Lead Opinion
Sean Deckard appeals the order of the district court
I. Background
At the times relevant to this appeal, Hostess provided an “employee welfare benefit plan” (“Plan”) under the Employee Retirement Income Security Act of 1974 (“ERISA”). See 29 U.S.C. § 1002(1). Hostess served as the administrator of the Plan and retained CIGNA as a third-party claims administrator.
Hostess notified Deckard that his employment was terminated on September 11, 2006, soon after Deckard was determined to be disabled under the Social Security Act. COBRA also requires an administrator to give each participant a notice of certain health insurance coverage rights upon a “qualifying event,” such as the termination of the participant’s employment. See 29 U.S.C. § 1166(a). Again, Hostess does not dispute that it failed to provide the required COBRA notice to Deckard.
Due to an apparent clerical oversight, Hostess did not process certain aspects of Deckard’s termination for almost two years. During this post-termination period, Deckard continued to enjoy health care coverage under the Plan, paying no premiums but receiving about $19,000 in benefits through the Plan. On August 20, 2008, the Plan belatedly identified Deckard’s status as terminated and cancelled his coverage retroactive to September 11, 2006. CIG-NA attempted to recover, or “claw back,” Plan benefits that had been paid to various health care providers on Deckard’s behalf during the period of his post-termination
In April 2009, Deckard filed an administrative claim in Hostess’s long-running bankruptcy proceeding, stating a disputed claim for reimbursement for his medical expenses and penalties for Hostess’s failure to provide the required COBRA notices. On May 28, 2009, Hostess reinstated Deckard’s coverage under the Plan for the post-termination period of September 11, 2006 through February 1, 2009, the date on which Deckard had become eligible for Medicare health insurance coverage.
The bankruptcy court granted summary judgment to Hostess on Deckard’s claim for civil penalties for the failure to provide COBRA notices at both his commencement of participation and termination of employment, reasoning that his damages after cancellation of his coverage were not “proximately or logically” connected to the lack of notice two years earlier and, even if they were, “the prejudice [Deckard] experienced [from the cancellation of coverage] was insignificant compared to the benefit he received from two years of uninterrupted free health care.” The bankruptcy court also found that Hostess did not act in bad faith and that a civil penalty was unnecessary to promote compliance with ERISA, given the undisputed evidence that the tumult of Hostess’s bankruptcy reorganization likely caused Hostess’s inability to prove that the required COBRA notices were provided to Deckard. Finally, the bankruptcy court denied Deckard’s motion for attorney’s fees and costs without further analysis because Deckard’s “substantive claims” failed.
Deckard appealed the bankruptcy court’s decision to the district court, which affirmed. Deckard now appeals the denial of a civil penalty, arguing that the bankruptcy court erred by (1) considering the benefit to Deckard of receiving extended Plan coverage at no cost, (2) miscalculating the amount of premiums Deckard would have had to pay to maintain his coverage, (3) weighing the degree to which the lack of COBRA notices prejudiced Deckard, (4) holding that no liability can arise for a COBRA notice violation if the administrator continues to provide Plan benefits after the qualifying event, (5) ignoring the “purpose” of COBRA to prevent gaps in health care coverage, and (6) finding that Hostess acted in good faith. Deckard also appeals the bankruptcy court’s holding that he did not achieve the degree of success necessary for an award of attorney fees.
II. Discussion
“As the second court of appeal in a bankruptcy case, we apply the same standard of review as the District Court, reviewing the Bankruptcy Court’s legal
A. Civil Penalty
It is undisputed that Hostess failed to provide two notices required by COBRA. ERISA provides that a plan administrator who fails to meet the COBRA notice requirements “may in the court’s discretion be personally liable to such participant or beneficiary in the amount of up to [$110] a day from the date of such failure or refusal....” 29 U.S.C. § 1132(c)(1).
First, Deckard argues that the bankruptcy court engaged in “an impermissible hindsight analysis” by weighing the benefit of receiving extended Plan coverage at no cost against the claimed damages from the lack of COBRA notice. Deckard’s only cited authority for this argument, however, arose in a separate context and is no longer good law in any event. See Geissal v. Moore Med. Corp.,
Second, Deckard challenges the bankruptcy court’s factual findings with respect to the value of the coverage he received. The bankruptcy court found that, had Deckard exercised his COBRA rights upon termination, he would have had to pay $8,200 in premiums to maintain twenty-nine months of coverage through his Medicare eligibility date. Deckard contends
Deckard’s argument as to the accuracy of the potential $8,200 total premium over twenty-nine months does not demonstrate any abuse of discretion, however, because the bankruptcy court did not base its prejudice analysis on those figures. See In re Farmland Indus.,
Third, Deckard contends that the bankruptcy court should have given more weight to the damages he suffered. Deck-ard does not dispute the bankruptcy court’s recitation of his evidence of damages in the summary judgment record:
1. Deckard avoided and postponed seeking medical attention that he could not afford.
2. Deckard suffered stress because he postponed medical care because of a lack of insurance coverage.
3. Deckard had to pay unsubsidized retail prices for prescription medications.
4. Deckard had to resort to less expensive, generic medications.
5. Deckard had to expend additional effort to obtain necessary medicines because his on-line pharmacy would not fill his prescriptions.
