Opinion & Order
(1) Grаnting the Motion for Summary Judgment of Plaintiffs Norman, Danielle, & Carson Mull on the First Amended Complaint (“FAC”);
(2) Denying the Defendants’ Motion for Summary Judgment or in the Alternative Summary Adjudication on the FAC;
(3)Directing the Moving Plaintiffs to File an Amended Proposed Order No Later than Monday, October 13, 2014
This is an action under the Employee Retirement Income and Security Act of
As explained in greater detail below, the Court will grant these three plaintiffs’ motion for summary judgment on the ground that the reimbursement / recoupment provision which the Plan has enforced, is contained only in the Summary Plan Description (“SPD”) and not in any document which constitutes “the plan.” The determination that the provision is not legally enforceable also necessarily defeats the defendants’ motion for summary judgment. That will lеave only one plaintiff / counterdefendant, Lenai Mull, who is subject to a bankruptcy stay.
Defendants concede that this.Court has subject-matter jurisdiction under 29 U.S.C. § 1132(a)(1)(B) and that venue is proper because the ERISA plan in question is administered in Studio City, California. See Amended Answer to First Amended Complaint (“Am. Ans.”) (Doc. 46^4) ¶¶ 1-2; see also Couvrette v. Couvrette,
“Persons Empowered to Bring a Civil Action” provides that a civil action may be brought, inter alia,
(1) by a participant or beneficiary—
(A) for the relief provided for in subsection (cc) of this section; or
(B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan;
(2) by the Secretary, or by a participant, beneficiary, or fiduciary for appropri*913 ate relief under section 1109 of this title [personal liability for breach of fiduciary duty];
(3) by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter [I. Protection of Employee Benefit Rights] or the terms of the plan or (B) to obtain other appropriate equitable relief (I) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan;
(4) by the Secretary, or by a participant, or beneficiary for appropriate relief in the case of a violation of section 1025 [subsection] c of this title [Reporting of Participant’s Benefit Rights-Individual Statement By Administrator Furnished to Participants ... ];
29 U.S.C. § 1132(a)(1) through (4) (emphasis added).
BACKGROUND
Plaintiffs allege that while Lenai was entitled to comprehensive medical benefits under the Plan as a dependent of her father, she sustained severe injuries in an auto accident in February 2010, see First Amended Complaint filed Feb. 28, 2013 (Doc. 25) (“Am. Comp.”) ¶ 6 & Am. Ans. ¶ 6. Lenai underwent multiple surgeries, missed substantial time from college, and endured physical and mental pain and suffering, see Am. Comp. ¶ 6. Lenai’s total accident-related medical expenses were about $190,000 as of February 2013, and the parties agree that the Plan has paid about $148,000 of those expenses on her behalf, see Am. Comp. ¶ 6 and Am. Ans. ¶ 6.
The parties agree that the other driver settled Lenai’s claims against him for his liability insurance policy limit of $100,000, see Am. Comp. ¶ 7 & Am. Ans. ¶ 7. The Plan has demanded that Lenai turn that $100,000 over to the Plan pursuant to a subrogation and reimbursement provision in the Summary Plan Description (“SPD”) entitled Claims Involving Third-Party Liability. See id. (citing SPD
By contrast, plaintiffs allege, the cost of Lenai’s injuries is at least $2 million, so the settlement did not make her whole. They reason that since Lenai recovered only about 5% of total damages in her settlement, “she also recovered title to only about 5% of all her damages, including medical expenses ...” Am. Comp. ¶¶ 7 & 9.
Disagreeing, the Plan has refused to pay additional medical bills for Lenai until Le-
PROCEDURAL HISTORY AND PRIOR RULINGS
Plaintiffs asserted one legal claim and one equitable claim in their original complaint. Defendants filed a Fed. R. Civ. P. 12(b)(6) motion to dismiss for failure to state a claim on which relief can be granted. In December 2012, this Court partially granted and pаrtially denied the motion to dismiss. As to plaintiffs’ legal claim, the Court held that plaintiffs “failed to state a claim that the reimbursement provision violated the clarity requirements of the statute and regulations.” Mull v. MPI Health Plan et al.,
This Court allowed plaintiffs’ equitable claim to survive, however, writing as follows:
[T]hese arguments by the Plan are not conclusive at the 12(b) (6) stage; they beg the question, which appears at least arguable, whether Ninth Circuit law permits a plan participant/beneficiary to assert equitable defenses to eliminate, restrict, or offset the unjustly harsh effects of a plan’s, application of a plan provision.
