Prassenos v. E.I. Du Pont de Nemours and Company et al

Filing 70

ORDER denying, as set out, Defendants' 50 Motion for Partial Summary Judgment; granting, as set out, Plaintiff's 32 Motion for Summary Judgment as to Counts I and II. The Motions for Summary Judgment as to Count III are moot per doc. 65. Signed by Judge Kristi K. DuBose on 1/16/2015. (cmj) Modified on 1/16/2015 (cmj).

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
THE ESTATE OF EMMA PRASSENOS,
deceased, by and through its Administrator,
Ronald Jeffery Hester,
Plaintiff,

)
)
)
)
)
v.
)
)
E.I. duPONT de NEMOURS and CO, and
)
BENEFLEX EMPLOYEE LIFE INSURANCE )
PLAN of E.I. duPONT NEMOURS and CO.,
)
1
Defendants.
)

CIVIL ACTION NO. 13-00419-KD-C

ORDER
This matter is before the Court on Plaintiff’s Motion for Summary Judgment (Docs.
32-36, 38), Defendants’ Response (Doc. 41, 42, 44), and Plaintiff’s Reply (Doc. 46);
Defendants’ Motion for Summary Judgment (Docs. 50-53), Plaintiff’s Response (Doc. 56) and
Defendants’ Reply (Doc. 57); and Court Orders (Docs. 64, 65), Defendants’ Responses (Docs.
67, 68), Plaintiff’s Second Amended Complaint (Doc. 66), and Plaintiff’s Response (Doc. 69).2
I.

Findings of Fact3

This case against E.I. DuPont De Nemours and Co. (DuPont) and the Beneflex Employee
Life Insurance Plan of E.I. DuPont De Nemours and Co. (Life Insurance), concerns a spouse’s
claim for $100,281 in additional life insurance benefits from her late husband’s policy; and
1 Plaintiff did not sue the BeneFlex Dependent Life Insurance Plan and thus, that plan is not a defendant.
2 While the parties moved for summary judgment on Count 3, this Count was dismissed by Court order
per Doc. 65 and thus the parties’ motions as to this Count are MOOT.
3 On summary judgment, the Court must “resolve all issues of material fact in favor of the [non-movant],
and then determine the legal question of whether the [movant] is entitled to judgment as a matter of law under that
version of the facts.” McDowell v. Brown, 392 F.3d 1283, 1288 (11th Cir. 2004).

1

cancellation of her $100,000 Beneflex Dependent Life Insurance Plan (Dependent Life
Insurance) and a demand for reinstatement of same. After exhausting her administrative
remedies, Prassenos filed a Complaint in this Court asserting a claim for recovery of ERISA
welfare benefits,4 pursuant to Section 1132(a)(1)(B), against both Defendants; and a breach of
fiduciary duty claim, pursuant to Section 1132(a)(3), against DuPont.
Emma Prassenos (Prassenos) was married to Mr. William Prassenos (Mr. Prassenos) for
30 years before he passed away on August 9, 2012.

(Doc. 33 (Aff. Prassenos)). Mr. Prassenos

was employed with ChemFirst, Inc. (ChemFirst) from April 1983 to June 1, 2012. (Doc. 33 (Aff.
Prassenos); Doc. 42-1 at 1 (Aff. Bilson);5 Doc. 30 at 3). While Mr. Prassenos’ was employed, in
2002, DuPont acquired ChemFirst. (Doc. 42-1 at 1 (Aff. Bilson); Doc. 42-2 at 156). DuPont’s
acquisition did not change the post-retirement benefits available to ChemFirst employees, such
that ChemFirst employees and DuPont employees had different benefits both before and after
DuPont’s acquisition.

(Doc. 42-1 at 1-2 (Aff. Bilson)).6

As an employee, Mr. Prassenos’ participated in the DuPont BeneFlex Employee Life
Insurance Plan (Life Insurance plan),7 and was provided with life insurance “1x pay” paid by the

4 DuPont is the Administrator of the welfare benefit plans.

(Doc. 30 at 3-4; Doc. 42-2).

5 Bilson is DuPont’s representative. Bilson was a 40 year plus employee with DuPont when she retired in
March 2013, as well as a former Benefit Consultant and Delegate of the DuPont Benefit Appeals Committee and
participant in the committee’s determination of Prassenos’ claim and appeal. (Doc. 42-1 at 1 (Aff. Bilson)).
6 ChemFirst employees are not eligible for retirement benefits available to DuPont employees under the
DuPont Pension and Retirement Plan (PRP). (Id. at 2 (Aff. Bilson)). Even though the ChemFirst Pension later
merged into the DuPont PRP, ChemFirst employees have separate and different pension benefits under the
ChemFirst Pension, which is maintained as a separate section, Title V, within the DuPont PRP. (Id.) Thus,
ChemFirst retirees are not eligible for the same benefits DuPont retirees receive (e.g., life insurance). (Id.)
7 While called the DuPont life insurance plan, the summary of the plan (SPD) states that “[a]ll references
to ‘the Company’ in this document pertain to the specific company that employs you.” (Doc. 42-2 at 74, 95). The
full plan specifies: "The term ‘Company’ means E. I. du Pont de Nemours and Company, any wholly owned

2

company so long as his employment continued. (Doc. 42-1 at 3-4 (Aff. Bilson; Doc. 30 at 3;
Doc. 34 at 5-26 (SPD), 47-58 (full plan); Doc. 42-2 at 72-92). Mr. Prassenos purchased
additional coverage, “2x pay.” (Id.) Prassenos was Mr. Prassenos’ beneficiary.

(Doc. 30 at 3).

Mr. Prassenos also participated in the DuPont BeneFlex Dependent Employee Life
Insurance plan 8 (Dependent Life Insurance plan), through which he selected $100,000 in
coverage on Prassenos’ life.

(Doc. 42-1 at 3-4 (Aff. Bilson); Doc. 30 at 3; Doc. 34 at 30-45

(SPD), 60-64 (full plan); Doc. 42-2 at 93-108). Mr. Prassenos was Prassenos’ beneficiary.

(Id.)

On April 3, 2012, DuPont mailed the Total and Permanent Disability Income Plan (T&P)
Summary Plan Description (SPD)9 to Mr. Prassenos.

(Doc. 34 at 66-68; Doc. 42-1 at 4 (Aff.

