labor Amicus Br. at 10-11; see also id. at 14 (“The regulation’s ‘deemed exhausted’ directive would be totally frustrated if plans could simply amend the plan to resolve such procedural irregularities after the participant pursued his rights in court. Giving retroactive effect to a plan amendment in these circumstances thus plainly conflicts with the ‘deemed exhausted’ regulation.”). Coyne’s reading of the regulation, then, is also the Secretary of Labor’s, and it is an interpretation that we find persuasive.
A look at the context in which the “deemed exhausted” provision was adopted fortifies our conviction that the regulation may not be circumvented by a plan’s belated creation of an ERISA-compliant claims procedure. The regulation took effect in 2002, and superceded a similar but narrower provision that “deemed” any claims not acted on before the regulatory deadline “denied” (thereby clearing the way for judicial proceedings). See Linder v. BYK-Chemie USA, Inc.,
We note also that this interpretation of the “deemed exhausted” provision is consistent with our rather uncompromising approach to the earlier “deemed denied” regulation. Thus, in Nichols, we held that the plaintiffs administrative claim to benefits must be “deemed denied” because no timely determination was made; the fact that the plan was in “substantial compliance” with ERISA’s deadlines was irrelevant. Nichols,
CONCLUSION
For the reasons given above, we hold that, under the “deemed exhausted” provision of 29 C.F.R. § 2560.503-1(0, an ERISA benefits claimant is not required to exhaust a claims procedure that was adopted only after a suit to recover benefits has been brought. Accordingly, we Vacate the judgment of the district court, and Remand for that court to decide, in the first instance, Coyne’s claim to benefits under the Supplemental Plan.
Notes
. Sterling subsequently changed its name to STWB Inc. For the sake of simplicity, where possible we refer to the company as "Sterling'' without regard to the name change.
. The parties' submissions reflect a disagreement as to when Coyne began participating in the Supplemental Plan. Coyne alleged to the district court that he became a participant in 1982, and Defendant-Appellee Bayer Corporation ("Bayer”) counters that the Plan did not take effect until January 1, 1991, by which point Sterling's standard retirement plan had been combined with Eastman Kodak Company's. See infra. This disagreement is not material to the issue on appeal, and we therefore do not attempt to resolve it.
. Kodak and Coyne amended the complaint to add the ERISA claim and additional defendants after Sterling and Bayer moved to dismiss the initial complaint, inter alia, on the grounds that the breach of contract claim that was the essence of the original complaint was preempted by ERISA.
. Defendant STWB Inc. was voluntarily dismissed from the case below and is no longer before this court. For the sake of simplicity, we use the name of the corporate parent, Bayer, to refer to all remaining Defendants-Appellees collectively.
. At oral argument, counsel for Coyne indicated that the administrative claims proceeding had not resulted in a benefit determination in Coyne's favor. Hence, there is no suggestion that the instant appeal may be moot.
. The "requirements of this section" include, inter alia, timely benefit determinations, written or electronic explanation of adverse determinations, and the opportunity for appeal. See 29 C.F.R. §§ 2560.503-1(0, (g), (h).
. In her amicus brief, the Secretary argues that her interpretation of the regulation is entitled to the full measure of deference contemplated in Chevron U.S.A. Inc. v. NRDC,
. Bayer’s other arguments as to why the regulation does not control the outcome here are also not persuasive. Thus, Bayer contends that 29 C.F.R. § 2560.503-1(1) does not apply to Coyne because he did not file a claim, and hence, was not a "claimant” within the meaning of that provision. But 29 C.F.R. § 2560.503-l(a) defines "claimant” to mean plan participants and beneficiaries — a group that undoubtedly includes Coyne. Nor, in light of our decision that the regulation controls, do we need to consider Coyne’s alternative argument that it would be futile for him to avail himself of the Plan's administrative remedies.
. In resolving this appeal, we express no view as to whether 29 U.S.C. § 2560-503-1(/) applies in scenarios not presented here: for instance, where existing claims procedures comply substantially with the requirements of ERISA, or where an ERISA-compli-ant claims procedure is adopted after benefits are first sought, but prior to the filing of suit. See U.S. Dep’t of Labor, Employee Benefits Security Administration, Frequently Asked Questions About the Claims Procedure Regulation, FAQ F-2, http:// www.dol.gov/ebsa/faqs/faq claims proc reg. html (last visited June 26, 2006) (expressing the view that "not eveiy deviation by a plan from the requirements of the regulation justifies proceeding directly to court”).