Defendants assert that the Court may not consider equitable defenses and principles in deciding whether, and how, and to what extent a plan administrator may implement a plan provision, until and unless the Plan affirmatively asks for judicial relief. Yet the defendants have not shown that Ninth Circuit precedent compels that conclusion. On the contrary, the defendants cite only a Seventh Circuit decision for their proposition that a federal court may not consider the equities of allowing a plan administrator to enforce a plan provision without limitation “where a plan has not filed a civil action nor sought judicial relief to recover” overpayments. * * * Consequently, defendants have not shown that the equitable-defense theory is not based on a cognizable legal theory under federal common law as it exists in this circuit.
In sum, these arguments by the Plan go to the ultimate success or failure of the equitable-defense claim, not the adequacy of those claims for purposes of the Twombly / Rule 12(b)(6) / Rule 8 pleading stаndard. It is simply not clear as a matter of law, as the plan would have it, that “nothing in ... any common law developed by the Courts under ERISA ... authorizes the intrusion into the contractual relationship between the Plan and Plaintiffs [which is] demanded by the Plaintiffs.” MTD at 9.
The Court finds that the Mulls’ allegations and contentions raise their right to relief on their equitable-defense claim above the speculative level. * * *
The Supreme Court ... has not yet squarely addressed whether the statutory term “appropriate equitable relief’ requires consideration of traditional equitable defenses. * * *
* * * Traditionally at equity, it was within the province of the court to consider concerns of unjust enrichment when fashioning equitable remedies such as an equitable lien or a constructive trust, even where contract terms attempted to limit their application.
We agree with the Third Circuit that under § 502(a)(3), the district court, in granting “appropriate equitable relief,” may consider traditional equitable defenses notwithstanding express terms disclaiming their application.
* * * The CGI panel then remanded, instructing the district court to fashion “appropriate equitable relief’ pursuant to § 502(a)(3):
“Appropriate” relief would presumably include applying the equitable make-whole doctrine, or fashioning other fair relief by reducing the Plan’s recovery to ... the proportion of the beneficiary’s actual damages that she recovered. Traditional equitable remedies would also appear to support requiring the Plan to contribute to the firm’s fees under the common fund doctrine. Such traditional equitable principles should apply to the facts presented in this case.
Mull,
The Court granted plaintiffs leave to amend their complaint in specified respects, and stated that the parties could •file dispositive motions directed at the forthcoming amended complaint. See Mull,
As the Supreme Court explains the background of McCutchen,
* * * The plan paid $66,866 in medical expenses arising from the accident оn McCutchen’s behalf.
McCutchen retained attorneys, in exchange for a 40% contingency fee, to seek recovery of all his accident-related damages, estimated to exceed $1 million. The attorneys sued the driver responsible for the crash, but settled for only $10,000.... Counsel also secured a payment from McCutchen’s own automobile insurer of $100,000.... McCutchen then received $110,000 — and after deducting $44,000 for the lawyer’s fee, $66,000.
On learning of McCutchen’s recovery, U.S. Airways demanded reimbursement of the $66,866 it had paid in medical expenses. [It] relied on ... its summary plan description: * * *
US Airways, Inc. v. McCutchen, 569 U.S. -,
a health benefits plan that his employer ... established under ... ERISA.... That plan obliged U.S. Airways to pay any medical expenses McCutchen incurred as a result of a third party’s actions — for example, another person’s negligent driving. The plan in turn entitled U.S. Airways to reimbursement if McCutchen later recovered money from the third party.