Bilson); Doc. 42-2 at 56-71). The T&P SPD provides an employee is automatically enrolled in
the disability plan on the date of eligibility, and states as follows:

subsidiary or part thereof and any partnership or joint venture in which E. I. du Pont de Nemours and Company is
joined which adopts this Plan with the approval of the Company, or such person or persons as the Company may
designate." (Doc. 34 at 48). The same applies to the Dependent Life Insurance Plan. (Doc. 34 at 61).
8 Id.
9 A Summary Plan Description or SPD is meant to summarize the contents of a particular plan, not replace
the plan. Notably, per DuPont, for the plans at issue in this case, “[i]n the event of a discrepancy between this SPD
and the Plan document, the Plan document will govern.” (Doc. 34 at 7, 32). See, e.g., Curran v. Kemper Nat.
Servs., Inc., 2005 WL 894840, *4 (11th Cir. 2005) (“Curran's reliance on the SPD clause, “In case of a conflict
between this summary and the plan's legal documents, the plan's legal documents control” is misplaced….Even if
the two documents were viewed as conflicting…the SPD controls…If the [plan] were silent on the issues…such
silence would not create a conflict with the SPD. See Jensen v. SIPCO, Inc., 38 F.3d 945, 952 (8th Cir.1994)
(explaining that specific language in one plan document and silence in another does not create a conflict between the
two)[]”); Kamlet v. Hartford Life and Acc. Life Ins. Co., 144 Fed Appx. 755, 756 (11th Cir. 2005) (“A plan's
summary does not comply with …[ERISA] if it is not an accurate interpretation of the original plan.…“ERISA
provides that the summary shall be an accurate and comprehensive document that reasonably apprises the employees
of their rights under the plan.” Id. If there is an inconsistency between the plan and its summary, the summary's
interpretation controls. Id.”); Cone v. Walmart Stores, Inc. Assoc.’s Health and Welfare Plan, 2012 WL 1946503
(M.D. Ga. May 30, 2012) (“the SPD is a critical feature of the ERISA regulatory scheme because it ‘simplif[ies] and
explain[s] a voluminous and complex document’ to plan participants and beneficiaries.” … “where a plan
participant or beneficiary relies on a provision in the SPD that conflicts with the plan, he or she may enforce the
terms of the SPD over the terms of the plan.” Id.[]”).

3

This Plan provides income protection in the event you become disabled. Benefits begin
the first of the month following your termination if your disability has been found to be
total and permanent. Benefits will continue, as long as you remain totally and
permanently disabled and continue to meet the requirement of the Plan….
You will need to satisfy the requirements described in this SPD to receive Total and
Permanent Disability Income benefits.
(Doc. 42-2 at 58, 59).10
On April 9, 2012, Mr. Prassenos was contacted by a MyInfo Service Center
representative who discussed the T&P benefits with him.

(Doc. 34 at 66-68; Doc. 42-2 at 1-3).

ChemFirst also sent Mr. Prassenos a letter dated May 2, 2012, an “Informational Notice,”
which

contained

details

and

further

calculations

and

information

regarding

his

retirement/pension benefit from the “Retirement Plan for Employees of ChemFirst Inc.” (Doc.
42-2 at 19-50).

This Notice explained that under the disability provisions of the plan, Mr.

Prassenos could choose to commence his benefit any time between his disability date and his
normal retirement date, and included an estimate packet “assuming you want to defer your
[retirement/pension benefit] commencement to age 65.” (Id. at 19).
COBRA enrollment packaged was mailed to Mr. Prassenos.

On May 31, 2012, a

(Doc. 34 at 73).11

Mr. Prassenos was diagnosed with cancer and effective June 1, 2012, separated from
ChemFirst earning $100,281/year.

(Doc. 30; Doc. 34 at 191, 194).

Mr. Prassenos separated

from ChemFirst on disability under DuPont’s T&P plan (the disability plan) (versus retired at
that time).

(Doc. 42-1 at 4 (Aff. Bilson); Doc. 30; Doc. 41 at 4).

Because Mr. Prassenos

10 Eligibility under the T&P is based on, per the SPD, being: a Full-Service Employee of DuPont U.S.
Region; a Full-Service Employee of a participating DuPont subsidiary or joint venture that elects to adopt this Plan.
(Id. at 56-71).
11 DuPont contends that a life insurance conversion notice was included.
to support this contention.

4

However, there is no evidence

separated from ChemFirst on disability under the T&P disability plan, his retirement would later
take effect and would be governed by Title V of the DuPont Pension and Retirement Plan (PRP)
(Doc. 42-2 at 109-232), but not the entire PRP:
Effective December 31, 2007 …. the Retirement Plan for the Employees of ChemFirst,
Inc. were merged into the Plan. The Plan was amended effective January 1, 2008 to add
Title IV and Title V .… Title V consists of the provisions of the Retirement Plan for the
Employees of ChemFirst, Inc. in effect on January 1, 2008.
(Id. at 112). Title V is the “Retirement Plan for Employees of ChemFirst, Inc.” (Id. at 155-232).12
Following Mr. Prassenos’ separation from ChemFirst on disability, the couple received a
June 1, 2012 DuPont “Confirmation of Lost Coverage” letter notification which indicated that
because Mr. Prassenos lost his eligibility (as he was no longer an active employee), the benefits
coverage had been cancelled and ended officially on May 31, 2012 13 (i.e., that both Mr.
Prassenos’ “2x pay” life insurance, and Prassenos’ $100,000 dependent life insurance canceled).
(Doc. 33 at 3 (Aff. Prassenos); Doc. 34 at 79; Doc. 38 at 15; Doc. 42-2 at 54).

According to

Prassenos, as a result of receiving this letter, neither she nor her husband contacted the insurance
company (Prudential) or paid any monthly premiums “since the letter did not inform us that we
could continue our life insurance, despite our desire to do so, because we were both diagnosed
with cancer. We did continue with medical coverage.” (Id.)
On August 9, 2012, Mr. Prassenos died at 58 years old. (Doc. 30 at 3; Doc. 34 at 184).
According to DuPont, as Mr. Prassenos separated from ChemFirst under DuPont’s T&P
12 This distinction makes clear that ChemFirst retirees are treated differently than DuPont retirees, as a
specific section was carved out of the DuPont PRP to govern ChemFirst retirees. Mr. Prassenos separated from
ChemFirst on disability (to then later retire). As a ChemFirst employee, once he became eligible for retirement
(for age, etc.) he would be subject to Title V of DuPont’s PRP, which addresses former ChemFirst employees.
13 The parties dispute this date, varying between this and June 1, 2012, and moreover, Prassenos contends
July 31, 2012 should be the earliest date of coverage ending per the plan’s terms.

5

plan as a ChemFirst disabled employee, he received “1x pay” life insurance ($100,281), and so
DuPont paid Prassenos that benefit.
(Doc. 42-2 at 60).

(Doc. 42-1 at 4 (Aff. Bilson); Doc. 41 at 4).

