Shafer v. Metro. Life Ins. Co.

MARILYN O. SHAFER, Plaintiff, v. METROPOLITAN LIFE INSURANCE COMPANY, a New York Insurance Company,and SCHLUMBERGER TECHNOLOGIES, INC., a Texas Corporation, Defendants.

Civil Action No. 14-cv-00656-RM-KMT

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO

July 2, 2015

Judge Raymond P. Moore

ORDER

In this matter, Plaintiff Marilyn O. Shafer alleges¹ that (1) Defendant Metropolitan Life Insurance Company ("MetLife") violated the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq., by denying her claim for life insurance benefits under the 2012 MetLife Policy (ECF No. 1 ¶¶ 25-26); (2) Defendant MetLife violated ERISA by failing to provide Plaintiff with a summary plan description ("SPD") for the 2012 MetLife Policy (ECF No. 1 ¶¶ 27, 29)²; and (3) Defendant MetLife and Defendant Schlumberger TechnologyCorporation³ ("STC") breached their contract by not paying the full amount of life insurance benefits due Plaintiff under the 2012 MetLife Policy (ECF No. 1 ¶¶ 30-31).

This matter is before the Court on "the merits for judicial review of an ERISA claim." (ECF Nos. 30; 33; 34; 35.)

For the reasons stated below, the Court finds (1) MetLife did not violate ERISA by denying Plaintiff's claim for benefits in excess of the amount of $873,000 plus interest; (2) Plaintiff did not allege a claim against STC for its alleged breach of its fiduciary duties under ERISA and therefore, this "claim" is subject to dismissal; (3) Plaintiff did not allege a claim against STC for its alleged failure to provide Plaintiff with a SPD and therefore, this "claim" is subject to dismissal; (4) MetLife did not violate ERISA by not providing Plaintiff with a SPD; and (5) ERISA preempts Plaintiff's breach of contract claim⁴.

I. BACKGROUND

A. Relevant Factual Background

Effective January 1, 2012, STC changed its life insurance carrier and contracted with MetLife to provide group life insurance for its employees in 2012, i.e., the "2012 MetLife Policy." (Admin. R. ("AR") 0001-0099, 0818-19.)

In 2011, Plaintiff's deceased husband, Michael Shafer ("Decedent"), was employed at Smith International, Inc. ("Smith"). (See AR 1047.) STC acquired Smith. (AR 1047.) As a prior Smith employee, STC offered Decedent employee benefits under the 2012 MetLife Policy. (See, e.g., AR 1856.) The open enrollment period for employee benefits for the 2012 MetLife Policy was during the month of November 2011. (AR 1862.)

On November 15, 2011, Decedent went on short-term disability leave. (See AR 1106.)

Also on November 15, 2011, Plaintiff called STC's benefits department regarding questions about life insurance. (AR 1921; ECF No. 30-1 at 20, Report Tr. of Shafer Rec 1921 at 9:8-10.) An STC representative, Tiffany Gauvin ("Gauvin"), informed Plaintiff that life insurance coverage was still in effect while an employee was on disability leave. (AR 1921; ECF No. 30-1 at 20, Report Tr. of Shafer Rec 1921 at 9:8-13.) Gauvin inquired as to whether Decedent would be "on disability at some point, soon." (AR 1921, ECF No. 30-1 at 20, Report Tr. of Shafer Rec 1921 at 9:16-17.) Plaintiff informed Gauvin that Decedent has "already applied for it this year. But he's probably going to be back to work before next year" and that "it's just short-term . . . disability" and "he'll probably be back to work before . . . the beginning of 2012." (AR 1921, ECF No. 30-1 at 20-21, Report Tr. of Shafer Rec 1921 at 9:20-25 and 10:3-6.)

On November 15, 2011, Decedent enrolled for life insurance benefits provided by the 2012 MetLife Policy using Schlumberger Automated Benefits Link ("SABL"). (ECF No. 30-2, Pl.'s 2012 Enrollment Summary⁵; AR 1885; AR 1920; ECF No. 30-1 at 4, Report Tr. of Shafer Rec 1920 at 3:13-23.) Decedent's enrollment form (ECF No. 30-2 at 5, Pl.'s 2012 Enrollment Summary), stated that "I am aware that the plan(s) I may choose have prescribed benefits, exclusions, and other limitations that apply to me. . . ." (See AR 0710, 0819, 0822.)

In 2011, Decedent's life insurance benefits were covered by a Group Variable Universal Life policy ("GVUL Policy") insured by MetLife. (AR 1055-1097, 1588, 1856.) The face value of the GVUL Policy was $873,000. (AR 1586-88.)

Decedent elected life insurance benefits under the 2012 MetLife Policy in excess of that provided under his GVUL Policy. (Compare AR 1587-88 with ECF No. 30-2 at 2, Pl.'s 2012Enrollment Summary; AR 1737.) Plaintiff contends that Decedent elected benefits in the amount of $1,010,000.00. (ECF No. 35 ¶ 7.) MetLife computed that under the GVUL, Decedent had the following life insurance coverage:

• Base coverage = 2 X $124,548 annual earnings = $249,098, rounded to $250,000.

• Supplemental coverage = 5 X $124,648 annual earnings = $622,740, rounded to $623,000.

