Singletary v. Prudential Insurance Company of America, et al

Filing 72

ORDER & REASONS granting 57 Motion for Summary Judgment by Prudential Insurance Company of America; granting 60 Motion for Summary Judgment by United Parcel Service Flexible Benefits Plan & United Parcel Service Inc.; denying 62 Motion for Summary Judgment by Linda Singletary. Signed by Judge Martin L.C. Feldman on 8/5/2015. (caa)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
LINDA SINGLETARY

CIVIL ACTION

v.

NO. 14-2648

THE PRUDENTIAL INSURANCE COMPANY
OF AMERICA, ET AL.

SECTION "F"

ORDER AND REASONS
Before

the

Court

are

three

motions:

(1)

The

Prudential

Insurance Company of America's motion for summary judgment; (2) The
United Parcel Service Flexible Benefits Plan and United Parcel
Service,

Inc.'s

motion

for

summary

judgment;

plaintiff's cross-motion for summary judgment.
that

follow,

the

defendants'

motions

are

and

(3)

the

For the reasons
GRANTED

and

the

plaintiff's motion is DENIED.
Background
This lawsuit arises out of a widow's efforts to recover life
insurance benefits under the Employee Retirement Income Security
Act of 1974, following her husband's tragic death at age 37 in a
weekend motorcycle accident; benefits that were denied because of
her late husband's active military status.
Linda Singletary worked for United Parcel Service, Inc. as a
part-time, non-union employee.

As a UPS employee, Mrs. Singletary

participated in the UPS Service Flexible Benefits Plan, which
provides

group

insurance

coverage

1

to

certain

qualified

UPS

employees and their dependents.

Mrs. Singletary was enrolled in

basic and optional dependent term life insurance.

The Plan, which

includes benefits for both basic dependent life insurance benefits
and optional, supplemental dependent life benefits,1 is an employee
welfare benefit plan governed by the Employee Retirement Income
Security Act, 29 U.S.C. § 1001, et seq.

The Plan provides:

FOR DEPENDENTS INSURANCE
You are eligible
Insurance while:
•
•

to

become

insured

for

Dependents

You are eligible for Employee Insurance; and
You have a Qualified Dependent.

Qualified Dependents:
These are the persons for whom you may obtain Dependents
Insurance:
•

Your spouse or Domestic Partner.

*********
Exceptions:
For Dependents Term Life Coverage:
(1) Your spouse or Domestic Partner is not your Qualified
Dependent while on active duty in the armed forces of any
country; or
********
When You Become Insured
FOR DEPENDENTS INSURANCE

1

Under the Plan, as a dependent of Linda Singletary,
Timothy Singletary was allegedly covered in the amount of $2,000
for basic dependent life benefits and $500,000 for optional
dependent life benefits.
2

Your Dependents Insurance under a Coverage for a person
will begin the first day on which all of these conditions
are met:
•

The person is your Qualified Dependent.

********
•

You have met any evidence
Qualified Dependent.

requirement

of

that

UPS is the Plan sponsor. The Prudential Insurance Company of
America is the insurance carrier for Life Insurance and AD&D
benefits under the Plan.

The Certificate of Coverage describing

the Plan's dependent term life insurance benefits provides that
Prudential decides if a participant receives benefits under the
Plan.2

Prudential is also the claims administrator with respect to

the life insurance benefit at issue.3

As claims administrator,

Prudential has the discretion to decide claims and appeals.

The

Plan's Summary Plan Description states:
Certain benefits offered under the Plan are provided
through an insurance contract issued to UPS ("the
Company") by an insurance carrier. In this case, the
insurance carrier is the applicable claims fiduciary with
respect to claims for benefits provided under the
insurance contract.
This means that the insurance
carrier – not the UPS Claims Review Committee ("the
Committee") – has the discretionary authority to

2

The Certificate of Coverage states:
"You must give
evidence of insurability for a Qualified Dependent spouse. . . .
This requirement will be met when Prudential decides the evidence
is satisfactory."
3

In connection with the Plan, Prudential issued to UPS
a group life insurance policy, Group Policy Number G-76536-GA,
which insured, among other things, dependent life insurance
benefits.
3

determine benefits that are insured by the insurance
carrier.
Mrs. Singletary's husband, Timothy, died on October 21, 2012
as a result of injuries sustained in a motor vehicle collision.4
Mr. Singletary was a member of the United States Army, but he was
stationed stateside and was off-duty at the time of his death.
After her husband's death, Mrs. Singletary submitted a claim to
Prudential for life insurance benefits under the Plan.

