discussing ERISA’s “extraordinary pre-emptive power” which “converts an ordinary state common law complaint into one stating a federal claim . . . .”
How later courts described this case
- discussing ERISA’s “extraordinary pre-emptive power” which “converts an ordinary state common law complaint into one stating a federal claim . . . .”
- finding the plaintiff’s unjust enrichment and quantum meruit claims “similarly fail to establish an independent duty under Davila or Montefiore”
- extensively reviewing the statute’s enactment history
- holding denial is arbitrary and capricious where plan administrator or fiduciary has “impose[d] a standard not required by the plan’s provisions, or interpret[ed] the plan in a manner inconsistent with its plain words”
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF NEW YORK
-----------------------------------X
JOHNNIE MIRANTI,
Plaintiff,
MEMORANDUM & ORDER
-against- 19-CV-7077(JS)(AYS)
AMALGAMATED INDUSTRIAL TOY &
NOVELTY WORKERS OF AMERICA LOCAL
223; AMALGAMATED PRODUCTION &
SERVICE EMPLOYEES UNION LOCAL 22;
and INTERNATIONAL UNION OF ALLIED
NOVELTY & PRODUCTION WORKERS, AFL-
CIO,
Defendants.
-----------------------------------X
APPEARANCES
For Plaintiff: Stephen Goldblatt, Esq.
44 Court Street, Suite 1217
Brooklyn, New York 11201
For Defendants: Sheri Dorothy Preece, Esq.
McCarthy & Preece PLLC
118 North Bedford Road, Suite 100
Mount Kisco, New York 10549
SEYBERT, District Judge:
On December 18, 2019, Johnnie Miranti (“Plaintiff”)
initiated this action against Amalgamated Industrial Toy & Novelty
Workers of America Local 223 (“Local 223”), Amalgamated Production
& Service Employees Union Local 22 (“Local 22”), and International
Union of Allied, Novelty & Production Workers, AFL-CIO
(“International,” and together with Local 223 and Local 22,
“Defendants”) alleging violations of the Employee Retirement
Income Security Act of 1974 (“ERISA”), breach of contract, unjust
enrichment, and promissory estoppel based on Defendants’ decision
to deny Plaintiff access to certain union medical and severance
benefits. Pending before the Court are the parties’ cross-motions
for summary judgment. (Defs. Mot., ECF No. 25; Defs. Support Memo,
ECF No. 25-2; Defs. Reply, ECF No. 29; Pl. Opp’n, ECF No. 28.)
For the following reasons, Defendants’ motion is GRANTED, and
Plaintiff’s motion is DENIED.
BACKGROUND
Unless otherwise noted, the following facts are
undisputed.1
1 Unless otherwise noted, the following facts are taken from
Defendants’ Local Rule 56.1 Statement (“Defs. 56.1 Stmt.,” ECF No.
25-1); Plaintiff’s Local Rule 56.1 Statement (“Pl. 56.1 Stmt.,”
ECF No. 28-4); and Defendants’ Local Rule 56.1 Counterstatement
(“Defs. 56.1 Counterstmt.,” ECF No. 29-1). Defendants’ exhibits,
which are attached to the Affidavit of Sheri Preece (ECF No. 25-
4), are identified by numbers. Plaintiff’s exhibits, which are
attached to the Affirmation of Stephen Goldblatt (ECF No. 28-5),
are similarly identified by numbers.
As Defendants correctly point out, Plaintiff failed to submit a
counterstatement to Defendants’ Local Rule 56.1 Statement, as the
Local Rules requires. See Local Rule 56.1(b). “Upon the failure
to properly controvert a movant’s statement of material fact, such
statement ‘will be deemed admitted for the purposes of the
motion.’” Adams v. Liberty Mar. Corp., 407 F. Supp. 3d 196, 199
(E.D.N.Y. 2019) (quoting Local Rule 56.1(c)). However, “a district
court must ensure that there is support in the record for facts
contained in unopposed Rule 56.1 statements before accepting those
facts as true.” United States v. Abady, No. 03-CV-1683, 2004 WL
444081, at *3 (S.D.N.Y. Mar. 11, 2004) (citing Giannullo v. City
of New York, 322 F.3d 139, 140–43 (2d Cir. 2003)). As a result,
the uncontroverted statements in Defendants’ Local Rule 56.1
Statement that the Court finds are supported by the record are
deemed admitted for purposes of the pending cross-motions.
I. Facts
A. Background and Plaintiff’s Indictment
International is a national labor union that represents
workers in many industries, including general manufacturing.
International is divided into multiple locals within the five
boroughs of New York City, such as Local 223.2 (See Am. Compl.,
ECF No. 16-2, ¶¶ 4-6.) Plaintiff was employed by Local 223 for
approximately twenty years, from 1996 until August 16, 2016.
(Defs. 56.1 Stmt. ¶ 1.) During that time, Plaintiff served as
Recording Secretary-Treasurer and an Executive Board member. (Am.
Compl. ¶ 11.) In this role, Plaintiff drafted all the meeting
minutes. (Defs. 56.1 Stmt. ¶ 15.)