6. Deckard had to rely on others to obtain his medications for him.
7. Paying retail prices for Deckard’s medications caused him stress.
8. Deckard suffered demands for payment by medical service providers, their collectors, and CIGNA’s collectors.
9. Deckard’s credit rating was adversely affected.
10. Financial demands from collectors and providers caused Deckard stress.
11. Deckard’s providers were slow to refund money after reversal of the “claw*536 backs” and, even then, the providers did not pay him interest on those refunds.
Deckard argues that other courts addressing circumstances similar to his have found prejudice sufficient to justify a penalty. For example, in Fadalla v. Life Auto. Prods., Inc., No. 2:06-cv-02679,
Based on the evidence in the record here, Deckard’s circumstances are analogous to the daughter in Fadalla, not the spouse. Deckard avers that he had to pay retail pharmacy prices and switch to generic medications during his no-coverage period, but the Fadalla court did not find that type of prejudice sufficiently severe to warrant a penalty. Likewise, although Deckard avers that he postponed medical care, he offers no specific evidence as to what that medical care would have been or how the postponement resulted in a “physical impact” on him. Id. In the absence of any evidence that Deckard’s postponement of medical care during his no-coverage period presented an increased risk such as the spouse in Fadalla faced, we cannot say that the bankruptcy court weighed the prejudice against him incorrectly with regard to his evidence of damages.
Moreover, of the several decisions cited by Deckard finding that evidence of uncovered medical expenses or financial hardship was sufficiently prejudicial to justify a penalty, none of those cases involved counterbalancing that prejudice against the benefit of a long period of continuing post-termination coverage at no cost. As a result, those decisions are only marginally instructive at best. Deckard directs us to no authority suggesting that the bankruptcy court’s balancing of those factors was an abuse of its discretion.
Fourth, Deckard argues the bankruptcy court made an error of law by holding that no liability can arise for a COBRA notice violation if the administrator continues to provide Plan benefits after the qualifying event. See 26 C.F.R. § 54.4980B-4(c) (stating that, in order for an event such as termination of employment to qualify as one that triggers COBRA notice requirements, “a loss of coverage need not occur immediately after the event, so long as the loss of coverage occurs before the end of the maximum coverage period”). However, the bankruptcy court did not state categorically that no liability can attach in such a case. Instead, it recognized its discretion to award a civil penalty and properly considered circumstances such as “the prejudice to the plaintiff and the nature of the plan administrator’s conduct” in making its determination. See Starr,
Sixth, Deckard challenges the bankruptcy court’s finding that Hostess acted in good faith. A finding of bad faith typically requires a “willful failure on [the plan administrator’s] part to send the notice.” Starr,
For these reasons, we affirm the bankruptcy court’s grant of summary judgment to Hostess on Deckard’s claim for civil penalties for the failure to provide COBRA notices.
B. Attorney’s Fees
Deckard contends that even if he is not entitled to recover civil penalties, an award of attorney’s fees is appropriate. In an action for civil penalties under § 1132(c)(1), “the court in its discretion may allow a reasonable attorney’s fee and costs of action to either party.” 29 U.S.C. § 1132(g)(1). As a threshold matter, “a fees claimant must show ‘some degree of success on the merits’ before a court may award attorney’s fees under § 1132(g)(1).” Hardt v. Reliance Standard Life Ins. Co., 560 U.S. -,
Deckard challenges the bankruptcy’s court’s finding that he failed to meet the necessary threshold for success, arguing that he successfully (1) demonstrated Hostess’s failure to provide the required COBRA notices and (2) obtained reinstatement of his coverage and reimbursement for his medical expenses, even if he did not prove an entitlement to recover civil penalties. To be sure, we previously have reversed a district court’s denial of attorney’s fees under § 1132(g)(1) where the claimant ultimately lost on the issue of whether civil penalties under § 1132(c)(1) were warranted, yet prevailed at trial on contested issues such as whether notices were sent, whether coverage should be reinstated, and whether medical expenses should be reimbursed. See Starr,
Accordingly, we affirm the bankruptcy court’s denial of attorney’s fees and costs to Deckard.
III. Conclusion
For the foregoing reasons, we affirm the bankruptcy court’s grant of summary judgment to Hostess and the denial of attorney’s fees.
