Geter v. St. Joseph Healthcare Systems, Inc.

• Decision Date: 28 August 2008
• Docket Number: No. Civ-07-1132 LCS/ACT.,Civ-07-1132 LCS/ACT.
• Citation: 575 F.Supp.2d 1244
• Parties: David GETER, Plaintiff, v. ST. JOSEPH HEALTHCARE SYTEMS, INC., a New Mexico Non-Profit Corporation, Catholic Health Initiatives, a Colorado Corporation, and St. Joseph Long-Term Disability Plan a.k.a. Catholic Health Initiatives Long-Term Disability Plan, Defendants.
• Court: U.S. District Court — District of New Mexico

575 F.Supp.2d 1244

David GETER, Plaintiff, v. ST. JOSEPH HEALTHCARE SYTEMS, INC., a New Mexico Non-Profit Corporation, Catholic Health Initiatives, a Colorado Corporation, and St. Joseph Long-Term Disability Plan a.k.a. Catholic Health Initiatives Long-Term Disability Plan, Defendants.

No. Civ-07-1132 LCS/ACT.

United States District Court, D. New Mexico.

August 28, 2008.

David Geter, pro se.

Lisa Mann, Modrall Sperling Roehl Harris & Sisk PA, Albuquerque, NM, for Defendants.

MEMORANDUM OPINION AND ORDER OF REMAND

LESLIE C. SMITH, United States Magistrate Judge.

THIS MATTER comes before the Court on Plaintiffs Motion to Remand, filed on July 29, 2008. (Doc. 34.) The Court, acting upon consent and designation pursuant to 28 U.S.C. § 636(c) (see Docs. 5, 13), and having reviewed the motions and considered the submissions of counsel, relevant authorities, and being otherwise fully advised, finds that the motion should be GRANTED.

I. FACTS

This action arises out of a dispute about Plaintiffs long-term disability plan. Plaintiff, Mr. David Geter, worked for St. Joseph Healthcare Systems, Inc. [SJH] for ten years "until he claimed total disability and discontinued working in 2001." (Doc. 23 at 2:1 (citing Doc. 14 at 1:3), Doc. 27 at 2:7.) SJH is a non-profit subsidiary of Catholic Health Initiatives [CHI]. (Doc. 1, Aff. of Nada Vanous at 1:2.) SJH offered its employees long-term disability benefits at no cost to the employees. (Doc. 1, Aff. of Nada Vanous at 1:5, Doc. 23, Ex. A at 3.) These benefits "were paid under a policy issued by Unum Life Insurance Company of America" ["Unum"]. (Doc. 1, Aff. of Nada Vanous at 1:5, Doc. 23, Ex. A at 1.)

In June, 2001, Plaintiff was diagnosed with Emery-Dreyfus Muscular Dystrophy. (Doc. 27 at 1:6.) "As a result of the diagnosis, Mr. Geter began working with St. Joseph [Healthcare's] Human Resources Department to apply for long[-]term disability benefits." (Doc. 14 at 2:7.) Upon applying for long-term disability benefits, Mr. Geter received "a booklet entitled `OTIONS,' dated July, 2001 (`Options booklet')." (Doc. 23 at 3:5 (citing Doc. 14), Doc. 32.) The Options booklet

describes in general terms all of the benefits available to St. Joseph Healthcare employees (including health insurance, dental insurance, vision care, life insurance, flexible spending accounts, health care spending accounts, holidays, bereavement leave, tax sheltered annuities, birthday meal cards, access to cosmetic surgery centers and health club memberships, on-line grocery shopping, group auto insurance, pet sitting and the like[)].

(Doc. 23 at 3:5-4 (citing Doc. 14).)

With respect to long-term disability, the Options booklet briefly describes the benefits available:

Long-term disability is provided by SJH at no expense to all employees in a budgeted .8-1.0 FTE status beginning the first of the month following date of hire.

You must be continuously disabled for six (6) months to receive a benefit. The benefit is equal to 60 percent of base salary to a maximum of $5,000 per month.

If you become disabled and file a claim, you must contact the Human Resources Department to obtain claim application forms. An attending physician's statement must be obtained and forwarded to the insurance company. The insurance company will investigate the claim and provide you with any additional assistance you need while on disability. To be sure that your benefits begin on time, you should complete the claim application forms and forward them to the insurance company 45 days prior to the time your benefits are scheduled to begin.

A long-term disability booklet is sent to employees when first enrolled. Additional booklets are available in the Human Resources Department. The booklet provides a comprehensive summary of the coverage and how the plan works.

(Doc. 32 at 15.) It is this abbreviated summary of benefits that Plaintiff relied on when making his long-term disability benefits claim. (See Doc. 14 at 3:8.) The Options booklet does not disclose that an employee's long-term benefits will be offset by certain types of income or disability earnings. (See Doc. 32.) The final paragraph in the foregoing summary, however, makes it clear that the Options booklet is not the source for "comprehensive" information about long-term disability benefits. (Id. at 15.) Moreover, a disclaimer on the inside cover of the booklet expressly states that:

The information in this handbook is intended as a brief review of the various plan benefits. For more information, see the policies and/or plan documents for the appropriate benefit. In all cases where the policy and/or plan document differ from the information contained in this handbook, the provisions of the policy and/or plan document will govern. Employees are encouraged to pick up and review additional documents before signing up for benefits.

