The court concluded “as a matter of law” that the document was not a summary plan description. According to the opinion, the document, entitled “NG Flexible Benefits Program Overview,” appeared to be a series of PowerPoint slides reflecting bullet point “highlights” of the benefits program. The court pointed out the document contained none of the information that the Employee Retirement Income Security Act (ERISA) and the implementing regulations required be contained in a summary plan description.
U.S. District Judge John W. Lungstrum wrote in the opinion that the document “is so lacking in any detail that it cannot be deemed a summary plan description.” According to the opinion, the document did not contain any information concerning the circumstances which may disqualify a participant from securing benefits and covered accidental death and dismemberment insurance in just one page with two bullet points concerning basic and optional coverage amounts.
“Because the November 2002 document is not a summary plan description, the maxim that the summary plan description governs when it conflicts with the plan is inapplicable here,” Lungstrum wrote.
The court also rejected the parents’ claim for civil penalties for failing to provide requested plan documents, including the actual summary plan description. Lungstrum said their claim fails because they never requested in writing a copy of the summary plan description. The letters written by the parents’ attorneys only requested the specific “actual policies of insurance in effect” at the time of Allie Louderback’s death as well as “actual signed contracts” dating back to the start of the decedent’s employment. “Nowhere does plaintiffs’ counsel specifically request a summary plan description or any other plan documents,” the opinion said.
Clara and George Louderback are the parents of Allie Louderback, a woman who died from an infection secondary to surgical treatment for a pre-existing health condition. Clara Louderback was also the named beneficiary in her daughter’s group accident insurance policy.
Allie Louderback was a participant of the Group Accident Plan for employees of PRC Division of Litton Industries, Inc. According to the court opinion, the policies that made up the plan specifically provided that benefits will not be paid for any loss caused by or resulting from “. . . (b) bacterial infections, except those which occur with a cut or wound at the time of the accident; (c) any kind of disease; (d) medical or surgical treatment (except surgical treatment required by the accident);â€¦”
After Gerber Life Insurance Company denied Clara Louderback’s claim for benefits, she and her husband filed suit under ERISA to recover accidental death benefits and to recover statutory penalties for violations of ERISA’s document disclosure requirements.
The opinion is here .