Chang v. Pfizer, Inc
OPINION & ORDER re: 25 MOTION to Dismiss (PARTIAL DISMISSAL), filed by Pfizer, Inc, 28 MOTION to Remand to State Court and for an Award of Attorneys Fees Incurred as a result of the Improper Removal, filed by Nashonie Ch ang. Plaintiff's Motion To Remand is denied, Plaintiff's request for attorney's fees is denied as moot, and Defendant's Partial Motion To Dismiss is granted. Plaintiff's claims, to the extent they seek benefits and/or damag es pursuant to the LTD plan, are dismissed. Plaintiff may file an Amended Complaint, addressing the deficiencies identified herein, within 30 days from the date of this Opinion. If Plaintiff declines to file an Amended Complaint, Defendant shall file an Answer to the Complaint within 60 days from the date of this Opinion. The Clerk of Court is respectfully directed to terminate the pending Motions. (Dkt. Nos. 25, 28.) SO ORDERED. (Signed by Judge Kenneth M. Karas on 3/9/17) (yv)
UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
No. 15-CV-8994 (KMK)
-vOPINION & ORDER
Christopher J. Carcich, Esq.
Michael Malatino, Esq.
Deutsch Atkins, P.C.
Counsel for Plaintiff
Jennifer B. Courtian, Esq.
Mina M. Wood, Esq.
Kevin G. Lauri, Esq.
Jackson Lewis P.C.
New York, NY
Counsel for Defendant
KENNETH M. KARAS, District Judge:
Plaintiff Nashonie Chang (“Plaintiff”) brings this Action against Pfizer Inc
(“Defendant”), asserting claims for breach of contract, breach of the duty of good faith and fair
dealing, willful misconduct, and equitable relief arising from Defendant’s determination that
Plaintiff did not qualify for short-term disability benefits. (See generally Am. Notice of Removal
Ex. A (“Complaint”) (Dkt. No. 8).)1 Defendant removed the case from state court on the ground
Defendant notes that the caption of the Complaint is incorrect. Defendant’s name is
“Pfizer Inc” not “Pfizer, Inc.”
that portions of Plaintiff’s claims are completely preempted by the Employee Retirement Income
Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. Defendant has filed a Partial Motion
To Dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6), seeking to dismiss the portion
of Plaintiff’s claims that are preempted by ERISA. (Dkt. No. 25.) Plaintiff has filed a Motion
To Remand the case back to state court and for attorney’s fees incurred as a result of the
allegedly improper removal. (Dkt. No. 28.) For the following reasons, Plaintiff’s Motion To
Remand is denied, Plaintiff’s request for attorney’s fees is denied as moot, and Defendant’s
Partial Motion to Dismiss is granted.
A. Factual Background
The following facts are drawn from Plaintiff’s Complaint and the documents appended
thereto, and are taken as true for the purpose of resolving the Motions.
Plaintiff began working for Defendant in February 2002 as a packaging employee in
Defendant’s Brooklyn, New York plant. (Compl. ¶ 3.) “Not long after” Plaintiff began working
for Defendant, she experienced “a severe sinus infection.” (Id. ¶ 4.) Plaintiff continued to work
at Defendant’s Brooklyn plant in various capacities until she was terminated in 2009. (Id. ¶¶ 5–
8.) Plaintiff was rehired by Defendant in April 2011 as a “Managing – Engineer.” (Id. ¶¶ 10–
11.) During her employment with Defendant, Plaintiff was a participant in various employee
benefits plans, including short-term disability (“STD”) and long-term disability (“LTD”) plans.
(Id. ¶ 12.)
Plaintiff continued to suffer from issues related to her sinuses after being rehired. (See id.
¶ 15.) On March 4, 2014, Plaintiff went to work “despite having breathing difficulties.” (Id.
