Opinion
No. 17-CV-9523 (NSR)
08-09-2019
LOUIS DISTEFANO, JR., Plaintiff, v. SHEET METAL WORKERS NATIONAL PENSION FUND and THE BOARD OF TRUSTEES OF THE SHEET METAL WORKERS NATIONAL PENSION FUND, Defendants.
ORDER & OPINION
Plaintiff Louis DiStefano, Jr., by Complaint filed on December 5, 2017 and amended on December 20, 2017 ("Amended Complaint," ECF No. 6) initiated the instant action against Defendants Sheet Metal Workers National Pension Fund ("Fund" or "Pension Plan") and the Board of Trustees of the Sheet Metal Workers National Pension Fund ("Board"). Plaintiff alleges that Defendants violated the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1001 et seq. Presently before the Court are Plaintiff's motion for summary judgment and Defendants' cross motion for summary judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure. (ECF Nos. 36 & 50.) For the reasons that follow, Plaintiff's motion is DENIED, and Defendants' motion is GRANTED.
BACKGROUND
I. Factual background
The following facts derive from Parties' Rule 56.1 submissions and the record, and they are undisputed unless noted otherwise.
Plaintiff, at all relevant times, was a member of the Sheet Metal Workers' Local Union 28 ("Union"). (Pl.'s Statement Pursuant to Local Civil Rule 56.1 ("Pl.'s 56.1") ¶ 5, ECF No. 41.) Defendant Fund is a multiemployer pension plan under 29 U.S.C. § 1002(21)(A), and Defendant Board is a plan fiduciary and administers the Pension Plan. (Pl.'s Resp. to Defs.' Statement Local Civil Rule 56.1 ("Pl.'s 56.1 Resp.") ¶¶ 2 - 3, ECF No. 42.) The Pension Plan's Plan Document ("Plan Document") gives Defendant Board the power to interpret and apply the Plan Document and determine entitlement to pensions, and Defendant Board has delegated this authority to the Appeals Committee which has the same discretionary power as Defendant Board. (Id. ¶¶ 4 - 5.)
For approximately thirty-seven years and four months, Plaintiff worked for contributing employers and participants in the Pension Plan. (Pl.'s 56.1 ¶ 4.) From 2012 to 2016, Plaintiff also worked part time for various companies, some of which were not signatories to a Union collective bargaining agreement. (Id. ¶ 8); (Santi Decl. in Supp. of Defs.' Mot. for Summ. J. ("Santi Decl.") Ex. A ("Administrative R."), ECF No. 40), AR00072 - 73.) His work for these employers included car detailing and body and fender repair. (Id. ¶ 9); (Defs.' Local Rule 56.1 Statement of Material Facts ("Defs.' 56.1") ¶ 12, ECF No. 43.) Parties dispute whether this employment was work in the sheet metal industry for purposes of Plaintiff's eligibility for certain retirement benefits, including a 55/30 pension and early retirement benefits.
Around January 2017, Plaintiff applied to Defendants for pension benefits and, in connection to that application, authorized Defendants to obtain information from the Social Security Administration ("SSA"). (Defs.' 56.1 ¶¶ 7 - 8) (Administrative R. AR00086.) Defendants sent Plaintiff a letter on March 6, 2017 advising him that the SSA had reported that Plaintiff earned income from Air Logistics Services Corp. ("Air Logistic"), BTC Industries Inc. ("BTC"), and other companies, and Defendants requested more information about those positions. (Pl.'s 56.1 ¶ 13.) After Plaintiff responded to this request, Defendants asked him to complete an affidavit about his employment with BTC and Air Logistic. (Id. ¶ 14); (Administrative R. AR00072.) Plaintiff completed the affidavit and, when asked to describe the work he performed for Air Logistic, he stated that he performed body and fender repair but that he did "no welding, no metal repair, [and no] engine work." (Pl.'s 56.1 ¶ 15); (Administrative R. AR 00068.). In support of Plaintiff's affidavit, Plaintiff's former Air Logistic supervisor wrote to Defendants that Plaintiff's responsibilities included "repairing cars, trucks, and motorcycles" but that he "at no time did sheet metal work." (Pl.'s 56.1 ¶ 16); (Administrative R. AR00067.) Plaintiff received a letter and a document labeled "Pension Detail" around June 14, 2017, which contained an assessment of Plaintiff's pension but did not provide a final determination of Plaintiff's application for benefits. (Administrative R. AR00044 - 66.)
