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Moore v. Lafayette Life Insurance
458 F.3d 416
6th Cir.
2006
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*1 prejudice have been IV. CONCLUSION would not weight of the other given Strickland reasons, foregoing For the we hold that trial. inculpatory evidence offered unreasonably apply the TCCA did not Even without identification of Garza’s clearly an- established federal law as passenger Amador male the cab as the Supreme nounced Court. We shootings, jury on night therefore AFFIRM the district court’s de- voluntary heard Amador’s statement de- nial of habeas relief. have” had he scribing what he “would done shootings and con-

been involved all

cluding that this about the “[i]f stuff they prove can it in

murder is true and

court, my then I take death sentence.” will jury testimony The also heard from Mar- MOORE, Richard L. Plaintiff- tinez, who described Amador’s confession Appellant, detailing happened to her what on the v. night shootings, of the mentioned Ama- prior CO., dor’s statement that he’wanted to do LAFAYETTE LIFE INSURANCE taxicab,” something “crazy involving a Corporation; Michigan an Indiana Tooling Association, testified Amador had written her a Michigan Cor- prison warning letter from her not to testi- poration; Michigan Tooling Associa- fy. jury also heard about the Long Crime Disability Plan; tion Term Stoppers tip that led to Amador’s arrest Michigan Tooling Association Short and Amador’s accurate identification of the Disability Plan, Jointly Term and Sev- guns caliber of the shooting used erally, Defendants-Appellees. Moreover, in custody. once witness Esth- Moore, Richard L. Plaintiff- testified, er Menchaca placing Amador and Appellant/Cross- Rivas at the scene of the abandoned taxi- Appellee, shortly shootings cab after the occurred 4, 1994, early morning January explaining that she previously had identi- Lafayette Co., Life Insurance fied a photo array. Amador from Corporation, Defendant-Ap Indiana pellee/Cross-Appellant, great

Given the weight of additional' evi- Amador, dence say we cannot Michigan Tooling Association, a Michi that, there probability reasonablе but gan Corporation; Michigan Tooling for the admission of the identification evi- Long Disability Association Term dence, the outcome of the trial would have Plan; Michigan Tooling Association Strickland, been different. See 466 U.S. Disability Plan, Jointly Term Short 2052. Accordingly, S.Ct. Severally, Defendants. unreasonably apply clearly TCCA did not 04-1146, 04-1942, 04-1945, Nos. 05-1109. established federal law it when held that argue point counsel’s failure to ade- United States of Appeals, Court quately appeal does not rise to the level Sixth Circuit. Mayabb, constitutional error. See Argued: Dec. 2005. (“When F.3d at 869 we preju- do find Aug. Decided and Filed: error, extension, dice from the trial we cannot prejudice appellate find from an issue.”). predicated

error on the same *8 O’Donnell, Durkin, Mary C.

ARGUED: O’Donnell, Detroit, McDonnell, Clifton & Por- D. Andrew Michigan, Appellant. for Johnson, Miller, & Cummis- Snell tinga, A. Michigan, Elaine key, Rapids, Grand Southfield, Parson, Prokop, Raymond & ON BRIEF: Appellees. for Michigan, Clifton, O’Donnell, A. Gregory Mary C. O’Donnell, Durkin, McDonnell, & Clifton Detroit, Michigan, Appellant. Michigan. for D. An- the state of MTA hired Plain- Miller, Johnson, Portinga, drew Snell & life, tiff in 1971 to all group handle disabili- Cummiskey, Rapids, Michigan, Grand ty, and compensation workers’ insurance Parson, Wilson, Jeffrey A. D. Ray- Elaine for MTA and companies. its member Southfield, Prokop, Michigan, mond & for initially While Plaintiff was hired as a sala- Appellees. employee, ried in 1972 MTA and Plaintiff agreed that Plaintiffs compensation would COOK, Before: CLAY and Circuit come from premiums commissions for Judges; OLIVER, Judge.* District paid signed and a “Memorandum of Un- CLAY, J., (“MOU”) opinion derstanding” delivered the of the to that effect. OLIVER, 449), (p. court. D.J. delivered a responsibilities Plaintiffs taking included separate concurring opinion, in which “complete responsibility for all Group Life J., joined. COOK, 449-53), COOK. (pp. J. Disability insurance for the Detroit delivered a separate opinion concurring in Tooling Association .... handling] all part dissenting in part. questions, problems generally servicing] all participants in OPINION (J.A. 1722.) ....” pro- MOU also

CLAY, Judge. Circuit vided that Plaintiff pay would all his own Plaintiff, expenses. MTA Moore, filed 1099s on Plaintiff Richard L. appeals the income tax purposes. district court’s judgments favor of De- Lafayette fendants Life Insurance Co. MTA operated and Plaintiff under the (“Lafayette”) and the Michigan Tooling MOU until December when Plaintiff (“MTA”). Association The district court signed and MTA a “Consulting Service granted judgment to Defendants on Plain- Agreement” (“CSA”),whereby MTA would tiffs claims Employee under the Retire- pay $75,000, Plaintiff a fixed sum of ment Security Income Act of 1974 monthly installments, and Plaintiff was (“ERISA”), 29 U.S.C. 1001 et seq. an “independent deemed contractor.” appeals Plaintiff also the district court’s responsible Plaintiff was partial attorneys’ award of fees and costs taxes, all federal payroll and state all ex- Defendants, along with sanctions penses incurred in Michigan, the state of attorney. Defendant and was accept free to consulting outside Lafayette cross-appeals the award of at- agreements. MTA continued to file 1099s torneys’ fees its favor as too low. For on Plaintiff for income tax purposes. follow, the reasons which we AFFIRM the 1996, Royal Prior to Maccabees Insur- decision of the district court in respects. all provided ance MTA disability life and in- policies. surance Plaintiff rec-

I. ommended to MTA that MTA switch its BACKGROUND provider insurance Lafayette. Lafay- A. Substantive Facts ette became provider MTA’s of group life disability 1996;

Defendant insurance in March MTA is an ap- association of proximately signed companies Application Group member metal-working industry in Michigan. agent. Insurance as a licensed As the Plaintiff is a agent licensed insurance in signing agent, Plaintiff attested: *9 * Oliver, Jr., Ohio, The Honorable sitting Solomon United by designation. Judge States District for the Northern District ultimately that Lafayette determined Policyhold- to the fully explained

I have Em- in Active un- Employee “employee” not a covered any Plaintiff was er eligible otherwise or in a class рloyment plan. Lafayette does not der the ERISA on the coverage for insurance apply 1, January “prior [the dispute any Contract Date Effective Contract eligible effective was date] [Plaintiff] CSA Company will not be by the to be issued is- coverages insurance group for certain any such insurance apply for eligible However, ..:. facts by Lafayette sued until Company unless and by the issued 1,1999, January [Plain- that effective show Employee becomes time such such were changed. with MTA We status tiffs] apply for eligible a class member of until change in not aware of this status coverage. insurance were sub- claims for benefits [Plaintiffs] 236.) (J.A. at (J.A. 1923.) at mitted to us.” Lafayette at the time In March “[a]ny em- policy The states STD MTA, polices insurance writing began commenced on employment whose ployee compa- MTA member employees, its policy date of this or before the effective “employee” nies, was listed as Plaintiff on full time actively [sic]” and is at work submitted statements premium plan’s coverage upon for through eligible December From 1996 MTA. (J.A. 1434.) on his own premiums paid at The STD effective date. directly disability insurance for coverage provides coverage policy further Lafayette. date starting after the effective employees policy The defines policy. of the STD operated MTA Plaintiff and employee in the service “employee” 2000. Dur- as “an 1999 and into throughout CSA the costs of employ- MTA deducted terms of ing period, employer this whose of the (“STD”) long- disability short-term 20 hours him to work at least require ment (“LTD”) from disability premiums term 1435.) (J.A. policy The per week.” and re- monthly remunerations on full “actively at work defines further insurer, Lafay- to the premiums mitted the at least “actually working to mean time” was reliant asserts that MTA ette. MTA employ- working day at the per hours six to MTA of representations on Plaintiffs location or other placе er’s of business “employee” under would be a covered who employee requires where his business Neither plan. of the the terms 1435.) (J.A. at tobe.” terms Lafayette of the nor MTA informed “employee” defines policy LTD of the CSA. mean: filed for September benefits, later then one month STD duly re- employee full-time regular, A filed the LTD MTA requested benefits. records payroll on the corded- as such of Plaintiff forms on behalf request benefit work- regularly Policyholder, who the' La- same months. Lafayette those of the duration through the entire ing adjudicate the claims proceeded to fayette week, work Policyholder’s benefits; although there are indications week, per 30 hours not less than event Lafayette initially indi- in the record terms of under the and is insured the STD adjudicate cated that MTA should Policy. ultimately claim, Lafayette MTA and payroll The clause “on adjudicate Lafayette would agreed that further defined. is not records” claims. both *10 History opinion B. Procedural dismiss and an judg- issued and 19, ment August on the motions on 2002. Plaintiff action in filed the instant dis- trict court on 2001. Plaintiff October The district court denied MTA’s motions alleged that Defendants violated numerous (of I, on Count dismissed the first three responsibilities under STD and LTD five) II against subclaims Count as policies MTA’s ERISA benefit and Defendants, both denied the motion dis- prayed for relief in the form of benefits III, miss on Count dismissed Count asV due, costs, attorneys’ fees and and statuto- against Lafayette, and dismissed VI Count ry penalties. Specifically, alleged: against Additionally, as both defendants. wrongfully Count I: that he was denied the court concluded Wilkins con- STD and LTD as an MTA- benefits discovery trolled in the case and therefore “employee” covered under 29 U.S.C. discovery to underly- restricted Plaintiffs 1132(a)(1)(B); ing allegations process of denial of due Count II: fi- Defendants breached the withholding of information count. duciary respect duties to Plaintiff with Plaintiff filed a motion to on reconsidеr to the plan; September 2002. The district court Count III: if Plaintiff not cov- found the untimely exceeding motion as “employee,” ered qualifies for 10-day limit for motions to reconsider benefits as a “participating employer” as set Federal Rule of Civil Procedure plan; under the 6(a). The court further found the motion Count IV: that pay Defendants should merit, to be without noting that Plaintiff attorneys’ Plaintiffs fees and costs with did point to additional authority respect action; to the ERISA facts supposedly left out of the court’s Count V: that Defendants refused to consideration of the earlier motions. furnish requested information as re- period After a discovery, of limited quired by 1182(c); 29 U.S.C. parties filed for partial cross-motions sum- Count VI: estopped that Defendants are mary judgment. The district court ruled from asserting that Plaintiff was not on September these on motions covered under the and LTD poli- STD order, In its district court denied cies. Plaintiffs summary motion for judgment (list formatting 17-28 not in origi- V, on Counts II and further denied nal).) request expanded discovery conference, At an.initial Rule 16 under Count granted Lafay- I. The court objected to application of the rules set ette’s summary judgment motion for on Baptist forth Wilkins v. Healthcare II, Count granted and likewise re- MTA’s Inc., Sys., Cir.1998), 150 F.3d 609 quest summary judgment on Counts controlling the form and extent of discov- II, III, surviving and V. The Counts were ery Accordingly, the case. magis- Count I both Defendants for deni- judge parties trate ordered the to brief the al of Count III designate benefits and applicability of In conjunction Wilkins. Plaintiff a “participating employer” as Wilkins, its with brief and motion De- (the against Lafayette having court found Lafayette fendant filed motion to dismiss IV, attorneys’ Count fees and II, V, respect with to Counts and VI. costs, was more Likewise, properly considered Defendant MTA moved to dis- element requested of relief I, II, III, under the re- respect miss to Counts counts). maining VI. district judge substantive The Court consolidated the Wilkins motions and the mоtions to further Lafayette noted that while did not *11 timely Plaintiffs summary judgment on Plaintiff and counsel a motion for file III, appealed attorneys’ award of fees and grave had doubts the court Count 20, viability imposition July a claim. The court of sanctions on of such to the stipu- Lafayette timely either ‍​‌​‌‌‌‌​​​​​‌‌​​​​‌​‌​​‌‌​‌​​‌​‌‌​​​​​‌‌‌​‌​‌‌​​‍cross- Plaintiff 2004. Defendant therefore ordered III appealed attorneys’ Count fees as too late as to the dismissal its award Lafayette, 29, or indicate the court July low on 2004. against pursue Count Plaintiff intended that in which Lafayette, case against