¶ 16.) She was subsequently discovered in a hallway struggling to breathe and was “rushed to
medical and eventually sent home.” (Id.) Plaintiff was thereafter seen by “many” medical
professionals, (id. ¶ 18), who eventually diagnosed her with “hypersensitive airway disease
grouped with Bronchitis and Asthma,” (id. ¶ 20). After missing four days of work, Plaintiff
applied for and was granted STD benefits, which are payable for up to six months if an employee
is “seriously ill.” (Id. ¶¶ 19, 21, 52 (internal quotation marks omitted).)
Despite ongoing efforts to treat Plaintiff’s condition, Defendant terminated Plaintiff’s
STD benefits on May 12, 2014, (id. ¶ 28), because Plaintiff did not provide sufficient evidence to
establish she was receiving “active and effective treatment,” (id. ¶ 29 (internal quotation marks
omitted); see also id. Ex. D). Plaintiff appealed this determination, explaining that she was being
treated by eight different healthcare providers. (Id. ¶ 30; see also id. Ex. E.) Defendant denied
the appeal on the ground that Plaintiff provided “insufficient medical documentation of ongoing
medical treatment.” (Id. ¶ 32 (internal quotation marks omitted); see also id. Ex. F.) Plaintiff
alleges that the STD plan requires neither “active and effective treatment” nor “ongoing medical
treatment.” (Id. ¶ 33 (internal quotation marks omitted).)
After being informed that her appeal had been denied, Plaintiff immediately contacted
Dr. Nicole Schaffer (“Dr. Schaffer”), the doctor who approved the denial of Plaintiff’s STD
benefits. (Id. ¶ 34.) Plaintiff “pleaded” with Dr. Schaffer to reinstate Plaintiff’s STD benefits,
but Dr. Schaffer accused Plaintiff of “being off someplace” and explained that Defendant
revoked Plaintiff’s STD benefits because Plaintiff “was not getting better anytime soon.” (Id.
¶ 35 (internal quotation marks omitted).) Plaintiff then asked whether she should apply for LTD
benefits. (Id. ¶ 36.) Dr. Schaffer allegedly responded that Plaintiff was never going to get LTD
benefits because Plaintiff needed to receive STD benefits for six months to qualify. (Id.) The
LTD plan summary itself reflects that a disabled employee “may be eligible to begin receiving
LTD benefits after 180 consecutive days of disability.” (Decl. of Jennifer B. Courtian (“Courtian
Decl.”) Ex. 3, at 7 (“LTD Plan Summary”) (Dkt. No. 27).)2
Plaintiff then asked Defendant for clearance to return to work, or in the alternative, the
ability to work from home. (Compl. ¶ 37.) Both requests were denied, and Plaintiff was
terminated on July 11, 2014. (Id. ¶¶ 37–38.) Since that time, Plaintiff has lost her health
insurance and been rendered homeless. (Id. ¶¶ 40, 49.) She has been unable to have the surgery
necessary to treat her sinus condition. (Id. ¶ 47.)
Plaintiff alleges that Defendant breached its contractual obligation to provide Plaintiff
STD benefits. (Id. ¶ 48.) She contends that she was “seriously ill” within the meaning of the
STD plan during the relevant period of time and that Defendant imposed the “active and
effective treatment” and “ongoing medical treatment” requirements as a pretext to deny her
benefits. (Id. ¶¶ 53–54 (internal quotation marks omitted).) By impermissibly denying benefits,
Defendant prevented Plaintiff from obtaining LTD benefits. (Id. ¶ 57.) Plaintiff seeks
compensatory and punitive damages and an injunction requiring Defendant to retroactively
reinstate her benefits to the date of her termination, “including application for long-term
disability.” (Id. ¶ 71.)
B. Procedural Background
Plaintiff initiated this Action on October 23, 2015, by filing the Complaint in state court.
