Order Granting Motion to Dismiss and Dismissing First Amended Complaint without Prejudice
I. INTRODUCTION
Before the Court is a motion to dismiss the First Amended Complaint of Plaintiff
Twenty-two months later, in November 2011, a representative of the Kaiser Per-manente Retirement Center notified Plaintiff that she had been overpaid by more than $240,000 and that she was obligated to repay the overage, with interest. The overpayment resulted solely from Hewitt’s apparent data entry error.
Plaintiff has exhausted her administrative remedies and instituted this civil action. The FAC asserts three separate claims: as against Kaiser, (1) equitable estoppel, as provided under the Employee Retirement Income Security Act (“ERISA”) at 29 U.S.C. § 1132(a)(3), and, as against Hewitt, (2) negligence and (3) negligent misrepresentation. Defendants have filed a motion to dismiss the FAC pursuant to Federal Rule of Civil Procedure 12(b)(6) on the grounds that federal law precludes.Plaintiffs negligence claims and equitable principles provide no basis for relief.
Having carefully considered the parties’ papers and argument in light of the applicable law of the Ninth Circuit, and for the reasons set forth below, the Court Grants Defendants’ motion and Dismisses Plaintiffs FAC. The dismissal is without prejudice to further amendment.
II. BACKGROUND
Given the procedural posture of this case, the Court accepts as true the well-pleaded factual allegations of Plaintiff s FAC and construes them in the light most favorable to Plaintiff. The parties do not dispute that ERISA governs the subject Plan.
A. Kaiser Offers an Early Retirement Package in 2009
Plaintiff Ramona Groves began her permanent employment with Kaiser in May 1976. (FAC ¶ 7.) Kaiser provided its employees with the opportunity to participate in the Kaiser Permanente Salaried Retirement Plan, a defined benefit plan. (FAC ¶ 8.) Plaintiff participated in the Plan. (Id.)
In or about March of 2009, Kaiser sent a letter to its employees regarding changes to the calculation used to determine the
Before you make a retirement or a pension distribution decision, review all your payment options carefully. Contact the Kaiser Permanente Retirement Center to talk to a Retirement Specialist who can advise you about your particular options. You may also want to talk to a professional financial planner. If you DO want to retire before the PPA changes take effect, keep in mind that you must retire (and initiate your retirement paperwork) no later than October 1, 2009 ... with the distribution date of December 1, 2009.
(FAC ¶ 12.) The booklet stated that an estimate of a pension benefit could be received over the phone by contacting the Kaiser Permanente Retirement Center. (Id.).
B. Plaintiff Decides to Take Early Retirement in 2009
Plaintiff, who was 55 years old at the time, was eligible for early retirement in 2009. (FAC ¶ 13.) In reliance on materials provided by Kaiser, and particularly on the statement that “it may be in her best interest” to retire early, Plaintiff contacted Kaiser Permanente Retirement Center by phone on or about July 7, 2009 to discuss the possibility of early retirement. (FAC ¶¶ 13-14.) Plaintiff spoke with “Christopher,” who represented himself as a Retirement Specialist. (FAC ¶ 14.) Christopher stated that the date of “early” retirement, prior to the implementation of retirement changes pursuant to the PPA would be November 30, 2009. (Id.) Christopher quoted Plaintiff an early retirement lump sum payout of $729,677.05. (Id.) In response to Plaintiffs inquiry about the amount she would receive if she chose to retire after January 1, 2010, Plaintiff was given a quote of $619,697.11. (Id.) Concerned about such a large difference in the quotes, Plaintiff sought assurances from Christopher about the correctness of figures given. (Id.) Christopher repeatedly stated that the quotes provided were correct. (Id.)
Plaintiff requested that Kaiser Perma-nente Retirement Center provide her with a written statement of pension benefit estimates for both options — early retirement effective November 30, 2009, and retirement effective January 1, 2010. (FÁC ¶ 15.) Kaiser, through statements “delivered by Hewitt,” provided Plaintiff with the requested information. The figures in the written statements matched the verbal information provided by Kaiser Perma-nente Retirement Center during the telephone conversation on July 7, 2009. (Id.)
