OPINION & ORDER

ALGENON L. MARBLEY, District Judge.

I. INTRODUCTION

This matter is before the Court on Defendant The Prudential Insurance Company of America's ("Defendant" or "Prudential") Motion to Dismiss the Complaint filed by Plaintiff Troy L. Stinson ("Plaintiff" or "Stinson"). (Doc. 3, 7.) For the reasons stated herein, this Court GRANTS Defendant's Motion to Dismiss.

II. BACKGROUND

A. Factual Background

Plaintiff is a resident of Piketon, Ohio, and his deceased wife, Gretchen Y. Stinson ("Decedent"), was also a resident of Piketon. Prudential is a life insurance company authorized to transact business in the State of Ohio, with its principal place of business in Newark, New Jersey. Decedent was a teacher in the Scioto Valley Local School District and licensed by the Ohio Department of Education. Decedent was also a member of the National Education Association ("NEA"), which is a labor union for educators.

Plaintiff alleges that "Prudential underwrote the Accidental Death and Dismemberment Plan held by the NEA Member Insurance Trust, policy GC 31490," and that Decedent was a primary insured under that plan. (Compl. at ¶ 3.) Plaintiff explains in his Complaint, however, that he failed to attach a copy of the relevant plan because "Plaintiff has not been able to timely procure a verifiably accurate copy of it prior to the commencement of this action." Id. Defendant attaches a copy of a document, entitled "Your NEA Insurance Booklet and Certificate," ("Booklet") to its Motion to Dismiss which Defendant states contains information about the plan at issue in this lawsuit; the "NEA Members Insurance Plan." (Doc. 7, 7-1.) Plaintiff concedes in his Memorandum Contra to Defendant's Motion to Dismiss ("Memorandum Contra") that the NEA Members Insurance Plan ("Plan") is the plan at issue in this lawsuit.1 While as a general rule, courts are not to consider matters outside of the pleading when deciding a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), Tackett v. M & G Polymers, USA, LLC, 561 F.3d 478, 488 (6th Cir. 2009), an exception arises when a plaintiff fails to introduce pertinent documents as part of his or her pleading, and the defendant may then introduce those documents in exhibits as part of a Rule 12(b)(6) motion, Thomas v. Publishers Clearing House, Inc., 29 Fed.Appx. 319, 322 (6th Cir.2002).2 As the Sixth Circuit has explained, "[o]therwise, a plaintiff with a legally deficient claim could survive a motion to dismiss simply by failing to attach a dispositive document upon which it relied." Weiner v. Klais & Co., 108 F.3d 86, 89 (6th Cir.1997). Therefore, when deciding Defendant's Motion to Dismiss, this Court may properly consider the Booklet containing information about the Plan that was incorporated by reference in the Plaintiff's Complaint.

Pages 24 through 28 of the Booklet contain a "Summary Plan Description." (Doc. 7-1 at 24-28.) NEA sponsors the Plan, which provides "NEA members with group insurance benefits in the event of death, accident, sickness, disability, or other occurrences affecting members and families." Id. at 25. The benefits are funded by one or more group insurance policies acquired and maintained by the trustees of the NEA Members Insurance Trust. The Life and Accidental Death & Dismemberment Insurance3 is open to NEA members on a voluntary basis. Participants select the type of coverage they want, pay the entire cost themselves, and NEA does not contribute to the cost of coverage, except during total disability waiver. The Booklet explicitly states that the purpose of the Summary Plan Description is to "inform [the participant] about the Plan's structure," and "is being furnished to [the participant] in compliance with the Employee Retirement Income Security Act of 1974 (ERISA)." Id.

Participants in the Plan "are entitled to certain rights and protections under ERISA." Id. at 27. Those right are summarized in the Summary Plan Description and include: the right to examine documents and contracts associated with the Plan, the right to copy those documents, and the right to obtain a summary financial report. The Summary Plan Description also explains that ERISA imposes duties on NEA, the trustees who operate the Life and Accidental Death & Dismemberment Insurance, and Prudential. These entities are fiduciaries, and specifically, Prudential is the "appropriate named fiduciary for purposes of the enrollment process, claim settlement, and review of denied claims." Id. Moreover, the processes by which a participant can contest a claim for a benefit that has been denied are described, and a participant is told that if his or her claim is denied or ignored, he or she "may file suit in a state or federal court." Id.