UPS, on

behalf of Mrs. Singletary, filed an "Application for Group Life
Claim"

for

basic

and

optional

dependent

benefits on November 9, 2012.

term

life

insurance

Mrs. Singletary submitted her

beneficiary statement on November 26, 2012.
In investigating Mrs. Singletary's claim for dependent life
insurance benefits, Prudential reviewed the Department of the
Army's "Report of Casualty."

That report indicated that Mr.

Singletary was on active duty, although "Off duty", at the time of
his death. On December 4, 2012, Prudential's Sherea Williams spoke
with Gerald Hensen with the Army's Human Resources Department to
clarify the report.

Mr. Hensen confirmed that Singletary was on

active duty in the United States Army at the time of his death.

4

On October 21, 2012, Mr. Singletary was a member of
the United States Army, stationed stateside. He was operating a
2003 Honda motorcycle on State Highway 195 in Killeen, Texas when
he was involved in a collision with another vehicle. After Mr.
Singletary was thrown from his motorcycle and came to rest in a
traffic lane, another vehicle drove over him and he became lodged
underneath the vehicle until it stopped.
Mr. Singletary was
transported to a nearby hospital, where he was pronounced dead.
4

Mr. Hensen explained that the "off duty" notation on the Report of
Casualty was merely an internal code for the Army's administration
area regarding Mr. Singletary's location at the time of his death.
The same day that Ms. Williams confirmed with Mr. Hensen that
Singletary was on active duty at the time of his death, on December
4, 2012, Prudential denied Mrs. Singletary's claim; Prudential
informed Mrs. Singletary that, under the Plan terms, Mr. Singletary
was not eligible for coverage at the time of his death because he
was on active duty in the Armed Forces.5

Mrs. Singletary twice

appealed Prudential's adverse benefits determination on the grounds
that (a) Mr. Singletary was a qualified dependent at the time of
his

death

because

he

was

off

duty;

and

(b)

discrimination to deny benefits to a serviceman.

it

is

illegal

Prudential twice

denied Mrs. Singletary's appeals.6
Having exhausted her administrative remedies under the terms

5

The group policy exclusion provides, in part:
Your spouse or Domestic partner is not
your Qualified Dependent while on active
duty in the armed forces of any
country[.]

6

Prudential denied the February 6, 2013 appeal on May 6,
2013, noting that Singletary did not meet the definition of a
qualified dependent because he was on active duty in the Army on
the day he died. Prudential denied the October 29, 2013 appeal,
reiterating its prior finding; Prudential acknowledged that Mr.
Singletary was not killed in combat, but reiterated that he did not
meet the definition of qualified dependent because he was on active
duty in the Army, making him ineligible under the definition of a
qualified dependent under the Plan.
5

of the Plan and ERISA, on November 19, 2014, Mrs. Singletary sued
The Prudential Insurance Company of America, the United Parcel
Service Flexible Benefits Plan, and United Parcel Service, Inc.
Mrs. Singletary seeks to recover damages related to the denial of
basic and optional dependent life insurance benefits under the
benefit plan sponsored by her employer, UPS.7

She originally

advanced four theories of recovery in her complaint.

First, Mrs.

Singletary seeks to recover from Prudential dependent group life
insurance benefits; a claim governed by ERISA (Count I).