McCutchen, 569 U.S. at -,
This Court has held that a health-plan administrator like U.S. Airways may enforce such a reimbursement provision by filing suit under ... 29 U.S.C. § 1132(a)(3). See Sereboff v. Mid Atlantic Medical Services, Inc.,547 U.S. 356 ,126 S.Ct. 1869 ,164 L.Ed.2d 612 (2006). That section authorizes a civil action “to obtain ... appropriate equitable relief ... to enforce ... the terms of the plan.”
We here consider whether in that kind of suit, a plan participant like McCutchen may raise certain equitable defenses deriving from principles of unjust enrichment. In particular, we address one equitable doсtrine limiting reimbursement to the amount of an insured’s “double recovery” and another requiring the party seeking reimbursement to pay a share of the attorney’s fees incurred in securing funds from the third party. We hold that neither of those equitable rules can override the clear terms of a plan. But we explain that the latter [equitable doctrine], usually called the common-fund doctrine, plays a role in interpreting U.S. Airways’ plan because the plan is silent about allocating the costs of recovery.
McCutchen,
In US Airways, the Court held that a company could not rely on unjust enrichment or other equitable principles to defeat its contractual obligations to pay on a benefits plan when the recipient had already received compensation from a third party. The Court explained the situation as “the modern-day equivalent of an ‘equitable lien by agreement,’ the enforcement of which ‘means declining to apply rules — even when they would be equitable in a contract’s absence — at odds with the parties’ expressed commitments.
Marsh Supermarkets, Inc. v. Marsh,
In McCutchen, Justice Scalia wrote an opinion denominated as a dissent, joined by Chief Justice Roberts and Justices Thomas and Alito. The dissenters, however, agreed with the majority on a fundamental principle relevant to our case: “[We] agree with Parts I and II of the Court’s opinion, which conclude that equity cannot override the plain terms of the [ERISA plan] contract.” McCutchen, 569 U.S. at -,
PROCEEDINGS WITH REGARD TO PLAINTIFF / COUNTERCLAIM-DEFENDANT LENAI MULL
This Court has denied two separate motions by Lenai seeking to voluntarily dismiss her own claims. See Mull v. MPI Health Plan, CV 12-06693 Doc. 29 (C.D.Cal. July 29, 2013) (Fairbank, J.) and Mull v. MPI Health Plan, CV 12-06693 Doc. 49,
DEFENDANTS’ AMENDED ANSWER.
In their amended answer to the first amended complaint, the Plan defendants assert seven affirmative defenses, including failure to state a claim on which relief can be granted, estoppel by conduct, waiver by conduct, unjust enrichment, unclean hands, and failure to exhaust administrative remedies “with respect to claims regarding the application of the Plan’s overpayment procedures.” Am. Ans. (Doc. 46-4) at 4-5 Affirmative Defenses 1-6. Defendants further contend that “plaintiffs are not entitled to the equitable relief requested by reason of the doctrine ‘acquits [sic] sequitur legem [,]’ ” Am. Ans. (Doc. 46-4) at 5, by which they presumably mean the doctrine equitas sequitur legem, “equity follows the law.” See Hedges v. Dixon Cty.,
LEGAL STANDARD: SUMMARY JUDGMENT
On summary judgment pursuant to Federal Rule of Civil Procedure 56, “ ‘[v]iew-
ANALYSIS: These Three Plaintiffs Are Entitled tо Judgment Because No Plan Document Contains a Third-Party Recovery Reimbursement Provision, Only the Summary Plan Description (“SPD”) Does
Plaintiffs persuasively contend that the defendants may not enforce the third-party recovery reimbursement provision because that provision is stated only in the Summary Plan Description, not in any actual, formal Plan document. See Plaintiffs’ Opening Brief in Support of Motion for Summary Judgment (“Plaintiffs’ MSJ”) (Doc. 56) at 27-29. Plaintiffs properly rely on the Supreme Court’s decision in CIGNA v. Amara, — U.S. -,
[ejven if the District Court had viewed the summaries as plan “terms” (which it did not, see supra ...), however, we cannot agree that the terms of statutorily rеquired plan summaries (or summaries of plan modifications) necessarily may be enforced (under § 502(a)(1)(B)) as the terms of the plan itself.