During all relevant times, Plaintiff alleges that he was a beneficiary of the Life and Accidental Death & Dismemberment Insurance under the Plan. On or about November 12, 2008, Decedent died as a result of accidental bodily injuries that she sustained on October 28, 2008. As a result, Plaintiff became eligible for benefits under the Life and Accidental Death & Dismemberment Insurance, making Prudential liable to Plaintiff in a total amount of $60,000. Plaintiff alleges that he has given Prudential notice and proof of his claim, performed all necessary conditions of the Plan, filled out all of the requested proof of losses, acted in good faith, and exhausted all administrative remedies under the Plan. Nevertheless, Prudential rejected his claim for benefits in its entirety.

Prudential disputes the facts related to Plaintiff's claim, and contends that Plaintiff's claim was denied in a letter dated December 14, 20094 on the basis that Decedent died "as the result of medical treatment of a sickness, which is expressly stated as a non-covered loss under the terms of the Plan." (Doc. 7.) Prudential also contends that Plaintiff never appealed Prudential's decision, despite the fact that the Plan provides Plaintiff with an opportunity to do so.

B. Procedural Background

On or around June 15, 2011, Plaintiff filed his Complaint in the Court of Common Pleas for Pike County, Ohio. Prudential removed this case in late July, pursuant to 28 U.S.C. § 1332, on the grounds that there is complete diversity jurisdiction, and also pursuant to 28 U.S.C. § 1331, on the grounds that there is federal question jurisdiction because this Court must determine whether Plaintiff's claims are preempted in whole or part by ERISA. Stinson did not file a motion for remand.

Shortly thereafter, Prudential filed this Motion to Dismiss, which is ripe for review.

III. STANDARD OF REVIEW

Federal Rule of Civil Procedure 12(b)(6) permits dismissal of a complaint for "failure to state a claim upon which relief can be granted." Fed.R.Civ.P. 12(b)(6). A complaint must contain a "short and plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a). Although a plaintiff need not plead specific facts, the complaint must "give the defendant fair notice of what the claim is, and the grounds upon which it rests." Nader v. Blackwell, 545 F.3d 459, 470 (6th Cir.2008) (quoting Erickson v. Pardus, 551 U.S. 89, 93, 127 S.Ct. 2197, 167 L.Ed.2d 1081 (2007)).

The plaintiff's ground for relief must entail more than "labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). The plaintiff has satisfied Rule 12(b)(6) if he or she pled enough facts "to state a claim to relief that is plausible on its face." Ashcroft v. Iqbal, 556 U.S. 662, 129 S.Ct. 1937, 1949, 173 L.Ed.2d 868 (2009). Additionally, the Court must accept as true allegations of fact contained in the complaint, and the complaint must be construed in the light most favorable to the party opposing the motion to dismiss. Davis H. Elliot Co. v. Caribbean Util. Co., Ltd., 513 F.2d 1176, 1182 (6th Cir.1975).

When a complaint is dismissed for failure to state a claim upon which relief can be granted, the statement of the claim itself is defective as a matter of the applicable substantive law. Wright & Miller, 5B Fed. Prac. & Proc. Civ. § 1357 (3d ed. 2004). However, in the situation where an affirmative defense bars a claim, the claim is stated adequately, but in addition to the claim, the contents of the complaint include "matters of avoidance that effectively vitiate the pleader's ability to recover on the claim." Id.; see also Riverview Health Inst. LLC v. Med. Mut. of Ohio, 601 F.3d 505, 512 (6th Cir.2010) (quoting Wright & Miller).

IV. LAW & ANALYSIS

A. Subject Matter Jurisdiction

As a preliminary matter, this Court must address subject matter jurisdiction issues raised by Plaintiff in his Memorandum Contra. It is not clear to the Court whether Plaintiff is contesting this Court's subject matter jurisdiction, but for ease of analysis, the Court will treat Plaintiff's arguments as such a challenge.

