Lead Opinion
Opinion by Judge REINHARDT; Dissent by Judge TASHIMA
Plaintiff Karla Schikore, a 20-year employee of Bank of America, NT & SA, seeks lump-sum disbursement of retirement benefits she has accrued as a participant in the BankAmerica Supplemental Retirement Plan, an employee benefits plan covered under the ERISA statute. The defendant Plan denied Schikore’s request on the ground that she failed properly to follow the Plan’s payment election procedure. Specifically, the Plan contends that Schikore failed to submit the requisite benefit payment election form one year in advance of her request for lump-sum disbursement, as mandated by the Plan’s rules, and that it has no record of having received the form. Schikore asserts that she mailed the form well in advance of the deadline, that she submitted evidence of such a mailing, and that the common law mailbox rule, under which receipt is presumed upon proof of mailing, should apply. Whether the federal and state common law mailbox rule applies to an ERISA plan’s benefit decisions is a question of first im
FACTUAL AND PROCEDURAL BACKGROUND
Schikore was employed by Bank of America, NT & SA (“Bank”) from 1978 to March 31, 1998, when she voluntarily terminated her employment. The Bank is a subsidiary of BankAmerica Corporation (“Corporation”), which established the BankAmerica Supplemental Retirement Plan (“Plan”) for its employees and employees of its subsidiaries and affiliates. The rules of the Plan are contained in the summary description document (“Plan Description”). During Schikore’s employment with the Bank, she participated in several retirement plans offered by the Corporation; the one at issue here is an ■ unfunded retirement benefits plan intended to provide supplementary benefits for certain management and highly compensated employees of various subsidiaries and affiliates of the Corporation. As an unfunded plan, the Plan is not required to segregate the funds to be used to pay benefits. The plan administrator for purposes of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1002(16)(A), is the BankAmerica Corporation Employee Benefits Administrative Committee (“Plan Administrator”), which consists of senior officers of participating Corporation subsidiaries and affiliates. The Plan Administrator has discretionary authority under the Plan to determine eligibility for benefits and to construe the terms of the Plan.
The Plan rules, contained in the Plan Description, provide that an employee with at least $10,000 in her account who wishes lump-sum disbursement of benefits following termination of employment must submit a benefit payment election form to the BankAmerica Retirement Plans Service Center (“Service Center”) at least one year prior to the termination date. The daily administration of the Service Center is handled by a third-party administrator, Kwasha Lipton (“Third-Party Administrator”), but overseen by the Plan Administrator. If employment is terminated before the one-year anniversary of the filing of the election form, the request for lump-sum disbursement is not honored and benefits are instead paid in five annual installments beginning in the calendar year after the employee reaches 65 years of age.
Schikore, who is 51 years old, stated that she completed the election form in December 1996 and mailed it to the Service Center, retaining a copy for her records. In March 1998, prior to terminating her employment with the Bank, Schikore applied for lump-sum disbursement of her benefits. Schikore was informed by the Plan that she did not have an election form on file at the Service Center. Immediately upon learning this, Schikore faxed a copy
Schikore appealed the Plan’s decision to the Plan Administrator, asserting that the common law mailbox rule creates a presumption of receipt which the Plan had failed to rebut. The Plan Administrator denied Schikore’s appeal on the grounds that (1) because ERISA preempts common law rules, the mailbox rule is inapplicable to employee benefit plans, (2) even if the mailbox rule would otherwise apply, the Plan rules, as a matter of contract, expressly require actual receipt as opposed to mere mailing of the document, and (3) the Plan rules do not permit lump-sum disbursement because the Service Center did not have her election form on file one year prior to her March 1998 request.