III II. Lafayette an court afford

district would ANALYSIS for to file a second motion opportunity voluntarily summary judgment. Plaintiff The Determi- A. District Court’s Initial Lafayette on against III Count dismissed nations ERISA Under 30, 2003. September arguments Court, In av- to this Plaintiff final on district court took action The August ers in its 2002 order case counts on Jan- the substantive improperly district court dismissed sub- 2004. court dismissed uary The (c) (a), (b), claims and Plaintiffs Count MTA, reasoning remaining against I Count (breach fiduciary duty) improper- II and MTA, Lafayette, and not was that because ly entirety VI in dismissed Count its un- for claims administration responsible (promissory estoppel). proper MTA not a defen- plan, was der Finally, in a claim for benefits. dant Review Standard of Plaintiff not a concluded court This Court reviews a district of the employee purposes for STD covered in an case de judgment court’s judgment policies granted LTD and and novo, of re the same standard applying on Plaintiffs sole Lafayette Defendant for re view to administrator’s action as remaining claim for benefits the suit. Wilkins, quired district court. See by the in the timely appealed all orders 150 F.3d 615-16. Claims for breaches 26,2004. January case duty promissory estoppel and fiduciary mo- Defendant MTA thereafter filed and are not for denial of benefits claims and and attorneys’ for fees costs tions in addressed the first are therefore coun- 11 sanctions Plaintiffs Rule court, no requiring stance in the district Lafayette filed motion sel. Defendant action or administrator’s deference attorneys’ and costs. Plaintiff fees decision. of the taxed cross-filed review clerk’s costs as Defendants. bill of submitted Correctly Dis- 2. The District Court 21, 2004, Plain- the court denied On June (a), (c) (b), and missed Subclaims La- motion MTA’s and granted tiffs and Count II attorneys’ fayette’s motions for fees II that De alleged Plaintiffs Count costs, ordering pay percent fiduciary their duties fendants breached attorneys’ fees addition of Defendants’ obligations as follows: of costs to Defendants’ taxed bill (a) 2552). and au- addition, found, failed make under Defendants disability term authority thorize short Rule and its both disability pay- long term benefit counsel U.S.C. at a time when plaintiff severally ments jointly be liable should MTA knew Lafayette assessment. percent the 50 and/or enti- should have known he was district court was correct. The al- *12 benefits; to such legedly wrongful tled actions referred to (a) (c) through (b) subclaims all relate to ar- unreasonably Defendants and/or point Plaintiffs denial of benefits and to bitrarily payments in bad withheld remedy the as under knowing plaintiffs claims to same Plaintiffs claim faith the such, valid; I. precluded Count As be is 1132(a)(3) § using allegedly from (c) unreasonably, arbitrarily Defendants wrongful actions under addressable plain- pay bad faith failed to 1132(a)(1). § tiffs a time defen- benefits at when dants] had insufficient information Correctly District Court Dis- actions; justify

to such Entirety missed Count VI in its (d) Defendant failed to a provide MTA plan written document and a claims VI, Count Under claims that LTD procedure for the STD and Lafayette estopped MTA and are from policies as ERISA required asserting that Plaintiff is not covered 402 respectively; §§ and 503 employee under the STD LTD poli- (e) of fiduciary Other breaches duties cies. Plaintiff claims that Plaintiff relied unknown, yet which but will become representations by Lafayette on MTA and plaintiff through discovery. to known his disability coverage that would continue CSA, under the and in particular at claims Count under premium payments MTA’s of II remittance brought were U.S.C. Lafayette 1132(a)(3), to on § Plaintiffs behalf is conduct “catch all” ERISA’s remedial inconsistent subsequent position section. that Plaintiff not eligible for benefits. The district court reasoned that sub- (a) (c) through claims merely were restate This recognized promis- Court has ments of Plaintiffs claim for benefits. The sory estoppel theory is a viable district court reasoned Plaintiffs abili Sprague welfare benefit actions. See ty bring to suit for payment benefits Motors, Inc., Gen. 1132(a)(1) § precluded under 29 U.S.C. Cir.1998). estoppel The elements of an Plaintiffs suit under the “catch-all” reme claim are as follows: dial section for sounding those subclaims (1) there must be conduct language or pay as Varity failure due benefits. See amounting a representation Howe, 489, 512, Corp. v. 516 U.S. 116 S.Ct. fact; material (1996); 134 L.Ed.2d 130 see also (2) party the be estopped must be Wilkins, (“Because 150 F.3d at 615-16 facts; aware of true the 1132(a)(1)(B) § provides remedy [the (3) party estopped the must be intend plaintiffs] ... alleged injury he not does on, representation the acted be have a to a right cause action for breach or the party asserting estoppel the 1132(a)(3) fiduciary duty pursuant reasonably must believe that .... To rule in plaintiffs] [the favor would party intends; estopped to be so allow him and other ERISA claimants to (4) the party asserting estoppel simply characterize a denial of benefits facts; must be unaware the true of fiduciary duty, breach which result the Supreme expressly rejected.”) Court (5) Varity

(citing Corp., 516 at party U.S. asserting estoppel (1996)). S.Ct. 1065 reasonably justifiably must rely representation his detri- ment MTA. Plaintiff was self-ac- knowledged expert ment. welfare benefits cov- for MTA. Plaintiff erage admitted that he (list formatting Sprague, 133 F.3d policy at issue MTA like- sold in original). explained policy terms to MTA wise estoppel occur when a Typically, actions officers, including the term on covered em- actual fiduciary misrepresents plan Plaintiff admitted that ployees. he was meaning in a where terms situation *13 “go guy questions the to” for insurance plan ambiguous. the itself is See id. companies. by held MTA and its member under an 404. Plaintiffs cannot recover 1031-32.) (J.A. at Plaintiff had worked in estoppel theory misrepresentations years. for over 30 the insurance Under unambiguous, contradict written which MTA, 1972 MOU Plaintiff and between reliance on the plan terms because their questions Plaintiff handled all and claim unrea subsequent representation would be problems for life and group MTA’s disabil- id. court found sonable. See The district ity plans. Any by insurance reliance promis that Plaintiff had failed to base his representations by Plaintiff on MTA man- claim on that the sory estoppel premise agement going coverage, insurance Because, in plan ambiguous. terms were therefore, would have been unreasonable determination, Plaintiff the district court’s under the circumstances of this case allege plan did not that the documents acknowledged light superior Plaintiffs granted the ambiguous, were district policies on expertise specific insurance on judgment for Defendants Plaintiffs at issue. promissory estoppel theory.1 say This is not to that an insurance

This Court can affirm a district court on prevail can in an “expert” never any supported by the record. See basis estoppel theory, under promissory action City Mgt. Corp. Corp., v. U.S. Chem. Cir.1994). by that Plaintiff did reasonable reliance Plaintiff F.3d require allege representation documents from properly would some- as Plaintiff was ambiguous, specific knowledge were insofar with better or more one arguing meaning “employee” Plaintiff, over or at from someone than least Nonetheless, Plaintiff plan. under Plaintiff have reasonably who believed to prove prom- cannot at least element of one knowledge. specific Under better more issory Defen- estoppel respect with to each case, circumstances of for exam- this prevail. dant and therefore cannot had ple, Lafayette known terms relationship MTA Plaintiffs under his Plaintiff cannot show that reliance represented to Plaintiff the CSA and then any alleged misrepresentations by MTA under plan, that Plaintiff was covered reasonable, management required was as theory promissory estoppel by Supreme Court and this Circuit. facts Under the of this might be viable. 403; Sprague, Gregg See case, however, Lafayette did not know the Int’l, Transp. Am. 343 F.3d Workers of terms, (6th Cir.2003). and therefore did not the CSA Plaintiff admits “employee” know whether Plaintiff was an being knowledgeable about more insurance plan. infra, Part coverage anyone manage- than under the See II.C. Con- issues Judge Judge partial join conclusion on Cook’s insists that this Cook could Oliver’s dissent not, promissory estoppel Court’s the merits of Plaintiff’s determination that Plaintiff claim, fact, ERISA, infra, promissory estoppel is “employee” see inasmuch merely theory recovery deprives jurisdiction an alternative un- this Court of over Judge der ERISA benefits claim. case. We therefore fail to see how Plaintiff's any sequently, alleged representations cision, such as an lack alleged of due Lafayette while Lafayette were not made process afforded the administra- (criteria of the “aware true facts” two alleged part. tor or bias on its This claim), promissory estoppel for a also means that prehearing dis- Plaintiff assert promisso- therefore cannot covery at the district court level ry estoppel Lafayette. procedural be should limited to such challenges. Properly B. The District Court Limited Id. Discovery Scope for the Re- argues alleged because he maining Claims Under Wilkins process Defendants denied him due argues the district court benefits, his claim adjudicating scope improperly limited the of discovery was entitled to discovery into his denial of remaining his benefits breach of argues benefits claim. Plaintiff that his duty fiduciary disagree. claims. We *14 case is distinct from the action Wilkins 1) because, among other things: the claim- 1. Standard Review of ant in that case did not allege violations of This Court reviews the district 2) process, due there was no confusion in court’s conclusions applicability as to the of the case Wilkins about which documents Putney Wilkins de novo. v. Medical Cf. actually constituted the applicable ERISA Mut., 111 Fed.Appx. Cir. 3) plan, and there was no confusion in 2004) (unpublished opinion). Wilkins about who was the adminis- Applies 2. Wilkins to All ERISA Bene- trator. Cases fit Plaintiff While is correct about the Wilkins, this Court per- clarified the factual dissimilarities between Wilkins and scope