Plaintiff argues that the amount-in-controversy in this case depends on whether this Court determines that the Plan is an ERISA-qualified plan as Defendant urges. Plaintiff alleges $60,000 is due under the Life and Accidental Death & Dismemberment Insurance, and an unspecified amount is due in punitive damages as a result of the bad faith claim. In Prudential's Notice of Removal, it states that given damages alleged, the total damages exceeded the jurisdictional threshold of $75,000. But Plaintiff argues that a proceeding under ERISA does not allow for punitive damages, and that "[t]he claim that an action should be removed because of the amount in controversy exceeds the threshold criteria of $75,000 when the same act of removal will reduce the contested amount below that level is nonsensical." (Doc. 10) (citing 29 U.S.C. § 1132(a)(3); Allinder v. Inter-City Prod. Corp., 152 F.3d 544, 552 (6th Cir.1998)).

Plaintiff's reasoning is flawed. Prudential removed this case on two alternative jurisdictional grounds. Prudential asserted in its Notice for Removal that there is diversity jurisdiction in this case because the Plaintiff is a resident of Ohio, Prudential is a corporation with its principal place of business in New Jersey, and the amount-in-controversy exceeds of $75,000. Prudential then explains that this case is also removable because there is a federal question as to whether Plaintiff's claims are preempted by ERISA. Plaintiff does not set forth arguments contesting either of these grounds individually, and therefore, the Court finds that this case has been properly removed to this Court.

B. ERISA Preemption

Prudential asks this Court to dismiss Plaintiff's claims because they are based entirely on state law and as a result, are preempted by ERISA. In its Motion to Dismiss, Prudential contends that ERISA preempts all state law claims that "relate to any employee benefit plan," and that a claim "relates to" an ERISA plan where "it has a connection with or reference to such a plan." (Doc. 7) (citing 29 U.S.C. § 1144(a); Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 97, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983)). Prudential cites Sixth Circuit case law to support its position that state law claims to recover benefits under an ERISA-regulated plan "relate to" the Plan.

Plaintiff argues his claims are not preempted by ERISA because the Plan is not established or maintained by an employer or employee organization and qualifies as a "governmental plan" which is exempt under ERISA. Plaintiff relies entirely on a case from the Ninth Circuit, Daniels-Hall v. National Education Association, to support its arguments. 629 F.3d 992, 995 (9th Cir.2010). Prudential retorts that the Daniels-Hall case is distinguishable; NEA is an employee organization not a governmental entity, and therefore, the Plan cannot be categorized as a governmental plan; and the Plan informs its participants that it is governed by ERISA, and is, therefore, subject to ERISA.

ERISA does, in fact, preempt all state law claims which "relate to any employee benefit plan." 29 U.S.C. § 1144(a). The Supreme Court has said that a state law claim relates to an ERISA plan "if it has a connection with or reference to such a plan." Shaw, 463 U.S. at 97, 103 S.Ct. 2890. "Congress was concerned that state laws might interfere with the administration and management of such plans." Bloemker v. Laborers' Local 265 Pension Fund, 605 F.3d 436, 440 n. 2 (6th Cir.2010) (internal citations omitted). A state common law suit "for alleged improper processing of [] claims for benefits under [an] ERISA-regulated benefit plan" is preempted under ERISA, Pilot Life Insurance Company v. Dedeaux, 481 U.S. 41, 41, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987), as are bad faith breach of insurance contract claims, Tolton v. American Biodyne, 48 F.3d 937, 941 (6th Cir.1995).

An "employee benefit plan" under ERISA is defined as "an employee welfare benefit plan or an employee pension benefit plan5 or a plan which is both an employee welfare benefit plan and an employee pension benefit plan." 29 U.S.C. § 1002(3). An "employee welfare benefit plan" is defined as:

29 U.S.C. § 1002(1) (emphasis added). An "employee organization" is defined under ERISA as a "labor union or any organization of any kind, or any agency or employee representation committee, association, group, or plan, in which employees participate and which exists for the purpose, in whole or in part, of dealing with employers concerning an employee benefit plan, or other matters incidental to employment relationships." 29 U.S.C. § 1002(4).