Schikore filed suit under § 502(a)(1)(B) of ERISA, which permits a participant “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). The district court granted summary judgment in favor of Schi-kore, concluding that the Plan Administrator abused its discretion by refusing to apply the common law presumption of receipt. The court remanded for the Plan Administrator to determine whether Schi-kore had presented sufficient evidence of mailing to invoke a presumption of receipt and, if so, whether the Plan had sufficiently rebutted that presumption by contrary evidence of non-receipt. The Plan filed a timely notice of appeal. Schikore cross-appealed on the issue of remand to the Plan Administrator and on the district court’s denial of attorney’s fees. Both parties argue that a remand to the Plan Administrator is neither necessary nor desirable.
STANDARD OF REVIEW
In an ERISA case, we review the district court’s determinations de novo. Friedrich v. Intel Corp.,
The abuse of discretion standard requires reversal of the findings of the Plan Administrator if they are found to be arbitrary and capricious. We have held that plan administrators abuse their discretion when they “render decisions without any explanation, or construe provisions of the plan in a way that conflicts with the plain language of the plan.” Eley v. Boeing Co.,
Additionally, “if a benefit plan gives discretion to an administrator or fiduciary who is operating under a conflict of interest, that conflict must be weighed as a ‘facto[r] in determining whether there is an abuse of discretion.’ ” Firestone Tire and Rubber Co.,
DISCUSSION
The Plan’s determination was arbitrary and capricious and it abused its discretion in (1) finding that ERISA preempted the common law mailbox» rule, (2) finding that the rule was one of construction and therefore inapplicable to the Plan’s requirement of actual receipt, and (3) failing to adequately develop the factual record before denying Schikore’s claim of eligibility for benefits.
I. The Application of the Common Law Mailbox Rule to Schikore’s Eligibility Determination
The mailbox rule provides that the proper and timely mailing of a document raises a rebuttable presumption that the document has been received by the addressee in the usual time. It is a settled feature of the federal common law. Hagner v. United States,
The common law mailbox rule is consistent with the purposes of ERISA and applies to ERISA plans where receipt is a factual issue in dispute.
In the instant case, there is a critical evidentiary question: specifically, who bears the ultimate burden of establishing receipt when receipt is disputed and the evidence is inconclusive. We note that the Plan requires only actual receipt and does not require any particular form of mailing. In the absence of the use of registered or certified mail, on the one hand, and “[a] returned envelope or other indication of failed delivery,” on the other, both receipt and non-receipt are “difficult to prove conclusively.” Nunley v. City of Los Angeles,
We have never previously considered the question of precisely how the common law mailbox rule should be applied to an ERISA plan’s benefit decisions. The answer is not difficult. Like the application of all common law rules, the application of the mailbox rule to an ERISA plan’s benefit decisions must be done in a manner consistent with the purposes of ERISA, the central purpose of which is to “protect the interests of participants in employee benefit plans and their beneficiaries.” 29 U.S.C. § 1001(b) (congressional findings and declaration of policy). See also Shaw v. Delta Air Lines, Inc.,
Because the common law mailbox rule operates as a rebuttable presumption, the factfinder must determine whether Schi-kore has presented sufficient evidence of mailing to invoke the presumption of receipt and, if so, whether the Plan has presented sufficient evidence of non-receipt to rebut the presumption.
The Plan relied in its factual determination of non-receipt only on the fact that the form is not presently contained in its records. Permitting a retirement plan to find non-receipt simply on the basis that the records office now cannot find the document, although there is evidence of mailing, is inconsistent with ERISA’s purpose to protect employee rights.
The Plan has asserted that the entirety of its administrative record on this determination has been admitted into evidence. There is nothing in that record to suggest that the Administrator conducted any fact-finding beyond that of “confirming” with the Third-Party Administrator that Schi-
It is clear that the common law mailbox rule was not applied to Schikore’s claim.
II. Remand to Plan Administrator
Neither party sought to introduce evidence beyond the administrative record in district court, and neither party sought a remand to the Plan Administrator for any other purpose. Both parties agree that such a remand is not necessary or desirable, because what is required here is a legal determination that the courts must ultimately make.