missible in an discovery case, his these do dissimilarities not make action in federal district court. 150 F.3d the Court’s instructions in any Wilkins at 618-19. This Court instructed district applicable less to the case at bar. Plain courts to follow a two-step process adju- tiffs arguments about inapplicability dicating an ERISA benefit action: all Wilkins come back to whether Plaintiff action, As to merits of the had opportunity present sufficient evi district court should conduct a de dence and arguments to Defendants and to solely novo review upon based respond to Defendants contentions—in es record, administrative and render sence, process all due issues. The Wilkins findings of fact and conclusions of panel foresaw pro occasions which the accordingly. law The district court cedural process of all gathering pertinent may consider parties’ arguments may information have broken down at the concerning proper analysis administrative level and directed the evidentiary materials contained courts to permit discovery in those cases. record, in thе administrative but Wilkins, (“The at 619. district may not admit or consider evi- court may consider evidence outside of the presented dence not to the adminis- only administrative record if trator. evidence is support offered in procedural of a chal may 2. The district court consider evi- decision.”) lenge to the administrator’s If dence outside of the administrative discovery alleged procedural if into the record de evidence is of- in support procedural supports plaintiffs allegations fered of a fects challenge denial, to the process administrator’s de- due then a district court is enough more evidence to determine whether discovery into obligated permit claim. plaintiffs of a areas had substantially substantive been denied process If finds that due id. a court See procedural protections. There is ERISA’s however, denied, appro- then it is was inconsistency no between the district further deny court to priate the district holding actions court’s and this Court’s areas, discovery or else into substantive Moreover, only logical Vanderlock. circumvent the directive plaintiff could reading of this instructions in Wil- Court’s by pleading process a due merely Wilkins process is that until a due violation is kins id. problem. Cf. established, colorably at least additional beyond rec- discovery the administrative Applied Properly 8. The District Court plaintiffs into a denial of benefits ord Wilkins impermissible. Wilkins was permitted The court dis district properly followed. actually covery into whether was due district process. denied Properly The District C. Court Grant- dis expand court will not noted “the Summary Judgment ed Defen- covery until a denial proven it is such dants on Plaintiffs Claims process occurred.” of due Fiduciary Duty Breach entirely order consistent This 1132(c) Monetary Penalties intent letter of Wilkins.2 *15 argues the district court ruling on district court’s argues the high granted summary Defendants improperly held Plaintiff to а Wilkins somehow un requires duty than this Court fiduciary er standard on of judgment his breach (See (“In PI. Br. nei 1132(c) 23-24 der Wilkins. § conclude that claims. We this nor Wilkins did ther Vanderlock properly court found that the district the al require plaintiff prove Court of present Plaintiff had evidence failed process per it leged denial of due before process or breach a due violation either con discovery both expanded mitted addition, fiduciary the dis- of duties. of of evidence outside sideration additional its trict court did not abuse discretion record.”).) find the administrative We refusing grant 29 U.S.C. penalties argument without merit. 1132(c). § found, of as a matter panel Vanderlock law, court evidence before the the 1. Standard Review of action plaintiff that the in that established summary judgment This Court reviews substantially proce had been denied the Image Co. v. novo. Eastman Kodak de by afforded ERISA. protections dural Inc., 451, Servs., n. 504 U.S. 466 Technical Accident v. Provident & Vanderklok Life (1992). 2072, 10, 112 119 L.Ed.2d 265 S.Ct. Cir.1992). (6th Co., 610, 617 F.2d Ins. 956 Summary judgment appropriate is when conclusion, this reaching After such fact, genuine of there is no issue material district court Court remanded judg to a thereby entitling the movant action, discovery. In the Id. instant v. Multi- ment as a matter of law. Kocsis discovery into district court deferred (6th 876, Inc., F.3d 882 Mgt., until it had 97 claims Care Plaintiffs substantive proven the denial "[U]ntil dis- Plaintiff has permitting court was tion: 2. That district respect covery process process, expand will into due issues with court of due clearer denial of benefits is even Defendants’ benefits claim.” denial of review court's when Court considers the lower opinion on motion Plaintiff's for reconsidera- 432 Cir.1996). fiduciary duty “inquiry, This Court’s there- Breach a. claims un-

fore, unavoidably asks whether reasonable der ERISA preponder- could find [fact-finders] recognized This Court equitable has an plaintiff ance of evidence that the is enti- claim a participant against ERISA [judgment].” tled Liber- to a Anderson v. plan fiduciary arising out of 29 U.S.C. Inc., 242, ty 247, Lobby, 477 106 U.S. S.Ct. 1132(a)(3) § a fiduciary when misleads a (1986). 2505, 91 L.Ed.2d 202 participant beneficiary. See Krohn v. “This Court de ‘the reviews novo 542, Hosp’l, Huron Mem. F.3d question procedure em whether (6th Cir.1999). ployed by fiduciary in denying the 1002(21)(A) § Pursuant to of ERISA: the requirements meets ” of Section person fiduciary respect [A] Marks v. Newcourt Credit [503].’ (i) a plan to the extent he Inc., (6th exercises Group, 342 F.3d Cir. 2003) any discretionary authority or (quoting discre- Kent v. United Omaha Co., tionary respecting management Ins. Cir. control Life 1996)). such any authority or exercises or control respecting management or Because a district has dis (iii) disposition of its assets ... or he in the monetary penalties cretion award of any discretionary authority has or dis- 1132(c), § under 29 U.S.C. re Court cretionary responsibility in the adminis- views a district court’s decision under that tration of plan. such section for an abuse discretion. Bar tling 1062, 1068 Corp., 29 F.3d 1002(21)(A). § 29 U.S.C. also pro- Fruehauf (6th Cir.1994). An abuse discretion ex fiduciary vides that “a discharge shall his reviewing ists when the firmly court is duties with to a respect plan solely in the that a convinced mistake has made. been interest of the participants beneficia- In re Litig., Bendectin 857 F.2d 1104(a)(1). ries.” 29 U.S.C. *16 (6th Cir.1988). fiduciary A duty breaches his by providing plan participants with materi Properly The District Dis- Court ally information, misleading “regardless of missed Fidu- Breach Plaintiffs fiduciary’s whether statements or ciary Duties Claim omissions were made or negligently inten The district court allowed Plaintiffs (internal tionally.” Krohn, 173 F.3d at 547 fiduciary breach of claim proceed, duties omitted). quotation and citation “Mislead discovery, to the extent that claim ing communications to participants 1) alleged that Defendants had made mate- (for regarding plan administration exam misrepresentations rial to Plaintiff about ple, eligibility a plan, under extent 2) benefits, eligibility Plaintiffs for benefits under plan) a will a support claim that Defendants had failed provide breach fiduciary duty.” a Drennan Plaintiff with requested plan documenta- 246, v. Corp., Gen. Motors 977 F.2d 251 40-M5.) tion. Inherent in these (6th Cir.1992) (internal quotation and cita allegations was Plaintiffs assertion that omitted). tion A lower court in this Cir Defendants had pro- denied Plaintiff due applied cuit has the fiduciary duty/misrep adjudication in cess of his denial of claim, resentation law of case this benefits and the Court a district court plaintiffs reached claim a process misrepresentation Plaintiffs due allegations on ruling precluded Plaintiffs her seeking breach from alternative duty. fiduciary disability sources of coverage. See Parks