(Id., second scanned page of exhibit.)¹

The Options booklet also refers to a separate "Summary Plan Description" in at least three different places. (Id. at 9, 10, 16.) On pages 9 and 10, the booklet notes that "A complete description of the benefits and limitations can be found in the summary plan description." (Id. at 9, 10.) In the Statement of Rights on page 16, beneficiaries are informed that' they are entitled to "Examine without charge at the Plan Administrator's office all Plan documents including insurance contracts and copies of all documents filed by the Plan such as Summary Plan Descriptions." (Id. at 16.) The booklet also directs employees several times to examine additional information in the "plan documents" or other named sources, or by contacting the Human Resources Department. (Id. at 14, 15, 28, 35-37, 40-42.) While the Options booklet provides written notice that comprehensive information regarding benefits was available elsewhere, it is unclear from the record whether Plaintiff ever received or requested copies of these documents, or whether he examined the Plan documents at the Plan Administrator's office. (Id. at 9, 10, 16, Doc. 27 at 2:8; see also Doc. 29, Ex. 1 at 49:3-25, 50:1-18, 55:22-25, 56:1-25.)

The more comprehensive long-term disability policy issued by Unum is entitled "CHI/St. Joseph Healthcare, Your Group Long Term Disability Plan (Policy No. 520686)" [The Plan]. (Doc. 23, Ex. A Front Cover.) The document is not specifically marked as the "Summary Plan Description." (See id., Ex. A.) The Plan clearly discloses to beneficiaries in at least six different provisions that any monthly longterm disability benefits provided would be reduced by deductible sources of income and disability earnings. (See id., Ex. A at 3, 10-13, 22, 24.) Accordingly, when Plaintiff started receiving benefits in February, 2002, the benefits were offset by the amount Plaintiff receives under Social Security. (Doc. 14 at 3:12.)

The parties agree that at the time Plaintiff claimed disability and began receiving benefits, the long-term disability plan was a "church plan" as defined in 29 U.S.C § 1002(33)(A).² Some time after 2002, Catholic Health Initiatives elected to have the long-term disability plan be governed by ERISA. (Doc. 1, Aff. of Nada Vanous at 2:8.) As such, on January 12, 2004 CHI filed the appropriate paperwork with the Department of Labor and paid the applicable taxes back through the year 1998. (Id.) Plaintiff filed this claim in state court on October 3, 2007. (Doc. 1, Ex. 1.) Defendants removed the suit to this court on November 8, 2007. (Doc. 1.)

II. ANALYSIS

A. Standard for Motion to Remand

The federal rules mandate that "[i]f at any time before final judgment it appears that the district court lacks subject matter jurisdiction, the case shall be remanded." 28 U.S.C. § 1447(c). "This rule is inflexible and without exception, requiring a court to deny jurisdiction in all cases where it does not affirmatively appear in the record." Wind v. Aegis Sec. Ins. Co., 2006 WL 3703882, at *2 (D.Colo. Dec.14, 2006) (citing Amundson & Assocs. Art Studio v. Nat'l Council on Compensation Ins., 977 F.Supp. 1116, 1120-21 (D.Kan.1997) (internal citation omitted)). "The party invoking the jurisdiction of a federal court has the duty to establish that federal jurisdiction does exist, but since the courts of the United States are courts of limited jurisdiction, there is a presumption against its existence." Id. (citing Basso v. Utah Power & Light Co., 495 F.2d 906, 909 (10th Cir.1974)). "Indeed, it is the burden of the party opposing remand `to show jurisdiction by a preponderance of the evidence.'" Id. (quoting Karnes v. Boeing Co., 335 F.3d 1189, 1194 (10th Cir. 2003); citing Nat'l Inspection & Repairs, Inc. v. George S. May Int'l Co., 202 F.Supp.2d 1238, 1241 (D.Kan.2002)). "Thus, any doubt concerning whether a case is removable must be resolved in favor of remand." Id. (citing Fajen v. Found. Reserve Ins. Co., Inc., 683 F.2d 331, 333 (10th Cir.1982)).

B. Jurisdiction

The jurisdictional issue before the Court is, with respect to a claim arising under a "church plan" exempt from enforcement under ERISA, whether the court determines subject matter jurisdiction at the time the claim arose or at the time the plaintiff filed suit. I hold that subject matter jurisdiction is determined at the time the claim arose, and this case will be remanded.

"ERISA is a `comprehensive statute designed to promote the interests of employees and their beneficiaries in employee benefit plans.'" Lown v. Cont'l Cas. Co., 238 F.3d 543, 547 (4th Cir.2001) (quoting Ingersoll-Rand Co. v. McClendon, 498 U.S. 133, 137, 111 S.Ct. 478, 112 L.Ed.2d 474 (1990) (internal quotation marks and citation omitted)). "ERISA applies to employee benefit plans established or maintained by any employer engaged in commerce." Id. (citing 29 U.S.C. § 1003(a)). There are several different types of employee benefit plans which are exempt from enforcement under ERISA, one of which is known as a "church plan." 29 U.S.C. § 1003. A church plan is defined as "a plan...