III. Attorneys’ Fees
Schikore requests an award of the attorney’s fees incurred at the district court level and in this appeal under 29 U.S.C. § 1132(g)(1), which authorizes recovery of attorney’s fees and costs in any ERISA action under 29 U.S.C. § 1132(a)(1)(B). The district court gave no reasons for its denial of fees to Schikore; the court therefore abused its discretion to grant or deny an award of fees. Accordingly we are required to set its decision aside. Smith v. CMTA-IAM Pension Trust,
CONCLUSION
We conclude that the Plan Administrator abused its discretion in denying Schi-kore lump-sum disbursement of her retirement benefits without applying the mailbox rule. In light of the parties’ agreement that remand to the Plan Administrator by the district court was inappropriate, we hereby vacate that part of the court’s order and remand to that court to apply the common law mailbox presumption to the facts contained in the administrative record already before it.
AFFIRMED in part; VACATED in part; and REMANDED.
Notes
. The district court’s order remanding to the Plan Administrator is an appealable final order under Hensley v. Northwest Permanente P.C. Ret. Plan & Trust,
. We note that the employer responsible for funding Schikore's benefits (the Bank) is a BankAmerica Corporation subsidiary, and the Plan Administrator responsible for determining Schikore's eligibility for benefits (the Committee) consists of employees of the Bank and other Corporation subsidiaries and affiliates. We also note that, as an unfunded plan, the Plan is not required to segregate the funds used to pay benefits, and that BankAmerica, as a financial services corporation borrows, invests, and lends money based on the size of the pool of available assets. Under these circumstances, a motive may exist for the plan administrator to deny for illegitimate reasons a claimant's request for lump-sum disbursement, in order that the Corporation might make use of such funds in the period before the claimant turns 65.
.Our determination that the common law evidentiary "mailbox” rule applies to the Plan is not inconsistent with our decision that a Plan Administrator need not apply a common-law definition of a Plan's term that differs from the definition that is used by the Internal Revenue Service (IRS) and favored by the Plan Administrator. See Hensley,
. When denying Schikore's appeal, the Plan found that the mailbox rule, as a common law rule, was preempted by ERISA. The Plan, it seems, has since abandoned this preemption contention. We must nonetheless consider the source of the governing law in order to determine whether the mailbox rule applies to ERISA plans.
. See also, e.g., Sec. Life Ins. Co. of Am. v. Meyling,
. This is the approach followed in other Circuits as well. See Manning v. Hayes,
. In Nunley v. City of Los Angeles, we held that a "specific factual denial of receipt” by the addressee is sufficient to rebut the presumption of receipt in the context of the addressee’s motion for an extension of time to file an appeal made under Federal Rule of Appellate Procedure, Rule 4(a)(6).
. See Anderson v. United States,
. The record shows that it was legal counsel who advised the Plan Administrator that the common law mailbox rule was not applicable. Regardless of whether the Administrator relied on counsel in coming to its erroneous conclusion, the conclusion still constitutes an error of law and, thus, an abuse of discretion.
. We are not presented with the question whether or in what manner a provision in a plan, of which the participants have notice, may reject the mailbox rule and adopt a contrary principle. Accordingly, we express no view on that question here.
. We do not remand to a plan administrator where the plan administrator has neither engaged in the necessary factual inquiry, nor provided reasons for his determination and is therefore not entitled to substantial deference. See Booton v. Lockheed Medical Benefit Plan,
Dissenting Opinion
dissenting:
I disagree with the majority that the Plan Administrator abused its discretion in denying Schikore’s claim.
First, the majority implies that a heightened standard of review may be appropriate because of a potential conflict of interest between the employer responsible for funding Schikore’s benefits and the Plan Administrator responsible for determining Schikore’s eligibility for benefits. Maj. op. at 960 n. 2. It is true that an “apparent” conflict of interest exists when a plan administrator is responsible for both funding and paying claims.