On July 1, 2015, Plaintiff was indicted for his
participation in a kickback scheme related to his role as Trustee
to the Local 223 Sick Benefit Fund. (Defs. 56.1 Stmt. ¶ 2); see
also United States v. Miranti, No. 15-CR-0415 (S.D.N.Y.). The
grand jury indicted Plaintiff on three counts for conspiracy to
defraud the United States in violation of 18 U.S.C. § 371,
including: (1) conspiracy to solicit and receive kickbacks to
influence the operation of an employee benefit plan;
(2) conspiracy to embezzle from an employee benefit plan; and
(3) conspiracy to commit theft or embezzlement in connection with
2 In February 2017, Local 223 was merged into Local 22.
a health care benefit program. (Defs. 56.1 Stmt. ¶ 2.) At a July
15, 2015, Local 223 Executive Board meeting, Plaintiff informed
the Executive Board of his indictment and stated that the
allegations in the indictment were untrue. (Id. ¶ 3.) Defendants
assert that Plaintiff “continuously professed his innocence to the
Executive Board and never informed the Executive Board when he
began negotiating a plea deal.” (Id. ¶ 4.)
B. The Benefit Programs at Issue
Plaintiff claims that he is entitled to funds or coverage
under three separate welfare employee benefit plans: (1) the Local
223 Severance Policy; (2) the Local 223 Lifetime Medical Benefits
Policy; and (3) the International Non-Qualified Deferred
Compensation (“NQDC”) Plan.
1. The Severance Policy
Local 223’s Severance Policy entitles its members to
receive severance “upon termination of office of employment by
reasons of death, disability, or resignation.” (Defs. 56.1 Stmt.
¶ 13.) The severance is paid out in weekly installments over a
thirty-six-month period. (Id.) After Plaintiff’s indictment, at
a November 28, 2015 “special membership meeting” held to amend
Local 223’s Constitution and Bylaws, Plaintiff proposed a
modification to the Severance Policy. (Id. ¶ 14.) Specifically,
Plaintiff requested the Severance Policy be amended to include
officers who were terminated “for any reason.” (Id.) Plaintiff
testified that the Board approved the proposed modification
“because my Board didn’t want to hurt me, with everything I was
going through, as far as the indictment,” that is, “to make sure
that I got my severance benefit.” (Pl. Depo. Tr. at 49:17-24, Ex.
22, attached to Preece Aff.)
2. Lifetime Medical Benefits Policy
Similarly, Local 223’s Lifetime Medical Benefits Policy
entitles members to a monthly Medicare Supplement Benefit “upon
termination of office or employment or retainer . . . by reason of
death, disability, or resignation.” (Defs. 56.1 Stmt. ¶¶ 18, 21.)
The Lifetime Medical Benefits Policy is provided through the Local
223 Sick Benefit Fund, which is an ERISA-governed welfare benefit
fund. (Id. ¶¶ 19-20.) While the policy originally provided for
a lifetime preferred provider organization plan, in 2012 the
Executive Board, including Plaintiff, amended the policy to
provide a Medicare supplement benefit. (Id. ¶¶ 21-23.)
At an August 17, 2015 Local 223 Executive Board meeting,
Plaintiff proposed modifying the Lifetime Medical Benefits Policy
to include a length of service requirement. (Id. ¶¶ 24-25.) After
amendment, the provision read: “All Union Officers with at least
fifteen (15) years of service will receive lifetime medical
coverage for themselves and their spouse to be paid by the Union
upon their separation from employment.” (Id. ¶ 24 (emphasis
added).) Notably, the change from termination “by reason of death,
disability, or resignation” to “separation from employment” was
not reflected in the Executive Board meeting minutes. (Id. ¶ 25.)
As Plaintiff later testified regarding the amendment, “I was there
for over 15 years and I wanted to make sure that my lifetime
medical benefits were secured.” (Id. ¶ 26.)
3. The NQDC Plan
International administers the NQDC Plan, an ERISA-
governed plan that provides certain deferred compensation benefits
to eligible International Officers and General Executive Board
members. (Id. ¶¶ 29-30.) Under International’s Constitution:
The International Union, from its General
Funds, shall establish a Non-Qualified
Deferred Compensation and Severance Plan
providing such benefits as may be determined
by the General Executive Board for the
International Officers and General Executive
Board members. To be eligible for benefits
(under the NQDC Plan), the International
Officer or General Executive Board member must
have retired from any position of office with
the International Union, any subordinate body,
and any benefit fund of the subordinate body
or related to the subordinate body.
(Id. ¶ 31 (emphasis added).) The NQDC Plan is governed by the
terms of the NQDC Plan Document, which provides in relevant part
that “[t]he [Advisory] Committee shall have the sole right to
reconcile, determine, interpret, and construe any question or
dispute arising in connection with definitions of terms, rights,
status or classification of Participants, or any other dispute
arising under the [NQDC Plan],” and that “such reconciliation,
determination, interpretation or construction shall be final and
conclusive.” (Id. ¶ 32.) The NQDC Plan Document further provides
that only the Advisory Committee has the authority to determine
eligibility and the right to participate in the NQDC Plan, and
that “[n]o person shall have any vested right to the benefits
provided by the [NQDC] Plan.” (Id.) Benefits from the NQDC Plan
are paid from the general assets of International. (Id. ¶ 33.)
C. Plaintiff’s Guilty Plea and Termination
On August 8, 2016, Plaintiff pleaded guilty to one count
of conspiracy to solicit and receive kickbacks to influence the
operation of the Local 223 Sick Benefit Fund. (Id. ¶ 6.) On
August 16, 2016, Plaintiff was terminated from his employment as
Union Officer of Local 223 and Trustee of the Sick Benefit Fund.