"[B]y its express terms, ERISA encompasses welfare plans provided through the purchase of insurance." Fugarino v. Hartford Life & Accident Ins. Co., 969 F.2d 178, 184 (6th Cir.1992), rev'd on other grounds Raymond B. Yates, M.D., P.C. Profit Sharing Plan v. Hendon, 541 U.S. 1, 124 S.Ct. 1330, 158 L.Ed.2d 40 (2004). Nevertheless, the United States Department of Labor ("DOL") has promulgated regulations that provide certain insurance and benefit plans are excluded from ERISA's coverage. Under the regulations, the term "employee welfare benefit plan" does not include:

29 C.F.R. § 2510.3-1(j). A plan is exempt under ERISA only if all four of the "safe harbor" criteria are satisfied. Thompson v. Am. Home Assurance Co., 95 F.3d 429, 435 (6th Cir. 1996). Usually the factor that proves most difficult to analyze is the third, specifically determining what constitutes an "endorsement" of a Plan within the meaning of the regulation. This Circuit held that "finding an endorsement is appropriate if, upon examining all the relevant circumstances, there is some factual showing on the record of substantial employer involvement in the creation or administration of the plan." Id. at 436. Moreover,

Id. at 437 (internal citations omitted). The Thompson Court also held that to qualify as an ERISA-plan a court must inquire whether "from the surrounding circumstances a reasonable person [could] ascertain the intended benefits, the class of beneficiaries, the source of the financing, and the procedures for receiving benefits," id. at 435 (citing International Resources, Inc. v. New York Life Insurance Company, 950 F.2d 294, 297 (6th Cir.1991)), and if the employer established or maintained the plan with the intent of providing benefits to its employees, id. (citing McDonald v. Provident Indemnity Life Insurance Company, 60 F.3d 234, 236 (5th Cir.1995)).

The Plan at issue here falls under the definition of an "employee welfare benefit plan," because it is a "plan ... which was heretofore or is hereafter established or maintained ... by an employee organization... for the purpose of providing its participants or their beneficiaries, through the purchase of insurance or otherwise,... death ... benefits ...." See 29 U.S.C. 1002(1). NEA is an "employee organization" because it is a labor union that exists in part to deal with employers concerning an employee benefit plan. Pettit v. The Prudential Ins. Co. of America, No. 5:98-cv-00690, slip op. at 11 (W.D.Tex. Aug. 17, 1999) (characterizing NEA as the "plan sponsor and ERISA `employee organization'"). Moreover, the benefits at issue in this case are death benefits.

This Court must next determine whether the Plan is excluded from ERISA's coverage under the DOL regulations. The first factor appears to be satisfied, but NEA does contribute "during total disability waiver." (Doc. 7-1 at 25) ("NEA does not contribute to the cost of these overages except for contributions during total disability waiver."). The second factor is easily satisfied because the Summary Plan Description states that "[p]articipation for Life and Accidental Death & Dismemberment Insurance is open to NEA members on a voluntary basis." Id. The third factor, however, is problematic. Under the Thompson Court's precedent, NEA is endorsing the Plan. The Summary Plan Description "specifically refers to ERISA in laying out the employee's rights under the policy." Id. at 25, 27 ("This plan is being furnished to you in compliance with the Employee Retirement Income Security Act of 1974 (ERISA)"; "Your rights under ERISA"; "As a participant in the NEA Members Insurance Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA)"; "Under ERISA, there are steps you can take to enforce your rights."); see also Thompson, 95 F.3d at 437. The Plan, therefore, is not exempt under the DOL regulation's safe harbor. See 29 C.F.R. § 2510.3-1(j). Because the third factor is not satisfied, this Court does not need to examine the fourth. Thompson, 95 F.3d at 435 (explaining all four factors must be satisfied to be exempt under the safe harbor).