433 by F.S.B., 889, testimony to statements Defendants 897 F.Supp.2d v. Fin. (W.D.Tenn.2004). no exact time reference. Plain- contain cites only time reference statements tiffs for breach To establish a claim meeting. at a “December 1998” made duty alleged misrep on fiduciary based (See 273, J.A. at Defendant MTA’s coverage an concerning resentations deposition in a later witness testified plaintiff a must plan, employee benefit took meeting place December show: day signed one after (1) acting a that the defendant addition, deposi- CSA. elsewhere his it when made the fiduciary capacity testimony, tion Plaintiff asserts that he challenged representations; within moments of its signed the CSA (2) [representations] consti- these him, discussing its presentation without misrepresentations; material tuted disability effect on Plaintiffs terms its coverage The district with Defendants. (3) on those mis- plaintiff that the relied subsequent court refused consider representations to detriment. [his] support Plaintiff in affidavit submitted Armstrong Corp., v. Pirelli Tire James judgment as an summary of his motion Cir.2002). 439, 449 “Wheth- F.3d pursuant Penny unreliable affidavit misrepresentation was er an affirmative Serv., United Parcel question of law and a mixed ‘material’ is (6th Cir.1997) (noting “party that a cannot material misrepresentation fact. [][A] of material fact genuine create issue it likelihood that if there is a substantial affidavit, motion for sum- filing an after a employee mislead reasonable would made, that mary has been es- judgment decision making informed adequately sentially deposition his earlier contradicts (internal if retire.” Id. and when to about testimony”). Plaintiffs late-filed affidavit omitted). Finally, quotations and citations and received sought states that Plaintiff misrepresenta- on the plaintiffs reliance Defendants, sign- prior from assurance Parks, 345 must be “reasonable.” tion CSA, that would not ing the CSA 897; F.3d at Gregg, F.Supp.2d cf. disability coverage. Plaintiffs affect (requiring plan administra- defendant ex- reliance on financial tor show its court’s alleges that the district reasonable). perts was deposition testimo- reference to unjusti- incomplete ny was somehow correctly conclud- b. The district *17 fied, for Defen- and asserts that counsel no issues materi- genuine ed that dants, had taking deposition, the somehow as to lia- al existed fact Defendants’ the al- obligation to establish when the misrepresentations bility alleged for (See were made. misrepresentations leged by made misrepresentations No were i. that argues further PI. Br. Plaintiff. to Plaintiffs prior either Defendant improperly court discounted the district CSA signing the affidavit. Plaintiffs found that Plaintiff The district court assertions that some Plaintiffs any put forth evidence had failed the counsel had burden how Defendants’ Lafayette misrepresenta- or made MTA alleged of Plaintiff when pulling out of the to Plaintiff the effect about tions made are without misrepresentations were “employ- as a covered on his status CSA summary judgment stage, théAt merit. of the signing to Plaintiffs CSA. prior ee” putting evi had the burden Defendants to Plaintiffs court referred The district the district argument before Plaintiffs dence testimony, which deposition had ii. which showed that Plaintiff Plaintiff cannot show reasonable re- any on alleged misrepresenta- liance genuine failed to establish a issue of mate- by tions MTA signed after Plaintiff rial fact. See Fed. 56. De- R. Civ. Proc. the CSA this, respect any did fendants with mis- representations allegedly made alleges misrep Plaintiff that MTA before CSA, disability resented Plaintiffs signed eligibility Plaintiff by pointing to signed by benefits after Plaintiff the CSA deposition Plaintiffs testimony and deducting premium payments from Plain (See 470-71.) lack dates therein. J.A. at monthly tiffs remitting remunerations and The burden then shifted to Plaintiff to premiums Lafayette. these show evidence in the record from which any found district court reli- reasonable trier of fact find could on by by ance Plaintiff statements made ‍​‌​‌‌‌‌​​​​​‌‌​​​​‌​‌​​‌‌​‌​​‌​‌‌​​​​​‌‌‌​‌​‌‌​​‍Defendants misrepresentations did make unreasonable, personnel MTA would be prior to Plaintiffs signing of the CSA. when Plaintiff self-acknowledged was the Plaintiff does not do this. expert coverage welfare benefits MTA. Plaintiff admitted that he sold the Instead, points Plaintiff to his policy at issue MTA and likewise ex- late filed affidavit and defense counsel’s officers, plained policy terms MTA “failure” to al establish dates including the on employees. term covered leged statements. We find dis Plaintiff admitted that “go he was the to” correctly trict court excluded the affidavit guy questions by insurance held MTA from consideration because it cannot be companies. its member Plaintiff had deposition reconciled testi worked in 30 years. insurance for over mony that signed Plaintiff the CSA within began Plaintiff his insurance career as an receiving moments of asking it and without Casualty. underwriter for AETNA Plain- any beyond questions “who ... wants tiff originally hired MTA in 1971 to 1059.) Further, this?” the dis manage programs. MTA’s insurance correctly trict court found that Plaintiff signed When and MTA an MOU had to put failed forth sufficient evidence Plaintiff continued to handle all summary judgment. to survive questions problems and claim for MTA’s cannot establish for the alleged date group and disability life insurance. misrepresentations, and Defendants’ evi correctly We find that the district court dence indicates that discussions toas that any concluded reliance Plaintiff on disability Plaintiffs continued if coverage, representations by MTA management per- оccur, such discussions did took place after sonnel toas effect on Plaintiffs CSA’s signed the CSA.3 Plaintiff there disability coverage would be unreasonable fore could not have alleged relied these light undisputed position of Plaintiffs misrepresentations in signing CSA. management vis-a-vis MTA on insurance *18 additionally argues general 3. Plaintiff that as- nothing lied. These statements do more than by management year speak sertions MTA management's in the to at desire the time the CSA, leading up upon to the that Plaintiff's were statement made to Plaintiff's maintain status, change coverage coverage. retirement or represent his The statements do not CSA, under the benefit would remain the that subsequently which Plaintiff same, materially misrepresented signed, actually eligibil- Plaintiff's maintained Plaintiff's disability argument ity fact, benefits to Plaintiff. general This for In benefits. assur- very generality fails due to the specific agreement of the state- any ances do not to refer upon purportedly ments which arrangement. Plaintiff re- Correctly Court Con- 8. The District was not an argues that he issues. Plaintiff to Plaintiff Had Failed expert on ERISA. cluded That undisputed Plaintiff undisputed expert on be an Material need not Genuine Issue Create undisputed ERISA, however, to be the Fact as to Whether Was Plaintiff in or knowledgeable person operating most Adjudi- Process in the Denied Due on issues. with MTA welfare benefit His cation Claim this in his brief to Court Plaintiff admits court found that de The district to answer that Plaintiff was unable when prop initial confusion as to the spite some question employee or member’s an MTA documentation, lack er ERISA benefits, Plaintiff would refer on welfare some summary plan description, and initial Lafayette. Plaintiff does questions such to Lafayette MTA and disagreement between refer such not that Plaintiff would assert adjudicating responsible as to for who questions to a member of unanswerable claim, the was ulti Plaintiffs STD Lafayette, not management. Were MTA mately adjudicated any without substan MTA, Plaintiff that represented to have to procedural tive to Plaintiffs impairment “employee” Plaintiff was covered rights. The court concluded that district CSA, reliance of the Plaintiffs terms opportu full Plaintiff had been afforded a light of Plaintiffs might be reasonable. any and to nity present all evidence however, superior knowledge, insurance of Plaintiffs claims Lafayette support any representations Plaintiffs reliance disability that Plaintiff could have management be unreason- MTA would appeals process of an advantage taken able. so. Plaintiff have chosen to do should that La- in. Plaintiff has failed to show proce- argues that numerous Plaintiff fayette misrepresentations to made any “deprived [Plaintiff] defects dural signed the Plaintiff after Plaintiff that be process assurance would some- CSA (Pl.Br.47.) arbitrary.” thing other than forth put fails, however, does how these Plaintiff show Plaintiff Lafayette knew the terms of evidence procedural prejudiced Plaintiffs defects prior application CSA in front of ability put desired evidence argues disability benefits. Plaintiff adjudicator, Lafayette. the claims Gener- Lafayette going knew that Plaintiff was ally, recognized in the courts have arrangement operate consulting under a procedural violations entail sub- cases beginning knowing but with MTA some useful stantive remedies when relationship MTA was that Plaintiffs Kent, 96 F.3d purpose would be served. change not the same as know going to any, point Neither does ing relationship. terms of that new or to the Court evidence briefs he could not recall Plaintiff testified that he argues court district which of the Lafayette copy with a providing Lafayette had placed have before would any evidence Without CSA. opportunity. given Plaintiff been of Plain Lafayette knew terms prej he was argues that CSA, any alleged tiffs under the status adjudication Lafayettе’s udiced by Lafayette could not misrepresentations a claim. Under Plaintiffs STD made. The negligently even have been MTA, Lafayette Agreement between correctly granted district therefore for STD to administer claims agreed MTA judgment Lafayette on Plain summary however, MTA, Lafayette *19 asked benefits. fiduciary duty/misrepresen tiffs breach administer claim STD Plaintiffs to tation claim. benefits because a feared conflict of requirements can result in remand by a interest due to Plaintiffs close association the reviewing court to the administrator. ultimately Lafayette agreed with MTA. to VanderKlok, See 956 F.2d at 619. This MTA, alleges do so. Plaintiff that were Court, however, adopted has the rule that Lafayette, adjudicated instead to have administrators need substantially claim, pre- his Plaintiff would have STD comply require- with these ERISA notice in pursuit vailed his of benefits because Kent, in ments order to avoid remand. MTA “admitted” that Plaintiff was a cov- 807. To there decide whether “employee” under the plan ered ERISA in compliance, substantial this Court consid- (PI. its Answer to Plaintiffs Complaint. ers all communications an between admin- Br.46.) argument, however, Plaintiffs plan participant istrator and to determine obligations Defendants’ misconstrues to provided whether the information was suf- Lafayette ultimately Plaintiff. was re- under ficient the circumstances. See sponsible under the terms of the STD Marks, 461; 342 F.3d at see also White v. adjudication policy itself of STD Co., Aetna Ins. 210 F.3d Life subsequent contract between claims. The (D.C.Cir.2000); Brehmer v. Inland Steel Lafayette legal MTA not did confer Plan, Indus. Pension 114 F.3d entitlements on Plaintiff. Plaintiff was (7th Cir.1997) (“The question is whether compliance by entitled substantial De- [plaintiff] supplied with a statement of procedural fendants with re- ERISA’s reasons that under circumstances of quirements in claims administration. sufficiently permitted the case un- clear arrangements Contractual as to who was derstanding of the administrator’s decision process not engage do affect review.”). permit effective “When claim actually enjoyed whether Plaintiff these communications as whole are sufficient procedural protections. purposes to fulfill the of Section 1133 the requires claim administrators to upheld decision will be even if a put a claimant notice of the reasons for particular communication does not meet its denial and afford an oppor- claimants Kent, requirements.” those 96 F.3d at adjudicator’s an tunity appeal de- initial analysis, 807. In this this Court asks § cision. Pursuant to plan whether the administrators fulfilled - Every employee plan benefit shall § the essential purpose notifying 503— (1) Plaintiff of their denying reasons for provide adequate writing his notice affording claims and participant opportunity him fair beneficiary whose claim for benefits for review. Id. under the has denied, setting been forth the specif- argues that Lafayette’s denial denial, ic such reasons for written inadequate letter was and that Plaintiff a manner calculated to be under- was an appeals process. denied Plaintiffs stood the participant, and however, arguments, unsupported by are (2) afford opportunity reasonable Lafayette’s the record. denial letter ex- any participant whose claim for ben- plained denying its reason efits has been denied for a full and claim in depth Lafayette’s determination — fair review appropriate not “employee” Plaintiff was an fiduciary named of the decision for plan. the terms of the denying the claim. pages denial letter was more than four U.S.C. length explained and further the factual

Generally, for Lafayette’s basis an administrator’s determination that comply failure to procedural with ERISA “employee.” Plaintiff was We find *20 it dispute MTA does not did Plaintiff mation. clearly placed very that the letter denying summary plan description as why Lafayette was a produce as to not on notice court, benefits. ERISA. The district required however, in refus- exercised its discretion clearly very af- Similarly, Plaintiff was monetary as penalties author- ing to assess any Before appeals procedure. forded 1132(c). In § reach- ized under 29 U.S.C. had been claim decision on Plaintiffs decision, ing its district court noted reached, adjudicator to forwarded a copy that Plaintiff had received Lafayette’s copy counsel summary plan in if policies, relevant not the used connection “Grievance Procedure” LTD The Griev- Lafayette’s policy. descriptions, expertise that Plaintiffs in with per- a contact Procedure established against any ance field benefit counseled wish- any claimant procedure son and prejudice a result of a lack of finding as coverage determination. ing to contest summary plan descriptions, that Plain- Moreover, July Lafayette’s letter of not, fact, any tiff had demonstrated benefits, by stat- denying concluded summary plan from prejudice lacking the ing: descriptions. disagree with you your client Should may This Court has said that courts long-term our conclusions that neither any or lack thereof in prejudice consider disability bene- disability short-term nor 1132(c) penalties § deciding whether are you may certainly, prior paid, can be fits Bartling, warranted. See 1068. any grievance to formal the institution firmly find that the evidence does not We us, provide with the written us a “mistake has made.” establish that been your opinion any informa- basis Id. therefore affirm the district court’s We supporting your tion belief us writ- grant monetary penalties under refusal it. ing and we will consider 1132(c). § Plaintiff does not contend any attempted that he to submit additional d! THE COURT COR- DISTRICT Lafayette attempted evidence he JUDGMENT RECTLY GRANTED grievance procedures formal institute IN OF DEFENDANTS ON FAVOR Lafayette’s policy outlined documents BENE- PLAINTIFF’S CLAIM FOR held Plaintiffs counsel. FITS Plаintiff was full We find that afforded the district court argues opportunity present and fair his claims concluded that Plaintiff was improperly Lafayette. Without for benefits to “employee” under ERISA a covered from precluded that Plaintiff was evidence was not entitled to benefits therefore evidence, or that Plaintiff submitting such plan. applicable under the an ad- prevented undertaking from Plaintiffs claims for appeal,

ministrative Review Standard of must fail. process due violations review a denial of bene

Courts Court Did Not Abuse challenged District fits U.S.C. A Refusing its Discretion novo, Grant 1132(a)(1)(B) § de unless Monetary Penalties Under fiduciary gives plan administrator or 1132(c) § U.S.C bene discretionary authority to determine the terms eligibility fit or construe V, Plaintiff Under Count asserted 1132(c) & Rubber Co. plan. Tire Firestone under 29 U.S.C. 101, 115, Bruch, S.Ct. requested infor- U.S. MTA for failure furnish *21 438 (1989). parties