(Id. ¶ 7.) Plaintiff disputes this, arguing that he resigned from
his position and pointing to his deposition testimony in support.
(Pl. 56.1 Stmt. ¶ 3; Pl. Depo. Tr. at 59:3-7.)
On that same day, International placed Local 223 into
temporary trusteeship. (Defs. 56.1 Stmt. ¶ 35.) On September 28,
2016, International sent notice to all Local 223 members that Local
223 was to be placed into permanent trusteeship based on
Plaintiff’s conviction for crimes against the Local 223 Sick
Benefit Fund. (Id. ¶ 36.) On February 24, 2017, International
sent notice to all members that Local 223 would merge into Local
22. (Id. ¶ 38.) As a result of the merger, the trusteeship of
Local 223 was terminated. (Id. ¶ 39.)
D. Plaintiff’s ERISA Denials
On September 13, 2016, International denied Plaintiff’s
initial claim for benefits from the NQDC Plan on the grounds that
Plaintiff’s conviction made it unlawful for International to pay
Plaintiff additional compensation from the International’s general
assets. (Id. ¶ 40.) Specifically, International relied on 29
U.S.C. § 504(d), which prohibits individuals who are convicted of
certain criminal acts from participating in, and from receiving
salary from, a labor organization. (Id.) Similarly, on September
19, 2016, Local 223, acting through the International-appointed
Trustee, denied Plaintiff’s initial claim for benefits under the
Lifetime Medical Benefits Policy on the grounds that providing
that benefit would violate 29 U.S.C. § 504(d). (Id. ¶ 41.)
Plaintiff unsuccessfully appealed the unfavorable determinations.
(Id. ¶¶ 42-44.)
Later, on June 14, 2017, Plaintiff submitted a second
appeal and request for payment under the Severance Policy. (Id.
¶ 45.) International denied Plaintiff’s request based on his
indictment and subsequent attempt to amend the Local 223
Constitution and Bylaws prior to his removal from office. (Id. ¶
46.) More than a year later, Plaintiff submitted a third appeal
to the newly formed Local 22, arguing that he is entitle to
severance and to the benefits under the Lifetime Medical Benefit
Policy because they are vested benefits under ERISA. (Id. ¶ 47.)
Local 22 denied Plaintiff’s third appeal pursuant to 29 U.S.C. §
504(d); it also rejected Plaintiff’s contention that the benefits
had vested. (Id. ¶ 48; see also Correspondence, Exs. 12-20,
attached to Preece Aff.)
II. Procedure
Plaintiff initiated this action on December 18, 2019.
Based on the foregoing allegations, Plaintiff asserts one cause of
action under ERISA Section 502(a)(2), 29 U.S.C. § 1132, for
International’s denial of Plaintiff’s request for payment under
the NQDC Plan, as well as causes of action under New York State
law for breach of contract, promissory estoppel, and unjust
enrichment based on Defendants’ denial of Plaintiff’s request for
payment under the NQDC Plan, Severance Policy, and Lifetime Medical
Benefit Policy. (See generally Am. Compl.) The parties completed
discovery on December 8, 2020, and the instant motion practice
ensued.
DISCUSSION
I. Legal Standard
Summary judgment is appropriate where there is “no
genuine dispute as to any material fact and the movant is entitled
to judgment as a matter of law.” Fed. R. Civ. P. 56(a). “Material
facts are those which might affect the outcome of the suit under
the governing law, and a dispute is genuine if the evidence is
such that a reasonable jury could return a verdict for the
nonmoving party.” Wagner v. Chiari & Ilecki, LLP, 973 F.3d 154,
164 (2d Cir. 2020) (quoting Coppola v. Bear Stearns & Co., 499
F.3d 144, 148 (2d Cir. 2007)) (internal quotation marks omitted).
“The moving party bears the initial burden of showing that there
is no genuine dispute as to a material fact.” CILP Assocs., L.P.
v. PriceWaterhouse Coopers LLP, 735 F.3d 114, 123 (2d Cir. 2013)
(cleaned up). “In moving for summary judgment against a party who
will bear the ultimate burden of proof at trial,” as Plaintiff
does here, “the movant may satisfy this burden by pointing to an
absence of evidence to support an essential element of the
nonmoving party’s claim.” Gummo v. Village of Depew, 75 F.3d 98,
107 (2d Cir. 1996) (citing Celotex Corp. v. Catrett, 477 U.S. 317,
322–23 (1986)). “If, as to the issue on which summary judgment is
sought, there is any evidence in the record from which a reasonable
inference could be drawn in favor of the opposing party, summary
judgment is improper.” Hetchkop v. Woodlawn at Grassmere, Inc.,
116 F.3d 28, 33 (2d Cir. 1997). Moreover, “the court is not to
make assessments of the credibility of witnesses” on a motion for
summary judgment, as “[c]redibility assessments, choices between
conflicting versions of events, and weighing of the evidence are
matters for the jury.” Id.
On a motion for summary judgment the court considers the
“pleadings, deposition testimony, answers to interrogatories and
admissions on file, together with any other firsthand information
including but not limited to affidavits.” Nnebe v. Daus, 644 F.3d
147, 156 (2d Cir. 2011). In reviewing the record, “the court is
required to resolve all ambiguities and draw all permissible
factual inferences in favor of the party against whom summary
judgment is sought.” Sheet Metal Workers’ Nat’l Pension Fund v.