On or around June 30, 2017, Defendants sent Plaintiff their benefits determination by letter. (Administrative R. AR0009 - 11.) In that letter, they informed Plaintiff that he was ineligible for a 55/30 pension and that his early retirement was subject to delays under the Pension Plan because he had performed at least one hour of employment after September 1, 1988 in the sheet metal industry that was not covered by a collective bargaining agreement between the Union and the employer. (Pl.'s 56.1 ¶ 21); (Administrative R. AR00009 - 11.) Defendants found that his employment with Air Logistic was disqualifying because that company was not a signatory to the Union's collective bargaining agreement. (Pl.'s 56.1 ¶ 22.) The letter notified Plaintiff that he had a right to appeal, that he must submit any supporting documents, and that he would not have another opportunity to submit supporting documents after the Appeals Committee conducted its review. (Defs.' 56.1 ¶¶ 25 & 27); (Administrative R. AR00011.)
Plaintiff initiated his internal appeal on approximately August 3, 2017, and he requested copies of all documents and records relevant to his benefits claim. (Pl.'s 56.1 ¶ 23.) In the same letter, Plaintiff informed Defendants that he strongly disagreed with their benefits decision. (Pl.'s 56.1 ¶ 25); (Administrative R. AR00008.) Around August 14, 2017, Defendants provided Plaintiff with the requested information and informed him that his appeal would be heard at the Appeals Committee meeting scheduled for September 11, 2017. (Id. ¶ 24); (Def.'s 56.1 ¶¶ 31 - 32); (Administrative R. AR00012 - 13.) Plaintiff did not submit additional evidence in support of his appeal. (Pl.'s 56.1 Resp. ¶ 25.)
The Appeals Committee met on September 11, 2017 and denied Plaintiff's appeal because they agreed that his work for Air Logistic, an employer without a collective bargaining agreement with the Union, was in the sheet metal industry, and they sent a letter informing him of the denial on September 15, 2017. (Pl.'s 56.1 ¶¶ 30 - 32.) The Appeals Committee also agreed that Plaintiff's Air Logistic employment made him ineligible for a 55/30 pension and subjected his early retirement benefits to delays. (Defs.' 56.1 ¶ 40.)
II. Procedural background
Plaintiff asserts five causes of action in his Amended Complaint: (1) failure to provide benefits; (2) entitlement to a declaratory judgment concerning his rights to future benefits; (3) breach of ERISA fiduciary duties; (4) failure to provide a full and fair review; and (5) wrongful alienation of benefits. Parties stipulated to dismiss Plaintiff's third cause of action on August 28, 2018. (ECF No. 32.) On October 5, 2018, Plaintiff moved for summary judgment and argued that Defendants' decision was arbitrary and capricious because it was unreasonable, not supported by substantial evidence, not the result of a full and fair process, and influenced by a conflict of interest. Defendants filed a cross motion for summary judgment on October 5, 2018. According to Defendants, they are entitled to summary judgment because the Appeals Committee's decision was reasonable and amply supported by the record and they had afforded Plaintiff full and fair review. They assert that Plaintiff's remaining causes of action should fail because they "are merely repackaged claims for benefits and otherwise legally defective."
The docket entry was corrected on August 5, 2019 to reflect Defendants' motion.
LEGAL STANDARDS
I. Summary judgment
A "court shall grant summary judgment if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). The moving party bears the initial burden of pointing to evidence in the record, "including depositions, documents [and] . . . affidavits or declarations," id. at 56(c)(1)(A), "which it believes demonstrate[s] the absence of a genuine issue of material fact." Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The moving party may also support an assertion that there is no genuine dispute by "showing . . . that [the] adverse party cannot produce admissible evidence [in] support" of such a contention. Fed. R. Civ. P. 56(c)(1)(B). A fact is material if a dispute over that fact could impact the outcome of the lawsuit under the governing law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). If the moving party fulfills its preliminary burden, the onus shifts to the non-moving party to identify "specific facts showing that there is a genuine issue for trial." Id. (quotations and citations omitted).