103 L.Ed.2d 80 The do not Under a is a person ERISA appeal the lower court’s determination that fiduciary only respect aspects to those plan the administrator here does not have plan the over he or which she exercises discretionary benefit eligibility authority. authority or control. See v. Grindstaff This Court reviews district court’s de- Green, (6th 416, Cir.1998). 133 F.3d 426 cisions on matters of law an ERISA When company administers insurance benefits action de novo and its factual find- employee plans claims for welfare benefit ings for clear error. See v. W. & S. Stoll authority grant claims, has deny or (6th Co., 986, Fed.Appx. 64 990 Ins. Life “fiduciary” the insurance a company is for Cir.2003) (unpublished opinion). purposes. ERISA Libbey-Owens- See v. Ford Co. Blue Cross & Blue Shield Mut. Properly 2. The District Court Dis- Ohio, (6th 1031, 1035 Cir.1993). 982 F.2d a missed MTA as Defendant employer An not who does control or influ The district court concluded that deny ence the decision to benefits is not a proper MTA was not defendant for a fiduciary with respect ben denial of claim for benefits because MTA did not v. efit claims. Chiera John Hancock Mut. participate deny the decision tо Co., (6th 384, Ins. 3 Fed.Appx. Life benefits under either STD or the LTD Cir.2001) decision) (“Defen (unpublished Rather, policies. Lafayette, as the claims fiduciary company] [insurance dant is a for administrator, proper party was the defen purposes of ERISA inasmuch as it had a dant for Plaintiffs denial of benefit claim. role in administering plan it because ERISA, According to a plan “fidu had authority accept reject or claims for ciary” is one any who “exercises discre losses group under the policy insurance authority tionary or discretionary control by rejection evidenced letter that it respecting management [an ERISA] sent to Plaintiff response her attor any or authority exercises control or letter.”) ney’s respecting management disposition or Here, despite some initial confusion over of its assets” or who “has discretion titles, proper Lafayette and MTA ary authority discretionary responsibili or agreed early on in litigation that while ty in the administration plan.” of such administrator, MTA is the plan Lafayette 1002(21)(A). U.S.C. This Court has is the claims administrator and exercised fiduciary found that “the definition of a full authority in adjudicating Plaintiffs one, under ERISA is functional [and] Lafayette benefits. It was who intended to be broader than the common- made a with respect decision to Plaintiffs law definition” such that the issue of benefits, Lafayette, not MTA. and not whether one is fiduciary considered a does MTA, is proper party therefore the defen- upon turn not formal designations. Smith by dant for denial of benefits claim Plain- Bank, 609, v. Provident 170 F.3d Co., tiff. See Kennard Unum Cir.1999). Ins. Therefore, purposes Life 01-217-B-K, 412067, No. *1- WL ERISA, “fiduciary” includes 3, 2002 U.S. Dist. LEXIS at *4-6 persons specifically named as fiduciaries (D.Me. 2002) Mar. (unpublished opin- plan, anyone the benefit but also else ion) (dismissing employer from discretionary who exercises benefits control or au thority suit when company, over a insurance and not em- plan’s management, admin decisions). istration, ployer, made benefit dis- assets. See Mich. Affiliated Sys., Sys. dismissing Healthcare Inc. v. trict court did not err in MTA Corp. CC Mich., (6th Cir.1998). 139 F.3d from Plaintiffs suit benefits. prod- manner and means which the Properly Found The District Court accomplished. Among That Was Not uct is other Covered *22 Employee inquiry to are the factors relevant in- the of the required; skill source matter, As a threshold a. tools; the strumentalities and location meet “em- must the definition of work; of the the duration of the rela- ployee” under ERISA parties; the tionship between whether action for arises un- benefits has as- hiring party right the the to 1132(a), § enables a which der U.S.C. sign projects to the hired additional to enforce the plan “participant” benefit of party; party’s the extent the hired of provisions ERISA. The Act substantive long discretion over when and how “participant” “any as elsewhere defines work; payment; the method of the of an em- employee employee or former in hiring hired role party’s paying may eligible ... or become ployer who is assistants; part work whether the type from a of an receive benefit regular hiring of the business of the 1002(7). ....”§ employee benefit party; hiring party is in whether allege that he Plaintiff does not has vest- business; provision employee his as benefits due to status a ed welfare benefits; and the tax treatment of the of MTA reference to employee” “former hired party. In- prior work MTA his 751-752, 490 U.S. at 109 S.Ct. 2166 stead, he is a alleges “partici- omitted). (footnotes pant” “employee” because was an he (Second) Thus, under Plain- Agency MTA while the CSA. Restatement Cf. 220(2) “can (1958) tiffs claim for benefits under ERISA (listing nonexhaustive if ‘employ- succeed he was [MTA’s] identifying criteria for master-servant ” ee,’ Supreme under the The while CSA. 87-41, Rev. Rui. 1987-1 relationship); as an “em- qualify Court has held that (setting forth 20 Bull. 298-299 Cum. plaintiff ployee” purposes, for ERISA guides determining factors as wheth- for em- must meet the common law test qualifies as common- er individual Ins. v. Dar- рloyee. Nationwide Mut. Co. tax law con- “employee” law various den, 318, 320-321, 503 U.S. S.Ct. texts). con- common-law test Since the (1992). Only Plain- 117 L.Ed.2d 581 once magic formula shorthand tains no he tiff has demonstrated that meets the applied can find the phrase that be meaning “employee” law common answer, all of the ... incidents should this Court turn whether must be assessed and relationship as in the STD “employee” was an defined being one factor deci- weighed with no LTD distinct from an “em- policies, sive. ployee” under ERISA. Nationwide, 503 112 S.Ct. U.S. (internal quotations and citations law em- is not common b. Plaintiff omitted). ployee all fac- district court considered The Supreme adopted Court has district outlined Nationwide. The tors employee law definition of under

common court conducted that: ERISA: significant no control a. MTA exercised party a hired determining whether his performed over how Plaintiff general employee is an duties, Plain- CSA described agency, law consider common we contractor;” “independent tiff as an hiring party’s right to control the required significant represented b. Plaintiff skill to that he had “incorporated duties, perform his counseling receiving himself’ and that he was pay- finding Plaintiff an employ- ment “until end of contracts that ex- ee; pire 12-31-00.” MTA, c. Plaintiff had an office at While We find the district court’s factual he of his covered much own ex- findings clearly are not erroneous. We penses; further agree with the district court that appear require d. MTA did the balance of the supports evidence *23 MTA; Plaintiff work on at to site conclusion Plaintiff not does meet the e. While MTA and Plaintiff worked to- definition of an “employee” under the com- gether years, many they did so self-representation mon law. Plaintiffs under a contractual relationship, Security the Social Administration com- is changed which in December 1998 pelling. in conjunction When viewed signed; when the CSA was 1099s, of responsi- the issuance Plaintiffs f. CSA, Under the of MTA terms taxes, bility payroll for his own and refer- right did not assign have addi- ence to Plaintiff as “independent an con- Plaintiff; tional duties itself, tractor” the CSA Plaintiff not g. Plaintiff significant had discretion employee common law and therefore ineli- work; over how long when and gible an plan. under ERISA benefit pursuant h. Plaintiff paid was to the independent CSA as an contractor E. The District Court Did Not Abuse and had to remit his own taxes and Awarding its Discretion Partial security payments; social Attorneys’ Fees Under 29 U.S.C. i. appeared Plaintiff free to hire assis- 1132(g)(1) Against § Plaintiff and chose; tants if he so in Sanctioning Plaintiffs Counsel j. Plaintiffs services were essential to argues Plaintiff that the Court’s conclu- regular MTA; business of sion that Plaintiff is not a common law k. eligible Plaintiff not was for “em- employee, and a “partici- therefore not ployee benefits” in the normal pant” ERISA, in a results determi- course of pursu- MTA business and nation that Plaintiff lacks statutory stand- CSA, ant language of the and ing this Court therefore lacks provided

which for remittance of the jurisdiction § 1132(g)(1) under 29 U.S.C. balance due under the CSA in the against to award fees In Plaintiff. of event Plaintiff’s extended illness alternative, argues incapacity; the dis- medical and trict court abused its discretion award- l. Plaintiffs tax treatment indicated ing attorneys against fees pursu- employee, not an be- addition, § ant to 29 reported 1132(g)(1). cause MTA U.S.C. Plaintiffs re- attorney muneration Plaintiffs argues 1099s and that the W-2s. district court abused its discretion in sanctioning (J.A. 103-10.) In addition to the Na- Plaintiffs attorney holding the attorney factors, tionwide the district court also jointly severally liable with Plaintiff considered Plaintiffs representation of his Plaintiff, for the award of fees. employment status on a security social dis- attorney, Lafayette ability forms, also take issue application. benefit In those with the district court’s Plaintiff asserted that he was “self-em- calculation ployed” “president reject man awarded fees. arguments [a] one We these company.” Plaintiff further in turn. in a under the statute. involved suit See Review Standard of § 1132(g)(1). 29 U.S.C. the terms of

This Court construes de novo. Jordan v. ERISA statute self- argument We find Plaintiffs both Fund, Teamsters Mich. Welfare Conf. serving and incorrect.5 Were the Court’s Cir.2000). 207 F.3d on the factual determination merits a district Court reviews This “employee” Plaintiffs status as an deter attorneys’ fees and costs court’s award “partic minative Plaintiff was a of whether 1132(g)(1) § for an abuse under 29 U.S.C. statute, ipant” under our mer 1132(g)(1) ‍​‌​‌‌‌‌​​​​​‌‌​​​​‌​‌​​‌‌​‌​​‌​‌‌​​​​​‌‌‌​‌​‌‌​​‍discretion. See U.S.C. its determination would render Plaintiff (“[T]he may allow a court in its discretion statutory standing without and this Court attorney’s fees costs reasonable jurisdiction all, to hear case at without ”). Similarly, .... this Court reviews inapposite Supreme prec a result Court impose sanctions court’s decision to district edent, despite Judge Cook’s conclusion to attorney for abuse discretion. contrary partial her dissent *24 § 28 1927.4 abuse of “[A]n U.S.C. See case. court has when the discretion exists firm conviction the definite and “participants” a. and Fire- ERISA judg a error of court made clear district stone weighing in rele upon ment its conclusion Labor Sec’y Dep’t v. vant factors.” of of Plaintiffs action for benefits arises un- (6th Cir.1985). King, 775 F.2d 669 1132(a), § 29 which enables a der U.S.C. plan to “participant” benefit enforce the Authority Had to 2. The District Court provisions ERISA. The Act substantive Against Impose Attorneys’ Fees “participant” “any as elsewhere defines employee or former of an em- employee argues Plaintiff first the district eligible ployer may ... who or become is authority impose attorneys’ to court lacked type from any receive a benefit of an to court had against Plaintiff because the fees employee plan benefit which covers em- “employee” an that Plaintiff was not found ” .... 29 ployees employer of such U.S.C. ineligible under ERISA and was therefore 1002(7). § that was alleges he an an ERISA cause to recover bеnefits under disability of MTA when his be- employee argues that the district of action. Plaintiff who gan, making “employee him an ... is as court’s factual conclusion ” .... a eligible to receive benefit an means that Plain- “employee” status as “participant” a under ERISA therefore can not a “participant” tiff be argues that standing with to sue. MTA which authorizes the award 1132(g)(1), “independent an contractor” Plaintiff was attorneys’ participant, fees not “employee.” an ERISA an beneficiary, fiduciary plan or Appeals for the "Any attorney person admitted to 5. The United States Court 4. or other explicitly rejected Ninth Circuit has such any conduct cases in court of the United argument presents self-serving any Territory or thereof who so multi- States Mgrs. See Credit Assoc. So. here. Calif. plies proceedings case unreason- in Co., Accident Ins. F.3d Kennesaw &Life ably vexatiously may required be 1994) (”[I]t unjust would Cir. be costs, satisfy personally the excess court to [plaintiff] insulate itself liabili permit from attorneys’ expenses, reasonably in- fees attorney’s simply ty [he] fees because of such conduct." U.S.C. curred because prevail evidence to produce sufficient failed § 1927. claims.”). [his] statutory Judge standing Cook cites Ward v. Alternative under the term “partici- 115-18, Delivery pant.” Systems, Health Id. 109 S.Ct. 948. The (6th Cir.2001), proposition plaintiffs for the that this in Firestone were em- former subject jurisdiction matter ployees Court lacks of the tire manufacturer who brought by plaintiff over an ERISA suit they claimed that were entitled benefits standing. statutory who lacks While we pay plan under a termination that Fire- agree standing is that lack of determina- place had in at the time stone Firestone jurisdiction tive of the of this in an Court sold the plaintiffs business which action, agree Plain- we do not plaintiffs argued, part, worked. The tiff lacks case at standing bar they were entitled to receive analogous that this to that case cited from information Firestone after Firestone plaintiff argued Ward. The Ward sold plain- the business unit in which the under the existing extension of law corol- agreed tiffs worked. district court lary standing “beneficiary” prong of Firestone, however, that at the time This ERISA. Id. Court refused (after plaintiffs requested the information to extend the “beneficiary” definition of to the sale of the unit they business in which providers. include health care Id. This worked), plaintiffs longer no partici- were law, ruling a factual determi- pants of plans, Firestone’s ERISA obviat- plaintiff nation that not qual- the Ward did ing obligations provide Firestone’s in- ify beneficiary as a under traditional defi- formation. Id. at 109 S.Ct. 948. The nitions. court, Third Circuit reversed the district *25 reasoning right request the to in at arguing the case bar is not receive information an employee an about extension of existing ERISA stand- plan ing Rather, sensibly benefit “most both argues that, law. extend[s] as a fact, people who are in fact matter an entitled to a “employee” of Plaintiff was benefit under the plan when his those who claim disability began. goes This 108, to be in fact are at the but not.” Id. 109 Questions statutory merits. stand- S.Ct. ing (quoting 948 from the Third merge. and cause of action often Circuit This opinion). is the circumstance the case at bar. alleges that he an employee was appeal, Supreme On the rejected Court of the Defendant MTA when he became the Third Circuit’s contention that liti- a fact, In disabled. whether or not Plaintiff gant’s bald assertion of participant status was an employee is determinative in the 117, inquiry. ended the Id. at 109 S.Ct. suit. It is argue circular to that because Supreme 948. The Court noted that “Con- the Court has determined that Plaintiff gress say did not that all ‘claimants’ could