After obtaining the written quotes from Kaiser, Plaintiff, as suggested by Kaiser’s materials received in March 2009, sought the services of a professional financial adviser. (FAC ¶ 17.) Plaintiff provided the adviser with all relevant documents sent by Kaiser and/or Hewitt reflecting the final figures of pension benefit payouts for the years of 2009 ($729,677.05) and 2010 ($619,697.11) and all relevant information concerning Plaintiffs personal financial situation. (FAC ¶ 18.) Plaintiff explained
After significant consideration and in reliance on the information provided by Defendants, Plaintiff decided to retire early from her 35-year career with Kaiser. (FAC ¶ 21.) In August 2009, Plaintiff notified her manager of her intent to retire effective November 30, 2009. (Id.) Had Plaintiff been properly informed by the Plan of the correct calculations, she would have immediately withdrawn her resignation and remained as a full-time employee of Kaiser. (Id.).
C. RETIREMENT ARRANGEMENTS AND BENEFITS Confirmed
After she gave notice of intent to retire early, Plaintiff began the process of completing the required paperwork. (FAC ¶22.) During the process, which lasted several months, she made multiple calls to Kaiser Permanente Retirement Center to discuss various topics, including the payout amount. (Id.) During each of these telephone calls, the payout amount was confirmed, notwithstanding minor modifications. (Id.) Defendants provided Plaintiff with documents indicating that the amount calculated was “final.” (Id. )
The amount of payout was recalculated by Kaiser and/or Hewitt numerous times. (FAC ¶ 23.) The total pension benefit payout sum increased to $748,740.93, reflecting Plaintiffs unused paid time off and accrued extended sick leave. (Id.) In October 2009, Plaintiff was notified that her payout amount increased to $748,961.97. (Id.)
In January 2010, prior to receiving the payout, Plaintiff received the final correspondence concerning her payout, dated January 11, 2010. The letter stated:
When you completed your payment elections for your Plan benefit, the benefit amounts were based on the information we had on file about you at the time of your initial benefit calculation. We’ve recalculated your benefit based on your final payroll information and interest rates. Based on the results of the new calculation, your final lump sum payment will be equal to $766,889.54.
(FAC ¶ 24 (emphases in FAC).)
The Plan provides that it is a duty of the Administrative Committee (the Plan) to assure prompt and correct payment of all Plan benefits. (FAC ¶ 25 (emphasis in FAC).) Plaintiff assumed that the amounts cited to her by Kaiser and/or Hewitt were correct. (Id.) The Plan also provides that a “Single Sum” method of payment means “An amount equal to the present value of the Participant’s Pension as of the Benefit Starting Date is provided to him in a single payment.” (FAC ¶ 26 (emphasis in FAC).)
•On January 15, 2010, the Plan issued a final check in the amount of $766,889.54. Plaintiff has since commingled these funds with others and has incurred and paid substantial taxes as a result of the amount of the lump sum payout as described above and having accessed portions of these funds. (FAC ¶ 27.)
Roughly 22 months later, on or about November 16, 2011, Plaintiff received a call from a person identifying himself as “Christopher” of the Kaiser Permanente Retirement Center, stating that, as a result of an audit, it was determined that Plaintiffs early retirement payout was overpaid in excess of $257,000.00. (FAC ¶ 29.) Plaintiff was not given any further explanation as to the reason for the miscalculation. (Id.) The Kaiser Permanente Retirement Center representative informed Plaintiff that a letter with further explanation was forthcoming. (Id.)
Subsequently, Plaintiff received the “Overpayment Notice” from Kaiser and/or Hewitt dated November 15, 2011. (FAC ¶ 31.) The Notice stated:
As a result of a recent audit, it’s been determined the pension benefit you received was based on incorrect information. Specifically, your benefit payment was based on incorrect pay rates beginning March 1, 2006 to February 28, 2007.... Our records show you received a pension benefit in the amount of $766,889.54 and the correct pension benefit amount is $526,504.26. The difference between these amounts is an overpayment plus interest of $257,908.91 and you’re required to return this amount to the pension plan.