If "the evidence is such that a reasonable jury could return a verdict for the nonmoving party," a motion for summary judgment should fail. Id. at 258. Courts must "constru[e] the evidence in the light most favorable to the non-moving party and draw[ ] all reasonable inferences in its favor." Fincher v. Depository Tr. & Clearing Corp., 604 F.3d 712, 720 (2d Cir. 2010) (quotations and citations omitted). The party asserting that a fact is genuinely disputed must support their assertion by "citing to particular parts of materials in the record" or "showing that the materials cited do not establish the absence . . . of a genuine dispute." Fed. R. Civ. P. 56(c)(1)(A)-(B). "Statements that are devoid of any specifics, but replete with conclusions, are insufficient to defeat a properly supported motion for summary judgment." Bickerstaff v. Vassar Coll., 196 F.3d 435, 452 (2d Cir. 1999).
The nonmoving party "may not rely on conclusory allegations or unsubstantiated speculation." FDIC v. Great Am. Ins. Co., 607 F.3d 288, 292 (2d Cir. 2010) (quotations and citations omitted). Similarly, "a party cannot create an issue of fact by submitting an affidavit in opposition to summary judgment that contradicts prior deposition testimony." Gorzynski v. JetBlue Airways Corp., 596 F.3d 93, 104 (2d Cir. 2010) (citing Perma Research & Dev. Co. v. Singer Co., 410 F.2d 572, 578 (2d Cir. 1969) (noting that such affidavits "greatly diminish the utility of summary judgment as a procedure for screening out sham issues of fact"). However, the mere fact that a non-movant's factual allegations in opposition are "self-serving" does not automatically render them insufficient to defeat summary judgment. Danzer v. Norden Sys., Inc., 151 F.3d 50, 57 (2d Cir. 1998). Instead, summary judgment should be granted when a party "fails to make a showing sufficient to establish the existence of an element essential to that party's case," where "that party will bear the burden of proof at trial." Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986).
In reviewing the record, "the judge's function is not himself to weigh the evidence and determine the truth of the matter," nor is it to determine a witness's credibility. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). Rather, "[t]he inquiry performed is the threshold inquiry of determining whether there is the need for a trial." Id. at 250. If the Court finds that one party to a case has "no real support for its version of the facts," a motion for summary judgment should be granted. Community of Roquefort v. William Faehndrich, Inc., 303 F.2d 494, 498 (2d Cir. 1962).
II. ERISA claim denial
Courts should review a denial of benefits that is challenged under ERISA de novo unless the benefit plan gives the plan fiduciary or administrator discretionary authority to determine eligibility for benefits or to interpret the terms of the plan. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989). If the latter, the court reviews the denial for an abuse of discretion to determine whether the decision was arbitrary and capricious. Alto v. Hartford Life Ins. Co., 485 F. App'x 482, 483 (2d Cir. 2012); McCauley v. First Umum Life Ins. Co., 551 F.3d 126, 130 (2d Cir. 2008); Solomon v. Metro. Life Ins. Co., 628 F. Supp. 2d 519, 527 (S.D.N.Y. 2009). The arbitrary and capricious standard is narrow and only allows courts to "overturn an administrator's decision to deny ERISA benefits [ ] if it was without reason, unsupported by substantial evidence or erroneous as a matter of law." Hobson v. Metro. Life Ins. Co., 574 F.3d 75, 83 (2d Cir. 2009). Substantial evidence is "such evidence that a reasonable mind might accept as adequate to support the conclusion reached" and it "requires more than a scintilla but less than a preponderance." Miller v. United Welfare Fund, 72 F.3d 1066, 1072 (2d Cir. 1995).
Generally, courts applying the arbitrary and capricious standard in ERISA cases should only consider evidence in the administrative record. Miller, 72 F.3d at 1071 ("We follow the majority of our sister circuits in concluding that a district court's review under the arbitrary and capricious standard is limited to the administrative record."). However, courts may in their discretion admit evidence outside of the administrative record for good cause. Krauss v. Oxford Health Plans, Inc., 517 F.3d 614, 631 (2d Cir. 2008).
DISCUSSION
There is no dispute that the Plan Document contains explicit language granting Defendant Board with the discretion to interpret the Pension Plan and determine eligibility for pension benefits, or that Defendant Board delegated this authority to the Appeals Committee. (Pl.'s 56.1 Resp. ¶¶ 2 - 5.) Therefore, the Court reviews the Appeals Committee's decision for abuse of discretion in determining whether summary judgment should be granted for Plaintiff or Defendant. It is also worth noting that there is no genuine dispute of material fact. Rather, Parties disagree about the result of applying the facts to the definition of work in the sheet metal industry in the Plan Document and Sheet Metal Workers' International Association's constitution.