was not an employee, Plaintiff lacked receive information about plans. benefit standing to sue and that this Court there- To say that a ‘participant’ is person jurisdiction. Rather, fore lacks Plaintiff who begs question claims to be onе the had a colorable claim that he anwas em- who a ‘participant’ is and renders the defi- ployee and that he was therefore covered 1002(7) § superfluous.” nition set forth in Logic the statute. dictates the Id.; 1002(7) 29 see also U.S.C. (defining federal courts be able to reach ques- “any participant as or employee former tion. employee an employer ... who is or Supreme may The eligible Court addressed this become a issue receive benefit of in any type Firestone Tire and an employee plan Rubber Co. from benefit Bruch, 101, 109 ”). at Supreme U.S. S.Ct. 948. The .... The Court was therefore Firestone Court question requiring addressed the appeals the court of to address litigant claim be par- “employee definition of must an or particularized more

the in the statute. ticipant employee” participant available a is former as de- statute, in fined the ERISA deter- case, the remanding Supreme a mining “participant” status court must view, our “[i]n further noted that Court do more than take the claimant’s bald as- naturally ‘participant’ term read follow, however, It sertion. does not in, reasonably or employees mean either a claim benefits which revolves around in, currently covered em- expected be a question litigant of whether is or was employees ... former who ployment “employee” an devolves into expectation ... a of re- have reasonable standing a employment or who issue alone. turning to covered a claim to have colorable vested benefits.” Firestone, Supreme Since Court has Rubber, U.S. at Firestone Tire & revolving claim- ruled on a case around the (internal and cita- quotations S.Ct. employee. status as an See Nation- ant’s omitted). Supreme The Court ex- tions wide, at 503 U.S. S.Ct. 1344. The further on its definition even panded parties posture Nationwide was noting that: very case posture similar tо the that he or she order to establish “[i]n The plaintiff bar. former insurance benefits, ‘may eligible’ for become agent for defendant Nationwide. After claimant must have colorable agen- plaintiffs Nationwide terminated the (1) prevail in a he or she will suit cy, plaintiff brought suit under ERISA (2) benefits, eligibility re- or that to enforce the terms of a retirement in the quirements will be fulfilled future. eligibili- claimed plaintiff under which This view attributes conventional mean- ty. pro- Id. 112 S.Ct. 1344. ings statutory language since all ceedings in the lower court turned on employment employees covered qualified plaintiff whether the “em- employees former with colorable claim ployee employee” or former of Nationwide ‘may eligible.’ to vested benefits become *26 eligible a to thereby “participant” and employee A who has neither a former at 321- claim benefits under ERISA. Id. expectation returning of reasonable 22, Supreme 112 1344. The Court S.Ct. nor a employment covered colorable agency principles that common law held benefits, however, simply claim to vested plaintiff applied to whether the determine phrase ‘may be- does not fit within the ” The “employee” was an ERISA. eligible.’ come Supreme remanded the case for the Court (internal 118-19, quo- Id. 109 S.Ct. 948 legal the correct standard. application of omitted). and The Su- tations citations 328, The 112 1344. Court did Id. at S.Ct. of question not reach the preme Court did finding any way, in imply, qualified partici- the claimants whether employee would plaintiff the was not Firestone, preferring in to leave that pants of their strip the federal courts function appeals upon to the court of determination authority the over case. 118,109 remand. Id. at S.Ct. logical reading Supreme The of the jurisdictional and b. When the merits by is that opinion Firestone Court’s merge issues statutory definition of failing to look to the directly point on Firestone is While appeals abrogated court participant, the of in- standing, have also been favors we statutory on enti- restriction who was gen- more minimum, Supreme structed Court At tled information. jurisdiction statute- when erally that a assume Supreme saying Court seemed be 444

ry standing questions converge. only and merits This “standard is met where the 678, 681-82, Hood, plaintiffs plausible v. 66 claim ‘has no founda See Bell 327 U.S. (1946). 773, clearly prior 90 L.Ed. 939 The Fifth tion’ or ‘is foreclosed S.Ct. ” Williamson, meaning Supreme decision.’ Circuit has summarized Court very it at 416 v. (quoting that case well as relates to cases 645 F.2d Bell Health- (5th Mor, Inc., 342, 549 F.2d Cir. such as one bar: 344 1977)). jurisdiction the basis of federal is When plaintiffs

intertwined federal McCotter, 790, v. 793 Eubanks 802 F.2d action, cause of should assume Cir.1986). jurisdiction the ease and decide over Supreme recently has ex- Court Hood, on the case merits. Bell v. 327 panded premise on the of Bell v. Hood 678, 681-82, U.S. 66 S.Ct. 90 L.Ed. emphasized that the courts not ex- must (1946) subject .... question “The subject jurisdic- concept tend the matter jurisdiction matter merits will and the tion, which deals with the of cases “classes normally be considered intertwined falling ... adjudicatory a court’s within provides where the statute both [same] authority,” capture other instances subject the basis of federal court matter which a court dismiss or should refuse

jurisdiction and the cause of action.” Ryan, take case. See Kontrick v. Texas, Clark v. County, Tarrant 443, 455-56, U.S. S.Ct. (5th Cir.1986) (citation 736, 742 (2004) (distinguishing L.Ed.2d between omitted). ], Tucker [v. Williamson subject jurisdiction issues of matter explained we rules). processing claims This Court re- purpose by indirectly no is ar- served cently reflected the Kontrick distinction guing the merits in the context Recoveries, Gunter, Primax Inc. jurisdiction. economy federal Judicial plaintiffs which a panel held that a is best promoted when the existence 1132(a)(3) properly under ERISA right directly federal reached claim, dismissed failure to state a and, exist, no claim is where found to subject not for jurisdiction, lack of matter the case is dismissed the mer- plaintiff sought legal when the relief and a general its.... Therefore as rule a the statute authorized ac- equitable claim cannot be dismissed lack of (6th Cir.2006). tions. 519-20 433 F.3d subject jurisdiction matter because of The Primax Recoveries further held panel the absence of a federal cause ac- that because possessed the district court tion. subject jurisdiction case, matter over *27 [404,] Cir.1981], 645 F.2d 415-16 [5th though plaintiff even the failed state a The basic reason for this is rule obvious. claim, possessed authority the court full If jurisdiction federal turned the suc- attorneys’ award prevailing fees to the of plaintiffs cess of federal cause ac- party under the ERISA statute. at Id. tion, no such case could ever be dis- 520. The Primax panel cited to Steel Co. missed on the merits. Env’t, 83, v. Citizens Better 523 U.S. exceptions 1003, The (1998), the rule of Bell v. 118 S.Ct. 140 L.Ed.2d 210 jurisdictional are that noting Hood subject dismissal is that for lack dismissal of if proper “clearly ap- jurisdiction federal claim matter of because the inade- pears to solely quacy be immaterial and made proper only of federal claim is jurisdiction insubstantial, for the purpose obtaining of a claim “so implausi- when is or ble, wholly by where such a claim is insub- prior foreclosed decisions of Hood, Court, stantial and v. frivolous.” Bell of completely otherwise devoid 682-83, 327 at .... U.S. 66 S.Ct. 773 so merit as not involve a federal ‍​‌​‌‌‌‌​​​​​‌‌​​​​‌​‌​​‌‌​‌​​‌​‌‌​​​​​‌‌‌​‌​‌‌​​‍contro- Recoveries, F.3d at 775 F.2d at 669. The district court King, versy.” Primaz Co., U.S. at (citing Steel each of these in turn. addressed factors 1003). found, S.Ct. court first The district and fore- most, litigate good Plaintiff that did not case, In instant presented a color- faith. While Plaintiff claim that he makes at least a colorable benefits, claim for Plaintiff asserted a able “employee,” and therefore an an was against number of “near frivolous” claims the time his “participant,” ERISA Defendants, Plaintiff refused to dis- both disability. is so His claim not insubstantial against one Defendant or an- miss claims present a controver it fails to federal was other once it became clear which Co., 523 U.S. at S.Ct. sy. Steel claim, Moreover, proper Defendant a factual determination Plaintiffs status was unnecessarily prolonged litigation on the merits that employee an does not actually that of by filing and pursuing unreliable briefs jurisdiction the federal courts of over strip rejection by even after their arguments Rather, under the rules Bell the case. addition, district court the court. Co., may properly Hood and Steel we quo- “improperly found that Plaintiff took case and the merits reach out of context and made strained tations jurisdiction appropriate make retain misinterpret- upon based such arguments attorneys as envisioned fees’ award citations.” ed Congress crafting when the ERISA that the district court’s conclu- We find scheme. supported sions are the record. For parties agreed that example, after Did Not Abuse District Court 3. The plan La- MTA was the administrator while Awarding Attor- its Discretion administrator, fayette the claims was neys’ Fees and Costs his to dismiss claim for Plaintiff refused district argues MTA to dis- against and refused benefits awarding court abused its discretion turn over his claim failure to miss portion attorneys’ their Defendants The case Lafayette. documents fees costs. proper is a very clear about who law in this consider five Courts Circuit claims. party defendant for each of these attorneys’ deciding fees factors district court need not determine questions: faith pursued matter in bad the entire (1) party’s degree opposing of the part culpability level on the find some faith; or bad culpability unnecessary scope of of Plaintiff for the (2) satisfy opposing party’s ability to litigation. fees; attorneys’ an award of argues that the district Plaintiff further (3) of an award on the deterrent effect to reach a con- had insufficient basis similar circum- persons other pay afford to that Plaintiff could clusion stances; The district imposed attorneys’ fees. *28 (4) requesting party fees whether fact that its conclusion on the court based to confer a common benefit sought half a reported approximately Plaintiff had participants and beneficiaries on all in 1998 and 1999. million dollars income signifi- of an or resolve ERISA no to the dis- evidence presented legal questions regarding cant ERISA; court, no evi- presents and indeed and trict Court, his support of con- (5) dence parties’ the relative merits pay that he cannot fees. tention positions. 446 argues

