MARK A. GOLDSMITH, District Judge.
This is an employee-benefits case, in which Plaintiff seeks to recover surviving-spouse benefits allegedly due to her pursuant to her decedent husband's employer-sponsored plan. Plaintiff contends that in denying her claim for benefits, Defendant violated the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001
Robert Lee Sanders ("Robert") was an employee at Chrysler LLC and participated in the Chrysler LLC-UAW pension plan. Robert retired under the terms of that plan on May 31, 2007, with payments effective June 1, 2007. Administrative Record ("A.R.") at 50 (Dkt. 18).
In selecting his retirement plan, Robert elected to enroll in a surviving-spouse option.
After Rosemary's death, Robert married Plaintiff Delores Sanders on September 13, 2009.
Benefit Express rejected Plaintiff's claim because (i) Robert never cancelled his surviving-spouse coverage in favor of Rosemary after her death; and (ii) Robert never re-elected the surviving-spouse coverage, designating Plaintiff as the new beneficiary.
The pension plan at issue provides that "[t]he Board of Administration shall have discretionary authority to interpret the Plan and determine eligibility for and the amount of benefits in accordance with the terms of this Pension Plan. Any Board interpretation or Board determination shall be given full force and effect unless it can be shown that the interpretation or determination is arbitrary and capricious." A.R. at 281. Within the Board's power is the ability "[t]o carry out the rules and procedures set forth in this Pension Plan to be followed by employees, former employees and surviving spouses in filing applications for benefits," and "[t]o find facts and determine the rights of any employee, former employee or surviving spouse applying for retirement benefits."
The plan further provides that any retiree "who marries or remarries, subsequent to the earliest date surviving spouse coverage was in effect ... may elect, or re-elect, surviving spouse coverage."
Barring a procedural challenge to a decision denying benefits, the Court's review of an ERISA benefits action is limited to the evidentiary materials contained within the administrative record.
The parties agree that arbitrary and capricious review should apply. Def. Br. at 8-10; Pl. Br. at 5-6. Under the arbitrary and capricious standard, the Board's decision must be "upheld if it is `rational in light of the plan's provisions.'"
Defendant submits that its decision denying Plaintiff surviving-spouse benefits was not arbitrary and capricious because Robert never elected Plaintiff as his beneficiary using the standard enrollment form. Defendant asserts that the plan expressly requires that a form electing the surviving-spouse option be received by the Board for the coverage to run. Def. Br. at 11. Because there is no evidence in the record that Robert either completed a form, or that the Board received such a form, Defendant reasons that the Board properly denied Plaintiff the spousal benefits.
Defendant also points to the "plan documents rule" in support of the Board's decision. According to Defendant, "the plan documents rule allows pension plans to rely on forms issued by pension plans exclusively, without the need to look outside of plan issued forms to determine a participant's intent, and requires participants to use plan issued forms."
Plaintiff argues that the Board's decision denying Plaintiff benefits was arbitrary and capricious because the Board interpreted ambiguous provisions of the pension plan against a plan beneficiary, contrary to the remedial nature of ERISA and the standard rules of contract interpretation. Plaintiff concedes that no completed form was received by the Board. Pl. Br. at 3. However, because Robert elected to participate in the surviving-spouse option for his previous wife, Rosemary, Plaintiff argues that Robert would have elected to participate in the surviving-spouse option again, in favor of his new wife, Plaintiff.
Plaintiff claims that because the plan does not have an express provision for the circumstances presented here — where a participant dies while the window for making elections is open, but before the participant actually made the election — the plan is ambiguous.
In its reply to Plaintiff's motion for judgment, Defendant argues that Plaintiff's reliance on Benefit Express's and the Board's error when denying Plaintiff benefits is overstated. Def. Reply at 1-2 (Dkt. 30). What is important, Defendant argues, is that Robert never elected Plaintiff as a beneficiary for the surviving-spouse option, and that both decisions denying Plaintiff benefits explicitly referenced Robert's failure to do so.