Plaintiff did not address Defendants' motion for summary judgment arguments against his declaratory judgment and wrongful alienation of benefits claims (Defs.' Mem. in Supp. of Defs.' Mot. for Summ. J. pp. 17 - 18) and did not show that he was entitled to summary judgment on those claims in his motion. Therefore, the Court in its discretion deems those claims to be abandoned. See Moinari v. Bloomberg, 564 F.3d 587, 609 n.15 (2d Cir. 2009); Black Lives Matter v. Town of Clarkstown, 354 F. Supp. 3d 313, 328 (S.D.N.Y. 2018).
Any other factual disputes are not material or are easily resolved by reference to the evidence in the administrative record.
I. Defendants' decision was reasonable
The Appeals Committee's delay of Plaintiff's early retirement benefits and determination that he was not qualified for 55/30 benefits was reasonable.
In reaching its decision, the Appeals Committee reviewed and summarized the applicable rules which the Court summarizes again below. (Administrative R. AR00001 - 4.)
Under § 5.09(d)(1) of the Plan Document, a Pension Plan participant who performs at least one hour of employment on or after September 1, 1988 in the sheet metal industry that was not covered by a collective bargaining agreement between the Union and the employer is not eligible for a 55/30 pension. (Santi Decl. Ex. C.) Such employment could also delay a participant's early retirement benefits, as described in § 5.07(c)(1). For every quarter in which a Pension Plan participant had employment in the sheet metal industry on or after September 1, 1988 that was not covered by the collective bargaining agreement, their early retirement benefits is delayed by six months. (Id.)
The applicability of each of these provisions hinges on the definition of work in the sheet metal industry. The "sheet metal industry" is defined under § 1.35 as "any and all types of work covered by collective bargaining agreements to which the Union and/or any Local are a party; or under the trade jurisdiction as described in the [Sheet Metal Workers' International Association]'s constitution." (Id.) Under Article I, section 5(t), "trade jurisdiction" includes:
Any and all types of sheet metal work, coppersmith work and mechanical work in connection with or incidental to the manufacture, fabrication, assembling, maintenance and repair of automobiles, buses, trucks, airplanes, pontoons, dirigibles, blimps and other type of aircraft and equipment, and any and all types of aircraft hangars.(Administrative R. AR00004.)
Based on these rules and the evidence, discussed below, the Appeals Committee reached a reasonable conclusion. See Fiscina v. N.Y. City Dist. Council of Carpenters, 401 F. Supp. 2d 345, 353 (S.D.N.Y. 2005) (upholding a pension plan's determination because, in part, it was based on a reasonable application of the plan's rules); see also Gordon v. ILWU-PMA Benefit Funds, 616 F.2d 433, 440 (9th Cir. 1980) (reversing the lower court's decision and finding that the administrator's interpretation of its rules was reasonable). It determined that Plaintiff's work for Air Logistic from 2013 to 2016 qualified as work in the sheet metal industry. It also found that Air Logistic was not a signatory to a collective bargaining agreement with the Union. Therefore, based on a reasonable application of § 5.09, Plaintiff was ineligible for a 55/30 pension. Additionally, under a reasonable interpretation of § 5.07, Plaintiff's early retirement benefits were subject to a "30 month delay resulting from 5 quarters in non-signatory employment in the Sheet Metal Industry." (Administrative R. AR00001.)
II. Defendants' decision was supported by substantial evidence
Based on the evidence in the record, the Appeals Committee's decision was supported by substantial evidence. In reaching its initial decision, Defendants considered the SSA earnings report, Plaintiff's affidavit, and the letter from his Air Logistic employer. (Administrative R. AR00010.) Although Plaintiff was informed multiple times—including on June 30, 2017 and August 14, 2017—that he should submit any additional evidence to the Appeals Committee, he submitted no additional support. (Administrative R. AR00011 & 13); (Pl.'s 56.1 Resp. ¶ 27.) In fact, on August 25, 2017, Plaintiff informed Defendants that he would submit no additional evidence. (Administrative R. AR00001 n.1); (Pl.'s 56.1 Resp. ¶ 33.) Therefore, aside from Plaintiff's letter stating that he strongly disagreed with the initial decision, the Appeals Committee essentially only had the same evidence that Defendants relied upon in the original denial. (Administrative R. AR00001): the SSA earnings report, Plaintiff's affidavit relating to his Air Logistic employment, and a letter submitted by Brian Lewis about Plaintiff's work at Air Logistic.