She asserted four causes of action: (1) breach of contract; (2) breach of the duty of good faith and
There appears to be agreement between the Parties that an employee cannot obtain LTD
benefits without first receiving STD benefits for 180 consecutive days. (See Pl.’s Mem. of Law
in Opp’n to Def.’s Mot. To Dismiss 8 (Dkt. No. 36).) The Parties have not provided the LTD
plan itself, but the LTD plan summary states: “To receive benefits from the Plan, you must
become disabled, as described in the previous section, while a participant in the Plan. If you are
disabled, you may be eligible to begin receiving LTD benefits after 180 consecutive days of
disability (this is called the ‘benefit waiting period’).” (LTD Plan Summary 7.)
fair dealing; (3) willful misconduct; and (4) equitable relief. On November 16, 2015, Defendant
removed the Action to federal court. (See Notice of Removal (Dkt. No. 1).) Pursuant to a
Scheduling Order, Defendant filed its Partial Motion To Dismiss and accompanying papers on
March 25, 2016. (Dkt. Nos. 25–27.) Plaintiff filed her Motion To Remand and accompanying
papers on March 29, 2016. (Dkt. Nos. 28–29.) Plaintiff filed her opposition to Defendant’s
Partial Motion To Dismiss on April 27, 2016, (Dkt. No. 36), and Defendant filed opposition
papers to Plaintiff’s Motion To Remand on the same date, (Dkt. No. 39).
A. Motion To Remand
Plaintiff argues that her state-law causes of action are not preempted by ERISA, and
therefore, the Court lacks federal subject matter jurisdiction to adjudicate her claims. She
contends that Defendant’s liability arises out of its interpretation of the STD plan, which is not
governed by ERISA. (Pl.’s Mem. of Law in Supp. of Mot. To Remand (“Pl.’s Remand Mem.”)
2 (Dkt. No. 29).) She admits, however, that the LTD plan “provides a benchmark for damages.”
(Id. at 8.) Defendant argues that Plaintiff’s state-law claims are completely preempted by ERISA
“to the extent they arise out of [Plaintiff’s] inability to obtain LTD benefits or seek damages
calculated pursuant to [Defendant]’s LTD [p]lan.” (Def.’s Mem. of Law in Opp’n to Pl.’s Mot.
To Remand (“Def.’s Remand Opp’n”) 1 (Dkt. No. 39).) Therefore, the Court must determine
whether Plaintiff’s claims, to the extent they relate to and seek damages under the LTD plan, are
completely preempted by ERISA and were properly removed to federal court.
“A party seeking removal bears the burden of showing that federal jurisdiction is proper.”
Montefiore Med. Ctr. v. Teamsters Local 272, 642 F.3d 321, 327 (2d Cir. 2011). “A civil claim
filed in state court can only be removed to federal court if the district court would have had
original jurisdiction to hear the claim.” Id. (citing 28 U.S.C. § 1441(a)). “District courts have
original jurisdiction over ‘federal question’ cases, or cases ‘arising under the Constitution, laws,
or treaties of the United States.’” Arditi v. Lighthouse Int’l, 676 F.3d 294, 298 (2d Cir. 2012)
(quoting 28 U.S.C. § 1331). “Ordinarily, determining whether a particular case arises under
federal law turns on the ‘well-pleaded complaint’ rule.” Aetna Health Inc. v. Davila, 542 U.S.
200, 207 (2004) (some internal quotation marks omitted). “Under the ‘well-pleaded complaint
rule,’ federal subject matter jurisdiction typically exists only ‘when the plaintiff’s well-pleaded
complaint raises issues of federal law,’ and not simply when federal preemption might be
invoked as a defense to liability.” Montefiore, 642 F.3d at 327 (quoting Metro. Life Ins. Co. v.