The Amara Court further held:
For these reasons taken together we conclude that the summary documents, important as they are, provide communication with beneficiaries about the plan, but that their statements do not themselves constitute the terms of the plan for purposes of § 502(a) (1)(B). [Amara,] 131 S.Ct. [at] 1878 (emphasis added).
This changed the law in the Ninth Circuit and many other circuits. In the instant case, the MPI SPD [Summary Plan Description] contains a reimbursement provision purporting to waive all equitable defenses. See Ex. 1, SPD, p. 58. However, the MPI formal plan document, entitled “Agreement and Declaration of Trust” clearly does not. This complete document is attached as Exhibit 2.
Attached as Exhibit 3 is a letter from plaintiffs [sic] ■ counsel to defense coun*919 sel dated March 28, 2012 requesting the formal plan document.
Attached as Exhibit 4 is the April 17, 2012 letter from defense counsel enclosing the Agreement and Declaration of Trust (“ADT”).
Plaintiffs’ MSJ at 27-28. In Amara (2011), the Supreme Court further explained that
we find it difficult to reconcile the ... [view that the terms of the Summary Plan Description are terms of the Plan itself] with the basic summary plan objective: clear, simple communication. To make the language of a plan summary legally binding could well lead plan administrators to sacrifice simplicity and comprehensibility in order to describe plan terms in the language of lawyers.
Amara, — U.S. at -,
Our Circuit had occasion to apply Amara’s distinction between an ERISA plan and the corresponding Summary Plan Description (“SPD”) in Oldoerp v. Wells Fargo & Co. Long Term Disability Plan,
*920 On the record before us, the Plan, by its terms, was made up of the group policy, the Certificate of Insurance, and amendments or endorsements to the group policy. [Footnote 2: The Certificate declares that those documents are the entire contract.] There is no indication that any one of those documents confers discretion upon [plan administrator] MetLife. The Summary Plan Description (“SPD”) and a document referred to as additional information did indicate that MetLife has discretionary authority-
However, the Supreme Court has made it clear that extraneous documents, like SPDs, “are not themselves part of the plan.” Amara, — U.S. at -,131 S.Ct. at 1877 . As the Court pointed out, summary documents make statements “about the plan, but ... their statements do not themselves constitute the terms of the plan.” Id., at -,131 S.Ct. at 1878 ; see also Skinner v. Northrop Grumman Ret. Plan B,673 F.3d 1162 , 1165 (9th Cir.2012) (recognizing that “SPD language is not an enforceable part of the retirement plan”). Thus, we reject [plan administrator] MetLife’s argument that because of the SPD and the ERISA information document, the Plan confers discretion upon it. The district court erred, and must now review MetLife’s “denial of benefits de novo.” Abatie v. Alta Health & Life Ins. Co.,458 F.3d 955 , 963 (9th Cir.2006) (en banc).
Oldoerp,
In Tuttle v. Varian Med. Systems, Inc.,
Ms. Tuttle argues that the Policy is not a Plan document because the Policy refers to other Plan documents that may be obtained from the Plan administrator. For example, the Policy states that a Plan participant may contact the administrator for “assistance in obtaining documents” or “to obtain, ... copies of the latest annual report ... and update[d] Summary Plan Description.” Those*921 statements do not show that the Policy is not the operative Plan Document in this matter but demonstrate that there are other documents related to the Plan described in the Poliсy. “An employee benefit plan under ERISA can be comprised of more than one document.” Gonzales,861 F.Supp.2d at 1107 .
Ms. Tuttle also suggests that the Policy is not a Plan document because the Plan existed before the Policy became effective in 2009 and the terms of the Plan were defined before [plan administrator and Plan insurer] UHIC became the insurer that year. Ms. Tuttle incurred the medical expenses at issue in 2009. The Plan covers any claims for expenses incurred on [or] after January 1, 2009.