The evidence before Defendants substantially supported the conclusion that he was not entitled to a 55/30 pension and that his early retirement benefits should be delayed. The SSA earnings report revealed that Plaintiff earned a total of $27,950 from work for Air Logistic from 2013 until 2016, and Plaintiff did not dispute that Air Logistic was not a signatory to a collective bargaining agreement with the Union. (Administrative R. AR00001, 79 - 84.) In his affidavit, Plaintiff stated that his work at Air Logistic included body and fender repair. (Administrative R. AR00068 - 70.) Mr. Lewis informed Defendants that Plaintiff "worked part time repairing cars, trucks and motorcycles," that "[h]e did mechanical work and some sanding work and painting," and that "[h]e at no time did sheet metal work." (Administrative R. AR00067.) These characterizations of Plaintiff's work for Air Logistic could reasonably be interpreted as work in the sheet metal industry within the definitions established in the Plan Document and the Sheet Metal Workers' International Association's constitution.
Although Mr. Lewis states that Plaintiff "at no time did sheet metal work," his preceding description of Plaintiff's work expressly states that Plaintiff performed "mechanical work" and repaired cars, work which falls squarely within the definition of work in the sheet metal industry as described in the Plan Document § 1.35 and the Sheet Metal Workers' International Association's constitution at Article I, section 5(t), discussed supra Part I.
Considering this undisputed evidence, a reasonable mind could accept this evidence as sufficient to support the conclusion of the Appeals Committee and conclude that Plaintiff's early retirement was subject to a delay and that he was not qualified for a 55/30 pension. See Testa v. Hartford Life Ins. Co., 483 F. App'x 595, 597 (2d Cir. 2012) (upholding the decision to terminate the plaintiff's disability benefits because three physician reports showed that there was insufficient evidence to support the required disability determination and because the plaintiff's only evidence was self-reported and "supported by little, if any, objectively verifiable evidence"); see also S.M. v. Oxford Health Plans, Inc., 94 F. Supp. 3d 481, 508 (S.D.N.Y. 2015) (finding that an administrator's decision was supported by substantial evidence when the plaintiff failed to provide the information necessary to determine whether the plaintiff was entitled to the benefit).
III. Defendants' decision was the result of a full and fair process
ERISA requires that an employee benefit plan provide a reasonable opportunity to a participant whose claim for benefits has been denied for a full and fair review by the fiduciary of the decision denying the claim. 29 U.S.C. § 1133(2). "The purpose of this full and fair review is to provide claimants with sufficient information to prepare for further administrative review or appeal to the federal courts." Palmiotti v. Metro. Life Ins. Co., 423 F. Supp. 2d 288, 300 (S.D.N.Y. 2006) (citing Juliano v. HMO of N.J., Inc., 221 F.3d 279, 287 (2d Cir. 2000)). The Department of Labor has established the standards for a full and fair review. A plan provider must:
Provide claimants at least 60 days following receipt of a notification of an adverse benefit determination within which to appeal the determination; provide claimants the opportunity to provide written comments, documents, records, and other information relating to the claim for benefits; provide that a claimant shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimants claim for benefits; . . . [and] provide for a review that takes into account all comments, documents, records, and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination.29 C.F.R. § 2560.503-1. According to Plaintiff, Defendants did not provide him with adequate notice of the reasons his benefits were denied in their June 14, 2017 letter, and they "unreasonably refused to consider documents and other substantial proof of Plaintiff's work after the June 14, 2017 letter. Both claims are contradicted by the administrative record.