Vadaris Tech. Inc., No. 13-CV-5286, 2015 WL 6449420, at *2
(E.D.N.Y. Oct. 23, 2015) (quoting McLee v. Chrysler Corp., 109
F.3d 130, 134 (2d Cir. 1997)). When drawing inferences from
evidence in the record in favor of the non-moving party, however,
a court should not accord the non-moving party the benefit of
“unreasonable inferences, or inferences at war with undisputed
facts.” Berk v. St. Vincent’s Hosp. & Med. Ctr., 380 F. Supp. 2d
334, 342 (S.D.N.Y. 2005) (quoting County of Suffolk v. Long Island
Lighting Co., 907 F.2d 1295, 1318 (2d Cir. 1990)).
II. Analysis
First, Defendants argue that Plaintiff’s state law
claims for breach of contract, promissory estoppel, and unjust
enrichment are preempted by ERISA. Second, with respect to
Plaintiff’s remaining claim for wrongful denial of benefits under
ERISA, Defendants argue that International properly denied
Plaintiff’s claim for benefits under the NQDC Plan. The Court
addresses these arguments in turn.
A. Preemption
1. Applicable Law
“Congress enacted ERISA to ‘protect . . . the interests
of participants in employee benefit plans and their beneficiaries’
by setting out substantive regulatory requirements for employee
benefit plans and to ‘provid[e] for appropriate remedies,
sanctions, and ready access to the Federal courts.’” Aetna Health
Inc. v. Davila, 542 U.S. 200, 208 (2004) (quoting 29 U.S.C. §
1001(b)). To that end, “Section 502(a)(1)(B) of ERISA provides
participants or beneficiaries with a civil remedy to recover
benefits due under their plans, to enforce rights under their
plans, or to clarify rights to future benefits under their plans.”
Arditi v. Lighthouse Int’l, 676 F.3d 294, 299 (2d Cir. 2012)
(citing 29 U.S.C. § 1132(a) (“ERISA Section 502”)). Moreover,
ERISA contains “deliberately expansive” preemption provisions,
Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 45-46 (1987), aimed
at establishing a “uniform regulatory regime over employee benefit
plans” and ensuring “employee benefit plan regulation is
exclusively a federal concern,” Davila, 542 U.S. at 208. See also
Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 65-66 (1987)
(discussing ERISA’s “extraordinary pre-emptive power” which
“converts an ordinary state common law complaint into one stating
a federal claim . . . .”). ERISA Section 514 specifically provides
that it “shall supersede any and all State laws insofar as they
may now or hereafter relate to any employee benefit plan.” 29
U.S.C. § 1144. Essentially, “where a plaintiff brings a state law
claim that is in reality an ERISA-claim cloaked in state-law
language, ERISA’s preemption power will take effect.” N. Shore-
Long Island Jewish Health Care Sys., Inc. v. MultiPlan, Inc., 953
F. Supp. 2d 419, 427 (E.D.N.Y. 2013).
“Under the Supreme Court’s test in Davila, ERISA
preempts a cause of action where: (1) ‘an individual, at some point
in time, could have brought his or her claim under ERISA
§ 502(a)(1)(B);’ and (2) ‘no other independent legal duty . . . is
implicated by a defendant’s actions.’” Arditi, 676 F.3d at 299
(quoting Davila, 542 U.S. at 210). The Second Circuit has further
clarified that, under the first prong of Davila, the plaintiff
must show: “(a) he is the type of party who can bring a claim
pursuant to § 502(a)(1)(B) of ERISA; and (b) the actual claim
asserted can be construed as a colorable claim for benefits
pursuant to § 502(a)(1)(B).” Id. (citing Montefiore Med. Ctr. v.
Teamsters Local 272, 642 F.3d 321, 328 (2d Cir. 2011)). To
determine whether the plaintiff’s state law claims are preempted
by ERISA, the Court must examine the plaintiff’s complaint, the
statute on which the plaintiff’s claims are based, and the various
plan documents. Davila, 542 U.S. at 211.
2. Application3
i. Davila Prong One
The first Davila prong is satisfied because Plaintiff
could have brought his claim under ERISA. Davila, 542 U.S. at
210. Indeed, he brought a claim under Section 502 in his Amended
Complaint. See Arditi, 676 F.3d at 299 (finding first prong of
Davila satisfied where the plaintiff initially filed an action
seeking benefits pursuant to Section 502 of ERISA but then
3 Although Plaintiff does not address this issue, the Court notes
the programs in question are employee welfare benefit plans subject
to an ERISA preemption analysis. See Hall v. LSREF4 Lighthouse
Corp. Acquisitions, LLC, 220 F. Supp. 3d 381, 388 (W.D.N.Y. 2016)
(“‘Congress [only] pre-empted state laws relating to plans, rather
than simply to benefits’ because the concern of providing ‘a
uniform set of administrative procedures governed by a single set
of regulations’ only arises ‘with respect to benefits whose
provision by nature requires an ongoing administrative program to
meet the employer’s obligation.’” (quoting Fort Halifax Packing
Co. v. Coyne, 482 U.S. 1, 11 (1987))). Based on the undisputed
record, applying the factors identified in Fort Halifax, the Court
finds that Defendants’ “undertaking involves the kind of ongoing
administrative scheme inherent in a ‘plan, fund, or program.’”