Plaintiff next that the dis court rendered its decision for MTA’s fees § under both Rule 11 and 28 U.S.C. 1927 deterring trict is color- improperly court authority. The district court rendered its by awarding par able claims for benefits Lafayette’s decision fees under its 28 attorneys’ against tial fees Plaintiff. § authority. 1927 11 U.S.C. While Rule argument Plaintiffs without is merit. § 1927 are alternative sanctioning presumption While there is no award of schemes, possesses require each its own attorneys’ prevailing party fees to the NASCO, Inc., v. ments. See Chambers action, Gregori, an v. see Schwartz 32, 43-44, 2123, 501 U.S. 111 115 S.Ct. (6th 1116, Cir.1998), 160 F.3d 1119-20 (1991) 1927, § 27 (finding L.Ed.2d objective district court’s was not to deter 11, power Rule court’s inherent plaintiffs bringing from colorable claims concert). impose sanctions exist in This benefits, unnecessarily but from ex may impo Court affirm the district court’s panding complexity scope litiga sanctions, however, sition of if we find Finally, tion. the district court considered counsel’s conduct ei sanctionable under King that the fourth factor was inapplica § ther Rule 11 or may because we ble, and that the fifth factor favored De any affirm the grounds district court many fendants because of Plaintiffs sub- supported City Mgmt. the record. claims or duplicative were either lacked 251; Corp., 43 F.3d at see also Ridder merit. City Springfield, 109 F.3d 299 Cir.1997) This Court is not left with “definite (affirming attorneys’ award of and firm conviction that the district pursuant fees 1927when under award judgment.” improper). made clear error of Rule was We have reviewed Plaintiffs briefs to the dis- a. untimely Sanctions were agree trict court and with the district court Bule 11 relatively unreliable, that the briefs were Rule an revised sanc unreliability that continued in Under Plaintiffs tions under only appropriate Rule are addition, briefs to this Court. when a party made aware of the offend pursue continued against claims both ing document as filed with the court and Lafayette and MTA when the record had opportunity has an filing. withdraw the become clear that one or the other comm, Fed. R. advisory Civ. Proc. 11 *29 attorneys’ § Defendant’s fees. The holding. district 1927 See infra.

447 § N. 1927 sanction. See Trust its a 28 U.S.C. court did abuse b. The district Muller, 616 789 F.Supp. v. Co. sanctions imposing discretion (N.D.Ill.1985). This Court is not left with § 1927 the a “definite and firm conviction that provides: Section of judg a clear error district court made admitted attorney person or other Any ment.” the any court of cases conduct any Territory thereof United States or Attorneys’ Fee 5. The Size the of the multiplies proceedings who so Award Was Reasonable vexatiously may unreasonably and case in the alternative argues Plaintiff satisfy per- by the court required be of that of the district court’s award the size costs, expenses, and the sonally excess submitted fees was unreasonable. MTA reasonably be- attorneys’ incurred fees accountings monthly hourly invoices with such conduct. cause of hourly rate accompanied attorney held § has 1927. This Court U.S.C. charges. requested total amount MTA’s that: $166,000. The district approximately § question under 28 U.S.C. the charges La court found these reasonable. attorney “multipliefd] Plaintiffs whether however, only fayette, a total submitted and unreasonably ... proceedings at accompanying amount and an affidavit vexatiously.” An affirmative answer testing to the amount’s reasonableness. finding questiоn require does not of Lafayette requested a amount total faith, recklessness, subjective bad $75,000. court likewise The district about attorney an does impropriety; conscious Concluding amount reasonable. found this to burden not have carte blanche and counsel unnec that Plaintiff by pursuing claims courts federal scope complexi and essarily expanded the (see he are frivolous Jones should know by approximately ERISA action ty (6th F.2d 1225 Corp., Continental court ordered percent, district Cir.1986)) .... held jointly Plaintiffs counsel Plaintiff and TRW, 799 Div. Haynie v. Ross Gear severally percent of both and liable Cir.1986). 237, 243 Lafayette’s submitted fees. MTA’s and therefore, is whether inquiry, Our portion of the bill to no points that Plain support in record there is Plaintiff avers by MTA which submitted attorney “multiplie[d] proceedings tiffs charge. Rath represents unreasonable unreasonably vexatiously.” ... er, argues district against Plaintiffs district court’s sanction “careful matter give court failed finding the court’s as supported findings” counsel is “discrete analysis” and make of attor § the award dis supporting of bad faith 1927 sanction. We required for supra. neys’ against Plaintiff. See court held counsel agree. fees The district found for the same conduct specifically jointly responsible The district court tactics, mis the court’s award litigation underpinned “Plaintiffs counsel’s which Plaintiff, eharacterizations, conduct pursuit attorneys’ fees relentless in the court referenced positions satisfies which the district untenable claims accompanying may opinion hold A court memorandum 1927.” find awarding We therefore severally fees.6 attorney jointly order party’s percent of award of 50 attorneys’ the district court’s fees opposition’s for the liable foremost, found, presented a claim for While colorable district first and 6. The litigate good faith. did not that Plaintiff *30 448 manner,

Lafayette attorneys’ fees a rea verted to in a perfunctory MTA’s unаc award, pursuant companied by to the some at developed sonable district effort (in argumentation, are deemed waived.” findings court’s factual that Plaintiff and omitted)); quotation and unreasonably ternal citation see multiplied Plaintiffs counsel Central, Cook, v. also North Inc. litigation same amount. We Re/Max (7th Cir.2003) (find 562, Fed.Appx. 64 565 findings the district court’s satis believe ing party’s arguments attorneys’ as to fees fied trial this Court’s instructions appeal); waived for lack of development on provide explana courts “clear and concise Corp., v. AON 415 F.3d awarding at tion^] [their] reasons” cf. Taubenfeld 597, (7th Cir.2005) (applying waiver torneys’ Gettings v. Bldg. fees. Laborers analysis party’s 310, (6th Cir.2003). allegations of lower 300, Local 349 F.3d court in the attorneys’ error award of Plaintiff further in a argues, fees); v. E.I. DuPont Griggs de Nemours perfunctory way, that the district court Co., (4th 440, Cir.2004) & 385 F.3d awarding Lafayette erred fees to when (same). perfunctory argument Lafayette yet had to submit detailed hour and failure to elucidate relevant case law ly charges constituting a of its breakdown to a argu therefore amounts waiver of this argues fees.7 Plaintiff that such doc on appeal. ment “logical prerequi umentation would be a ” establishing site un ‘reasonableness’ 6. The District Court Did Not Abuse (Pl.Br.67.) der 1927. Plaintiff fails its Discretion the Amount Fees law, support this statement with case Lafayette Awarded to and further to any fails cite relevant Lafayette cross-appeals dis legal authority requires which this Court trict attorneys’ court’s award its fees as to overturn a district court’s award of at too low. Inasmuch as the amount awarded torneys’ fees in the an hourly absence of by the district court was on premised bill. Plaintiffs one argument sentence by Lafayette, amount submitted and the this effect therefore to pre insufficient fact the Plaintiffs claim for benefits was at argument appeal. serve “[The against least colorable Lafayettе, we appeals] courts of are not self-directed cross-appeal find that this is without merit. legal inquiry research, boards of but essentially legal questions arbiters of pre III. sented and argued parties.” See CONCLUSION Airlines, Inc., v. Am. Cruz 356 F.3d (D.C.Cir.2004); 333-34 Energy reasons, Indeck foregoing For the AFFIRM we Servs., Co., Inc. Energy Consumers the decision the district court in all (6th Cir.2000) (“[I]ssues respects. ad benefits, arguments Plaintiff asserted number of upon “near and made strained based Defendants, against frivolous” claims both misinterpreted such citations.” Plaintiff refused to dismiss claims one Defendant or another it once became clear proper which was the Defendant normally party seeking attorneys' While (e.g., provide the claim for failure fees under ERISA should submit detailed upon request), documentation and Plain- statements, hourly billing see Adcock-Ladd v. tiff unnecessarily prolonged litigation by filing Sec'y Treasury, 227 F.3d pursuing arguments unreliable briefs and Cir.2000), present proper Plaintiff's failure rejection by even after their the court. argument to unnecessary this Court makes it addition, the district found that Plaintiff us to reach this issue here. "improperly quotations took out of context *31 documents and