Plaintiff did not receive notification that Defendants had made a determination on his application for benefits until June 30, 2017. (Administrative R. AR00009 - 11.) The June 14, 2017 letter was a cover for a document clearly labeled "Pension Detail" while the June 30, 2017 letter, excerpted below, is plainly the decision on Plaintiff's benefits application:
We have completed your application for benefits . . . . After a review of your work records, we find that your pension is subject to early retirement delays as provided in Plan Document Section 5.07 for the reasons described below . . . . [Y]ou are [also] ineligible for a 55/30 Pension in accordance with Plan Document Section 5.09(d)(1) . . . .The June 30, 2017 denial details each of the reasons for Defendants' decision. Defendants describe the SSA earnings report and inform Plaintiff that Air Logistic was not a signatory to a Union collective bargaining agreement. Then, they define the specific meaning of "sheet metal industry" under the Plan Document and explain that Mr. Lewis's description of Plaintiff's work was work in the sheet metal industry because "it is work under the trade jurisdiction of the Union as described in the [Sheet Metal Workers' International Association's] constitution under Article 1 Section 5 (t)." Next, citing to and quoting portions of the rules, Defendants state that because of Plaintiff's work in the sheet metal industry for Air Logistic, an employer not signed with the Union, he is ineligible for a 55/30 pension and his pension is subject to early retirement delays. In light of the June 30, 2019 letter, Plaintiff's claims that he was not provided with adequate notice of the reasons for Defendants' decision and that he was not notified that he was ineligible for 55/30 benefits until September 15, 2017 are baseless.
Plaintiff's argument that Defendants refused to consider documents and other substantial proof of Plaintiff's work after the June 14, 2017 letter is also without merit. Plaintiff cites to no evidence that Defendants did not consider documents or other proof relating to Plaintiff's work for Air Logistic after their June 14, 2017 letter. (Pl.'s Mem. of Law in Supp. of Pl.'s Mot. for Summ. Judgment ("Pl.'s Mot.") p. 11, ECF No. 38.) The undisputed facts and Administrative Record also contradict Plaintiff's argument. The June 30, 2017 letter shows that Defendants considered evidence relating to Plaintiff's work after June 14, 2017, and the September 11, 2017 Appeals Committee Memorandum indicates that the committee reviewed Plaintiff's letter that he "strongly disagree[d]" with the initial benefits determination. (Administrative R. AR00001.) Plaintiff submitted no other evidence, beyond that short letter, to support his appeal.
Contrary to Plaintiff's arguments, Defendants complied with the Department of Labor recommendations and afforded Plaintiff a full and fair review. Plaintiff was informed through the June 30, 2017 decision letter that he would have 180 days from his receipt of the letter to appeal to the Appeals Committee. He also had the opportunity to provide written comments, documents, and records to Defendants; he simply failed to take advantage of that opportunity. By letter on August 14, 2017, Defendants notified Plaintiff that they had received his request for an appeal and informed him that any additional information should be submitted by September 4, 2017. (Administrative R. AR00013.) Defendants also, per Plaintiff's request, provided him with copies of all documents relevant to his claim, free of charge. (Administrative R. AR00012.) In a call on August 25, 2017, Plaintiff stated that he would not supplement his appeal, and, consistent with this statement, he provided no supplemental evidentiary support. (Administrative R. AR00001 n.1); (Pl.'s 56.1 Resp. ¶ 33.)
It is not incumbent on administrators to force beneficiaries to take advantage of an appeals process. They can only inform beneficiaries of their rights and deadlines, produce requested information, and allow them the opportunity to support their application. Defendants did so and satisfied their obligation to provide Plaintiff with a full and fair process.
IV. Conflict of interest
If the entity with discretion has a conflict of interest, that conflict is merely a "factor in determining whether there is an abuse of discretion." Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989) (internal quotation marks and alteration omitted). "The arbitrary and capricious standard applies whether a conflict of interest is established or not." Alto v. Hartford Life Ins. Co., 485 F. App'x 482, 483 (2d Cir. 2012) (citing Metro. Life Ins. Co. v. Glenn, 554 U.S. 105, 116 (2008)).
Plaintiff argues that Defendants' decision was affected by a structural conflict of interest because Defendants both decide and pay claims for benefits. Plaintiff also states that Defendants' decision was affected by its endangered status at the time Plaintiff's claim was denied. There is no evidence of the endangered status in the administrative record, and the Court in its discretion determines that there is not good cause to admit evidence of the endangered status. See Krauss v. Oxford Health Plans, Inc., 517 F.3d 614, 631 (2d Cir. 2008). As discussed above, Defendants' decision was reasonable and based on substantial evidence; there is nothing in the administrative record to give the Court cause to think that Defendants acted arbitrarily or capriciously. See Gosselin v. Sheet Metal Workers' Nat'l Pension Fund, No. 16-CV-4391(ADS)(AKT), 2019 WL 1785530, at *17 (E.D.N.Y. Mar. 4, 2019) (holding that even if the court could consider the fund's endangerment status, which was outside of the administrative record, that status would be insufficient to support the plaintiff's claim that the fund's conflict impacted its decision making). Therefore, the only support for this argument is Defendants' structural conflict.