Further, the Policy states that it “replaces and overrules any previous agreements relating to Benefits for Covered Health Services between Varían and UHIC.” The fact that UHIC became the insurer of the Plan in 2009, does not indicate that the Policy is not a Plan document for purposes of reviewing the denial of Ms. Tuttle’s benefits. The Plan is subject to change in any givеn year and benefits determinations are governed by the terms and conditions in effect during the applicable time period. Based on the administrative record before it, the Court determines that the various sections of the Policy described above are the controlling Plan documents.
Tuttle,
The Policy also includes a section entitled “ERISA Statement” with a subheading of “Summary Plan Description.” Plan administrators are required to provide Plan participants with summary plan descriptions and with summaries of material modifications “writtеn in a manner calculated to be understood by the average plan participant” that are “sufficiently accurate and comprehensive to reasonably apprise such participants and beneficiaries of their rights and obligations under the plan.” ... Amara, ...131 S.Ct. 1866 , 1874-75.... The Supreme Court has held that “the summary documents, important as they are, provide communication with beneficiaries about the plan, but their statements do not themselves constitute the terms of the plan.... ” [Amara ],131 S.Ct. at 1878 (emphasis in original).
Defendants argue that the statement is not the summary document they are required to furnish to Plan participants under 29 U.S.C. § 1022(a). Instead, they characterize the statement as a “Rider” to the Policy and as belonging to the set of Plan documents. But the Statement’s language and the Policy’s terminology indicate otherwise. The Statement is contained within a section of the Policy entitled “Amendments, Riders and Notices (As Applicable).” Only some of the subsection’s titles therein include the terms “amendment”, “rider”, or “notice.” The Statement is not one of them; it is not designated as a Rider anywhere in the Policy. Further, the Statement’s subheading is “Summary Plan Description” and includes much, but not all, of the information listed in 29 U.S.C. § 1022(b) as required in the mandated summary plan description. The Court finds that the statement is a summary plan description and is therefore not a Plan document.
Following Amara and Ninth Circuit cases applying it, the Court agrees with the plaintiffs that the Summary Plan Description here does not constitute part of the ERISA Plan itself. To begin with, the Court recognizes that an ERISA plan “may incorporate other formal or informal documents, such as a collective bargaining agreement or a certificate of insurance.” Gonzales v. Unum Life Ins. Co. of America,
Here, however, plaintiffs’ counsel represents, without contradiction, that when plaintiffs asked defendants to provide “the formal health plan document in force on the date of the accident”, see Doc. 60-3 (Attorney DeCamara’s March 28, 2012 Letter to Attorney Halford), defense counsel responded by sending only one document, the MPI Health Plan Agreement and Declaration of Trust Updated January 2010 (“ADT”). Moreover, defendants have not alleged that the Agreement and Declaration of Trust (“ADT”) or any alleged formal Plan document purported to incorporate the Summary Plan Description as part of the Plan itself (if that could even be a coherent and legally valid incorporatiоn). See Ingorvaia v. Reliastar Life Ins. Co.,
Defendants now take a position that seems inconsistent with their earlier position that the only formal Plan document was the ADT. Defendants now argue that the SPD is part of the formal plan document because there is a single entry at page 124 of the SPD indicating that, “[T]his book constitutes both the Plan document and the Summary Plan Description for the Motion Picture Industry Health Plan.” Doc. 56 (P’s MSJ) at 28 (citing Ex 1, page 132); see also Doc. 65 (Defs.’ Opp.) at 5 (“As evidence of the intent of the Directors to establish the SPD as the Plan Document, the SPD expressly provides that the document serves as both the SPD and the Plan Document.”). The Court agrees with plaintiffs* that “this self-serving statement cannot overcome the controlling provisions of ERISA” and that the SPD here cannot constitute a formal plan document because it lacks three of the four features which 29 U.S.C. § 1102(b) requires of such documents. See Doc. 56 at 28. Namely, section 1102(b), Establishment of Plan — Requisite Features of Plan, provides in its entirety:
Every employee benefit plan shall—
(1) provide a procedure for carrying out a funding policy and method consistent with the objectives of the plan and the requirements of this sub-chapter,
(2) describe any procedure under the plan for the allocation of responsibilities for the operation and administration of the plan (including any procedure described in section 1105(c)(1) of this title);
(3) provide a procedure for amending such plan, and for identifying the*923 persons who have authority to amend the plan, and
(4) specify the basis on which payments are made to and from the plan.