OLIVER, concurring. policies plan constituted Judge, District claim, promissory estoppel the dismissed join Clay’s I affirm Judge opinion Plaintiff filed a motion reconsideration court, district ex the decision the ing regarding other issues which were ad- II.A.3, which regard in Section cept order, in the court’s but did not dressed estoppel promissory discusses challenge finding poli- that the the court’s because, separately I unlike write claim. plan or cies were documents raise alter- Clay, trial court’s Judge I would affirm the Thus, argument ambiguity. native on estoppel claim promissory of the dismissal ample opportunity had reason and trial court ground on same the relied the argument the throughout raise this dis- upon which upon: failure to state a proceedings, trict court but did not. Since the trial granted. could be Before relief argument Moore never raised an about court, promissory estop Plaintiff based his below, may ambiguity he not do so now. upon Defendants’ pel claim on his reliance Ninety-Three States v. Fire- See United that and on the fact the representations (6th Cir.2003) arms, 414, 424 330 F.3d plan not policies in issue were insurance repeatedly (holding that court has “[t]his though Plaintiff had Even documents. arguments held that it will not consider with, of, intimately familiar and was copies first appeal raised for the time on unless argue, he did not as policies, insurance the the will our failure to consider issue result court, the that term argues he before this justice.”). plain miscarriage in a plans, used in the was am “employee” as I not reach the merits of the would trial that the court found biguous. claim, Judge Clay opinion. does in his plan policies LTD and were docu STD squarely The issues he addresses were Corp., Musto v. Am. Gen. ments. See court, thus, the there before district and (6th Cir.1988). The trial lawyers no incentive for the focus Sprague court further found that under arguments on the evidence law their 388, 404 Corp., 133 F.3d Gen. Motors bearing on those issues. (en Cir.1998) banc), plan where written exist, estoppel a promissory documents COOK, concurring in Judge, part Circuit plan unless docu claim cannot succeed the part. dissenting ambiguous. are Id. Plain Because ments agree I much of the lead Though with argue ambiguity there was tiff did not points. I two respectfully differ on opinion, documents, plan the court dismissed First, join Judge I concurrence Oliver’s estoppel claim. his dismissing estoppel promissory Moore’s court, wholly At the trial failed employed grounds claim on the argument alternative raise Second, the determination district court. ambiguous, even plan documents were employee not a that Moore is common-law briefing Sprague face of on Defen- (and leads me to “participant”) thus not strong from thе suggestions dants statutory that Moore lacked conclude on the hearing at the oral motion standing, accordingly that the district policies plan were docu- jurisdiction insurance over the merits court lacked claims, including fees supplemental filed of his ERISA ments. Plaintiff even certain argument, costs. after oral and before brief addressing court issued order whether its Moore Concluding I. Effect of Was existed, legally sufficient documents Employee not a Common-Law to raise an alter- but that brief also failed Moreover, majority’s application argument ambiguity. agree I native employment in Na- multi-factor test of insurance after the court ruled Darden, (1998). Co. v. 503 U.S. This tionwide Mut. Ins. court confirmed 117 L.Ed.2d 581 Delivery Sys., S.Ct. Ward v. Alternative Health *32 (1992), Inc., (6th Cir.2001), to conclude that Moore was not a 261 F.3d 624 that given But employee. person common-law this “participant” whether a is a or conclusion, agree I cannot that the district “beneficiary” under ERISA is a matter of jurisdiction court retained over Moore’s statutory standing. plaintiff The in Ward ERISA claims. was a member a network of health care who, providers on the basis of her clients’ a or empowers “participant ERISA ben- participation in employee brought an plan, eficiary” bring to civil action “to a recover claims ERISA network’s corre- due him” or an [from benefits to “for relief sponding HMO specialty manage- and care supply requested administrator’s refusal to company. agreed ment This court information],” 1132(a)(1)(B), § 29 U.S.C. the district court that plaintiff was “[the] empowers a “participant, beneficiary not an or participant ERISA benefi- fiduciary” bring or to a civil action “to and, therefore, ciary that she did not have equitable obtain other appropriate relief.” standing bring to her ERISA claims.” Id. 1132(a)(3). § pro- U.S.C. ERISA also at pendent the context of Ward’s any vides that action ... aby partici- “[i]n claims, law state the court left no doubt as beneficiary fiduciary, pant, or the court in consequence to the of that determination: may its discretion allow a reasonable attor- “[Pjlaintiff jurisdic- a ney’s standing s ERISA is fees and costs of action to either tional matter. § Once the district court dis- party.” 1132(g)(1). 29 U.S.C. No party missed the argues original claims within its “beneficiary” Moore a or jurisdiction subject for “fiduciary” ju- we examine lack of “participant” so matter risdiction, jurisdiction status. it did have to plaintiffs retain state law claims.” Id. defines to “participant” ERISA include likewise, upon And finding court’s “any employee or employee former of an Moore is not a “participant,” this court employer ... may eligi- who is or become should hold that the district court lacked ble receive benefit of from an type jurisdiction adjudicate his substantive employee plan,” benefit 29 U.S.C. claims. 1002(7), § defines “employee” “any as employed by individual an employer.” 29 majority distinguishes The Ward on the 1002(6). § clarify To help U.S.C. these ground plaintiff “argued that the there definitions, Court, Supreme in Nation- law,” an of existing extension rather than wide, 323-24, at 503 U.S. 112 S.Ct. appealing to “traditional definitions”—a adopted the employ- common-law test of distinction with which I am respectfully determining ment qualifies an who unfamiliar —and that therefore the court’s under ERISA. “employee” Because holding ruling law,” constituted “a rath- Moore is not a employee, common-law he er than a (Maj. “factual determination.” is not “employee” also for purposes of Op. at argument may Ward’s have and, definition, “partici- not a Moore’s, been weaker than but the cases pant.” all) (if kind, by degree, differ not by I cannot how statutory see Statutory language— standing issue wheth- —the particularly aer statute when combined with the plaintiff “authorizes [a] jurisdictional deserving sue”—is matter twelve-factor common test of employ- law judicial inquiry. of threshold legal Steel Co. v. ment —could question resolve Env’t, 83, 92, Citizеns a Better 523 U.S. one context and a question “factual” in a S.Ct. L.Ed.2d required S.Ct. closer case. Both cases the court eligible statutory may to un- who become ben- language [are] [for apply parallel facts; efits],” 1002(7), those each case 29 U.S.C. and that a disputed of the merely “partic- found fall outside plaintiff facts have been who claims be consequences of statutory concept. The ipant” fall Id. does not within statute. inquiries should not differ. 115-18, 109 S.Ct. 948. The Court did suggest phrase “may that the become eli- majority holding worries gible” “participant” extends term jurisdiction court lacked be the district employees employees or former who have “participant” is not a will cause Moore it a “colorable claim” to But did *33 produce presumably “circular” a benefits. result — not of statutory “par- extend the definition a it believes that such conclusion because ticipant” persons only have a who color- jurisdiction question over the forecloses being “employees able or former a in the “participant” Moore was whether (Maj. employees.” But place. Op. first at this over the merits with jurisdiction conflates puzzling The discussion is because Fire- questions jurisdic of “jurisdiction” over parsing “participant” stone’s of the term (and in always Courts are free fact tion. nothing majority’s analysis, adds to the juris required) to determine their own are (with I given previous holding its which res And that determination has diction. concur) fully “partic- Moore was not a that judicata Corp. Ins. Ir. v. effect. See of ipant.” plaintiff “partici- a a Whether is Guinee, Des 456 Compagnie Bauxites De pant” consequences differs from flow what 9, 2099, 694, 102 72 702 n. S.Ct. U.S. from the that he or she is determination (1982) (“A that has party L.Ed.2d 492 had not, only implicates first Firestone of opportunity litigate question question. We are still left to determine jurisdiction not, subject-matter may how “participant” implicates status whether evеr, in a reopen question that collateral statutory standing. It upon judgment. an adverse has attack Nationwide, Supreme “[t]he in which that of long principles been the rule res princi- law agency Court held that common judicata jurisdictional determina apply ples applied to determine whether subject personal.”) matter tions—both ” (Maj. plaintiff ‘employee’ Op. was an County Drainage Dist. v. (citing Chicot 443), suggest The ma- does not otherwise. 371, Bank, 308 Baxter State U.S. 60 S.Ct. jority that Court did not observes “[t]he (1940); Gottlieb, 317, v. 84 L.Ed. 329 Stoll imply” “par- that a plaintiff whether a was 165, 134, 59 S.Ct. 83 L.Ed. 104 305 U.S. statutory ticipant” question was a of stand- (1938)). circularity No results because the ing. “imply” But did it the con- Id. nor jurisdic that a court lacks determination trary. And fact that Nationwide over the of a claim not tion merits does published years sug- before Ward several authority de its to make that undermine gests poses that Nationwide no barrier termination. a being “participant” conclusion majority’s I am later puzzled implicates statutory standing. Tire & Co. discussion of Firestone Rubber Hood, only v. 327 That leaves Bell U.S. Bruch, 101, 948, 489 U.S. 109 S.Ct. (1946), L.Ed. 939 66 S.Ct. (1989). In of L.Ed.2d the cited section instructing majority which the reads as case, rejected gloss the Court jurisdiction “to federal courts assume applied “par- to the term the Third Circuit standing ques- and merits statutory when Supreme held that ticipant.” Court 443M4.) (Maj. Op. at converge.” tions actual “partieipant[s]” consisted proposi- employeefs] ... But Bell stands for the narrower “employee[s] former proper may that “the state a straightforward tion failure to while have been judgment on the cause of action calls for a case, it always Eligibility is not so. merits and not for dismissal for want of concept for relief a distinct is from wheth- jurisdiction.” 327 U.S. at 66 S.Ct. plaintiff er a is “participant,” thus the 773; Co., 89-90, see Steel U.S. merits Moore’s claim for do not benefits (“[T]he (as S.Ct. 1003 absence of a valid converge statutory with the issue of stand- arguable) opposed to cause action does ing. require Bell does not us to view implicate subject-matter jurisdiction, a “participant” whether Moore was as a ie., statutory the courts’ or constitutional question on merits. adjudicate power (emphasis the case.” Finally, viewing whether Moore was a original)). This is significant because “participant” question statutory question implicated by whether Moore judicial standing promotes the goal “participant” is a not whether Moore has economy. The district court should have action, proper stated a cause but wheth- and, addressed the first upon issue deter- proper plaintiff er he is a for those claims. *34 mining a “participant,” that Moore was not Co., Qf.steel 1003 U.S. S.Ct. dismissed all of Moore’s ERISA claims— (distinguishing questions may of who seek benefits, fiduciary duty, breach of at- relief a statute questions under from re- torneys’ fees, garding the of a scope statutory supply cause of and failure to infor- action); Recoveries, Primax v. Inc. Gun- mation —that stemmed from conduct oc-

ter, (6th Cir.2006) (character- curring ‍​‌​‌‌‌‌​​​​​‌‌​​​​‌​‌​​‌‌​‌​​‌​‌‌​​​​​‌‌‌​‌​‌‌​​‍signed after he the CSA.

izing the claim dismissal a under 29 1132(a)(3) II. Fees § improperly

U.S.C. sought relief, legal relief, rather than equitable Just as the jurisdic- district court lacked claim, failing to state rather than failing tion to consider the merits of Moore’s support jurisdiction the court’s —-and claims, jurisdiction so too it lacked dispute where there was no over whether attorneys’ to award fees under ERISA. plaintiff “participant”). was a To see 1132(g)(1) only Section allows a court to so, consider that the district award fees and “by par- costs actions fiduciary dismissed duty Moore’s ticipant, beneficiary, or fiduciary.” Be- (Count II) and failure to furnish above, cause Moore was none of the (Count V) information claim on the merits jurisdiction district court did not have over without relying on its later conclusion that fees), Moore’s Count IV such (seeking he was a “participant.” not Even under over the defendants’ motion for fees under Bell, reading the majority’s question ERISA. I would thus vacate the district “participant” whether Moore was a court’s award of fees Moore. jurisdictional could still be because the Because the district court held Moore’s merits of such claims did not converge jointly severally counsel statutory liable with standing. § 1132(g) for the penalty, Moore holding The same is true of Moore’s claim for jurisdiction that the court was without benefits, which the district court did re- award fees under ERISA would seem to solve on the basis that Moore not was remove the basis for that sanction. if “participant.” For the district court had However, because the district court sug- found that a “participant,” Moore was gested independent an basis for Moore’s inquiry. would have ended the court’s I liability, counsel’s It would remand still would have had to assess whether question Moore employee eligible appro- was whether sanctions were definitions, relief plan’s priate under 28 (given U.S.C. Rule that defendants’ majority’s conclusion I would also untimely).

11 motion was whether Moore question

remand a non- similarly liable on

himself

ERISA basis. America,

UNITED STATES

Plaintiff-Appellee, Defendant-Appellant. COLEMAN,

Sean

No. 04-4393. Appeals, Court of

United States Circuit.

Sixth July

Argued: 10, 2006. Aug. and Filed:

Decided notes a proper defendant for some of Plaintiffs (1993 amendments) (“[A] party cannot de subclaims, despite the communication of lay serving its Rule 11 motion until conclu legal authority relevant and clear for the ....”) sion of the ease This Court held as dismissal of one or defendant the other to Bidder, (“A much in party Plaintiffs counsel. The district court did must now serve Rule 11 motion on the not abuse awarding its discretion in attor- allegedly offending party twenty- at least ney fees’ Plaintiff. days one prior to the conclusion the ease judicial rejection of the offending con The District Court Did Not Abuse A tention.”). parties dispute do not its in Sanctioning Discretion Plain- the Rule 11 motions were made after the Attorney tiffs disposition summary judg of the case on argues the district ment. Therefore sanction under Rule court abused its discretion in holding constitutes abuse of discretion. We attorney jointly severally find, however, the district court’s pay liable Plaintiff to percent proper sanctions were under its alternative

Case Details

Case Name: Moore v. Lafayette Life Insurance
Court Name: Court of Appeals for the Sixth Circuit
Date Published: Aug 7, 2006
Citation: 458 F.3d 416
Docket Number: 04-1146, 04-1942, 04-1945, 05-1109
Court Abbreviation: 6th Cir.
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