If the Court were to consider Defendants' endangered status, such status would be insufficient to show that Defendants' decision-making was influenced by the conflict. --------
Considering the other factors showing that Defendants' decision was not arbitrary or capricious, the structural conflict is insufficient to allow this Court to supplant its judgment for that of the Appeals Committee. A structural conflict alone is usually insufficient to show that a conflict of interest influenced a fund's decision to deny benefits. S.M. v. Oxford Health Plans, Inc., 94 F. Supp. 3d 481, 499 (S.D.N.Y. 2015) (citing cases). Additionally, such conflicts are considered only if they "actually affected an administrator's decision-making." Jarosz v. Am. Axle & Mfg., Inc., 372 F. Supp. 3d 163, 176 (W.D.N.Y. 2019) (citing Durakovic v. Bldg. Serv. 32 BJ Pension Fund, 609 F.3d 133, 140 (2d Cir. 2010)). Plaintiff has presented no admissible evidence from which the Court could reasonably conclude that the structural conflict of interest actually affected Defendants' decision. See Roganti v. Metro. Life Ins. Co., 786 F.3d 201, 218 (2d Cir. 2015) (noting that the plaintiff has the burden of showing that a conflict of interest in fact affected an administrator's decision).
The evidence Plaintiff offers to show that Defendants failed to apply their discretionary authority consistently is inadmissible and, even if it were admitted, does not demonstrate that Defendants' decision-making was actually affected by a conflict of interest. Any evidence offered to support this argument is not in the administrative record, and the Court determines that there is not good cause to consider this extrinsic evidence. Lynch v. Sheet Metal Workers' Nat'l Pension Fund, No. 08-CV-0542(HKS), 2010 WL 5333689, at *6 (W.D.N.Y. Dec. 20, 2010) ("[T]he plaintiff maintains that the Fund has not applied its discretionary authority in a uniform manner as illustrated by the continuation of a fellow retiree's pension despite working in a position substantially similar to his. This extrinsic evidence, however, was not part of the administrative record, and therefore will not be considered by this Court.").
Were the Court to consider the examples presented by Plaintiff, they do not satisfy Plaintiff's burden of establishing that Defendants' decision was affected by their conflict of interest or was otherwise arbitrary and capricious. The cases offered by Plaintiff were not sufficiently similar to Plaintiff's situation to show that the Appeals Committee treated him arbitrarily. SSN xxx-xx-1424 involved a plan participant with disabilities, not early retirement issues. Due to the participant's disabilities, he was unable to perform physical labor and was not present at the worksite for his non-Union employer. The Appeals Committee approved his appeal of the denial of his disability benefits. (Pl.'s Mem. of Law in Supp. of Pl.'s Mot. for Summ. J. ("Pl.'s Mot.") p. 6, ECF No. 38); (Decl of Weiss Ex. 6, ECF No. 37.) In SSN xxx-xx-6062, the Appeals Committee reviewed a letter from the participant in which "the participant discussed his job tasks, which were not sheet metal work," and approved his appeal. (Pl.'s Mot. pp. 6 - 7.) Here, in contrast, Defendants reviewed Plaintiff's description of his responsibilities for Air Logistic and determined that they included sheet metal work; such a determination is not at odds with a vague description of a determination made in a different case on different facts. The Appeals Committee's denial of the participant's appeal in SSN xxx-xx-3643 does not show any arbitrariness for similar reasons. (Id. at 7.)
CONCLUSION
For the forgoing reasons, Plaintiff's motion to for summary judgment is DENIED and Defendants' motion for summary judgment is GRANTED. The Clerk of the Court is respectfully directed to terminate the motions at ECF Nos. 36 and 50 and to enter judgment in favor of Defendants. Dated: August 9, 2019
White Plains, New York
SO ORDERED:
/s/_________
NELSON S. ROMÁN
United States District Judge