As plaintiffs point out (Doc. 56 at 29), the Agreement and Declaration of Trust apрears to contain the four features which the statute requires for an employee benefit Plan Document, which means that it can constitute and be considered a formal plan document. By contrast, plaintiffs accurately note (Doc. 26 at 29 and Doc. 66 at 2) that the Summary, notwithstanding its conclusory assertion that it constitutes both the SPD and the Plan document, appears not to contain the features required by 29 U.S.C. § 1102(b)(1) (“a procedure for carrying out a funding policy arid method”), 1102(b) (3) (“a procedure for amending such plan, and for identifying the persons” authorized to amend it), and 1102(b)(4) (specify the basis on which payments are made to and from Plan). Cf. Creno v. Metropolitan Life Ins. Co.,
In their opposition brief, Defendants merely assert, without further explanation or citation to authority, that “Plaintiffs simply choose to ignore the fact that the Summary is the ‘Plan Document’ for those participants like the Mulls who participate in the MPI Health Plan.” Doc. 65 at 3; see also Doc. 65 at 5. Defendants do not show that the Summary contains the features which a Plan document must have under 29 U.S.C. section 1102(b)(1), (3), and (4). Defendants assert that “the SPD is the only document that includes the basis upon which payments are to be made to and from the MPI Health Plan”, as required by section 1102(b)(4), but they do not cite any particular provision or page of the SPD to support that assertion. Nor do defendants cite any precedential authority for the notion that a document may constitute a formal plan document (whose terms are the terms of the plan and thus enforceable) without satisfying thosе statutory requirements.
Thus, the Court determines that the Agreement and Declaration of Trust is the only formal plan document — just as defense counsel indicated by sending only that document in response to plaintiffs’ March 2012 request for the formal plan documents. Conversely, the Summary Plan Description here is not a Plan document. Consequently, following the Supreme Court’s decision in Amara, any provision which appears in this SPD but not in the ADT is not enforceable. See Sethi v. Seagate U.S. LLC Group Disability Income Plan,
Defendants may not claim additional rights for themselves on the basis of a term which appears in the SPD but not in the Plan documents, any more than a plan participant could claim additional benеfits and impose additional obligations on a plan based on a term appearing only in the SPD. See, e.g., Krieger v. Nationwide Mut. Ins. Co.,
The Court discerns a second, independent basis for determining that the SPD’s reimbursement provision is not enforceable as a tеrm of the Plan. As plaintiffs note (Doc. 56 at 29), the unnumbered fifth page of the Summary Plan Description (Ps’ MSJ Ex 1) states in pertinent part as follows,
The Plan is operated under the provisions of an Agreement and Declaration of Trust, and all benefits provided are subject to the terms of the Trust, this Plan of Benefits and the Group Master Contracts issued by: the Union Labor Life Insurance Company covering life insurance; Blue Shield of California; Health Net; Kaiser Permanente; Oxford Health Plans; Delta Dental PPO Plan; DeltaCare USA; Medco (prescription drugs); and Vision Service Plan. The contracts have been issued to the Executive Administrator on behalf of the Directors. The terms of these documents will prevail in the interpretation of questions concerning any subject matter covered in this SPD.
Emphasis added.