Under the traditional abuse of discretion standard, the “plan administrator’s decision to deny benefits must be upheld ... if it is based upon a reasonable interpretation of the plan’s terms and if it was made in good faith. The question we must ask is not ‘whose interpretation of the plan documents is most persuasive, but whether the interpretation is unreasonable.’ ” McDaniel,
It is true that, “[u]nder ERISA, Congress has authorized the courts ‘to formulate a nationally uniform federal common law to supplement the explicit provisions and general policies set out in [the Act].’ ” Sec. Life Ins. Co. of Am. v. Meyling,
The Plan states that the election form “shall become effective on the one year anniversary of the date the election is received by the Service Center.” Plan ¶ 5.4(b) (emphasis added). The Plan also provides that “[i]f the Participant does not have a benefit payment election in effect when Employment ends, the Participant’s benefits under the Supplemental Plan shall be paid in five annual installments commencing in the calendar year after the Participant attains age 65.” Plan ¶ 5.3(b). The Plan thus explicitly states that the election form must be received, not mailed, in order to be effective. The Plan Administrator interpreted these terms as requiring actual receipt, not merely evidence of mailing. Again, we “may overturn a decision only where it is so patently arbitrary and unreasonable as to lack foundation in factual basis and/or authority in governing case or statute law.” Hensley,
The majority attempts to distinguish Hensley by stating that the instant case is not concerned with the interpretation of a Plan term.
The majority relies on Horton v. Reliance Standard Life Ins. Co.,
By contrast, the majority’s reasoning in the instant case both negates the Plan’s requirement that the election form be “received” in order to be effective and imposes on the Plan Administrator the majority’s own contrary interpretation of the receipt requirement. It is not merely, as the majority asserts, “a tool for determining, in the face of inconclusive evidence, whether or not receipt has actually been accomplished.” Maj. op. at 961. The Plan requires that the election form be received by the Service Center. The Service Center had no record of having received the form. The Plan Administrator determined that this meant that the form was not received and so was not in effect. This interpretation of the receipt requirement is neither arbitrary nor unreasonable and should be upheld.
. This assumes that the Plan Administrator is responsible for both funding and paying claims, an assumption that is open to question. In Winters v. Costco Wholesale Corp.,
. The majority's generalized allegations, see maj. op. at 960 n. 2, are similarly insufficient to support application of the less deferential standard of review. See Atwood,
.The Hensley court was applying the arbitrary and capricious standard of review, which the court described as "interchangeabl[e]” with the abuse of discretion standard. Hensley v. Northwest Permanente P.C. Ret. Plan & Trust,
. In Hensley, the plan administrators interpreted the term “employee” as a “W-2” employee for Internal Revenue Service purposes, even though the term was not defined as such in the plan. The district court decided that the administrators had abused their discretion by applying the W-2 definition, rather than the common law definition of "employee.” On appeal, we reversed that aspect of the district court's decision, holding that the administrators were not required to apply the federal common law definition of the term.
. The majority concludes that because the Plan relied “only on the fact that the form is not presently contained in its record,” to find non-receipt,, the evidence was somehow insufficient and inconsistent with ERISA. Maj. op. at 963 (emphasis added). But what else can a custodian of a record rely on, except on . the record's absence, to prove non-receipt? Contrary to the majority's reasoning, it is a well-established and long-accepted evidentia-ry rule that the absence of a communication is proof that it was never received. See Fed.R.Evid. 803(7) (providing that "evidence that a matter is not included in [regularly kept] records” is admissible "to prove the nonoccu-rence or nonexistence of the matter”); United States v. De Georgia,
. Imposing the use of a common law presumption in the circumstances of this case goes beyond reviewing the Plan Administrator’s decision for an abuse of discretion. It is unprecedented in that we are taking on a supervisory role not given to us by ERISA. Imposing such a requirement is no different than prohibiting an ERISA plan from relying on hearsay in making decisions or imposing other rules of evidence. I respectfully suggest that review for abuse of discretion does not