Taylor, 481 U.S. 58, 63 (1987)); see also Davila 542 U.S. at 207 (“[T]he existence of a federal
defense normally does not create statutory arising under jurisdiction, and a defendant may not
generally remove a case to federal court unless the plaintiff’s complaint establishes that the case
arises under federal law.” (alteration, citation, and internal quotation marks omitted)). “There is
an exception, however, to the well-pleaded complaint rule. When a federal statute wholly
displaces the state-law cause of action through complete pre-emption, the state claim can be
removed.” Davila, 542 U.S. at 207 (alteration and internal quotation marks omitted). This
exception exists because “[w]hen the federal statute completely pre-empts the state-law cause of
action, a claim which comes within the scope of that cause of action, even if pleaded in terms of
state law, is in reality based on federal law.” Beneficial Nat’l Bank v. Anderson, 539 U.S. 1, 8
2. General ERISA Preemption Principles
“Congress enacted ERISA to ‘protect . . . the interests of participants in employee benefit
plans and their beneficiaries’ by setting out substantive regulatory requirements for employee
benefit plans and to ‘provid[e] for appropriate remedies, sanctions, and ready access to the
Federal courts.’” Davila, 542 U.S. at 208 (quoting 29 U.S.C. § 1001(b)). “Section 502(a)(1)(B)
of ERISA provides participants or beneficiaries with a civil remedy to recover benefits due under
their plans, to enforce rights under their plans, or to clarify rights to future benefits under their
plans.” Arditi, 676 F.3d at 299 (citing 29 U.S.C. § 1132(a)).
“To establish a ‘uniform regulatory regime over employee benefit plans,’ and ‘to ensure
that employee benefit plan regulation is exclusively a federal concern,’ ERISA includes
expansive pre-emption provisions.” Id. (quoting Davila, 542 U.S. at 208). ERISA provides that
it “shall supersede any and all State laws insofar as they may now or hereafter relate to any
employee benefit plan.” ERISA § 514(a), 29 U.S.C. § 1144(a).
In Davila, the Supreme Court established a two-part test to determine whether a cause of
action is preempted by ERISA. A claim is completely preempted where: (1) “an individual, at
some point in time, could have brought [her] claim under ERISA § 502(a)(1)(B),” and (2) “no
other independent legal duty . . . is implicated by a defendant’s actions.” 542 U.S. at 210. The
Second Circuit has clarified that under the first prong of Davila, courts should consider: (1)
“whether the plaintiff is the type of party that can bring a claim pursuant to § 502(a)(1)(B),” and
(2) “whether the actual claim that the plaintiff asserts can be construed as a colorable claim for
benefits pursuant to § 502(a)(1)(B).” Montefiore, 642 F.3d at 328. The Davila test “is
conjunctive; a state-law cause of action is preempted only if both prongs of the test are satisfied.”
The analysis of whether a claim is preempted by ERISA starts with the “presumption that
Congress does not intend to supplant state law.” Stevenson v. Bank of N.Y., Co., 609 F.3d 56, 59
(2d Cir. 2010) (internal quotation marks omitted). “Courts are reluctant to find that Congress
intended to preempt state laws that do not affect the relationships among” “the core ERISA
entities: beneficiaries, participants, administrators, employers, trustees and other fiduciaries, and
the plan itself.” Gerosa v. Savasta & Co., 329 F.3d 317, 324 (2d Cir. 2003). On the other hand,
“state laws that would tend to control or supersede central ERISA functions—such as state laws
affecting the determination of eligibility for benefits, amounts of benefits, or means of securing
unpaid benefits—have typically been found to be preempted.” Id.
Plaintiff asserts four, state-law causes of action—(1) breach of contract; (2) breach of the
duty of good faith and fair dealing; (3) willful misconduct; and (4) equitable relief—stemming
from Defendant’s decision to terminate Plaintiff’s STD benefits.3 It is undisputed that the STD
plan is not governed by ERISA. As Plaintiff explains, the STD plan is a “Payroll practice,” not
an “‘employee welfare benefit plan.’” 29 C.F.R. § 2510.3-1(b)(2) (explaining that the
“[p]ayment of an employee’s normal compensation, out of the employer’s general assets, on
account of periods of time during which the employee is physically or mentally unable to
perform his or her duties, or is otherwise absent for medical reasons (such as pregnancy, a
physical examination[,] or psychiatric treatment),” is not governed by ERISA). It is also
undisputed, however, that the LTD plan is governed by ERISA. The Court’s task is thus to
determine whether Plaintiff’s request for damages calculated pursuant to the LTD plan and her
Plaintiff has consented to the dismissal of the equitable relief claim. (Pl.’s Mem. of
Law in Opp’n to Def.’s Mot. To Dismiss 18.)