(Id. (ellipsis and emphasis in FAC).)
On or about December 14, 2011, Plaintiff filed a Claim Initiation Form with Kaiser Permanente Human Resource Service Center disputing the alleged overpayment of her pension benefit payout. (FAC ¶ 32.) On or about January 24, 2012, Plaintiff received a “Notice of Denial.” The Notice stated:
On February 26, 2006 you received a pay increase of $8,867.83. When the Kaiser Permanente Retirement Center calculated your pension benefit, a monthly pay rate of $86,367.83 was used in lieu of the correct compensation for that pay increase. This resulted in an overstated Final Average Compensation ... of $12,677.85. The correct [Final Average Compensation] that should have been used is $8,657.58. This resulted in your pension benefit being overstated.
(FAC ¶ 33 (emphases in FAC).)
Plaintiff timely appealed the Denial of Benefit Claim for overpayment of pension benefit. (FAC ¶ 34.) On or about June 11, 2012, Kaiser and/or the Plan denied Plaintiffs Appeal. (Id.) Plaintiff has exhausted all of the requisite administrative remedies. (Id.)
III. APPLICABLE LEGAL STANDARD
A motion to dismiss under Rule 12(b)(6) tests the legal sufficiency of the claims alleged in the complaint. Ileto v. Glock, Inc.,
IV. DISCUSSION
A. Equitable Estoppel
Plaintiffs first claim is for equitable es-toppel and is asserted against Kaiser and the Plan only. She brings this claim under ERISA’s civil enforcement provision, 29 U.S.C. § 1132(a)(3)(B). Section 1132(a)(3) provides that a civil action may be brought:
by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter or the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan.
29 U.S.C. § 1132(a)(3) (emphasis supplied). Plaintiff bases her equitable estoppel claim on subsection (B)’s authorization of “appropriate equitable relief.” (FAC ¶ 37.) As set forth below, Plaintiffs claim does not satisfy the Ninth Circuit’s stringent test for pleading an equitable estoppel claim under federal law.
1. Applicable Equitable Estoppel Principles
ERISA preempts state-law equitable estoppel claims. See 29 U.S.C. § 1144(a); Ellenburg v. Brockway, Inc.,
Though such claims are permissible, the range of circumstances under which they may succeed is narrow. ERISA plaintiffs generally may not prevail on an equitable estoppel theory unless they can plead and prove (1) material misrepresentation, (2) reasonable and detrimental reliance thereupon, and (3) “extraordinary circumstances.” Pisciotta v. Teledyne Indus., Inc.,
First, the provisions of the plan at issue must be ambiguous such that reasonable persons could disagree as to their meaning or effect.... Second, representations must be made to the employee involving an oral interpretation of the plan.... Unless both conditions are met ... a beneficiary has no equitable estoppel claim.
Id. (citing Greany,
These additional prerequisites rest on the premise that “[a] plaintiff cannot avail himself of a federal ERISA estoppel claim based upon statements of a plan employee which would enlarge his rights against the plan beyond what he could recover under the unambiguous language of the plan itself.” Greany,
2. Equitable Estoppel Analysis
Kaiser and the Plan argue that Plaintiffs claim fails because it would have the effect of expanding her rights beyond those provided by the Plan’s unambiguous language. (Mot. at 6; Reply at 2-3.) The Court agrees. Plaintiffs claim, if successful, would have the effect of enlarging Plaintiffs rights against the Plan by estop-ping Kaiser and the Plan from attempting to recoup the nearly $250,000 overpayment they made to her after Hewitt allegedly miscalculated Plaintiffs benefit and then repeatedly reported its miscalculation as a correct and final determination of her benefit. Plaintiff, in claiming that she is entitled to keep the overpayment, does not argue that it is the terms of the Plan which so entitle her. Rather, she contends that it would be unjust to permit the Plan to recoup such a considerable sum from her given her blamelessness for the overpayment, the degree of care with which she planned her retirement, Defendants’ considerable delay in discovering the overpayment, and the fact that Plaintiff, by the time Defendants apprised her of their mistakes, had long since commingled the funds with her personal finances and had even paid taxes on them. {See Opp’n at 14; PI. Supp. Brief at 2.) That argument runs contrary to the law of the Ninth Circuit.