The Court first observes that the plan language recited by the parties is not ambiguous. Indeed, it appears that Plaintiff is not actually arguing that the language of the plan itself is ambiguous,
In fact, the terms of the plan spell out precisely what a retiree must do to elect coverage and, given those terms, the Board's decision to deny Plaintiff benefits is reasonable, and therefore not arbitrary or capricious. First, the plain language of the plan states that any coverage under the surviving-spouse option "become[s] effective on the first day of the third month following the month in which the Board of Administration receives a completed election form." A.R. at 244. As conceded by both parties, no such form was received by the Board. As noted by Defendant, a completed enrollment form is important, because it allows a participant to clearly communicate his intentions to the plan administrator, subsequently allowing the administrator to distribute benefits without having to look outside the plan materials to discern a participant's intent. Furthermore, the plan-documents rule permits ERISA administrators to adhere to the letter of the plan documents, even in the face of other, contradictory evidence.
Here, the record contains no evidence that Robert would have wanted to enroll in the surviving-spouse option in favor of Plaintiff. There is no indication in the record that Robert attempted to elect surviving-spouse coverage for his new wife or that, in doing so, he encountered difficulties because of the clerical error with regard to his deceased wife. Plaintiff's arguments that Robert intended to elect surviving-spouse coverage for Plaintiff because he had elected the same option for his previous wife, and because he took the time to remove the pre-existing coverage following his previous wife's death (a required step before he would have been able to begin the re-election process) are not persuasive. As Defendant points out, Robert's revocation of his first election does not evidence any intent to provide coverage for his new wife, especially since it occurred prior to his subsequent marriage.
Furthermore, there could have been any number of reasons Robert would have chosen not to elect surviving-spouse coverage in favor of his new wife. For example, Plaintiff may have had sufficient assets of her own, such that it would have made sense for Robert to enjoy a higher pension benefit during his lifetime, rather than accept a lower benefit to protect Plaintiff after his death. Distributing surviving-spouse benefits to Plaintiff might well be contrary to Robert's wishes and may violate the plan administrator's fiduciary duty. Indeed, the purpose of the plan-documents rule is to enable a plan administrator to distribute benefits without having to speculate as to what might have been a deceased's intentions.
Second, an enrollment form is also important because it triggers the timeline by which the surviving-spouse coverage becomes effective. Without a completed election form, the plan administrator would be unable to determine when the coverage became effective. The effective date is important because for participants who are married at the time of their retirement — and for those who marry or remarry after retirement — the participant's death must occur on or after the effective date of election for the surviving spouse to receive his or her benefits. A.R. at 243-244. Absent an enrollment form, the plan administrator has no way of knowing whether Robert died on or after the effective date of election.
Finally, the Court finds that Plaintiff's remaining arguments also lack merit. That the pension plan granted participants a window of time in which to make an election does not also suggest that such an election could be made posthumously. This would be inconsistent with the plan-documents rule and would require plan administrators to speculate as to how the plan participant would have wanted the benefits distributed. The allotted time limit is also not rendered nugatory simply because the participant's death may prevent the participant from making an election he would have otherwise been entitled to make. Nor is the promise to pay surviving-spouse benefits an illusory one: Had Robert re-elected the surviving-spouse option in favor of Plaintiff, the plan administrator would have been obligated to distribute the surviving-spouse benefits in accordance with Robert's election.
Ultimately, Plaintiff appears to be asking the Court to read into the plan an additional procedure or process to accommodate the circumstances presented by Robert's death. However, "[t]he courts are not at liberty to rewrite the terms of an ERISA plan,"
Defendant argues that Plaintiff's claims, as personal representative of Robert's estate, should be dismissed because the estate failed to exhaust its administrative remedies before proceeding to federal court, as ERISA requires. Def. Br. at 13. Defendant asserts that the estate has not yet even submitted a claim for benefits to the Board of Administration.
It is unclear what interest the estate has in this case; both parties agreed at oral argument that the estate would not be entitled to seek surviving-spouse benefits. The complaint also does not appear to be seeking any additional benefits or reimbursements from the plan to which the estate would be entitled. In any event, the Sixth Circuit has held that "`[t]he administrative scheme of ERISA requires a participant to exhaust his or her administrative remedies prior to commencing suit in federal court.'"
For the aforementioned reasons, the Court grants Defendant's motion for judgment (Dkt. 19), and denies Plaintiff's motion for judgment (Dkt. 28).
SO ORDERED.