request for the ability to apply for LTD benefits satisfies the Davila test for complete
a. Davila Prong One
The Court first considers whether Plaintiff could have brought some portion of her claims
under ERISA § 502(a)(1)(B). See Davila, 542 U.S. at 210. In making this determination, the
Court must first consider whether Plaintiff is “the type of party that can bring a claim” under
§ 502(a)(1)(B), and then “whether the actual claim[s]” asserted in this Action constitute
“colorable claim[s]” for benefits under § 502(a)(1)(B). Montefiore, 642 F.3d at 328.
i. Type of Party
As noted above, ERISA § 502(a)(1)(B) provides that a civil action may be brought “by a
participant or beneficiary . . . to recover benefits due to [her] under the terms of [her] plan, to
enforce [her] rights under the terms of the plan, or to clarify [her] rights to future benefits under
the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). Plaintiff alleges that she was a participant in
Defendant’s LTD plan, (Compl. ¶ 12), and is therefore “the type of party who can bring an
ERISA claim.” Arditi, 676 F.3d at 299 (finding that the plaintiff was the type of party who could
bring an ERISA claim because he was “a [p]lan participant and he [was] seeking benefits under
ii. Colorable Claim
The Parties disagree on whether any part of Plaintiff’s claims “can be construed as . . .
colorable claim[s] for benefits pursuant to § 502(a)(1)(B).” Id. (internal quotation marks
omitted). Plaintiff argues that she could not bring her claims under ERISA because she “never
qualified for [LTD] benefits” due to the fact that she did not receive STD benefits for 180
consecutive days. (Pl.’s Mem. of Law in Opp’n to Def.’s Mot. To Dismiss 8 (Dkt. No. 36).)
Defendant does not dispute that Plaintiff could not qualify for LTD benefits, but nonetheless
argues that Plaintiff’s claims “‘implicate coverage determinations under the relevant terms of [an
ERISA] [p]lan,’” and are therefore colorable claims for benefits pursuant to ERISA. (Def.’s
Mem. of Law in Supp. of Mot. To Dismiss 7 (Dkt. No. 26) (quoting Montefiore, 642 F.3d at
“[T]o be colorable under § 502(a)(1)(B) . . . the actual claims asserted must be claims for
benefits.” Neuroaxis Neurosurgical Assocs., PC v. Cigna Healthcare of N.Y., Inc., No. 11-CV8517, 2012 WL 4840807, at *3 (S.D.N.Y. Oct. 4, 2012). Plaintiff’s claims can be construed as
colorable claims for benefits because Plaintiff is seeking damages calculated pursuant to the
terms of the LTD plan. Essentially, Plaintiff is seeking a determination that but for the
Defendant’s decision to terminate her STD benefits, she would have otherwise qualified for LTD
benefits. Plaintiff resists this conclusion by arguing that her state-law claims are not colorable
claims for ERISA benefits because she did not meet a necessary prerequisite to qualify for LTD
benefits—i.e., receiving STD benefits for 180 consecutive days—but this argument is too broad.
