STANLEY R. CHESLER, District Judge.
Plaintiff Lou Ann Woerner ("Plaintiff") brings this action under Section 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), to recover life insurance proceeds allegedly owed to her as the beneficiary of her late husband's employee life insurance plan. Defendant FRAM Group Operations, LLC ("FRAM"), moves to dismiss the complaint pursuant to Federal Rule of Civil Procedure 12(a)(6). In the alternative, FRAM seeks to compel the joinder of the Life Insurance Company of North America ("CIGNA"), pursuant to Federal Rule of Civil Procedure 19. (ECF No. 107). Plaintiff opposes the motion. (ECF No. 110). The Court has reviewed the parties' submissions and proceeds to rule without oral argument.
Plaintiff's late husband, Michael Woerner, was diagnosed with brain cancer in July 2010, while he was an employee of Honeywell International Inc. ("Honeywell"). (Am. Compl., ¶¶ 3, 13.) In June 2011, Mr. Woerner commenced short-term disability leave. (Am. Compl., ¶¶ 16.) Approximately one month later, in July 2011, Honeywell sold Mr. Woerner's business unit to FRAM, thereby making him an employee of the latter. (Am. Compl., ¶ 17.) Mr. Woerner remained on short-term disability leave as an employee of FRAM until his death in February 2012. (Am. Compl., ¶ 58.)
Plaintiff alleges that FRAM established a benefit plan for its employees that included basic and voluntary life insurance. (Am. Compl., ¶¶ 1, 4.) She alleges that Mr. Woerner enrolled in the life insurance benefits and that his coverage under them became effective on January 1, 2012. (Am. Compl., ¶¶ 30-36, 40.) Plaintiff further alleges that the life insurance benefits named her as a sole beneficiary, making her eligible to receive proceeds from them upon Mr. Woerner's death. (Am. Compl., ¶¶ 34-35, 39-40.) She alleges that she did not received those proceeds, however, because "Defendants," including FRAM, "(through their insurer) denied [her] life insurance benefits under the plan." (Am. Compl., ¶¶ 65, 70, 80).
In October 2012, Plaintiff commenced the instant action. (ECF No. 1.) Her amended complaint, filed in September 2014, asserts a single claim for denial of benefits in violation of Section 1132(a)(1)(B). FRAM now moves to dismiss the amended complaint on the ground that Plaintiff's allegations fail to establish that FRAM is a proper defendant in this action. Instead, FRAM argues, Plaintiff's allegations show only that CIGNA, which FRAM claims to have issued the group life insurance policy funding the benefits, is a proper defendant. In the alternative, FRAM seeks to compel the joinder of CIGNA on essentially the same grounds.
To survive a Rule 12(b)(6) motion to dismiss, "a complaint must contain sufficient factual matter, accepted as true, to `state a claim to relief that is plausible on its face.'"
When considering a Rule 12(b)(6) motion to dismiss, a court may consider allegations in the complaint, documents attached thereto or specifically referenced therein, and matters of public record.
ERISA empowers a "participant [in] or beneficiary [of]" an employee benefit plan to bring an action to "recover benefits due to him under the terms of his [or her] plan. . . ." 29 U.S.C. § 1132(a)(1)(B). To assert a claim for denial of benefits under Section 1132(a)(1)(B), a plaintiff must allege that "he or she . . . ha[s] a right to benefits that is legally enforceable against the plan,' and that the plan administrator improperly denied those benefits."
The proper defendant in action brought under Section 1132(a)(1)(B) is either "the plan itself (or plan administrators in their official capacities only)."
The Third Circuit has explained that "exercising control over the administration of benefits is the defining feature of the proper defendant under 29 U.S.C. § 1132(a)(1)(B)."
In the present case, Plaintiff's amended complaint does not specifically allege that FRAM delegated its discretion to determine eligibility for life insurance benefits to a third party. None of the documents that allegedly form the basis of the informal plan governing Plaintiff's claims contain such a delegation either. FRAM disputes this conclusion, arguing that Plaintiff's allegations "show that CIGNA is the entity with . . . authority" to "make benefit determinations." (ECF No. 107-1, Defendant FRAM Group Operations, LLC's Memorandum of Law in Support of its (1) Motion to Dismiss or, Alternatively, (2) Motion to Compel Joinder ("Mov. Br."), at 6.) FRAM cites an October 21, 2011, email from FRAM to its employees, a portion of which states that "coverage" for "supplemental term life insurance" would be "managed by" CIGNA. (See Am. Compl. ¶ 23, Exhibit A.) FRAM also points to Plaintiff's allegation that, after Mr. Woerner's death, "FRAM forced Plaintiff to deal with the insurance company [CIGNA] directly and alone, knowing full well that the insurance company was not going to make any payments. . . ." (See Am. Compl. ¶ 65-66, 70.)
Although both of these allegations indicate that CIGNA played a role in administering claims for the life insurance benefits at issue, both are consistent with the view that FRAM authorized CIGNA to process claims, while nonetheless retaining the power to decide, at its discretion, disputed claims. Therefore, neither allegation would foreclose an otherwise reasonable inference that FRAM had ultimate control over the administration of life insurance benefits.
Furthermore, Plaintiff's amended complaint contains sufficient factual content concerning FRAM's role in administering the employee benefit plan to justify the inference that FRAM is a proper defendant in this case. Plaintiff alleges that on October 21, 2011, FRAM sent employees an email announcing that "Open enrollment" for 2012 benefits would "begin on or about November 28, 2011 and run through December 9, 2011" and that "[e]nrollment into the 2012 benefits [would] be conducted via a web-based system or via telephone." (Am. Compl. ¶ 23, Ex. A.) Plaintiff also alleges that on October 28, 2011, FRAM sent an email that purported to "share with [employees] . . . details regarding [their] health care options," which FRAM would be offering "as part of [employees'] overall compensation and benefits package." (Am. Compl., ¶ 24, Exhibit B.) This email included information for "Basic Life/AD&D," for which "coverage [would be] provided by FRAM Group at no cost to employee[s]" and for which "CIGNA" would be the "carrier"; and "Voluntary Life/AD&D," for which "coverage" might be "purchase[d] . . . based on [an employee's] annual salary" "at each open enrollment [period]" and for which "CIGNA" would also be the "carrier." (
Based on these allegations, a trier of fact could reasonably infer that FRAM controlled the administration of life insurance benefits prior to Mr. Woerner's death. Accordingly, the Court will deny FRAM's motion to the extent that it seeks dismissal pursuant to Rule 12(6)(b).
Rule 19 "governs joinder of necessary and indispensable parties."
FRAM contends that in CIGNA's absence this Court cannot afford complete relief to Plaintiff because, first, CIGNA alone has the authority to pay out proceeds from the group insurance policy that it issued and, second, that policy is the informal plan's only asset. Therefore, FRAM argues, it cannot pay Plaintiff's claimed benefits "from the assets of the plan" in the manner described in
Therefore, for the foregoing reasons, FRAM's motion to dismiss, pursuant to Fed. R. Civ. P. 12(b)(6), or to compel joinder, pursuant to Fed. R. Civ. P. 19(a) is DENIED. An appropriate order shall issue.