Okun v. Montefiore Med. Ctr., 793 F.3d 277, 279 (2d Cir. 2015).
With respect to the Severance Policy, “[t]he term ‘employee welfare
benefit plan’ has been held to apply to most, but not all, employer
undertakings or obligations to pay severance benefits.” Hall, 220
F. Supp. 3d at 389 (quoting Schonholz v. Long Island Jewish Med.
Ctr., 87 F.3d 72, 75 (2d Cir. 1996)); see also id. at 392
(distinguishing Fort Halifax and James v. Fleet/Norstar Fin. Grp.,
Inc., 992 F.2d 463 (2d Cir. 1993)). The Severance Policy at issue
here is more like the severance benefit plans at issue in Okun and
Schonholz than in Fort Halifax and Fleet/Norstar, because the
Severance Policy “necessitated both managerial discretion and a
separate analysis of each employee in light of certain criteria,”
such as eligibility criteria, and “was not limited either to a
single payment or to a short span of time,” but rather would pay
out in weekly installments over a 36-month period. Schonholz, 87
F.3d at 76-77.
voluntarily dismissed the complaint). The first cause of action
in Plaintiff’s Amended Complaint is a claim for benefits under the
NQDC Plan brought pursuant to Section 502 of ERISA. (Am. Compl.
¶¶ 22-25.) Moreover, the undisputed record shows that Plaintiff
sought and was denied benefits under the Severance Policy and
Lifetime Medical Benefits Policy. See Arditi, 676 F.3d at 299
(“Arditi is the type of party who can bring an ERISA claim because
he is a Plan participant and he is seeking benefits under the Plan
. . . .”). There can be no doubt that Plaintiff is seeking benefits
established by ERISA plans and is therefore a party who could bring
a claim pursuant to ERISA Section 502.
Further, the actual claims asserted by Plaintiff,
namely, breach of contract, promissory estoppel, and unjust
enrichment, can be construed as colorable claims for benefits
pursuant to Section 502 of ERISA. See Arditi, 676 F.3d at 299
(citing Montefiore, 642 F.3d at 328). To arrive at this
conclusion, the Court has considered the distinction between
claims concerning a “right to payment” versus claims involving an
“amount of payment.” Montefiore, 642 F.3d at 331. Whereas right-
to-payment claims “implicate coverage and benefits established by
the terms of the ERISA benefit plan,” which may be brought under
Section 502(a)(1)(B), amount-of-payment claims are “typically
construed as independent contractual obligations between the
provider and . . . the benefit plan.” Id. Montefiore “teaches
that a dispute is a colorable claim for benefits under ERISA when
its resolution depends on an interpretation of the terms of an
ERISA-governed employee benefit plan; that is, when, in order to
determine whether the plaintiff is entitled to relief, the court
must look to the terms of employee benefit plan, itself.” Olchovy
v. Michelin N. Am., Inc., No. 11-CV-1733, 2011 WL 4916891, at *4
(E.D.N.Y. Sept. 30, 2011), report and recommendation adopted, 2011
WL 4916564; see also Montefiore, 642 F.3d at 331-32 (approving
district court’s approach to review the at-issue claims and plan
documents to determine whether the plaintiff’s claims are
colorable claims under ERISA); Paneccasio v. Unisource Worldwide,
Inc., 532 F.3d 101, 114 (2d Cir. 2008); N. Shore-Long Island Jewish
Health Care Sys., Inc., 953 F. Supp. at 438.
Here, Plaintiff’s state law claims fit comfortably in
the “territory of a right to payment claim.” N. Shore-Long Island
Jewish Health Care Sys., Inc., 953 F. Supp. 2d at 440. Plaintiff’s
efforts to collect under the various plans at issue here “implicate
coverage and benefits established by the terms of the ERISA benefit
plan[s],” because they implicate coverage determinations under the
terms of each Policy and Plan. See Montefiore, 642 F.3d at 331
(holding claims for reimbursement “appear to implicate coverage
determinations under the relevant terms of the Plan, including
denials of reimbursement because . . . ‘the member is not
eligible’”); Josephson v. United Healthcare Corp., No. 11-CV-3665,
2012 WL 4511365, at *3 (E.D.N.Y. Sept. 28, 2012) (Seybert, J.)
(concluding step two of Davila’s first prong satisfied where some
of the reimbursement claims at issue “were denied for reasons that
would implicate coverage determinations under the terms of the
United benefit plans”); Beth Israel Med. Ctr. v. Goodman, No. 12-
CV-1689, 2013 WL 1248622, at *3 (S.D.N.Y. Mar. 26, 2013); N. Shore-
Long Island Jewish Health Care Sys., Inc., 953 F. Supp. 2d at 440
(collecting cases). Put simply, Plaintiff sought to collect under
the ERISA benefit plans, and International or Local 223 denied his
claims and subsequent appeals based on the plan documents and
relevant federal law. As a result, Plaintiff’s claims could have
been brought under ERISA.
ii. Davila Prong Two
Even if the first prong of the Davila test is satisfied,
a claim is not preempted by ERISA if “some other, completely
independent duty forms another basis for legal action.” Enigma
Mgmt. Corp. v. Multiplan, Inc., 994 F. Supp. 2d 290, 301 (E.D.N.Y.