Second,

Mrs. Singletary alleges that UPS (only) has violated the Uniformed
Services Employment and Reemployment Rights Act of 1994 by denying
her equal access and coverage for life insurance benefits under the
terms of the Plan solely because her husband was on active duty
status in the armed forces at the time of his death (Count II).
Third, Mrs. Singletary seeks to recover, under the Louisiana
Military Service Relief Act, La.R.S. 29:402, an award of all basic
and optional dependent life insurance benefits under the Plan, plus
an amount equal to that award as liquidated damages and attorney's
fees.

Fourth, Mrs. Singletary seeks a declaration under La.R.S.

22:943(A) that the Plan's referenced exclusion (based solely on an
otherwise qualified dependent's status as a member of the armed
forces) is illegal.

7

Mrs. Singletary alleges that each of the three named
defendants are liable jointly, severally, and in solido.
6

Prudential previously moved to dismiss Counts III and IV of
the plaintiff's original and amended complaints.

And the Plan,

along with UPS, also moved to dismiss Counts II, III, and IV of the
original and amended complaints; finally, UPS also moved to dismiss
Count I insofar as it was named as a defendant to the plaintiff's
ERISA claim.

On April 30, 2015 the Court granted the motions,

disposing of the plaintiff's claims under the Uniformed Services
Employment and Reemployment Rights Act of 1994, 38 U.S.C. § 4301,
the Louisiana Military Service Relief Act, La.R.S. § 29:401, and
the Louisiana Insurance Code, La.R.S. § 22:943.

The plaintiff's

only remaining claim is her claim based on ERISA.

Contending that

Prudential's decision to deny the plaintiff's claim for benefits
was both correct and reasonable and that the plaintiff did not
incur a covered loss under the terms of the United Parcel Service
Flexible Benefits Plan, the defendants each seek summary judgment
in their favor; urging that the adverse benefits determination was
unreasonable, the plaintiff seeks summary relief by cross-motion.
I.
Federal Rule of Civil Procedure 56 instructs that summary
judgment is proper if the record discloses no genuine dispute as to
any material fact such that the moving party is entitled to
judgment as a matter of law.

No genuine dispute of fact exists if

the record taken as a whole could not lead a rational trier of fact
to find for the non-moving party.

7

See Matsushita Elec. Indus. Co.

v. Zenith Radio., 475 U.S. 574, 586 (1986).

A genuine dispute of

fact exists only "if the evidence is such that a reasonable jury
could return a verdict for the non-moving party."

Anderson v.

Liberty Lobby, Inc., 477 U.S. 242, 248 (1986).
The Court emphasizes that the mere argued existence of a
factual dispute does not defeat an otherwise properly supported
motion.

See

id.

Therefore,

"[i]f

the

evidence

is

merely

colorable, or is not significantly probative," summary judgment is
appropriate.

Id. at 249-50 (citations omitted).

Summary judgment

is also proper if the party opposing the motion fails to establish
an essential element of his case.
477 U.S. 317, 322-23 (1986).

See Celotex Corp. v. Catrett,

In this regard, the non-moving party

must do more than simply deny the allegations raised by the moving
party.

See Donaghey v. Ocean Drilling & Exploration Co., 974 F.2d

646, 649 (5th Cir. 1992).

Rather, he must come forward with

competent evidence, such as affidavits or depositions, to buttress
his claims.

Id.

Hearsay evidence and unsworn documents that

cannot be presented in a form that would be admissible in evidence
at trial do not qualify as competent opposing evidence.

Martin v.

John W. Stone Oil Distrib., Inc., 819 F.2d 547, 549 (5th Cir.
1987); Fed. R. Civ. P. 56(c)(2).
defeat

summary

judgment

"[T]he nonmoving party cannot

with

conclusory

allegations,

unsubstantiated assertions, or only a scintilla of evidence."
Hathaway v. Bazany, 507 F.3d 312, 319 (5th Cir. 2007)(internal

8

quotation marks and citation omitted).

In deciding whether a fact

issue exists, courts must view the facts and draw reasonable
inferences in the light most favorable to the nonmoving party.
Scott v. Harris, 550 U.S. 372, 378 (2007). Although the Court must
"resolve factual controversies in favor of the nonmoving party," it
must do so "only where there is an actual controversy, that is,
when both parties have submitted evidence of contradictory facts."
Antoine v. First Student, Inc., 713 F.3d 824, 830 (5th Cir.
2013)(internal quotation marks and citation omitted).
II.
A.
ERISA "permits a person denied benefits under an employee
benefit plan to challenge that denial in federal court."