The question presented is not whether Plaintiff would ultimately have been successful if she
applied for LTD benefits. See McCulloch Orthopedic Surgical Servs., PLLC v. United
Healthcare Ins. Co. of N.Y., No. 14-CV-6989, 2015 WL 3604249, at *5 (S.D.N.Y. June 8, 2015)
(“[T]he mere fact that [the plaintiff]’s claims might not succeed under ERISA does not mean that
they are not preempted by ERISA. The claim need only be colorable.” (internal quotation marks
omitted)); Olchovy v. Michelin N. Am., Inc., No. 11-CV-1733, 2011 WL 4916891, at *4
(E.D.N.Y. Sept. 30, 2011) (“[A] dispute is a colorable claim for benefits under ERISA when its
resolution depends on an interpretation of the terms of an ERISA-governed employee benefit
plan.”), adopted by 2011 WL 4916564 (E.D.N.Y. Oct. 17, 2011). Plaintiff’s claims are colorable
under the LTD plan because a determination as to the amount of her damages under the plan
“depends on an interpretation of the terms of an ERISA-governed employee benefit plan.”
Olchovy, 2011 WL 4916891, at *4. While Plaintiff purports to request the value of the LTD
benefits merely as a “benchmark” for damages, to determine the amount of damages, if any, a
court would be required to interpret and apply the terms of the LTD plan. Plaintiff’s claims, to
the extent she seeks damages calculated based upon Defendant’s failure to provide LTD benefits,
are thus colorable claims for ERISA benefits.
It cannot be the case that a plaintiff can avoid ERISA preemption simply by declining to
apply for ERISA benefits, but then file suit requesting damages calculated pursuant to the terms
of an ERISA plan. Indeed, the Second Circuit has held that a plaintiff’s claims were preempted
even though the plaintiff did not qualify for benefits under the defendant’s ERISA plan. See
Arditi, 676 F.3d at 299 (finding the first prong of Davila satisfied because the plaintiff sought to
enforce specific provisions of an ERISA plan and his claims implicated coverage established by
the terms of that plan). As in Arditi, Plaintiff’s claims “implicate coverage and benefits
established by the terms of the ERISA benefit plan.” Id. (internal quotation marks omitted).
Accordingly, the first prong of Davila is satisfied.
b. Davila Prong Two
“Under Davila, a claim is completely preempted only if there is no other independent
legal duty that is implicated by the defendant’s actions.” Montefiore, 642 F.3d at 332 (alteration
and internal quotation marks omitted). Plaintiff argues that Defendant’s breach of the STD plan
represents the independent legal duty upon which this Action is based. (Pl.’s Remand Mem. 6.)
Plaintiff relies heavily on the Second Circuit’s decision in Stevenson in making this argument.
(Id. at 7–8.)
In Stevenson, the plaintiff was employed by defendant Bank of New York Company
(“BNY”), but decided to accept a temporary position with an affiliated company. Before
accepting the position, the plaintiff asked the defendants about the status of his pension benefits
during his time with the affiliated business. 609 F.3d at 60. The defendants agreed to “maintain
those benefits,” even though the plaintiff otherwise would have lost his benefits because he was
accepting a position with another employer. Id. (alteration and internal quotation marks
omitted). Based on these promises, the plaintiff accepted the other position. Id. The plaintiff
later filed suit in state court asserting, among other causes of action, a breach of contract claim
because the defendants allegedly failed to honor these promises. Id. at 58. The defendants
removed the case to federal court, claiming that the plaintiff’s state-law claims were preempted
by ERISA. Id. The Second Circuit held that removal was improper. It explained:
The complaint’s allegations and the writings identified by [the plaintiff], whatever
their contractual significance, do not support a finding of ERISA preemption. First,
the defendants’ asserted liability under the original complaint does not “derive”
from “the particular rights and obligations established by [any] benefit plan,”
Aetna Health Inc. v. Davila, 542 U.S. 200, 213 (2004), but rather from a separate
promise that references various benefit plans, none of which directly applies to [the
plaintiff] by its terms, as a means of establishing the value of that promise. Because
[the plaintiff]’s state law claims derive from this promise rather than from an
ERISA benefits plan, their resolution does not require a court to review the
propriety of an administrator’s or employer’s determination of benefits under such
a plan. The BNY benefits plans may provide a benchmark for determining claimed
damages, but such damages would be payable from BNY’s own assets, not from
the plans themselves. Further, [the plaintiff]’s state law claims do not allege that
any plan administrator or employer breached a fiduciary duty or plan provision
relating to the BNY plans. Thus, those claims do not affect the relationships among
the “core ERISA entities” with respect to those entities’ roles under ERISA.
