Megan Moore v. Apple Central, LLC
Opinion
This is an interlocutory appeal under
I.
Apple Central acquired the Applebee's Neighborhood Grill & Bar in Rogers, Arkansas, and offered its employees a benefits package that included life insurance provided by The Guardian Life Insurance Company of America ("Guardian"). The Amended Complaint alleges that employee James Moore "submitted an enrollment form for voluntary life insurance to Apple as part of its employee benefits plan." The form, attached as Exhibit A to Moore's state court complaint, reflected that James Moore would have "basic life coverage" equal to 150% of his $62,000 annual salary, and chose "voluntary term life coverage" equal to five times his salary ($310,000). Moore was designated his primary beneficiary. The Amended Complaint alleges that Apple Central then withheld premiums for the voluntary coverage from James Moore's salary until he died on March 12, 2013, but "failed to pay over those premiums" and forward Moore's application to Guardian. After James Moore's death, Moore filed a proof of claim for life insurance benefits with Guardian. The Amended Complaint alleges that Moore's "claim for the elected voluntary life benefits was denied and it was indicated to Megan Moore that premiums had not been received from Apple." Accordingly, the Amended Complaint alleges, Moore "is left without appropriate insurance overage in the amount of $160,000.00, representing the difference between the elected coverage and the guaranteed benefit voluntarily paid by Guardian."
Moore's Amended Complaint asserts state law claims for breach of contract, negligence, breach of fiduciary duty, and promissory estoppel and seeks actual and punitive damages for Apple Central's "failure to procure" $160,000 of voluntary life insurance coverage under the Guardian policy. Apple Central filed a motion to dismiss, arguing ERISA preempted all of Moore's claims. The district court agreed:
*576
Moore's claims "are premised on the existence of an ERISA plan in which [Apple Central] failed to enroll her husband." The plan did not designate a plan administrator so Apple Central, the plan sponsor, was the plan administrator and an ERISA entity.
See
Moore filed a Second Amended Complaint alleging claims under ERISA and then obtained certification from the district court and from this court for her § 1292(b) interlocutory appeal of the district court's preemption ruling. The pending Second Amended Complaint, which is not at issue on appeal, asserts claims against Apple Central and Guardian under
II.
"ERISA is a comprehensive legislative scheme that includes an integrated system of procedures for enforcement that are essential to accomplish Congress' purpose of creating a comprehensive statute for the regulation of employee benefit plans."
Dakotas & W. Minn. Elec. Indus. Health & Welfare Fund v. First Agency, Inc.
,
Section 502(a) of ERISA,
["]The policy choices reflected in the inclusion of certain remedies and the exclusion of others under the federal scheme would be completely undermined if ERISA-plan participants and beneficiaries were free to obtain remedies under state law that Congress rejected in ERISA....["] Therefore, any state-law cause of action that duplicates, supplements, or supplants the ERISA civil enforcement remedy conflicts with the clear congressional intent to make the ERISA remedy exclusive and is therefore pre-empted.
Davila
,
*577 The Amended Complaint alleges that Moore's claims are not preempted by ERISA because "no employer-sponsored insurance policy was ever in place from which to claim the benefits sought." The pleadings establish that this is simply not true. The Amended Complaint alleges that Apple Central's failure to enroll James Moore in voluntary term life insurance coverage, while representing that it had done so by withholding premiums, caused Moore to lose voluntary term insurance benefits in the amount of $160,000. Recall that James Moore's enrollment form attached to the complaint showed that he applied for $93,000 in basic, employer-paid coverage and $310,000 in voluntary, employee-paid additional coverage-all offered within the same ERISA plan. Moore alleges that $160,000 "represent[s] the difference between the elected coverage and the guaranteed benefit voluntarily paid by Guardian." Thus, from the face of the Amended Complaint, it is apparent that Moore was paid plan benefits, a fact the record now confirms. In opposing this interlocutory appeal, Apple Central submitted to the district court an August 2013 letter from Guardian to Moore explaining that it had paid Moore $243,000 in life insurance benefits-$93,000 in basic benefits and $150,000 in voluntary term coverage. Guardian did not pay the additional $160,000 Moore claims in this lawsuit. 2
These undisputed facts establish that Moore's claims for additional plan benefits are within the purview of ERISA's exclusive remedies. As Guardian's payment of benefits confirms, James Moore was a "participant" in Apple Central's employee welfare benefit ERISA plan.
See
Moore argues her state law claims against Apple Central are not ERISA-preempted because, in
Davila
's terms, they implicate legal duties independent of Apple Central's ERISA duties.
*578
Prince v. Sears Holdings Corp.
,
Apple Central's role as ERISA administrator and fiduciary distinguishes this case from our decision in
Wilson v. Zoellner
,
Moore's state law claims against Apple Central are preempted by the exclusive ERISA remedies in
The Honorable P.K. Holmes, III, Chief Judge of the United States District Court for the Western District of Arkansas.
Though not before the district court when it dismissed Moore's state law claims, this document is part of the § 1292(b) record on appeal. Moreover, it may be considered under Rule 12(b)(6) because it contains facts related to an alleged breach of contract that are "necessarily embraced by the complaint."
Enervations, Inc. v. Minn. Mining & Mfg. Co.
,
Reference
- Full Case Name
- Megan MOORE, Plaintiff-Appellant v. APPLE CENTRAL, LLC, Defendant-Appellee.
- Cited By
- 4 cases
- Status
- Published