Brightman v. 1199SEIU Health Care Emps. Pension Fund

VICTORIA I. BRIGHTMAN, Plaintiff, v. 1199SEIU HEALTH CARE EMPLOYEES PENSION FUNDand 1199SEIU RETIREMENT COMMITTEE, Defendants.

No. 18 Civ. 4932 (CM)

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK

July 10, 2019

DECISION AND ORDER DENYING PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT AND GRANTING IN PART AND DENYING IN PART DEFENDANTS' MOTION FOR SUMMARY JUDGMENT

McMahon, C.J.:

On June 4, 2018, Victoria Brightman ("Plaintiff") filed this action against 1199SEIU Health Care Employees Pension Fund and 1199SEIU Retirement Committee ("Defendants") seeking relief pursuant to the Employee Retirement Income Security Act of 1974 ("ERISA"), as amended, 29 U.S.C. §§ 1132(a)(1)(B), (a)(3)(B), and (g)(1). On November 30, 2018, the Parties filed claims for summary judgment.

For the reasons stated below, Plaintiff's Motion for Summary Judgment is denied and Defendants' Motion for Summary Judgment is granted in part and denied in part. Two of Plaintiff's claims are being remanded to the Fund for reconsideration. This Court will retain jurisdiction while the Fund reconsiders Plaintiff's claims for benefits in light of the following opinion.

I. Factual Background

The factual background is derived from the administrative record and the Local Rule 56.1 statements Plaintiff and Defendants submitted in support of their motions, and in response to their opponent's motion. Denials without support or explanation are treated as admissions. See Ferring B.V. v. Allergan, Inc., 253 F. Supp. 3d 708, 710 (S.D.N.Y. 2015).

A. The 1199 SEIU Health Care Employees Pension Fund

At issue in this case is the 1199SEIU Health Care Employees Pension Fund (the "Plan"). (Decl. of Stanley D. Baum ("Baum Decl."), Dkt. No. 21, Ex. Q (the "Plan").) The Plan, which is governed by ERISA, covers employees "working under a Collective Bargaining Agreement between a Contributing Employer and 1199SEIU United Healthcare Workers East (the "Union") providing for contributions on [the employee's] behalf to this Pension Fund." (Plan at 14.) Plaintiff is a Plan participant and a Union member. (Defs.' 56.1 Statement of Material Facts in Supp. of their Mot. For Summ. J. ("Defs.' 56.1"), Dkt. No. 27, ¶ 7.)

Plaintiff has brought ERISA claims with respect to the Fund's calculation and payment of her pension benefits.

1. Pension Calculation

Plaintiff's pension is one-twelfth of the following sum: 1.85% of her Average Final Pay multiplied by her Credited Future Service, plus 1.5% of her Past Service Pay multiplied by her Credited Past Service. (Id. § 5.2(b) at 148-49.)

"'Average Final Pay' means for each Participant, the highest average Regular Pay during five (5) consecutive Plan Years of employment after his Applicable Effective Date and within his last ten (10) Plan Years of Credited Future Service." (Id. § 1.6 at 132).

"'Regular Pay' means for each Participant, his total pay in a Plan Year . . . during periods for which his Contributing Employer is required to make Contributions, excluding overtime, on-call pay, commissions, bonuses and gratuities, and expense allowances." (Id. § 1.29 at 137.) "For periods for which the Fund office is unable to obtain actual pay information, Regular Pay shall be calculated utilizing industry standards through a methodology approved by the Retirement Committee." (Id.)

"Credited Future Service" is the "total service on and after [Participant's] Applicable Effective Date, credited at the rate of one (1) month for each month for which Contributions are required to be made to the Fund by reason of the Participants employment." (Id. § 3.2(a) at 142.) "Credited Past Service" is "determined as of the date such person ceases to be an Employee and . . . it means for each Participant his total service prior to his Applicable Effective Date with all Contributing Employers . . . Service shall not be granted for any service with a Contributing Employer in a job category which has not been included for pension coverage under this Plan (i.e., contributions required) as of the date Participant last worked in [sic] Covered Service." (Id. § 3.2(b) at 143.)

2. Pension Eligibility

Pension payments begin when a Plan participant is eligible for retirement. Eligibility for retirement depends on a number of factors. Plaintiff became eligible on the first of the month following her 65^th birthday. (Id. § 4.1 at 145.)

After participants are eligible for retirement, they may continue to receive pension benefits even if they become "actively employed," with the following exceptions:

[E]xcept as required by law, no pension benefit payment shall be made or continue to be made to a Pensioner who is actively employed in full or part-time employment for more than 40 hours per month:

(a) in the healthcare or human service industry or a related industry (including, but not limited to, hospitals, nursing and convalescent homes, drugstores, laboratories, medical schools, and universities), and(b) utilizing skills applicable to his previous employment in the healthcare or human service or related industry, and

(c) in an Area covered by the Plan and within the meaning of "Section 202(a) (3)(B) Service" pursuant to Department of Labor Regulations 29 C.F.R. § 2530.203-3(c)(2).

