Danielle Mull, appointed Guardian Ad Litem for C. Mull; C. Mull, as Plaintiff and Danielle Mull is Appointed Guardian Ad Litem for C. Mull, Plaintiffs-Appellees,
Motion Picture Industry Health Plan, Defendant-Appellant, Lenai Mull; Norman Mull, Plaintiffs-Counter-Defendants-Appellees, Board of Directors of Motion Picture Industry Health Plan, Defendant-Counter-Claimant-Appellant.
and Submitted June 7, 2017 Pasadena, California
from the United States District Court No.
2:12-cv-06693-VBF-MAN for the Central District of California
Valerie Baker Fairbank, District Judge, Presiding
Kathryn Jane Halford (argued) and Elizabeth Rosenfeld,
Wohlner Kaplon Cutler Halford & Rosenfeld, Encino,
California, for Defendants-Appellants.
Mitchell de Camara (argued), Law Office of Donald M. de
Camara, Carlsbad, California; Drew M. Widders and Daniel E.
Wilcoxen, Wilcoxen Callahan LLP, Sacramento, California; for
Before: Susan P. Graber and Mary H. Murguia, Circuit Judges,
and Susan R. Bolton, [*] District Judge.
Retirement Income Security Act
panel vacated the district court's grant of summary
judgment in favor of the plaintiffs in an ERISA action.
district court enjoined an ERISA plan and its board of
directors from enforcing Summary Plan Description provisions
regarding reimbursement of benefits previously paid upon a
plan participant's receipt of a third-party recovery. The
district court ruled that these reimbursement/recoupment
provisions were not enforceable under ERISA because they were
found only in the Summary Plan Description and not in any
document that constituted the ERISA plan.
panel concluded that a Motion Picture Industry Plan Agreement
and Declaration of Trust, along with the Summary Plan
Description, together comprised the ERISA plan because only
the Summary Plan Description provided the basis on which
payments were made to and from the plan. The panel
distinguished CIGNA Corp. v. Amara, 563 U.S. 421
(2011), which held that summary documents do not constitute
the terms of an ERISA plan when there exist both a governing
plan document and a summary plan description. The panel
vacated the district court's grant of summary judgment
and remanded for further proceedings.
BOLTON, District Judge.
appeal arises from the order of the district court granting
summary judgment in favor of Plaintiffs Norman, Danielle,
Lenai, and C. Mull on claims under the Employee Retirement
Income Security Act of 1974 ("ERISA") against
Defendants Motion Picture Industry Health Plan (the
"Plan") and the Board of Directors of the Plan.
Plan is a self-funded multi-employer health and welfare
benefit plan established under a Motion Picture Industry Plan
Agreement and Declaration of Trust (the "Trust
Agreement"). The Board of Directors are named
fiduciaries and administrators of the Plan. The Board adopted
the Motion Picture Industry Health Plan Summary Plan
Description for Active Participants (the "SPD"),
which specifies eligibility requirements, conditions for the
receipt of benefits, the types of benefits, and the amount
and duration of benefits provided to participants and their
related provisions of the SPD are relevant to this appeal.
The SPD provides that no benefits will be payable in a
third-party liability claim unless the participant, or
applicable dependent, agrees to reimburse the Plan for any
benefits previously paid upon receipt of a third-party
recovery. The SPD further states that if reimbursement is
requested but not received by the Plan, the amount of ...