Metro.

Life Ins. Co. v. Glenn, 554 U.S. 105, 108 (2008) (citing 29 U.S.C.
§ 1001; § 1132(a)(1)(B)).

When reviewing a denial of benefits

made by an ERISA plan administrator, the Court applies a de novo
standard

of

review,

“unless

the

benefit

plan

gives

the

administrator or fiduciary discretionary authority to determine
eligibility for benefits or to construe the terms of the plan.”
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989).
the

benefit

plan

confers

on

the

claims

administrator

If
the

discretionary authority to determine eligibility for benefits, then
the Court applies the deferential, abuse of discretion standard of
review.

Holland v. Int'l Paper Co. Retirement Plan, 576 F.3d 240,

9

246 (5th Cir. 2009)("because the Plan indisputably gives the Plan
Administrator the discretionary authority to construe the Plan's
terms

and

to

render

benefit

decisions,

we

reverse

the

Plan

Administrator's denial of benefits to [the plaintiff] only if it
abused its discretion.").

Here, the Plan confers on Prudential,

the Plan Administrator, the discretionary authority to render
benefit decisions.8

Accordingly, this Court must apply an abuse of

discretion standard to review Prudential's decision to deny Mrs.
Singletary.
An

ERISA

claimant

bears

the

administrator abused its discretion.

burden

to

show

that

the

George v. Reliance Standard

Life Ins. Co., 776 F.3d 349, 352-53 (5th Cir. 2015)(citation
omitted);

Ellis v. Liberty Life Assurance Co. of Boston, 394 F.3d

262, 273 (5th Cir. 2005)("the law requires only that substantial
evidence support a plan fiduciary's decisions, including those to
deny . . . benefits, not that substantial evidence (or, for that
matter, even a preponderance) exists to support the employee's

8

As claims administrator, Prudential has the discretion
to decide claims and appeals. The Plan's Summary Plan Description
states:
Certain benefits offered under the Plan are
provided through an insurance contract issued
to UPS ("the Company") by an insurance
carrier. In this case, the insurance carrier
is the applicable claims fiduciary with
respect to claims for benefits provided under
the insurance contract. This means that the
insurance carrier – not the UPS Claims Review
Committee
("the
Committee")
–
has
the
discretionary authority to determine benefits
that are insured by the insurance carrier.
10

claim

of

disability.").

In

reviewing

a

plan

fiduciary's

interpretation of its plan, the Fifth Circuit has endorsed, but
does not always call for, the application of a two-step process9:
first, the Court determines the legally correct interpretation of
Id. at 269-70.

the plan.

Second, if the administrator did not

give the plan the legally correct interpretation, the Court then
determines whether the administrator's decision was an abuse of
discretion.

Id. at 270; Holland, 576 F.3d at 246 n.2 ("If the

determination was legally correct [step one], there is no abuse of
discretion; if it was incorrect, then we must review whether that
interpretation was an abuse of discretion.").
Under

the

abuse

of

discretion

standard,

the

Court

must

determine whether the administrator's decision was "arbitrary and
capricious."

Anderson v. Cytec Indus., Inc., 619 F.3d 505, 512

(5th Cir. 2010)("This is the functional equivalent of arbitrary and
capricious review: '[t]here is only a semantic, not a substantive,
difference between the arbitrary and capricious and the abuse of
discretion standards in the ERISA benefits review context.'")

9

The Fifth Circuit has "bypass[ed], without deciding,
whether the Plan Administrator's denial was legally correct" when
the parties fail to "conform[] their arguments to our traditional
two-step analysis." See Holland, 576 F.3d at 246 n.2 (noting that
"we are not confined to this test; we may skip the first step if we
can more readily determine that the decision was not an abuse of
discretion.")(citations omitted); see also Sanchez v. Life Ins. Co.
of North America, 393 Fed.Appx. 229, 232 (5th Cir. 2010)(proceeding
immediately to the second prong when presented with a case where
"we can more readily determine that the decision was not abuse of
discretion[.]")(internal quotations and citation omitted).
11

(citation omitted).