See also

However, Prassenos sought the “2x his pay” life insurance benefits from the

Defendants and the ability to continue her dependent life insurance, which was denied.
On September 18, 2012, DuPont denied Prassenos’ Level 1 Appeal concerning the
amount of life insurance in which Mr. Prassenos was enrolled, and the claim that he had wished
to continue the Dependent Life Insurance for Prassenos.

(Doc. 34 at 66-68; Doc. 42-2 at 1-3).

Specifically, DuPont explained its decision and quoted certain provisions from Page 3 of the
T&P SPD, and from Page 12 of the Life Insurance SPD, as the denial basis, as follows:
This letter is in response to your Level 1 Appeal received on September 17, 2012,
appealing the amount of life insurance in which your husband, William Prassenos, was
enrolled. You state that he was enrolled in 2 x Pay of Employee Life Insurance, not the 1
x Pay. You also state that he wished to continue Spousal Life Insurance at $100,000.
DuPont has directed the Benefit Determination Review Team to review your Level 1
Appeal. In reviewing your Level 1 Appeal, we considered the information submitted
with your written Level 1 Appeal, the records at Mylnfo, and the relevant plan
provisions. Your appeal has been denied.
Records indicate that Mr. Prassenos was enrolled in 2 x Pay of Employee Life Insurance
as an active employee. Mr. Prassenos separated from the company on June 1, 2012,
under the provisions of the Total and Permanent Disability Income Plan (T&P) and his
Employee Life Insurance was reduced to 1 x Pay as of that date. Records show that
he was mailed the 2008 Total and Permanent Disability Income Plan Summary Plan
Description on April 3, 2012. On the April 9, 2012, he was contacted by a representative
of the Mylnfo Service Center who discussed with him the T&P benefits, including the
continuation of medical coverage and the reduction of the life insurance. A COBRA
Enrollment Package was mailed to Mr. Prassenos on May 31, 2012, which would have
included the life insurance conversion notice. Mr. Prassenos had the right to convert the
lx Pay of additional life insurance and the Spouse Life Insurance by contacting
Prudential within 31 days of the loss. Converted life insurance is maintained and
premiums are collected directly by Prudential and would not have been part of the
benefit paid by DuPont. Mr. Prassenos was correctly enrolled in 1 x Pay of Employee
Life Insurance that was provided by DuPont as part of the T&P plan; therefore, your
6

request for coverage to be reinstated at a total of 2 x pay in Employee Life Insurance or to
continue Spouse Life Insurance through DuPont is denied.
The following can be found on page 3 of the 2008 Total and Permanent Disability
Income Plan Summary Plan Description, in pertinent part:
If you become disabled and are not eligible for DuPont retiree benefits:
Life Insurance: The Company provides continued life insurance equal to one times your
pay, subject to age reductions at age 65, at no cost to you for as long as you receive Total
and Permanent Disability Income payments. Any Contributory Group Life insurance or
supplemental life insurance that you purchased under BeneFlex Employee Life Insurance
is discontinued upon employment termination.
The following can be found on page 12 of the 2008 BeneFlex Employee Life Insurance
Summary Plan Description, in pertinent part:
Conversion rights
To exercise your conversion rights, you must be enrolled in BeneFlex Employee Life
Insurance Plan coverage at the time of the event that results in the loss of or reduction
in coverage. You must contact the insurance company within 31 days of the end of your
coverage under this Plan to exercise your conversion rights for BeneFlex Employee
Life Insurance Plan coverage.
You may convert the entire amount of your current BeneFlex Employee Life Insurance
Plan coverage. Premiums for the converted policy are determined by the insurance
company and are based on the amount of coverage, your age and the type of plan you
apply for.
Dependent Life Insurance: Your BeneFlex Dependent Life Insurance coverage ends at
the end of the month in which you leave the Company, for any reason, including
retirement. With some restrictions, your spouse/partner may be eligible to apply for
coverage under the portability feature of the Plan if your coverage ends for reasons other
than disability.
Your spouse/partner must contact the insurance company within 31 days of the loss of
coverage under this Plan to obtain a portability application. The application must be
completed within 31 days of the date it is mailed, or the opportunity to port coverage is
lost.
(Doc. 42-2 at 1-2 (emphasis in original)).
DuPont concludes Mr. Prassenos terminated on disability under the T&P SPD and relies
7

upon same for the discontinuation of supplemental life insurance upon termination.

DuPont

then relies upon the Life Insurance SPD’s 31 day conversion requirement (which it claims Mr.
Prassenos failed to do) to deny both the additional life insurance and dependent life insurance.
Further, while DuPont did not specifically state that Mr. Prassenos was a “ChemFirst”
employee (versus a DuPont employee) in the Level 1 denial, DuPont quoted the portion of the
T&P SPD providing for what happens if an employee becomes disabled and is “not eligible for
DuPont retiree benefits.” (Doc. 42-2 at 2).
On October 9, 2012, Prassenos’ niece/financial advisor, Debbie Morris, faxed a letter to
the DuPont Level 2 Appeal Benefit Determination Review Team, responding to the Level 1
appeal decision, detailing the history of the Prassenos’ communications with DuPont.
at 75).

(Doc. 34

Per Morris, in addition to DuPont sending the Prassenos couple “incorrect” DuPont

(versus ChemFirst) packets, Mr. Prassenos requested paperwork for the right to convert/port his
additional life insurance and Prassenos’ dependent life insurance but never received any.

(Id.)

On November 2, 2012, DuPont denied Prassenos’ Level 2 appeal explaining that when
Mr. Prassenos became disabled he was no longer eligible for certain benefits such as life
insurance in excess of “1x his pay,” and that the dependent life insurance coverage simply ended
because he was no longer employed.

(Doc. 42-2 at 4-5).