Stevenson, 609 F.3d at 60–61 (citation omitted). In other words, it was the defendants’ promises
to maintain the plaintiff’s benefits that rendered ERISA preemption inapplicable. See Arditi, 676
F.3d at 300 (“In Stevenson, an agreement separate and independent from the pension plan
governed the plaintiff’s benefits because the plaintiff was no longer in the bank’s employ and
was no longer a participant in the bank’s plan.”).
Plaintiff’s reliance on Stevenson, however, is misplaced because there are key differences
between Stevenson and this Action. In Stevenson, the defendants promised to maintain the
plaintiff’s pension benefits. Here, Defendant has made no similar promises; it is under no
independent obligation to provide LTD benefits to Plaintiff unless she otherwise qualifies under
the terms of the plan documents. Cf. Arditi, 676 F.3d at 301 (holding that the plaintiff’s claims
were preempted by ERISA because the defendant “made no promises of benefits separate and
independent from the benefits under the [p]lan”). Moreover, unlike in Stevenson, Plaintiff was a
member of the LTD plan at the time Defendant allegedly breached the STD plan. In Stevenson,
the plaintiff had no recourse under the benefits plans because he was no longer a participant in
those plans. Plaintiff is not seeking benefits under plans that do not “directly appl[y]” to her,
Stevenson, 609 F.3d at 61; she is seeking damages pursuant to the ERISA plan in which she was
Plaintiff notes also that courts in other circuits have held that state-law claims are not
preempted where adjudication of the claims requires only a “cursory examination” of plan
documents, Trs. of AFTRA Health Fund v. Biondi, 303 F.3d 765, 780 (7th Cir. 2002), or the
references to plan benefits serve “only [as] a way to articulate specific, ascertainable damages,”
Marks v. Newcourt Credit Grp., Inc., 342 F.3d 444, 453 (6th Cir. 2003) (internal quotation marks
omitted). Particularly relevant here is LeBlanc v. SunTrust Bank, No. 15-CV-630, 2015 WL
5038032 (M.D. Tenn. Aug. 25, 2015), where, under circumstances similar to those presented in
this Action, the court held that state-law claims relating to a short-term disability plan were not
preempted because the short-term plan was not governed by ERISA. In LeBlanc, the defendants
argued that the plaintiff’s claims were preempted because in reality the plaintiff sought benefits
under a long-term disability plan, which was governed by ERISA. Id. at *2. Citing Marks, the
court concluded that the asserted claims related only to the short-term plan. Id. at *3–4.
The Court respectfully disagrees with the LeBlanc court’s analysis and finds the courts’
statements in Biondi and Marks inapplicable to the facts of this case. Plaintiff’s reference to the
LTD plan, does not serve merely as a benchmark for determining the value of her damages. As
in Arditi, the ERISA plan “[is] the basis for the claimed benefits.” 676 F.3d at 300. Defendant’s
alleged breach of the STD plan tells the Court little about Defendant’s obligation to pay Plaintiff
LTD benefits. Indeed, the STD plan explains that the “LTD [plan] is administered independently
from [the] STD [plan], and is subject to different requirements.” (Courtian Decl. Ex. 2, at 13.)