Moreover, this Court thinks that "a reasonable person [could] ascertain the intended benefits, the class of beneficiaries, the source of the financing, and the procedures for receiving benefits," and that NEA established or maintained the plan with the intent of providing benefits to its employees. Id. The Plan makes clear that its purpose is to provide members of NEA with "group insurance benefits in the event of death, accident, sickness, disability, or other occurrences affecting members and their families"; that the Plan is financed through the NEA Members Insurance Trust; and that there is a claims procedure for receiving benefits. (Doc. 7-1 at 25?28.) Moreover, NEA established and maintains the program with the intent of providing benefits to NEA members. See, e.g., id. at 2 ("We are pleased to present you with this Booklet. It describes the Program of benefits you have selected through the NEA Members Insurance Trust and what you must do to be covered for these benefits. We believe this Program provides you worthwhile protection for you and your family.").

The arguments made by Plaintiff in his Memorandum Contra are unconvincing. First, it is clear that the Plan is not a "governmental plan." A "governmental plan" as defined under ERISA is a plan that is "established or maintained for its employees by the Government of the United States, by the government of any State or political subdivision thereof, or by any agency or instrumentality of any of the foregoing." 29 U.S.C. § 1002(32). The Plan is not established or maintained by the Scioto Valley Local School District but by the NEA, which this Court has already explained is an employee organization under ERISA. It is because the Decedent was a teacher in the Scioto Valley Local School District that she could become a member of the NEA, but that does not mean that the Plan was established and maintained by the District.

Next, the Daniels-Hall case is distinguishable and not controlling. It is factually and legally distinguishable because it dealt with tax-shelter annuities that the NEA was endorsing and marketing. 629 F.3d at 995. NEA worked with Nationwide Life Insurance and Security Benefit Life Insurance Company to offer NEA members annuities called Valuebuilder annuities. Id. at 995-96. The Ninth Circuit's analysis dealt with the definition of an employee pension benefit plan rather than a employee welfare benefit plan. Id. at 999. Moreover, a different DOL regulation and safe harbor was at issue — one that exempted certain section 403(b) retirement plans from ERISA's requirements. Id. at 1000.

C. Leave to Amend

Prudential argues that Plaintiff should be denied leave to amend his Complaint to assert claims arising under ERISA because Plaintiff failed to exhaust his administrative remedies under the Plan. (Doc. 7) (citing Hill v. Blue Cross & Blue Shield, 409 F.3d 710, 717 (6th Cir.2005) ("[I]t is well settled that ERISA plan beneficiaries must exhaust administrative remedies prior to bringing suit for recovery on an individual claim."); Miller v. Metro. Life Ins. Co., 925 F.2d 979, 986 (6th Cir.1991) ("The administrative scheme of ERISA requires a participant to exhaust his or her administrative remedies prior to commencing suit in federal court.")). Prudential cites a number of cases in which this Circuit has dismissed a complaint without prejudice for failure to exhaust administrative remedies prior to filing the lawsuit. See, e.g., Falandays v. Penn Treaty Am. Corp., 114 Fed.Appx. 738, 738 (6th Cir. 2004) ("[T]he ERISA claim nonetheless must be dismissed without prejudice for failure to exhaust administrative remedies.") (citing Miller v. Metro. Life Ins. Co., 925 F.2d 979, 986 (6th Cir.1991)).

Plaintiff does not move for leave to amend or contest Plaintiff's arguments. Rather, Plaintiff argues that if his "state law claims are preempted by ERISA, then his claim for bad faith goes away because ERISA does not recognize that cause of action" but his "central claim for benefits owed under an ERISA-qualified plan fall squarely within the scope of the civil enforcement provision of ERISA." (Doc. 10.)

This Court cannot, however, sua sponte morph Plaintiff's state law claims for wrongful denial of benefits under the Life and Accidental Death & Dismemberment Insurance into properly-pled ERISA claims. Plaintiff must move for leave to amend his Complaint and then properly plead ERISA claims, but Plaintiff has failed to do so. This Court, therefore, does not have to address Prudential's argument related to leave to amend.6

V. CONCLUSION

For the foregoing reasons, Defendant's Motion to Dismiss is GRANTED.

IT IS SO ORDERED.