Plaintiff argues that she can satisfy the Ninth Circuit test for equitable estoppel, but she also urges the Court to apply the decisional law of other circuits.due to the “unique circumstances” of this case. As to the first argument, the Court disagrees that the Ninth Circuit test has been met. While Plaintiff has adequately alleged a material representation, reasonable and detrimental reliance thereon, and “extraordinary circumstances,” Plaintiff has not identified an ambiguous plan provision and, consequently, is unable to allege an “oral interpretation” of such a provision. Piseiotta,
Plaintiffs key contention on this point is that the plan term “present value” is ambiguous in both meaning and effect “when it interacts with the information provided
Second, the Court determines that, while the Plan documents do not expressly define the term “present value,” they do provide a mechanism by which it may be calculated. (See Dkt. No. 27, Art. C, at 8-10.) That the formula provided is complicated does not necessarily render it ambiguous. Plaintiffs failure to address the particulars of the formula or articulate a competing, reasonable explanation of the Plan language itself renders the FAC without an adequately pled ambiguity. See McDaniel v. Chevron Corp.,
The Court turns now to Plaintiffs alternative argument, which invites the Court to follow the precedents of certain other circuits that do not impose the two additional Ninth Circuit prerequisites. (See Opp’n at 13-15 (urging application of Third Circuit and Sixth Circuit tests).) As compelling as Plaintiffs allegations are, the Court must decline the invitation. See Zuniga v. United Can Co.,
The Whitman case exemplifies the correct application of Ninth Circuit authority to facts similar to this case. Whitman v. Hawaiian Tug & Barge Corp./Young Bros., Ltd. Salaried Pension Plan,
[SJeveral circuits, including the Ninth Circuit, have rejected estoppel claims that were practically identical to Plaintiffs. [Citations.] In each case, the plaintiff received an incorrect benefit estimate prior to retirement, retired soon thereafter, and began receiving the incorrect benefit. The plan administration subsequently discovered the error and corrected the benefit. All three errors were substantial in magnitude, and all three plaintiffs claimed that they had relied ‘ on the erroneous figures. Nonetheless, all three courts rejected the plaintiffs’ claims, because the relief they sought was contrary to the terms of the plan. Each of those courts held, as does this court, that estoppel cannot be applied in the ERISA context to permit recovery that is contrary to the unambiguous terms of a plan. As the Ninth Circuit stated, “Otherwise, every communication about prospective benefits could create a unique plan for a single participant who is not differently situated from fellow employees for whom the plan is established. Such a result would run counter to ERISAs overriding interest in avoiding side agreements that deviate from a plan applicable to all employees.”
Id. at 1229-30 (quoting Watkins v. Westinghouse Hanford Co.,
While the Court is not convinced that allowing an opportunity to amend will yield a different result, the Court is cognizant of Plaintiff s request for such an opportunity. (Opp’n at 22.) Pursuant to the admonition of Federal Rule of Civil Procedure 15(a) that courts “should freely give leave when justice so requires,” leave to amend is given with extreme liberality. In re Korean Air Lines Co., Ltd.,
B. Negligence and Negligent Representation
Plaintiff asserts a negligence claim against Hewitt alone for negligently calculating her lump-sum benefit, as well as a negligent misrepresentation claim for telling her the result of its incorrect calculation. Hewitt contends that these common-law claims are barred by ERISA’s sweeping preemptive effect and thus, as a matter of law, must be dismissed with prejudice. Plaintiff responds by citing a handful of cases which, she says, stand for the proposition that ERISA does not preempt state-law professional malpractice claims against “non-fiduciary actuaries,” and asserts, without support, both that Hewitt is such an entity and that her negligence claims against Hewitt “amount[ ] to” a professional malpractice action. (Opp’n at 15.) As set forth below, neither side is entirely correct. The Court concludes that Plaintiffs negligence claims, as presently pled, are subject to dismissal, but that leave to amend is warranted.