Specifically, DuPont explained its decision and quoted certain provisions from Page 3 of
the T&P SPD, and from Page 8 of the Dependent Life Insurance SPD, as the denial basis, as
follows:
This letter is in response to your Level 2 appeal received in this office on October 10,
2012, appealing to be allowed to make premiums payments for an additional 1 x pay of
Employee Life insurance covering your spouse and former DuPont employee, William
8

Prassenos. You are also requesting to continue the Spousal Life Insurance policy that was
part of your husband's benefits when he was an active employee. Mylnfo denied the level
1 appeal stating that records indicate that Mr. Prassenos was enrolled in 2 x Pay of
Employee Life Insurance as an active employee. Mr. Prassenos separated from the
company on June 1, 2012, under the provisions of the Total and Permanent Disability
Income Plan (T&P) and his Employee Life Insurance was reduced to 1 x Pay as of that
date. Records show that he was mailed the 2008 Total and Permanent Disability
Income Plan Summary Plan Description on April 3, 2012. On the April 9, 2012, he was
contacted by a representative of the Mylnfo Service Center who discussed with him the
T&P benefits, including the continuation of medical coverage and the reduction of the
life insurance. A COBRA Enrollment Package was mailed to Mr. Prassenos on May 31,
2012, which would have included the life insurance conversion notice. Mr. Prassenos had
the right to convert the 1 x Pay of additional life insurance and the Spouse Life Insurance
by contacting Prudential within 31 days of the loss. Converted life insurance is
maintained and premiums are collected directly by Prudential and would not have been
part of the benefit provided by DuPont. Mr. Prassenos was correctly enrolled in 1 x Pay
of Employee Life Insurance that was provided by DuPont as part of the T&P plan;
therefore, your request for coverage to be reinstated at a total of 2 x pay in Employee Life
Insurance and/or to continue Spouse Life Insurance through DuPont is denied.
The DuPont Benefit Appeals Committee has reviewed your Level 2 appeal. Based on this
review, a decision has been made to uphold Mylnfo's original denial.
This appeal was denied in accordance with page 3 of the 2008 Total and Permanent
Disability Income Plan Summary Plan Description, If you become disabled and are not
eligible for DuPont retiree benefits: Life Insurance -The Company provides continued
life insurance equal to one times your pay, subject to age reductions at age 65, at no cost
to you for as long as you receive Total and Permanent Disability Income payments. Any
Contributory Group Life insurance or supplemental life insurance that you purchased
under BeneFlex Employee Life Insurance is discontinued upon employment termination.
Please also reference page 8 of the 2008 BeneFlex Dependent Life Insurance Plan
Summary Plan Description, When coverage ends: Your BeneFlex Dependent Life
Insurance coverage ends on any of the following: 1. the end of the month that you are
no longer eligible, 2. the end of the month that your covered dependent is no longer
eligible. Records show that your husband separated from DuPont on June 1, 2012, under
the provisions of the Total and Permanent Disability Income Plan. Once separated, he
was neither eligible to be enrolled in any more than the 1 x Pay of BeneFlex Life
Insurance nor eligible to maintain the Spouse Life Insurance with DuPont. Therefore, the
Benefit Appeals Committee has determined that Mr. Prassenos was enrolled in the only
life insurance benefit for which he was eligible and your request that he be enrolled in an
additional 1 x Pay of Employee Life Insurance is denied, as is your request to continue
Spousal Life Insurance through DuPont.
9

… this review by the Benefit Appeals Committee concludes your rights of appeal within
DuPont and is considered final….
(Doc. 42-2 at 4-5).
On August 14, 2013, having exhausted her administrative remedies, Prassenos initiated
this action for recovery of benefits and enforcement of rights under the Employee Retirement
Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (ERISA). (Doc. 1, 30). In so doing,
Prassenos alleges: Count 1 against both Defendants for additional life insurance benefits Mr.
Prassenos “was entitled to continue;” and Count 2 against only DuPont for breach of fiduciary
duty as to both the additional life insurance benefits and the dependent life insurance benefits.
II.

Conclusions of Law

A.

Summary Judgment Standard of Review
“The court shall grant summary judgment if the movant shows that there is no genuine

dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
R. CIV. P. 56(a).

Rule 56(c) provides as follows:

(1) Supporting Factual Positions. A party asserting that a fact cannot be or is
genuinely disputed must support the assertion by:
(A) citing to particular parts of materials in the record, including
depositions, documents, electronically stored information, affidavits or
declarations, stipulations (including those made for purposes of the motion only),
admissions, interrogatory answers, or other materials; or
(B) showing that the materials cited do not establish the absence or
presence of a genuine dispute, or that an adverse party cannot produce admissible
evidence to support the fact.
(2) Objection That a Fact Is Not Supported by Admissible Evidence. A party
may object that the material cited to support or dispute a fact cannot be presented
in a form that would be admissible in evidence.
10

FED.

(3) Materials Not Cited. The court need consider only the cited materials, but it
may consider other materials in the record.
(4) Affidavits or Declarations. An affidavit or declaration used to support or
oppose a motion must be made on personal knowledge, set out facts that would be
admissible in evidence, and show that the affiant or declarant is competent to
testify on the matters stated.
FED.R.CIV.P. Rule 56(c).

The party seeking summary judgment bears the “initial responsibility

of informing the district court of the basis for its motion, and identifying those portions of ‘the
pleadings, depositions, answers to interrogatories, and admissions on file, together with the
affidavits, if any,’ which it believes demonstrate the absence of a genuine issue of material fact.”
Clark v. Coats & Clark, Inc., 929 F.2d 604, 608 (11th Cir. 1991) (quoting Celotex Corp. v.
Catrett, 477 U.S. 317, 323 (1986)).

If the nonmoving party fails to make “a sufficient showing

on an essential element of her case with respect to which she has the burden of proof,” the
moving party is entitled to summary judgment.

Celotex, 477 U.S. at 323.

“In reviewing

whether the nonmoving party has met its burden, the court must stop short of weighing the
evidence and making credibility determinations of the truth of the matter … the evidence of the
non-movant is to be believed, and all justifiable inferences are to be drawn in his favor.”
Tipton v. Bergrohr GMBH-Siegen, 965 F.2d 994, 998-999 (11th Cir. 1992).
The applicable Rule 56 standard is not affected by the filing of cross-motions for
summary judgment.

See, e.g., Am. Bankers Ins. Group v. United States, 408 F.3d 1328, 1331

(11th Cir. 2005); Gerling Global Reins. Corp. of Am. v. Gallagher, 267 F.3d 1228, 1233 (11th
Cir. 2001).

“Cross-motions for summary judgment will not, in themselves, warrant the court in

granting summary judgment unless one of the parties is entitled to judgment as a matter of law
11

on facts that are not genuinely disputed.”
Cir. 1984) (citation omitted).

United States v. Oakley, 744 F.2d 1553, 1555 (11th

The Court is mindful that “[w]hen both parties move for

summary judgment, the court must evaluate each motion on its own merits,

resolving all

reasonable inferences against the party whose motion is under consideration.”

Muzzy Prods.,

Corp. v. Sullivan Indus., Inc., 194 F.Supp.2d 1360, 1378 (N.D. Ga. 2002)). The Court has
reviewed the facts submitted by each party and has made its own examination of the record.
The summary judgment analysis is “applied in a modified manner in an ERISA case.”
Rogers v. Hartford Life and Accident, Ins. Co., 2012 WL 1288349, *1 at n.2 (M.D. Ala. Apr. 16,
2012) (citing Blankenship v. Met. Life Ins. Co., 644 F.3d 1350, 1354 at n. 4 (11th Cir. 2011)).
B.