(Id. § 11.7 at 175.)

There are specific notice requirements to which the Plan must adhere when an individual who has received or is eligible for pension is precluded from receiving the pension because of his or her present work. The Plan requires that:

A Pensioner whose benefits are suspended as described above and a Participant who continues to work for a Contributing Employer beyond Normal Retirement Date shall receive (to the extent required under ERISA) a notice that includes the information and complies with Department of Labor Regulations 29 C.F.R. §2530.203-3(b)(4). Such notice shall be delivered by first class mail or personal delivery not later than the end of the first calendar month during which benefit payments are suspended.

(Id.)

3. Disability Benefits

The Plan also provides for disability benefits, which can be claimed earlier than retirement benefits. Under the Plan, "A Participant who is totally and permanently disabled . . . shall be eligible to receive a Disability Pension Benefit, provided that the condition or event giving rise to the total and permanent disability commenced or occurred on or before the last day of his Credited Service and the Participant's employment with a Contributing Employer terminated as a result of such condition or event." (Id. § 8.1 at 167.) Disability benefits "cease on the Participant's Normal Retirement Date [the first day of the month after the participant's 65^th birthday]. A Participant who is receiving a Disability Pension Benefit may [then] apply for a Normal Retirement Benefit in accordance with the Plan." (Id. § 8.4 at 168.) Disability benefits are calculated in the same way as retirement benefits. (Id. § 8.2 at 167.)

4. Participant's Appeal Rights

The Plan grants the Plan Administrator and Trustees discretionary authority to interpret the Plan and related Plan documents, decide all matters in connection with entitlement to benefits under the Plan, and make all factual determinations required to administer the Plan and related plan documents. (See Plan § IX.G at 92.)

If a Plan participant is denied benefits or believes that his or her pension amount is not correct, the participant has the right to appeal to the Retirement Committee by filing a written request with the Plan Administrator within 60 days of receiving notice of the adverse benefit determination. (Id. at § IX.B at 86.) The Retirement Committee must issue a decision during the next quarterly scheduled meeting. (Id.) The decision of the Retirement Committee must be made in writing and include an explanation of the decision and the basis for such decision; the decision is final, binding, and conclusive. (Id.)

B. Plaintiff's Relevant Work History

Between 1993 and 2014, Plaintiff worked as a physician's assistant ("PA") on Riker's Island. During this period, she was employed by various hospitals that contracted with New York City to provide medical services on Rikers Island. (Pl.'s Rule 56.1 Statement of Material Facts ("Pl.'s 56.1"), Dkt. No. 23, ¶ 1.)

From July 1993 to March 1994, Plaintiff was employed by Bronx Lebanon Hospital ("Bronx Lebanon"). (Id. ¶ 2.)

From 1993 to 1997, Plaintiff worked as a PA in a unit managed by St. Vincent's Catholic Medical Center ("St. Vincent's"). (Id. ¶ 3.) Plaintiff contends that while she was employed by St. Vincent's, it was a participating employer in the 1199SEIU Health Employees Pension Fund (the "Fund"). The Fund admits that St. Vincent's Catholic Medical Center was a "Contributing Employer to the 1199SEIU Health Care Employees Pension fund," but asserts that St. Vincent'sdid not make contributions for [Plaintiff's] job category [of PA]." (Compare id. ¶ 4 with Decl. of John Eng, Dkt. No. 26, Ex. A ("Admin Record") at 17.)

From January 1998 through around December 2000 - Plaintiff says December 2000 but the document included in the administrative record says January 2001 - Plaintiff worked as a PA employed by St. Barnabas Hospital. (Pl.'s 56.1 ¶ 5; Admin Record at 56.) Her position was governed by a contract collectively known as the "Riker's Island Contract." (Pl.'s 56.1 ¶ 5.)

While Plaintiff was working for St. Barnabas, Local 1199SEIU (the "Union") began organizing the St. Barnabas PAs to join the Union. (Id. ¶ 6.) Plaintiff says that during the organizational efforts, Mark Bergen, a Union organizer, informed the PAs, including Plaintiff, that if they joined the Union, St. Barnabas would credit their pre-1998 service as PAs. (Admin Record at 7, 61; Aff. of Victoria Brightman in Supp. of Mot. for Summ. J. ("Brightman Aff."), Dkt. No 20, ¶ 7.) Plaintiff contends that this means that her three years at St. Vincent's qualify for past service credit, because she was covered as a PA while employed by St. Vincent's. (Pl.'s 56.1 ¶ 8.)

Plaintiff claims that she...