"A plan administrator abuses its discretion

where the decision is not based on evidence, even if disputable,
that clearly supports the basis for its denial." Holland, 576 F.3d
at 246 (internal quotation marks omitted).

Put another way, a

decision is arbitrary only if made "without a rational connection
between the known facts and the decision or between the found facts
and the evidence."

Bellaire Gen. Hosp. v. Blue Cross Blue Shield,

97 F.3d 882, 828 (5th Cir. 1996); Truitt v. Unum Life Ins. Co. of
Am., 729 F.3d 497, 508 (5th Cir. 2013)(citation omitted).
The administrator's decision must be supported by substantial
evidence. See Ellis, 394 F.3d at 274. The Fifth Circuit instructs
that

"[i]f

the

plan

fiduciary's

decision

is

supported

by

substantial evidence and is not arbitrary or capricious, it must
prevail."

Corry v. Liberty Life Assurance Co. of Boston, 499 F.3d

389, 397-98 (5th Cir. 2007)(quoting Ellis, 394 F.3d at 273)).
"Substantial evidence is more than a mere scintilla, less than a
preponderance, and is such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion."

Id. at 398.

Ultimately, the Court's review of the administrator's decision
"need not be particularly complex or technical; it need only assure
that the administrator's decision fall somewhere on a continuum of
reasonableness–even if on the low end." Id. (quoting Vega v. Nat'l
Life Ins. Serv., Inc., 188 F.3d 287, 297 (5th Cir. 1999)(en banc)).
If the plan administrator has a conflict of interest (such as

12

where the ERISA plan administrator is also a payer of benefits),
the Court "weigh[s] the conflict of interest as a factor in
determining whether there is an abuse of discretion in the benefits
denial."

See Holland, 576 F.3d at 247, 248 n.3 ("meaning [the

Court must] take account of several different considerations of
which

conflict

of

interest

is

one";

eschewing

sliding

scale

approach that altered applicable standard of review in favor of
factor-based methodology)(citing, among others, Metro. Life Ins.
Co. v. Glenn, 554 U.S. 105, 112-13 (2008)).10

However, if there is

no evidence (other than the administrator's dual role and, thus,
structural conflict of interest) that the administrator's conflict
affected its benefits decision or that it has a history of abuses
of

discretion,

diminished.

the

relative

significance

of

the

conflict

is

See Glenn, 554 U.S. at 115-119.11

10

Notably, “a systemic conflict of interest does not
strip a plan administrator of deference.” Conkright v. Frommert,
559 U.S. 506, 513 (2010).
11

The Supreme Court offers this guidance:

The conflict of interest . . . should prove
more important (perhaps of great importance)
where
circumstances
suggest
a
higher
likelihood that it affected the benefits
decision, including, but
not limited to,
cases where an insurance company administrator
has a history of biased claims administration.
It should prove less important (perhaps to the
vanishing point) where the administrator has
taken active steps to reduce potential bias
and to promote accuracy, for example, by
walling off claims administrators from those
interested in firm finances, or by imposing
13

B.
At issue in the cross-motions for summary judgment is whether
or not Prudential's decision to deny the plaintiff's claim for
basic

and

reasonable.

optional

dependent

life

insurance

benefits

was

Seeking judgment as a matter of law, the plaintiff

challenges Prudential's adverse benefits determination based on the
"active duty" exclusion; she submits the decision was unreasonable
because her husband was off-duty and located off-base at the time
of his death.12

The defendants counter that judgment as a matter

of law in their favor is warranted because the administrative
record

leaves

no

question

that

Prudential's

reasonable

investigation demonstrated that Mr. Singletary was on "active duty"
in the armed forces of the United States at the time of his death,
which triggered the policy exclusion, and fully supports the denial

management checks that penalize
decisionmaking irrespective of
inaccuracy benefits.