ERISA Standard of Review
ERISA provides no standard for courts reviewing the benefits decisions of plan

administrators or fiduciaries, Doyle v. Liberty Life Assur. Co. of Boston, 542 F.3d 1352, 1355
(11th Cir. 2008), but the Supreme Court established guidance for same in Firestone Tire &
Rubber Co. v. Bruch, 489 U.S. 101, 109 (1989) and Metropolitan Life Ins. Co. v. Glenn, 554
U.S. 105 (2008).

More recently, the Eleventh Circuit has reiterated a multi-step framework to

guide lower courts when reviewing a plan administrator's benefits decision, and after Glenn, the
Eleventh Circuit no longer requires district courts to apply a heightened standard of review to a
conflicted plan administrator’s decision (the sixth step).

Doyle, 542 F.3d at 1360.14 This

framework consists of the following “six-step expanded Firestone” test:
14 Now, “the existence of a conflict of interest should merely be a factor for the district court to take into
account when determining whether an administrator's decision was arbitrary and capricious.” Doyle, 542 F.3d at
1360. Thus, while this court “must take into account an administrative conflict when determining whether an
administrator's decision was arbitrary and capricious, the burden remains on the plaintiff to show the decision was
arbitrary; it is not the defendant's burden to prove its decision was not tainted by self-interest.” Id.

12

1) Apply the de novo standard to determine whether the claim administrator's
benefits-denial decision is “wrong” (i.e., the court disagrees with the administrator's
decision); if it is not, then end the inquiry and affirm the decision.
2) If the administrator's decision in fact is “de novo wrong,” then determine whether he
was vested with discretion in reviewing claims; if not, end judicial inquiry and reverse
the decision.
3) If the administrator's decision is “de novo wrong” and he was vested with discretion in
reviewing claims, then determine whether “reasonable” grounds supported it (hence,
review his decision under the more deferential arbitrary and capricious standard).
4) If no reasonable grounds exist, then end the inquiry and reverse the administrator's
decision; if reasonable grounds do exist, then determine if he operated under a conflict of
interest.
5) If there is no conflict, then end the inquiry and affirm the decision.
6) If there is a conflict, the conflict should merely be a factor for the court to take into
account when determining whether an administrator's decision was arbitrary and
capricious.
Blakenship, 644 F.3d at 1355; Williams v. BellSouth Telecomms., Inc., 373 F.3d 1132, 1137
(11th Cir. 2004), overruled on other grounds by Doyle, 542 F.3d 1352. “All steps of the analysis
are ‘potentially at issue’ where a plan vests discretion to the plan administrator to make benefits
determinations.

Blakenship, 644 F.3d at 1356 at n.7.

Moreover, as set forth in Howington v. Smurfit-Stone Container Corp., 856 F.Supp.2d
1235, 1242-1243 (S.D. Ala. 2012) (case citations omitted) (emphasis added):
If there is a reasonable basis for the Plan Administrator's benefits decision, based upon
the facts known at the time, it must be upheld as not an abuse of discretion or arbitrary or
capricious, even where the evidence may support a different decision…“[W]here the
administrator exercises discretion, deferential (i.e., arbitrary and capricious) review is
appropriate according to trust principles, which guide review of decisions affecting
ERISA-governed plans.”…To determine whether the Plan Administrator's decision was
arbitrary and capricious, the Court begins with the language of the Pension Plan. …
Pursuant to ERISA, the Plan Administrator's fiduciary duties are defined as the “prudent
13

man standard of care”. 29 U.S.C. § 1104(a)(1)(A). The statute explains, in relevant part,
that the “fiduciary shall discharge his duties with respect to a plan solely in the interest of
the participants and beneficiaries and—(A) for the exclusive purpose of: (i) providing
benefits to participants and their beneficiaries; and (ii) defraying reasonable expenses of
administering the plan[.]” 29 U.S.C. § 1104(a)(1)(A). ERISA also states that the fiduciary
shall act “with the care, skill, prudence, and diligence under the circumstances then
prevailing that a prudent man acting in a like capacity and familiar with such matters
would use in the conduct of an enterprise of a like character and with like aims” and act
“in accordance with the documents and instruments governing the plan insofar as such
documents and instruments are consistent with the provisions of this subchapter and
subchapter III of this chapter.” 29 U.S.C. § 1104(a)(1)(B) & (D).
The parties do not dispute that DuPont is the fiduciary plan administrator, vested with
discretionary authority to determine eligibility for benefits, administer the plans, and construe the
terms and conditions of the plans.

Therefore, assuming for purpose of this order that DuPont’s

decision is “de novo wrong,” this Court must apply the arbitrary and capricious standard and
determine whether Defendants had “a reasonable basis for the decision, based upon the facts as
known to [it] at the time the decision was made.”

Jett v. Blue Cross & Blue Shield of Ala., Inc.,

890 F.2d 1137, 1139 (11th Cir. 1989); Blankenship, 644 F. 3d at 1355; Firestone, 489 U.S. at
111; Hunt v. Hawthorne Assocs., Inc., 119 F.3d 888, 912 (11th Cir. 1997) (“We have interpreted
Firestone to mandate an arbitrary and capricious standard of review, which is often used
interchangeably with an abuse of discretion standard, if the administrator has discretionary
authority to make eligibility determinations or to construe disputed terms of the plan[]”).
Under ERISA, the plan administrator must discharge its duties “in accordance with the
documents and instruments governing the plan.” 29 U.S.C. § 1104(a)(1)(D).

The terms of

ERISA plans are vital -- "[a]written plan is ... required [so] that every employee may, on
examining the plan documents, determine exactly what his rights and obligations are under the
plan." Curtiss-Wright Corp. v. Schoonejongen, 514 U.S. 73, 83-84 (1995). “One important duty
14

of an administrator is to determine if a beneficiary is eligible for benefits under the plan.

29

U.S.C. § 1102(b)(4), 1104(a) (emphasis added).
Here, Prassenos has the burden to establish that she is entitled to the plans’ benefits – that
DuPont was wrong. Watts v. BellSouth Telecomms., Inc., 218 Fed. Appx. 854, 856, (11th Cir.
2007).

If Prassenos satisfies that burden, as DuPont has discretion, she must then demonstrate

the decision was arbitrary and capricious (that reasonable grounds do not exist to support the
decision).

Herring v. Aetna Life Ins. Co., 517 Fed. Appx. 897, 899 (11th Cir. 2013).

