Federal Circuits, 6th Cir. (August 10, 1994)
Docket number: 92-6613
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U.S. Supreme Court - Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986)
U.S. Court of Appeals for the 3rd Cir. - Mack Boring and Parts, a New Jersey Corporation; Diesel Engine Service & Supply Co.; Engine City Technical Institute; Edward J. Mcgovern, as Administrator, Appellants, v. Meeker Sharkey Moffitt, Actuarial Consultants of New Jersey; Thomas Sharkey; Provident Mutual Life Insurance Company of Philadelphia, Appellees., 930 F.2d 267 (3rd Cir. 1991) a New Jersey Corporation; Diesel Engine Service & Supply Co.; Engine City Technical Institute; Edward J. Mcgovern, as Administrator, Appellants, v. Meeker Sharkey Moffitt, Actuarial Consultants of New Jersey; Thomas Sharkey; Provident Mutual Life Insurance Company of Philadelphia, Appellees.
Leslie Patterson Vose, Charles E. Christian (argued and briefed), Landrum & Shouse, Lexington, KY, for plaintiff-appellant.
J. Guthrie True, Stoll, Keenon & Park, Lexington, KY, Joan P. Simmons, James P. Condon (argued and briefed), Central States, Southeast & Southwest Areas Health & Welfare & Pension Funds, Rosemont, IL, for defendants-appellees.Before: KENNEDY, SILER, and BATCHELDER, Circuit Judges.SILER, Circuit Judge.Plaintiff Cathy Pope appeals the district court's summary judgment on her claim for medical benefits under 29 U.S.C. Sec . 1132(a)(1)(B), of the Employee Retirement Income Security Act ("ERISA"). Pope argues that a welfare plan amendment reducing coverage for certain medical benefits enacted by Central States' Joint Board of Trustees ("the Joint Board") is reviewable under ERISA's fiduciary duty standards. Pope further argues that the Joint Board violated these standards. We affirm.BackgroundArthur Pope was diagnosed with end-stage liver disease on March 7, 1987. He received a liver transplant, and was eventually provided coverage under Central States' welfare benefits plan. The plan suffered $64 million in losses during the 1987 calendar year. Thus, the Joint Board enacted a $50,000 lifetime coverage limit on benefits for liver transplants and other transplant procedures, effective January 1, 1989, as one means of ensuring the plan's solvency. On January 18, 1989, Arthur Pope received a second liver transplant. Central States refused to pay benefits exceeding the amended coverage limits. On June 20, 1989, Pope received a third liver transplant. Pope did not notify Central States of the transplant until after it occurred and did not administratively appeal Central States' failure to pay associated costs. On July 23, 1990, Pope filed this action alleging wrongful refusal to provide medical benefits. He died on October 2, 1990, and Cathy Pope, as administratrix of Arthur Pope's estate, was substituted as a party in this action.AnalysisCathy Pope asserts that the district court erred in granting summary judgment on her ERISA claim, arguing that the Joint Board did not comply with ERISA's fiduciary requirements in enacting the January 1, 1989 amendment.1 Summary judgment is appropriate if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that no genuine issue of material fact exists and that the moving party is entitled to a judgment as a matter of law. Fed.R.Civ.P. 56(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250, 106 S.Ct. 2505, 2511, 91 L.Ed.2d 202 (1986). In responding to a summary judgment motion, the non-moving party must set "forth specific facts showing that there is a genuine issue for trial." Fed.R.Civ.P. 56(e). We review a district court's grant of summary judgment de novo. Lavado v. Keohane, 992 F.2d 601, 605 (6th Cir.1993).The January 1, 1989, plan amendment is not reviewable for compliance with ERISA's fiduciary requirements. In reaching this conclusion, we apply the rule developed in cases clarifying " 'that when an employer decides to ... amend ... a benefits plan, as opposed to managing any assets of the plan and administering the plan in accordance with its terms, its actions are not to be judged by fiduciary standards.' " Adams v. Avondale Indus., Inc., 905 F.2d 943, 947 (6th Cir.) (quoting Musto v. American General Corp., 861 F.2d 897 (6th Cir.1988), cert. denied,Try vLex for FREE for 3 days
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