1. Applicable ERISA Preemption Principles
“There are two strands to ERISA’s powerful preemptive force.” Cleghorn v. Blue Shield of California,
The second strand of ERISA preemption bars state-law causes of action that fall within the scope of ERISA’s “comprehensive scheme of civil remedies to enforce ERISA’s provisions ... even if those causes of action would not necessarily be preempted” by § 1144(a). Cleghorn,
2. Preemption Analysis
Hewitt raises a preemption challenge to both Plaintiffs negligence and negligent misrepresentation claims. Because Plaintiffs negligence claims self-evidently “relate to” an ERISA plan in some sense, they are presumptively preempted. Cf. Castonguay,
The next question, then, is whether the negligence claims must be dismissed with prejudice. As the Court previously explained, leave to amend is granted with extreme liberality and will be granted in the absence of a showing of prejudice to a defendant or strong showing of futility, undue delay, or bad faith. Here, Hewitt argues that Plaintiffs negligence claims must be dismissed with prejudice as preempted because (i) they are “premised on and would not exist without the plan,” (ii) “would not exist without reference to the Plan’s payment of benefits,” and (iii)
V. CONCLUSION
For the foregoing reasons, the Court Grants the Motion to Dismiss of Defendants Kaiser Foundation Health Plan, Inc., Kaiser Permanente Retirement Plan, and AON, f/k/a Hewitt Associates, and Dismisses Plaintiffs First Amended Complaint in its entirely. However, if Plaintiff can amend the complaint consistent with Rule 11 and within the confines of Ninth Circuit authority, Plaintiff .may file a motion seeking leave to file such amended complaint, attaching the proposed pleading and explaining how she has corrected the deficiencies identified herein. Such motion shall be filed no later than Tuesday, April 22, 2014. If Plaintiff does not file the motion by that date, this dismissal shall be with prejudice.
This Order terminates Docket No. 17.
It Is So Ordered.
Notes
. Plaintiff names this defendant as "AON (formerly known as Hewitt),” alleging that AON is Hewitt's successor in interest. (Dkt. No. 11 (First Amended Complaint ("FAC”)) ¶ 15.) Defendants assert that Hewitt Associates LLC is the real party in interest. Either way, the entity is allegedly a "non-fiduciaiy service provider to the [Plan].” {Id. ¶ 6.) For simplicity, the Court refers to this entity as "Hewitt.”
. The Motion is fully briefed. (Dkt. Nos. 17 ("Motion”), 25 ("Opp’n”), 26 ("Reply”).) Further, the Court received supplemental briefing on certain matters (Dkt. Nos. 34 ("PL Supp.Brief'), 35 ("Defs.Supp.Brief”), and heard oral argument on November 12, 2013.
. Plaintiff alleges that her husband "was unable to work due to diabetes complications,” leaving Plaintiff as "the sole wage earner in her household since 2003.” (FAC ¶ 16.)
. The FAC alleges that the Plan provides no definition of the term "present value.” (FAC ¶ 26.) The Court, however, disregards this allegation. Though a court generally is obligated to regard the well-pleaded facts of a complaint as true when deciding a Rule 12(b)(6) motion, that principle gives way when the allegations contradict documents
. The amount that the Plan seeks to recoup from Plaintiff includes nearly $18,000 in interest.
. For this proposition, Plaintiff relies on Spink v. Lockheed Corp.,
. The Court rejects Plaintiff’s secondary argument that dismissal of her negligence claims is unwarranted solely because she would be left without a remedy. See Geweke Ford v. St. Joseph’s Omni Preferred Care Inc.,