Defendants argue that this case is “easily distinguished” from Amara and that “[cjases subsequent to Amara have limited the applicability of the Court’s decision to situations where there is a conflict in language of the SPD and the [language of] the controlling plan document.” Defendants’ Brief in Opposition to Summary Judgment (“Defs.’ Opp.”) (Doc. 65) at 5. Defendants’ argument on this score is untenable. For one thing, defendants cite no Ninth Circuit authority purporting to limit the applicability of the Supreme Court’s Amara decision, relying on a Sixth Circuit decision and a district-court decision, and they provide no reasoned argument as to why Amara should be read in such a limited fashion. Cf., e.g., Garrett v. Principal Life Ins. Co.,
The district-court decision cited by defendants, Langlois v. Metropolitan Life Ins. Co.,
To support that line of reasoning, however, the Langlois district court relied solely on a Ninth Circuit decision which pre-dated Amara and is flatly inconsistent with Amara. The Langlois court cited Bergt v. Retirement Plan for Pilots Employed by MarkAir, Inc.,
In any event, аs plaintiffs note in their reply (Doc. 66 at 2), the document which defense counsel themselves considered to be the “formal plan, the ADT, does not contain any reimbursement rights whatsoever, while the SPD does.” Therefore, it cannot be said that the formal plan document and the SPD are consistent with one another regarding reimbursement, because “if the ADT formal plan document is enforced, there would be no reimbursement, whereas the SPD provides for full reimbursement.” Doc. 66 (Plaintiffs’ Reply) at 2; cf. Heady v. Dawn Food Prods., Inc.,
This disposition obviates the need to consider other arguments advanced by either side as grounds for summary judgment. Because the reimbursement / recoupment provision in the SPD is not enforceable as a matter of law, one never reaches issues such as whether plan participants / beneficiaries may interpose equitable defenses to prevent or limit enforcement of such a plan provision.
ORDER
The motion for summary judgment of plaintiffs Norman Mull, Danielle Mull, &
The defendants’ motion for summary judgment on the FAC [Doc. # 63] is DENIED.
Norman Mull is TERMINATED as a party.
Danielle Mull is TERMINATED as a party.
Carson Mull is TERMINATED as a party.
No later than Monday, October 13, 2014, plaintiffs SHALL FILE an amended proposed order in which the monetary amount which defendants must pay to plaintiffs has been adjusted to reflect any applicable interest through and including Wednesday, November 12, 2014. Plaintiffs shall specify the source(s) of authority for any entitlement to interest and shall explain the method of calculating interest.
Said proposed order SHALL NOT summarize the controversy, the applicable law, this ruling, or past rulings. Nor shall the proposed order contain language relating to any other issue or аrgument not discussed herein which was raised in the parties’ pleadings or motions. Rather, the proposed order shall contain only the language necessary to provide declaratory, monetary, and injunctive relief to these three plaintiffs based only on the Court’s stated basis for today’s decision.
No later than Monday, October 27, 2014, defendants MAY FILE a response to the proposed order.
No later than Tuesday, November 11, 2014, plaintiffs MAY FILE a reply thereto.
Only plaintiff Lenai Mull’s claims in the first amended complaint remain pending against the defendants. The defendants’ counterclaim remains pending against plaintiff Lenai Mull only.
IT IS SO ORDERED.
This is not a final order because it does not dispose of all claims and counterclaims as to all parties. When this Order becomes appealable (upon the entry of final judgment), the Court of Appeals will review the grant of. summary judgment to these threе plaintiffs de novo. See Chemehuevi Indian Tribe v. Jewell,
Notes
. Section 1022(b) of ERISA, codified as 29 U.S.C. § 1022(b), defines the elements of an SPD. See Pollok v. Northrop Grumman Health Plan,
. The McCutchen dissent disagreed with the majority only on the application of the law to the particular ERISA plan that was before the Court there, stating as follows:
The court goes on in Parts III and IV, however, to hold that the terms are not plain and to apply the “common-fund” doctrine to fill that “contractual gap,”.... The problem with this is that we granted certio-rari on a question that presumеd the contract's terms were unambiguous — namely, “where the plan’s terms give it an absolute right to full reimbursement.”
McCutchen, 569 U.S. at -,
. In McCutchen, the United States Supreme Court noted that
[n]onetheless, the parties litigated this case, and both lower courts [the district court and the circuit court] decided it, based solely on the language [in the summary plan description] quoted above. Only in this Court, in response to a request from the Solicitor General, did the plan itself come to light. That is too late to affect what happens here: Because everyone in this case has treated the language from the summary description as though it came from the plan, we do so as well.
McCutchen, - U.S. at - n. 1,
. Plaintiffs’ inappropriately named "Proposed Judgment” (Doc. 62) is not suitable for this purpose.