inaccurate
whom the

Id. at 117.
12

The plaintiff does not meaningfully dispute whether or
not her husband was on active duty at the time of his death. On
the one hand, the plaintiff admits in her briefing that her husband
was a member of the United States Army at the time of his death and
that "[t]he group life insurance policy excludes coverage for
dependent life insurance benefits based solely on an individual's
status as an 'active duty' member of the armed forces without
regard to any connection between the insured's death and war[.]"
On the other hand, the plaintiff argues that her husband being
stationed stateside coupled with the fact that he was not on duty
(but, rather, riding his motorcycle on a weekend off of the base)
should not trigger the "active duty" exclusion.
14

of benefits.

The Court agrees.

As a threshold matter, the Court finds that the abuse of
discretion standard of review applies given that the Plan grants
Prudential the discretion "to determine benefits that are insured
by the insurance carrier."13

The plaintiff presses for application

of de novo review, but she fails to acknowledge that the Summary
Plan Description, which is incorporated into the Plan by reference,
specifically

grants

discretion

to

Prudential

"to

determine

benefits."14
Applying the abuse of discretion standard, the Court looks to
whether

"the

administrator's

decision

falls

somewhere

continuum of reasonableness – even if on the low end."

on

a

Corry, 499

F.3d at 398; Gothard v. Met. Life Ins. Co., 491 F.3d 246, 249-50 (5
Cir. 2007)("[The administrator's] decision may not be correct, but
we cannot say that it was arbitrary."). The Court finds that
Prudential's decision to deny the plaintiff's claim for basic and

13

Additionally, the Certificate of Coverage describing
the Plan's life insurance benefits makes clear that Prudential
decides if a participant receives benefits under the Plan: "You
must give evidence of insurability for a Qualified Dependent
spouse. . . . This requirement will be met when Prudential decides
the evidence is satisfactory."
14

Insofar as the plaintiff is suggesting that nowhere in
the policy is Prudential granted authority, explicitly, to
"construe the terms of the group policy," that appears to be
conceded by Prudential.
Nevertheless, Prudential submits that
necessarily included in its grant of sole discretion to "determine
benefits that are insured" is the task of construing policy terms
to make such determinations. Absent some contrary authority -none is offered up by the plaintiff -- the Court agrees.
15

optional dependent life insurance benefits under the Plan was
reasonable -- there is a rational connection between the known
facts (Mr. Singletary's status as an active duty member of the U.S.
Army) and the decision (determination that Mr. Singletary was not
a qualified beneficiary and, thus, denial of Mrs. Singletary's
claim for life insurance benefits).
According to the administrative record, Prudential reviewed
the plaintiff's claim file and conducted an investigation, which
revealed that Mr. Singletary was on active duty in the armed forces
at the time of his death.

In particular, a "Report of Casualty"

from the Department of the Army indicated that Mr. Singletary was
on "active duty."

Because the report also indicated that Mr.

Singletary was "off duty", Prudential contacted the Army's Human
Resources

Department

and

was

told

by

Gerald

Hensen

that

Singletary was on active duty at the time of his duty.

Mr.

Hensen

explained that the "off duty" notation on the report was an
internal code for the Army's administration regarding where Mr.
Singletary was located at the time of his death.
Mr. Singletary's active duty status triggered this policy
exclusion:
FOR DEPENDENTS INSURANCE
You are eligible to become
Insurance while:

insured

for

Dependents

•
You are eligible for Employee Insurance; and
•
You have a Qualified Dependent.
Qualified Dependents:

16

These are the persons for whom you may obtain Dependents
Insurance:
•

Your spouse or Domestic Partner.

*********
Exceptions:
For Dependents Term Life Coverage:
(1) Your spouse or Domestic Partner is not your Qualified
Dependent while on active duty in the armed forces of any
country[.]
(emphasis added).

Applying the plain words of the exclusion,15

Prudential determined that Mr. Singletary was not a qualified
dependent because he was on "active duty" as a member of the United
States Army at the time of his death.