If, as Plaintiff alleges, Defendant did breach the STD plan, she would be entitled to damages for
that breach. She contends those damages include the value of the LTD benefits she lost. But
Defendant’s breach of the STD plan does not necessarily mean that Plaintiff would have
otherwise qualified to receive LTD benefits. Both Parties acknowledge that the LTD plan is
governed by a separate set of requirements, one of which is being “disabled” for 180 consecutive
days. (LTD Plan Summary 7.) A court would independently have to read, analyze, and apply
the terms of the LTD plan to determine whether Plaintiff was “disabled”—a determination
ordinarily left to the plan’s Claims Administrator, (id. at 6)—before it could determine if
Plaintiff can receive damages calculated under the plan. This analysis would “affect the
relationships among” “the core ERISA entities,” Gerosa, 329 F.3d at 324, because
“[Defendant]’s obligations under the [LTD] [p]lan are inextricably intertwined with the
interpretation of [p]lan coverage and benefits,” Arditi, 676 F.3d at 299 (internal quotation marks
omitted). Congress’s goal of creating a “uniform regulatory regime over employee benefit
plans” would be frustrated if this analysis were not conducted in federal court. Id. (internal
quotation marks omitted).
Finally, while not directly applicable here, the Second Circuit also has drawn a
distinction between claims involving the “right to payment” and claims involving the “amount of
payment.” See Montefiore, 642 F.3d at 331. “The former are said to constitute claims for
benefits that can be brought pursuant to § 502(a)(1)(B), while the latter are typically construed as
independent contractual obligations . . . .” Id. Plaintiff’s claims are akin to claims involving the
right to payment because Plaintiff must first establish her entitlement to LTD benefits before a
court can calculate damages under the LTD plan.
As there is no independent legal duty for Defendant to provide LTD benefits to Plaintiff,
Plaintiff’s claims are completely preempted to the extent she seeks damages calculated in
accordance with the terms of the LTD plan.4 Accordingly, Plaintiff Motion To Remand is
denied; Defendant had a valid basis upon which to remove this Action.5
B. Motion To Dismiss
Defendant seeks to dismiss Plaintiff’s claims to the extent that they are completely
preempted. Defendant’s Partial Motion To Dismiss is granted because even if the preempted
portions of Plaintiff’s claims were re-styled as § 502(a)(1)(B) claims, they would fail.
“The Second Circuit has held that a claim for benefits pursuant to ERISA § 502(a)(1)(B)
may only be asserted against the plan itself, the plan administrator, and the plan trustees.” Star
Because the Court has determined that portions of Plaintiff’s state-law claims are
completely preempted, the Court declines to address Defendant’s argument that the claims are
also expressly preempted.
Plaintiff’s request for attorney’s fees resulting from the allegedly improper removal is
denied as moot.
Multi Care Servs., Inc. v. Empire Blue Cross Blue Shield, 6 F. Supp. 3d 275 , 292 (E.D.N.Y.
20 14); see also Crocco v. Xerox Corp., 137 F.3d I 05, I 07 (2d Cir. 1998) ("[O]nly the plan and
the administrators and trustees ofthe plan in their capacity as such may be held liable." (internal
quotation marks omitted)). Defendant is not the plan, the plan administrator, or a plan trustee.
Accordingly, Plaintiffs claims-to the extent they are construed to be asserted under ERISA
§ 502(a)( I )(B)-are dismissed.
For the foregoing reasons, Plaintiffs Motion To Remand is denied, Plaintiffs request for
attorney' s fees is denied as moot, and Defendant's Partial Motion To Dismiss is granted.
Plaintiffs claims, to the extent they seek benefits and/or damages pursuant to the LTD plan, are
dismissed. Plaintiff may file an Amended Complaint, addressing the deficiencies identified
herein, within 30 days from the date of this Opinion. If Plaintiff declines to file an Amended
Complaint, Defendant shall file an Answer to the Complaint within 60 days from the date of this
Opinion. The Clerk of Court is respectfully directed to terminate the pending Motions. (Dkt.
Nos. 25, 28.)
March q , 2017
White rfalns, New York
NNETH M. K~RA
ITED STATES DISTRICT JUDGE
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