2014) (emphasis in original) (quoting Montefiore, 642 F.3d at 332).
As a result, the Court considers whether Plaintiff’s claims for
breach of contract, promissory estoppel, or unjust enrichment
implicate some “other independent legal duty” per Davila’s second
prong. “A state law claim does not raise an independent legal
duty if liability derives entirely from the particular rights and
obligations established by the benefit plans.” Id. But there is
no preemption where the benefit arose from a separate promise and
did “not require a court to review the propriety of an
administrator’s or employer’s determination of benefits.”
Stevenson v. Bank of N.Y. Co., Inc., 609 F.3d 56, 61 (2d Cir.
2010).
Plaintiff claims that Defendants have been unjustly
enriched by withholding benefits to which he is entitled. He
further claims that Defendants promised under the respective plans
to pay out benefits if certain criterion were met, a promise that
Plaintiff relied on to his detriment when Defendants allegedly
violated their obligations under the plans by denying his claims.
In response, Defendants argue that they were entitled to deny
payment under the plans under the respective plan provisions and
federal law. The Court agrees with Defendants and finds that
Plaintiff’s state law claims are “claim[s] for unpaid benefits
that fall[] squarely within the terms of the ERISA plan and do[]
not raise any independent legal obligation.” Enigma, 994 F. Supp.
2d at 301 (citations omitted); see also Devlin v. Transp. Commc’ns
Int’l Union, 173 F.3d 94, 101 (2d Cir. 1999) (affirming district
court finding that the plaintiffs’ breach-of-contract claims were
preempted under ERISA); Kelly v. Deutsche Bank Sec. Corp., No. 09-
CV-5378, 2010 WL 2292388, at *1 (E.D.N.Y. June 3, 2010) (Seybert,
J.) (“It is well-settled that ERISA preempts common law state
claims that ‘do not attempt to remedy any violation of a legal
duty independent of ERISA.’ This includes breach of contract
claims.” (internal citation omitted)); N. Shore-Long Island Jewish
Health Care Sys., Inc., 953 F. Supp. 2d at 443 (finding the
plaintiff’s unjust enrichment and quantum meruit claims “similarly
fail to establish an independent duty under Davila or Montefiore”).
The Second Circuit’s decision in Stevenson is
distinguishable, as Defendants correctly argue. In that case, the
plaintiff left the employ of the defendant bank. Stevenson, 609
F.3d at 60. Nevertheless, the bank promised to maintain the
plaintiff’s benefits under its pension plan, notwithstanding the
fact pension beneficiaries would normally lose coverage upon
ending their employment with the bank. Id. The Stevenson Court
held that the plaintiff’s complaint did “not derive from the
particular rights and obligations established by any benefit plan
. . . but rather, from a separate promise that references various
benefit plans.” Arditi, 676 F.3d 294 (quoting Stevenson, 676 F.3d
at 300 (cleaned up)). Put otherwise, “[w]hatever rights the
plaintiff had arose not from the bank’s plan, but from the
independent agreement that gave him benefits even though he had no
right to them under the plan.” Id. (distinguishing Stevenson).
Conversely, in the instant action, there are no comparable promises
separate and independent from the three ERISA plans that governed
Plaintiff’s access to severance, lifetime medical, and deferred
compensation benefits. Defendants “made no promises of benefits
separate and independent from the benefits under the Plan[s].”
Id. at 301.
Plaintiff does not meaningfully address Davila’s inquiry
or explain why its analysis does not apply here. Instead,
Plaintiff cites to a pair of cases involving vested ERISA benefits.
(Pl. Opp’n at 10 (discussing Am. Federation of Grain Millers, AFL-
CIO v. Int’l Multifoods Corp., 116 F.3d 976 (2d Cir. 1997); Guidry
v. Sheet Metal Workers Nat’l Pension Fund, 493 U.S. 365 (1990)).)
But Plaintiff fails to controvert the undisputed evidence that the
employee welfare benefit plans from which Plaintiff seeks to
recover are not vested benefits. To the contrary, Defendants have
submitted evidence showing that the Local 223 and International
policies and plans could be amended, modified, or terminated at
any time. “Unlike pension plan benefits, the benefits provided by
a welfare plan generally are not vested and an employer can amend
or terminate a welfare plan at any time.” Am. Fed’n of Grain
Millers, AFL-CIO, 116 F.3d at 979. Indeed, Plaintiff facilitated
the amendment of the eligibility requirements governing the
Severance Policy and Lifetime Medical Benefits Policy shortly
after he was indicted.4
4 Nor does Guidry control here. In Guidry, the Supreme Court
addressed separate provisions of ERISA as applied to a pension
benefit plan, not a welfare benefit plan like those at issue in
this litigation.
In sum, Defendants’ conduct did not create a
sufficiently independent duty under Davila; rather, Defendants
denied Plaintiff’s requests for benefits based of the terms of the
at-issue plans and federal law. Therefore, Plaintiff’s state law
claims raise issues that are “inextricably intertwined with the
interpretation of Plan coverage and benefits,” which the Court
turns to next. Montefiore, 642 F.3d at 332.
B. Claim for Unpaid Benefits
Having concluded Plaintiff’s state law claims are
preempted by ERISA, the Court turns to Plaintiff’s remaining cause
of action under Section 502 of ERISA, which seeks recovery for
unpaid benefits under the NQDC Plan.