On summary judgment, the parties argue many facts and issues, including whether Mr.
Prassenos retired, or instead separated from ChemFirst (and/or DuPont) on disability (which was
not addressed during the administrative process); whether he/she failed to convert; whether
he/she failed to port; and whether those options were even available to him/her.

The Court has

waded through the administrative record, the issues framed by the parties, and the relevant
portions of the SPDs and plans, considered the varying contentions, and finds as follows.
C.

Count 1 – Recovery of Additional Life Insurance Benefits (Section 1132(a)(1)(B))
Against Both Defendants
While employed with ChemFirst, Mr. Prassenos was a participant and insured under the

DuPont BeneFlex Life Insurance Plan (Life Insurance plan), a welfare plan per ERISA, that
provides group life insurance benefits.
Doc. 42-2 at 72-92).

(Doc. 30 at 3; Doc. 34 at 5-26 (SPD), 47-58 (full plan);

Mr. Prassenos designated Prassenos as his beneficiary.

(Doc. 30 at 3).

As set forth in the plan’s SPD, life insurance coverage up to “1x pay” is provided at no
cost to employees, with the option for an employee to purchase his own additional insurance:
… you can elect to purchase Beneflex Employee Life Insurance Plan coverage … The
Company provides coverage of one times your pay at no cost to you, and you have the
15

option to purchase additional group term life insurance coverage with premium rates
based on your age. The Plan also offers additional features, including … a feature that
allows you to port your coverage if you leave the Company under certain conditions.
You will need to satisfy the requirement described in this SPD to receive BeneFlex
Employee Life Insurance Plan coverage or benefit payment.
***
(Doc. 42-2 at 74, 77).15 Per the SPD, there are differing options for coverage, from which
employees could select their benefit amounts (e.g., “1x pay” and higher for supplemental
coverage).

(Id. at 78).

Mr. Prassenos purchased additional coverage -- the “2x pay” option.

DuPont’s Level 2 denial of additional life insurance benefits is based on Mr. Prassenos’
status as having separated from employment on disability under the T&P (the disability policy),
with specific reliance on Page 3 of the T&P SPD (which states that supplemental life insurance is
discontinued upon termination of employment).

DuPont then references (with little

explanation) a 31 day conversion requirement, seeming to apply such to all of Prassenos’ claims.
DuPont’s final basis for this denial is linked to the “When Coverage Ends” section of the
Dependent Life Insurance SPD, for the proposition that Mr. Prassenos’ separation on disability
under the T&P rendered him ineligible for the additional and/or dependent coverage.
The Court’s review of the record indicates that there is a provision of the Life Insurance
plan that Defendants failed to address during the appeals process and which is dispositive to
Count 1.

As explanation, the evidence supports that Mr. Prassenos separated from his

employment on disability in June 2012, and in so doing, separated under the T&P.
Prassenos subsequently died in August 2012 (just over 2 months later).

Mr.

The Life Insurance plan

15 According to the SPD, eligibility was conditioned on being: a Full-Service Employee of DuPont U.S.
Region; a Full-Service Employee of a participating DuPont subsidiary or joint venture that has adopted this Plan; or
a Pensioner or Survivor of a participating DuPont subsidiary or joint venture that has adopted this Plan for
Pensioners and Survivors. (Doc. 42-2 at 74).

16

provides as follows:
XIII. CESSATION OF EMPLOYMENT
***
3.
CESSATION OF EMPLOYMENT DUE TO TOTAL AND PERMANENT
DISABILITY
Each participating employee terminated due to total and permanent disability, as
defined in the Company's Total and Permanent Disability Income Plan…will
become participants in this Plan and shall continue to receive insurance coverage in
the amount of coverage in effect up to one times Normal Annual Earnings at the
time employment was terminated. The coverage will be provided by the Company.
Insurance coverage in excess of one times Normal Annual Earnings, if in effect at the
time employment was terminated, will be paid to the beneficiary of the former employee
if the former employee's death occurs within one year after the termination of
employment. Such coverage shall continue until the end of the month in which the former
employee is found to be no longer totally and permanently disabled, in accordance with
the provisions of the Total and Permanent Disability Income Plan.
(Doc. 34 at 53-54) (emphasis added).
With the discovery of this provision, the Court ordered briefing by the parties on its
applicability.

Defendants responded, conceding the applicability of section XIII.3 to Mr.

Prassenos, and admitting that Prassenos’ “additional benefits are payable under the Life
Insurance Plan” due to this section.

(Doc. 67 at 2).

Defendants assert they “will process

payment for the additional life insurance benefits” and allow for the “recovery of benefits claim
under the Life Insurance Plan” (Count 1).

(Id.)

Given Defendants’ concession and admittance of the applicability of Section XIII.3 of the
Life Insurance plan, Defendants have admitted that their decision to deny Prassenos these
benefits was de novo wrong. This is because as a matter of law, the fiduciary shall administer
the plan in accordance with the documents and instruments governing the plan. 29 U.S.C. §
1104(a)(1)(D) (emphasis added).

Egelhoff v. Egelhoff, 532 U.S. 141, 151 note 4 (2001).
17

Here, the plan administrator – admittedly -- failed to do so.

This means that the plan

administrator’s decision was de novo wrong, and because it was vested with discretion in
reviewing claims, this Court must determine whether “reasonable” grounds supported it (e.g.,
review the decision under the more deferential arbitrary and capricious standard).

Upon

consideration, and given the administrator’s reliance on Mr. Prassenos’ disability status and its
current concession as to Section XIII.3, the Court cannot find that reasonable grounds existed to
have denied the additional “1x pay” in light of the plain terms of the Life Insurance plan.
Additionally, Prassenos did not receive the full and complete Life Insurance plan from
Defendants until long after her appeals process concluded – due to their unexplained 440 day
delay in producing the requested plan documents – such that she was not in a position to raise the
issue herself.

A fiduciary plan administrator who fails to apply an ERISA plan’s plain language

when making a benefits determination acts wrongly, and moreover, arbitrarily and capriciously.
See, e.g., Yochum v. Barnett Banks Inc. Severance Payment Plan, 234 F.3d 541, 547 (11th Cir.
2000) (discussing the plain meaning requirement the administrator must adhere to and that the
denial of an ERISA claim “based on … incomplete information was arbitrary and capricious, in
that the plain language of the Plan and the Agreement were violated[]”).
Thus, it is ORDERED that Prassenos’ motion for summary judgment is GRANTED as
to Count 1 and that this count will be CARRIED TO TRIAL solely to determine the amount of
final judgment (including attorneys’ fees and interest).16

16 There is no need to reverse/remand the decision for further administrative review because there is no
dispute that the denial of benefits was improper and the amount of benefits Plaintiff shall be paid may be made
determinable by this Court via trial on damages.