Notes
. The Honorable Nanette K. Laughrey, United States District Judge for the Western District of Missouri.
. The Honorable Jerry W. Venters, United States Bankruptcy Judge for the Western District of Missouri.
. Interstate Bakeries Corporation changed its name to Hostess Brands, Inc. during the pen-dency of this case. For simplicity, we will refer to both Interstate Bakeries Corporation and Hostess Brands as "Hostess.”
.While Deckard initially named J. Randall Vance as an additional defendant in his capacity as Plan administrator, on appeal he no longer contests that Hostess, rather than Vance, was the Plan administrator.
. The obligation to provide continuing health care coverage under COBRA ends on the date that the covered individual becomes eligible for Medicare benefits. See 29 U.S.C. § 1162(2)(D)(ii).
. Although the statute recites a civil penalty of up to $100 per day, the amount has been adjusted to $110 per day. See 29 C.F.R. § 2575.502c-l.
. In discussing whether Hostess acted in bad faith, the bankruptcy court also noted that, when Hostess reinstated Deckard’s coverage, it chose not to pursue "the more than $8,000 in premiums Deckard would have had to pay for the health care coverage Deckard received.” However, Deckard makes no argument that the good-faith finding depended on the precise value of the premiums Deckard would have owed.
. Because we affirm on the merits of Deck-ard's claim for civil penalties with regard to notice both at commencement of participation and termination, we need not address the bankruptcy court's alternative holding that Deckard’s claim with regard to notice at commencement is barred by the statute of limitations. In addition, we need not reach Hostess's alternative argument for affirmance that Deckard's claims, even if valid, would not qualify for administrative expense treatment.
Dissenting Opinion
dissenting.
I respectfully dissent from the decision to affirm the bankruptcy court’s denial of Sean Deckard’s claim for civil penalties against Hostess for the latter’s failure to provide Deckard with statutorily mandated COBRA notices. In addition, I respectfully dissent from the decision to affirm the bankruptcy court’s denial of Deckard’s request for attorney’s fees.
It is undisputed that Sean Deckard suffered a six-month gap in his health care coverage as a result of Hostess’s conceded failure to comply with COBRA notice requirements. Avoiding a gap in medical coverage is the main purpose of the COBRA notice requirements. See Livingston v. S.D. State Med. Holding Co., Inc.,
Under the summary judgment record considered by the bankruptcy court, it is also undisputed that Deckard was forced to forego treatment for his health issues during the gap in his health care coverage. Foregone or delayed medical treatment is one of the principle harms sought to be avoided by COBRA, and the presence of that factor alone constitutes sufficient prejudice to award statutory penalties. See Holford v. Exhibit Design Consultants,
In denying statutory penalties, the bankruptcy court essentially ignored the gap in health care coverage through which Deckard suffered and placed too much emphasis on Hostess’s post-litigation reinstatement of health care coverage. In Holford, the court awarded a statutory penalty, disregarding an employer’s after-the-fact “attemptf] to right the situation by offering to Plaintiff COBRA coverage retroactive to the effective date of her separation.”
As in this Court’s criminal cases, many defendants express respect and allegiance to the laws of the land while their deeds are being weighed in the balances of justice. The legitimate goal of deterrence (which is the object of the civil fine provision applicable in this case) is to see that litigants will observe the same respect for the laws when the courts are afar off and their conduct is hidden.
Id. at 905 n. 2.
In this case, there was abundant evidence that Hostess acted in bad faith before it got “caught,” so to speak. Hostess’s pre-litigation conduct included (1) its cancellation of Deckard’s health benefits retroactive to September 2006 even though the collective bargaining agreement (CBA) required it to provide Deckard benefits through September 2007; (2) its failure to even notify Deckard it was cancelling his coverage, leaving him to discover the cancellation when a prescription order was refused; (3) its attempts to “claw back” the health benefits it had provided Deck-ard from September 2006 through August 2008, even though it was obligated to cover some of those health benefits under the
Even if we assume the bankruptcy court was within its discretion to deny the claim for civil penalties, the denial of Deckard’s request for attorney’s fees was plainly wrong and an abuse of discretion. In Starr v. Metro Systems, Inc., we held a district court abused its discretion in failing to award attorney’s fees to a plaintiff who successfully proved a defendant’s COBRA violation notwithstanding our affir-mance of the district court’s denial of the claim for civil penalties.
In addition, when considering whether Deckard succeeded on the merits for purposes of awarding fees, it is significant that Hostess reinstated Deckard’s healthcare coverage only after Deckard initiated legal action. Although a voluntary change in the defendant’s conduct cannot be considered for determining “prevailing party” status, see Buckhannon Bd. & Care Home, Inc. v. W. Va. Dep’t of Health and Human Res.,
For the reasons stated, I respectfully dissent.