1. Applicable Law
“A denial of benefits challenged under ERISA §
502(a)(1)(B) is to be reviewed under a de novo standard unless the
benefit plan gives the administrator or fiduciary discretionary
authority to determine eligibility for benefits or to construe the
terms of the plan.” Krauss v. Oxford Health Plans, Inc., 517 F.3d
614, 622 (2d Cir. 2008) (quoting Firestone Tire & Rubber Co. v.
Bruch, 489 U.S. 101, 115 (1989) (cleaned up)). Where the fiduciary
establishes that it has such discretionary authority, “the
benefits decision is reviewed under the arbitrary and capricious
standard.” Id. (citing Fay v. Oxford Health Plan, 287 F.3d 96,
104 (2d Cir. 2002)). Under the “deferential” arbitrary and
capricious standard, the court will overturn a fiduciary’s denial
“only if the decision is ‘without reason, unsupported by
substantial evidence or erroneous as a matter of law.’” Kinstler
v. First Reliance Standard Life Ins. Co., 181 F.3d 243, 249 (2d
Cir. 1999) (quoting Pagan v. NYNEX Pension Plan, 52 F.3d 438, 442
(2d Cir. 1995)); see also O’Shea v. First Manhattan Co. Thrift
Plan & Trust, 55 F.3d 109, 112 (2d Cir. 1995) (holding denial is
arbitrary and capricious where plan administrator or fiduciary has
“impose[d] a standard not required by the plan’s provisions, or
interpret[ed] the plan in a manner inconsistent with its plain
words”). The Second Circuit defines substantial evidence as “such
evidence that a reasonable mind might accept as adequate to support
the conclusion reached by the decisionmaker and requires more than
a scintilla but less than a preponderance.” Miller v. United
Welfare Fund, 72 F.3d 1066, 1072 (2d Cir. 1995) (quoting Sandoval
v. Aetna Life & Casualty Ins. Co., 967 F.2d 377, 382 (10th Cir.
1992)). “The court may not upset a reasonable interpretation by
the administrator.” Jordan v. Ret. Comm. of Rensselaer Polytechnic
Inst., 46 F.3d 1264, 1271 (2d Cir. 1995) (citations omitted).
2. Application
To begin, the terms of the NQDC Plan Document grant
International’s Advisory Committee discretionary authority to
determine eligibility for benefits, including “the sole right to
reconcile, determine, interpret, and construe any question or
dispute arising in connection with definitions of terms, rights,
status or classification of Participants,” and further provides
that its interpretation is “final and conclusive.” Importantly,
NQDC Plan Document grants sole authority to the Advisory Committee
to “determine eligibility for benefits and the right to participate
in the Plan.” It further clarifies that benefits under the NQDC
Plan are not vested. Last, International’s “General Executive
Board” has “exclusive control over and management of the assets of
the Plan.” As a consequence of this grant of discretion, the
Court’s inquiry is whether International acted arbitrarily and
capriciously in denying Plaintiff’s claim for benefits.
Cirincione v. Plumbers Loc. Union No. 200 Pension Fund, No. 07-
CV-2207, 2009 WL 3063056, at *3 (E.D.N.Y. Sept. 24, 2009) (Seybert,
J.) (applying arbitrary and capricious standard where pension plan
granted reviewing board the “exclusive right to interpret the Plan
and to decide any matters arising thereunder in connection with
the administration of the Plan”), aff’d, 404 F. App’x 524 (2d Cir.
2010); see also Ganton Technologies, Inc. v. Nat’l Indus. Grp.
Pension Plan, 76 F.3d 462, 466 (2d Cir. 1996) (applying arbitrary
and capricious standard where the plan explicitly provided that
the trustees had authority to “resolve all disputes and ambiguities
relating to the interpretation of the Plan”); Jordan, 46 F.3d at
1270 (applying arbitrary and capricious standard where the plan
“confer[red] upon the Retirement Committee the power of
‘interpretation’”).
International’s Advisory Committee based its adverse
decision on (a) federal law, in particular 29 U.S.C. § 504, which
bars any member in a labor organization from receiving any salary
when he has been barred from his office or position; and (b) its
interpretation of the International Constitution, which provides
that only retirees are eligible for benefits under the NQDC Plan.
The Court addresses these bases in turn.
(a) Section 504
Section 504 of the Labor-Management Reporting and
Disclosure Act (the “LMRDA”) bars any person who has been convicted
of certain enumerated offenses, including bribery, extortion, and
embezzlement, from serving as an officer or employee of any labor
organization. 29 U.S.C. § 504(a). The provision further prohibits
any person who has been so barred from receiving “any salary which
would be otherwise due such person by virtue of such office or
position” until the conviction has been reversed, in which case
the bar is lifted and the individual is paid out of escrow for the
period of time during which a salary would have been due, or
sustained, in which case the withheld salary is returned to the
employer. Id. § 504(d). Any person who willfully violates Section
504 faces a fine not to exceed $10,000 and/or imprisonment not to
exceed five years. Id. § 504(b). In enacting Section 504(a),
Congress sought “to eliminate or prevent improper practices on the
part of labor organizations, employers, labor relations
consultants, and their officers and representatives which distort
and defeat the policies of the [LMRDA].” 29 U.S.C. § 401(c); see
also Nass v. Local 348, Warehouse Production, Sales and Servs.