18

D.

Count 2 - Breach of Fiduciary Duty (Section 1132(a)(3))17 Against DuPont
1.

Dependent Life Insurance

While employed with ChemFirst, Mr. Prassenos obtained a DuPont BeneFlex Dependent
Life Insurance Plan (Dependent Life Insurance plan) for Prassenos, making her a participant and
insured under this plan (with Mr. Prassenos as her beneficiary).

(Doc. 30 at 3; Doc. 34 at 30-45

(SPD), 60-64 (full plan); Doc. 42-2 at 93-108). The SPD and plan both provide that there is
choice of dependent coverage amounts for spouses ranging from $10,000 to $350,000. (Doc.
42-2 at 100; Doc. 34 at 62). 18

Mr. Prassenos selected $100,000 coverage for Prassenos.

Ultimately, Mr. Prassenos pre-deceased Prassenos, who is also now deceased.
Prassenos contends that as Mr. Prassenos’ spouse, upon his termination of employment
she was entitled to have DuPont continue her coverage under the Dependent Life Insurance plan
($100,000 worth) without having to convert such to an individual policy or pay premiums.
Prassenos asserts that because Mr. Prassenos retired on disability, any requirement he had to port
to continue the coverage on Prassenos was waived.

As grounds for her claim, Prassenos

references DuPont’s November 2, 2012 Level 2 denial of appeal and contends that the decision
was wrong because it failed to apply the plain language of certain sections of the Dependent Life
SPD (“When Coverage Ends,” “If you leave the Company,” “Applying for the portability
feature”).

(Doc. 30 at 8-9).

Specifically, Prassenos alleges as follows:

17 While DuPont couches Prassenos’ argument as one for individualized notice, it is not, and such an issue
is simply not before the Court in this case and will not be addressed further.
18 The SPD explains eligibility as: a Full-Service Employee of DuPont U.S. Region; or a Full-Service
Employee of a participating DuPont subsidiary or joint venture that adopted this Plan. (Doc. 42-2 at 95). The
Dependent Life Insurance plan clarifies that employees are eligible without regard to length of company service and
dependents shall become eligible under the plan only when the dependent is enrolled as a dependent by the
employee. (Doc. 34 at 62).

19

15.
The summary plan description of the 2008 BeneFlex Dependent Life Insurance
states on page 8: "With some restrictions, your spouse/partner may be eligible to apply
for coverage under the portability feature of the Plan if your coverage ends for reasons
other than disability." On the following page 9, the summary plan description states:
"Portability is a feature of the Plan that allows your spouse/partner to obtain similar
group term life insurance coverage after you terminate, or coverage ends due to your
death or divorce. Your spouse/partner and children may port coverage only if they are
already covered under the Plan and, in certain cases, only if you elect to port your
coverage as well. The requirement that you also port your coverage is waived in the
cases of retirement, death, divorce, if you terminate employment under the terms of
the Total and Permanent Disability Income Plan or a voluntary or involuntary
termination incentive." (Emphasis Added)….
16.
The summary plan description of the BeneFlex Dependent Life Insurance Plan,
Exhibit "C", states on page 8 that a spouse may apply for coverage under the portability
feature "if your coverage ends for reasons other than disability," but on the next page the
summary plan description states, "Portability is a feature of the Plan that allows your
spouse/partner to obtain similar group term life insurance coverage after you terminate, ...
The requirement that you also port your coverage is waived in the cases of
retirement, .. ." (Emphasis Added).
(Doc. 30 at 8-9 (emphasis added by Plaintiff)).

However, Plaintiff misinterprets the waiver.

The requirement that is waived is the requirement that Mr. Prassenos also port his coverage in
order for the spousal (dependent) coverage to be portable.

There is no waiver for Prassenos to

proactively port her coverage for it to continue.
In response, DuPont contends, referencing the Dependent Life Insurance plan, that
Prassenos was required to pay the premium and either convert or port the coverage to continue
same (Doc. 51 at 5-6) to keep her dependent coverage, based on the following:
1.
Any insurance under this Plan shall be cancelled automatically at the end of
the month (a) the employee ceases to be an employee of the Company or (b) the
employee discontinues the payment for coverage.
2.
In the event of termination of the dependent's coverage as a result of the
employee's death…or termination of employment due to retirement, disability…the
employee under this Plan may have the privilege of applying to transition coverage
without medical examination to a similar term life insurance policy as customarily issues
20

by the Insurance Carrier. Application to port coverage must be made directly to the
Insurance Carrier within 31 days after cancellation of coverage under this Plan and the
first premium payment must be made within 31 days of the date on the first bill. This
privilege applies only to insured spouses under age 70 … on the day the coverage ends.
(Doc. 34 at 64 (emphasis added)).
The Court finds that DuPont’s interpretation of the Dependent Life Insurance plan is not
de novo wrong.

Mrs. Prassenos was required to apply for coverage with the insurance carrier

(Prudential) within 31 days of June 30, 2012.

This she did not do.

However, Prassenos’ claim is not dependent on the correctness of DuPont’s decision.
Rather, based on a June 1, 2012 letter from DuPont entitled “Confirmation of Lost Coverage,”
Prassenos asserts a breach of fiduciary duty claim against DuPont pursuant to 29 U.S.C. §
1132(a)(3), which provides that “[a] civil action may be brought ... by a participant, beneficiary,
or fiduciary ... to obtain [] appropriate equitable relief ... to enforce any provisions of this
subchapter or the terms of the plan[.]” 29 U.S.C. § 1132(a)(3). The fiduciary duties imposed by
ERISA provide:
a fiduciary shall discharge his duties with respect to a plan solely in the interest of the
participants and beneficiaries ... for the exclusive purpose of ... providing benefits to
participants and their beneficiaries ... with the care, skill, prudence, and diligence under
the circumstances then prevailing that a prudent man acting in a like capacity and familiar
with such matters would use in the conduct of an enterprise of a like character and with
like aims.
29 U.S.C. § 1104(a)(i)(A) & (B).