• Total coverage = $250,000 base coverage + $623,000 supplemental coverage = $873,000.

(AR 0818-19.)

The week of November 28, 2011, STC sent all employees, including Decedent, a December 2011 "GetConnected" newsletter. (AR 1697; 1853-60.) The GetConnected newsletter stated "If you are not actively at work on January 1, 2012, any supplemental coverage you elected under the Schlumberger Life Insurance and Disability Plans during 2012 Annual Enrollment will not take effect until you have returned to work for one full day." (AR 1856.) The GetConnected newsletter stated that "[a]ll benefits are governed by the official plan documents that describe these benefit programs in greater detail." (AR 1860.)

STC mailed Decedent a copy of the "2012 Enrollment Guide." (AR 1861-88; ECF No. 34-1 at 3, Lisa Bartley ("Bartley") Decl. ¶ 5(a).) The 2012 Enrollment Guide was "designed to make it easy to learn about . . . benefits" but stated that "[a]ll benefits are governed by the official plan documents that describe these benefit programs in greater detail." (AR 1888.) The 2012 Enrollment Guide directed employees to SABL which has several documents pertaining to employee benefits, including the 2012 Enrollment Guide and the 2011 SPD. (See AR 1862-63.) The 2012 Enrollment Guide indicated that individuals were eligible for the 2012 MetLife Policy if they were "a full-time or part-time employee." (AR 1863.)

The 2012 MetLife Policy has an "actively-at-work" provision which requires an employee to be "Actively at Work" in order for the elected coverage to take effect. (AR 0040-41, 0092.) If an employee is "not Actively at Work on the date insurance would otherwise take effect, insurance will take effect when [the employee] resume[s] Active Work for at least one full scheduled day." (AR 0040.) Additionally, the employee "must also have been Actively at Work for at least 20 hours during the 7 calendar days preceding that date." (AR 0040.) The 2012 MetLife Policy defines Actively at Work as occurring where the employee is

performing all of the usual and customary duties of [his] job on a Full-Time or Part-Time basis. This must be done at:

• the Policyholder's place of business;

• an alternate place approved by the Policyholder; or

• a place to which the Policyholder's business requires [the employee] to travel. [The employee] will be deemed to be Actively at Work during weekends or Policyholder approved vacations, holidays or business closures if [the employee was] Actively at Work on the last scheduled work day preceding such time off.

(AR 0036.) The 2012 MetLife Policy lists the Plan Administrator as STC. (AR 0082.) The 2012 MetLife Policy provides that the "Plan Administrator" and "other Plan fiduciaries" have "discretionary authority to interpret the terms of the Plan and to determine eligibility for and entitlement to Plan benefits in accordance with the terms of the Plan." (AR 0086.)

The 2011 SPD twice states that "[i]f [an employee is] not actively at work on the day [his] coverage (or increased coverage) is scheduled to begin, [his] coverage (or increased coverage will take effect when [the employee has] returned to [his] assigned schedule of hours for one day." (AR 0363, 0367.) The 2011 SPD provides information on the life insurance benefits available under the 2012 MetLife Policy. (AR 0360-81.) The 2011 SPD lists the Plan Administrator as the Administrative Committee of the Schlumberger Group Life, Accidental Death and Dismemberment, and Business Travel Accident Plan. (AR 0376.) The 2011 SPD lists Aetna Life Insurance Company as the insurer. (AR 0369.)

On December 7, 2011, Plaintiff called STC to ask whether STC "ha[d] received [Decedent's] request for [Decedent's] new life insurance policy [i.e., the 2012 MetLife Policy], before [Decedent] submit[s] this withdrawal form with [Decedent's] old MetLife claim [i.e., the GVUL Policy]." (AR 1920; ECF No. 30-1 at 4, Report Tr. of Shafer Rec 1920 at 3:13-17.) The STC representative, Lateya Gunn ("Gunn"), responded that "[she] show[s] that [Decedent has] the basic life . . . [she] also show[s] supplemental for employee with five times the eligible compensation . . . So I do show . . . that you have enrolled." (AR 1920; ECF No. 30-1 at 5, Report Tr. of Shafer Rec 1920 at 4:9-18.) Gunn also referred Plaintiff to Lisa Bartley ("Bartley"), Benefits Manager at STC (AR 0719), regarding questions about reductions of benefits under the 2012 MetLife Policy if the GVUL Policy was not relinquished (AR 1920; ECF No. 30-1 at 5-7, Report Tr. of Shafer Rec 1920 at 4:22-7:10).

STC negotiated with MetLife that certain employees who were not "Actively at Work" would receive life insurance coverage but only for the same amount that those employees had in effect on December 31, 2011. (AR 0403, 0818, 1589-1692.) Decedent was one of those employees covered by this negotiation, otherwise referred to as those "grandfathered" at their former insurance levels. (AR 0403, 0813, 1099, 1589-1692.)

Beginning January 1, 2012, Decedent was charged premiums for the 2012 MetLife Policy. (AR 0814.) On June 15 and 29, 2012, STC refunded Decedent his premium contributions for the 2012 MetLife Policy. (AR 1700-03, 0814-15.) Bartley blamed the deductions on a ...