Emps. Union, 503 F. Supp. 217, 220 (E.D.N.Y. 1980) (“[I]n enacting
§ 504 Congress sought to eliminate the intolerable and corrupt
conditions which prevailed throughout segments of organized labor
during the 1950’s.”).
Plaintiff argues that Section 504(d) applies only to
salaries, not to what he incorrectly claims are vested benefits.
(Pl. Opp’n at 16.) Defendants counter that because the NQDC Plan
benefits are paid from the general assets of International, they
reasonably believed that paying Plaintiff out of these funds would
violate Section 504(d) and expose International to liability under
the statute. (Defs. Support Memo at 17-19; Defs. Reply at 15-17.)
The parties have not cited any authority on point, and the issue
appears to be one of first impression. Based on its review of
Section 504(d) and caselaw interpreting the provision, the Court
finds that Plaintiff’s construction of the statute is stronger:
the purpose of Section 504(d) is “to protect the interests of a
debarred union officer whose conviction was improperly obtained by
the government and later reversed.” McMahan v. Int’l Ass’n of
Bridge, Structural & Ornamental Iron Workers, 858 F. Supp. 529,
537-38 (D.S.C. 1994) (extensively reviewing the statute’s
enactment history). However, in the absence of controlling
authority, the Court cannot say that International’s construction
of the provision is unreasonable or “erroneous as a matter of law.”
This is especially the case since the NQDC benefits would be paid
out from International’s general assets, i.e., the benefits would
be paid out by International and not by a separate benefit fund.
Rather, where, as here, a claimant and fiduciary offer “two
competing yet reasonable interpretations,” the court “must accept
that offered by the administrator.” Wegmann v. Young Adult Inst.,
Inc., Trustees of Supplemental Pension Plan for Certain Mgmt. Emps.
of Young Adult Inst., No. 20-CV-1147, 2021 WL 3573753, at *1 (2d
Cir. Aug. 13, 2021) (quoting Pagan, 52 F.3d at 443 (cleaned up));
see also Jordan, 46 F.3d at 1273. Accordingly, the Court finds
that International’s reliance on Section 504(d) in denying
Plaintiff benefits under the NQDC Plan was supported by substantial
evidence and not arbitrary or capricious.
(b) Plaintiff’s Termination
The second basis for International’s decision further
supports the Court’s conclusion. As noted, to be eligible for
benefits under the NQDC Plan, the member “must have retired” from
the Union. According to Defendants, Plaintiff did not retire but
rather was terminated due to his felony conviction. Plaintiff
disputes whether he resigned, citing to his deposition testimony
in support. Plaintiff’s testimony on this point is inconsistent.
(Id. at 59:16-22 (testifying the attorney for International “came
down to New York . . . and said to me, ‘I think it is best that
you leave.’ And I said to him, ‘It was going to happen anyway.’”).)
It is further undermined by the termination letter Plaintiff
received on August 16, 2016 -- eight days after he pleaded guilty
-- in which International “relieved” Plaintiff of his duties as
the Business Manager of Local 223. Thus, there is nothing in the
record to support Plaintiff’s claim that he retired other than his
“own contradictory and incomplete testimony.” Jeffreys v. City of
New York, 426 F.3d 549, 555 (2d Cir. 2005) (affirming district
court grant of summary judgment where the plaintiff’s testimony
raising material issues of fact “was largely unsubstantiated by
any other direct evidence” and was “so replete with inconsistencies
and improbabilities” that “no reasonable juror would undertake the
suspension of disbelief necessary to credit the allegations made
in his complaint”). But even setting aside whether this case is
one of those situations in which the Jeffreys rule can be applied,
the Court is unable to conclude that International’s decision was
without reason. Rather, a reasonable mind could find the evidence
before International’s Advisory Committee, including the
termination letter, was sufficient to support its conclusion that
Plaintiff had been terminated from his position and, therefore,
was not eligible for the NQDC benefits per the International
Constitution.
* * *
Because the Court finds that Plaintiff’s New York State
law causes of action are preempted by ERISA, and Defendants are
entitled to judgment as a matter of law on his remaining ERISA
claim, the Court need not address Defendants’ remaining
contentions regarding Plaintiff’s alleged breach of his fiduciary
duties or unclean hands in seeking the benefits. Moreover,
applying the relevant factors, the Court declines to exercise its
discretion to award Defendants attorney’s fees under ERISA. See
29 U.S.C. § 1132(g)(1); Hardt v. Reliance Standard Life Ins. Co.,
560 U.S. 242, 254-55 (2010); Chambless v. Masters, Mates & Pilots
Pension Plan, 815 F.2d 869, 879 (2d Cir. 1987).
To the extent not expressly addressed, the Court has
considered the parties’ remaining arguments and finds them to be
without merit.
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CONCLUSION
Accordingly, for the stated reasons, IT IS ORDERED that
Defendants’ motion for summary judgment (ECF No. 25) is GRANTED;
and Plaintiff’s cross-motion for summary judgment (ECF No. 28) is
DENIED. The Clerk of the Court is respectfully directed to enter
judgment accordingly and mark this case CLOSED.
SO ORDERED.
/s/_JOANNA SEYBERT___________
Joanna Seybert, U.S.D.J.
Dated: June 23 , 2022
Central Islip, New York