This decision is supported

by evidence in the administrative record and falls on a continuum
of reasonableness.

Prudential reasonably denied the plaintiff's

claim for benefits.16

15

That the Plan does not define "active duty" does not
render the term ambiguous.
16

That Prudential was responsible for both determining
eligibility and paying benefits means that the Court must consider
this structural conflict as a factor in determining whether
Prudential abused its discretion in denying the plaintiff's claim.
This fact, without more, however, does not undermine this Court's
finding that Prudential did not abuse its discretion in making the
benefits determination. See Sanchez, 393 Fed.Appx. at 232 ("This
type of conflict . . . is a 'minimal' one.")(citing Corry, 499 F.3d
at 398). Indeed, "the specific facts of the conflict will dictate
its importance."
Holland, 576 F.3d at 248.
Notably, Mrs.
Singletary has not adduced any evidence, and very little argument,
regarding this or any other conflicts. (No party points the Court
to any evidence, for example, of a history of biased claims
administration or procedural unreasonableness on the part of
Prudential.)
Accordingly, absent evidence that suggests a
likelihood that the structural conflict affected the benefits
17

Notably, Mrs. Singletary does not dispute that her husband was
on "active duty" in the military at the time of his death; in fact,
she admits that he was a member of the United States Army,
stationed stateside.

But she presses that the exclusion is unfair

because it permits exclusion even where, as here, an active member
of the armed forces is killed while he is off-duty, rather than
killed while on-duty or performing duties incidental to his status
as a member of the Army.

The Court previously touched on the

plaintiff's appeal to fairness when it addressed (and upheld) the
defendants' challenges to the plausibility of her other claims.17

decision, this factor carries little weight in the abuse of
discretion analysis in light of the evidence supporting
Prudential's benefits determination.
17

Insofar as the plaintiff, again, argues that the
"active duty" group policy exclusion is unenforceable, the Court
refers Mrs. Singletary to the April 30, 2015 Order and Reasons.
The Court does not revisit the plaintiff's arguments invoking
Louisiana law. Finally, the plaintiff's argument that she did not
receive the certificate of coverage or group policy and, thus, did
not have notice of the military exclusion, rendering the exclusion
unenforceable, is unavailing. Review of the administrative record
shows that the plaintiff admitted in her appeal to Prudential that
she was provided with the Summary Plan Description, which included
the Enrollment Kit. These materials put the plaintiff on notice
that she should review the Certificate to understand all benefits
limitations and advised her how to obtain a copy. Per the Summary
Plan Description:
The benefits are described in this booklet for
your convenience; however, for complete
details you should also read: . . . The
Prudential
Insurance
Group
ContractCertificate,
available
by
contacting
Prudential at [telephone number]. If there is
any conflict between the . . . Certificate and
this description or the . . . Enrollment Kit,
18

There can be no dispute, however, that the Court is circumscribed
in its review of her ERISA claim; it is not for the Court to remark
on whether a policy exclusion is fair or unfair.
limited

to

resolving

whether

or

not

Prudential

The Court is
abused

its

discretion when it determined that Mr. Singletary was not Mrs.
Singletary's qualified dependent on account of his active military
status.

Because the administrative record supports Prudential's

determination, summary relief in favor of the defendants and
against the plaintiff is warranted.
Accordingly, the defendants' motions for summary judgment are
GRANTED and the plaintiff's motion for summary judgment is DENIED.
New Orleans, Louisiana, August 5, 2015

______________________________
MARTIN L. C. FELDMAN
UNITED STATES DISTRICT JUDGE

the . . . Certificate provisions apply.
Similarly, the Enrollment Kit advised that it was merely "a
summary" and "does not include all plan provisions, exclusions, and
limitations." Like the SPD, the Enrollment Kit advised that "[y]ou
may request a Booklet-Certificate [with complete plan information
including limitations and exclusions] by calling the UPS Benefits
Service Center." The plaintiff would have this Court fashion a
requirement that Prudential or the Plan automatically deliver the
Certificate or Group Policy to Mrs. Singletary, but she fails to
support her position in law.
19