Additionally, as enunciated in Jones v. American General

Life and Acc. Ins. Co., 370 F.3d 1065, 1072 (11th Cir. 2004):
In Ervast v. Flexible Prods. Co., 346 F.3d 1007 (11th Cir.2003), we recognized that an
ERISA participant has a right to accurate information, and that an ERISA plan
administrator's withholding of information may give rise to a cause of action for breach
of fiduciary duty. Id. at 1016 n. 10. Our sister circuits have reached the same conclusion,
consistently holding that ERISA plan participants may state a cause of action for breach
21

of fiduciary duty based on a plan administrator's material misrepresentations or
omissions. See, e.g., Unisys, 57 F.3d at 1265–69 (holding that participants in an
ERISA-governed plan had stated a claim for breach of fiduciary duty based on the plan
administrator's repeated assurances that plan benefits could not be terminated after their
retirement); Howe, 36 F.3d at 753 (“‘Misleading communications to plan participants
regarding plan administration will support a claim for breach of fiduciary duty.’”)
(internal alterations omitted) (quoting Berlin v. Michigan Bell Tel. Co., 858 F.2d 1154,
1163 (6th Cir.1988)); Mullins v. Pfizer, Inc., 23 F.3d 663, 669 (2d Cir.1994) (holding that
a plan administrator's affirmative material misrepresentations about proposed future
changes to an ERISA-governed plan are actionable as a breach of fiduciary duty under
ERISA); Bixler v. Central Pa. Teamsters Health & Welfare Fund, 12 F.3d 1292, 1300–01
(3d Cir.1993) (holding that an ERISA fiduciary's duty to provide “complete and accurate
information” to its beneficiaries “entails not only a negative duty not to misinform, but
also an affirmative duty to inform when the trustee knows that silence might be
harmful”), quoted in Ervast, 346 F.3d at 1016 n. 10; Drennan v. General Motors Corp.,
977 F.2d 246, 251 (6th Cir.1992) ( “Misleading communications to plan participants
regarding plan administration (for example, eligibility under a plan, the extent of benefits
under a plan) will support a claim for a breach of fiduciary duty.”) (internal quotations
omitted).
In Count II, Prassenos alleges that DuPont, as the administrator of the plans, “breached
its fiduciary duty to [her] by misleading both Mr. Prassenos and [her] with incomplete and
inaccurate information [in that letter] regarding the terms” of the plans. (Doc. 30 at 13 at ¶32).
Prassenos alleges that, as a result of the breach, she was injured in the form of: 1) the loss of the
life insurance proceeds on the lives of both Mr. Prassenos and herself; and 2) loss of earnings on
the loss of the life insurance proceeds, including interest on the benefits on the life of Mr.
Prassenos that should have been previously paid to her.

(Id. at 14 at ¶35).

Prassenos also

seeks “[t]he equitable remedy of surcharge...in the form of an award of monetary compensation
against [DuPont].

(Id. at 13 at ¶ 33).

On summary judgment, and as grounds, Prassenos contends: 1) the letter did not contain
any information about continuation or conversion of coverage; 2) the letter did not contain the
name of the insurance company, Prudential Insurance Company of America; 3) the letter stated
22

they “may be able to continue group health coverage for yourself and any covered dependents
under COBRA[;]” 4) the letter “did not also include any information that the insurance could be
maintained” by paying a “relatively nominal premium and notifying…Prudential…[]” instead
stating that the life insurance and dependent life insurance coverage terminated on May 31,
2012; and 5) that the date that coverage terminated was incorrect, that it was neither May 31,
2012 nor effective June 1, 2012 as DuPont claims, but was July 31, 2012. (Doc. 30 at 9-10).
Prassenos alleges that she was harmed by this fiduciary breach by having to litigate the issue of
additional coverage on her husband and also on her life insurance.

Prassenos asserts that

reinstatement of her dependent life insurance policy in the amount of $100,000 is the appropriate
equitable remedy.

Prassenos also seeks as relief, the life insurance proceeds for both she and

Mr. Prassenos, earnings on those lost proceeds (including interest on the additional benefits due
under Mr. Prassenos’ plan), and an equitable remedy of a surcharge.
DuPont responds that “Plaintiff or Mr. Prassenos via the summary plan descriptions,
were given clear instructions on how to continue the life insurance coverage.

As a result,

Defendants are entitled to summary judgment on the breach of fiduciary duty claim.”
The Court disagrees because the Dependent Life Insurance SPD, relied upon by DuPont
to defeat summary judgment, indicates that Mrs. Prassenos was not eligible to port her dependent
coverage because Mr. Prassenos’ coverage ended based on disability.

Specifically, the

Dependent Life Insurance SPD provides:
If you leave the Company
Your BeneFlex Dependent Life Insurance coverage ends at the end of the month in
which you leave the Company, for any reason, including retirement.
With some restrictions, your spouse/partner may be eligible to apply for coverage under
23

the portability feature of the Plan if your coverage ends for reasons other than
disability.
***
When coverage ends
Your Beneflex Dependent Life Insurance coverage ends on any of the following:
• the end of the month that you are no longer eligible
• the end of the month that your covered dependent is no longer eligible
With some restrictions, your spouse/partner may be eligible to apply for coverage under
the portability feature of the Plan if you are no longer eligible for the group coverage for
reasons other than disability.
(Doc. 34 at 39 (emphasis added) (Page 8 of the Dependent Life Insurance SPD)).
However, as relied upon by DuPont to deny coverage, the Dependent Life Insurance plan
provides:
1.
Any insurance under this Plan shall be cancelled automatically at the end of
the month (a) the employee ceases to be an employee of the Company or (b) the
employee discontinues the payment for coverage.
2.
In the event of termination of the dependent's coverage as a result of the
employee's death…or termination of employment due to retirement, disability…the
employee under this Plan may have the privilege of applying to transition coverage
without medical examination to a similar term life insurance policy as customarily issues
by the Insurance Carrier. Application to port coverage must be made directly to the
Insurance Carrier within 31 days after cancellation of coverage under this Plan and the
first premium payment must be made within 31 days of the date on the first bill. This
privilege applies only to insured spouses under age 70 … on the day the coverage ends.
(Doc. 34 at 64 (emphasis added) (Page 4 of the Dependent Life Insurance plan)).
Thus, even if Prassenos was provided the Dependent Life Insurance SPD, she was given
incorrect information.
Prassenos’ coverage.

Moreover, the letters did not provide information regarding porting
There is no dispute that neither Mr. Prassenos nor Prassenos were timely

provided the actual plan with the correct information.

DuPont has presented no other evidence

that the correct information was timely provided to either Mr. Prassenos or Prassenos.
24

Accordingly, the Court finds -- as to Count 2 (breach of fiduciary duty for the dependent life
insurance benefits) -- that DuPont’s motion for summary judgment is DENIED; and Prassenos’
motion for summary judgment against DuPont is GRANTED and that this count will be
CARRIED TO TRIAL solely on the amount of damages to be awarded to plaintiff.
DONE and ORDERED this the 16th day of January 2015.
/s/ Kristi K. DuBose
KRISTI K. DuBOSE
UNITED STATES DISTRICT JUDGE

25