Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca9-12-56541/USCOURTS-ca9-12-56541-0/pdf.json

Nature of Suit Code: 110
Nature of Suit: Insurance
Cause of Action: 

---

FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

ANDRE LEGRAS,

Plaintiff-Appellant,

v.

AETNA LIFE INSURANCE COMPANY;

FEDERAL EXPRESS CORPORATION

LONG TERM DISABILITY PLAN,

Defendants-Appellees.

No. 12-56541

D.C. No.

2:12-cv-02128-

R-JCG

OPINION

Appeal from the United States District Court

for the Central District of California

Manuel L. Real, District Judge, Presiding

Argued and Submitted

March 7, 2014—Pasadena, California

Filed May 28, 2015

Before: Harry Pregerson, Richard A. Paez,

and N. Randy Smith, Circuit Judges.

Opinion by Judge Paez;

Dissent by Judge N.R. Smith

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 1 of 22
2 LEGRAS V. AETNA LIFE INS. CO.

SUMMARY*

ERISA

The panel reversed the district court’s dismissal of an

action challenging the denial of an application for continued

long-term disability benefits under the Employee Retirement

Income Security Act.

The panel held that the district court erred in dismissing

the action for failure to exhaust administrative remedies. The

plaintiff’s internal appeal from the denial of his benefits

application was denied as untimely under a 180-day appeal

period. The panel held that the plaintiffs’ notice of internal

appeal was timely because it was filed on the Monday after

the Saturday on which the 180-day period ended. The panel

adopted this method of counting time as part of ERISA’s

federal common law.

Dissenting, Judge N.R. Smith wrote that as a matter of

contract interpretation, the plaintiff’s administrative appeal

was untimely.

* This summary constitutes no part of the opinion of the court. It has

been prepared by court staff for the convenience of the reader.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 2 of 22
LEGRAS V. AETNA LIFE INS. CO. 3

COUNSEL

Peter S. Sessions (argued) and Glenn R. Kantor, Kantor &

Kantor LLP, Northridge, California, for Plaintiff-Appellant.

David P. Knox (argued), Federal Express Corporation,

Memphis, Tennessee, for Defendants-Appellees.

OPINION

PAEZ, Circuit Judge:

Andre LeGras appeals the district court’s judgment in

favor of Defendants Federal Express Corporation Long Term

Disability Plan and AETNA Life Insurance Company

(collectively, “AETNA”). In a letter denying LeGras’s

application for continued long-term disability benefits,

AETNA informed LeGras that he could file an internal appeal

of the decision within 180 days. The 180-day period ended

on a Saturday. Although LeGras mailed his appeal the

following Monday, AETNA denied it as untimely. The

district court dismissed LeGras’s action for failure to exhaust

administrative remedies. We reverse. We hold that because

the last day of the appeal period fell on a Saturday, neither

that day nor Sunday count in the computation of the 180 days. 

As LeGras mailed his notice of appeal on Monday, it was

timely. This method of counting time is widely recognized

and furthers the goals and purposes of the Employee

Retirement Income Security Act (“ERISA”), 29 U.S.C.

§ 1001 et seq. We therefore adopt it as part of ERISA’s

federal common law.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 3 of 22
4 LEGRAS V. AETNA LIFE INS. CO.

I.

In October 2008, LeGras seriously injured himself while

working as a ramp transport driver for Federal Express

Corporation (“FedEx”), a job he had held for twenty-three

years. LeGras suffered a serious back injury that caused

severe and sustained pain. Subsequent surgeries did not

correct the problem. As an employee of FedEx, LeGras was

a participant and beneficiary of FedEx’s Long Term

Disability Plan (“LTD Plan” or “Plan”). In May 2009, he

began receiving disability benefits under the Plan. 

Subsequently, AETNA, the Plan’s Claims Paying

Administrator, informed LeGras that his benefits would

terminate on May 24, 2011, unless he could establish that his

disability qualified as a “total disability” under the LTD Plan.

After LeGras attempted to make the required showing,

AETNA sent LeGras a letter explaining that the evidence he

submitted did not establish that he suffered from a total

disability. Of concern to AETNA was LeGras’s alleged

failure to prove that he could not “sit or use [his] upper

extremities for sedentary work.” LeGras received the letter

at 1:23 p.m. on April 18, 2011. The letter stated, “[i]f you

disagree with the above determination, in whole or in part,

you may file a request to appeal this decision within 180 days

of receipt of this notice.”

The parties agree that the 180-day appeal period expired

on October 15, 2011, a Saturday. LeGras mailed his appeal

the following Monday. On January 17, 2012, AETNA denied

LeGras’s appeal as untimely. LeGras filed an action in the

district court pursuant to 29 U.S.C. § 1132, the civil

enforcement provision of ERISA. After answering the

complaint, AETNA filed a motion for judgment on the

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 4 of 22
LEGRAS V. AETNA LIFE INS. CO. 5

pleadings under Federal Rule of Civil Procedure 12(c). 

AETNA argued that LeGras failed to exhaust his

administrative remedies because he mailed his appeal after

the 180-day period specified in the April 18, 2011 denial

letter lapsed. The district court granted the motion and

entered judgment in favor of AETNA.1

LeGras timely appealed.2

II.

We review de novo an order granting a motion for

judgment on the pleadings under Rule 12(c). Fleming v.

Pickard, 581 F.3d 922, 925 (9th Cir. 2009). We accept the

factual allegations in the complaint as true, and view them in

a light most favorable to the plaintiff. Hoeft v. Tucson

Unified Sch. Dist., 967 F.2d 1298, 1301 & n.2 (9th Cir. 1992).

The federal statute governing claims procedures under

ERISA requires that “in accordance with regulations of the

Secretary [of Labor], every employee benefit plan shall . . .

afford a reasonable opportunity to any participant whose

claim for benefits has been denied for a full and fair review

by the appropriate named fiduciary of the decision denying

1 ERISA itself does not require a participant or beneficiary to exhaust his

administrative remedies before bringing an action under ERISA’s civil

enforcement provision. Vaught v. Scottsdale Healthcare Corp. Health

Plan, 546 F.3d 620, 626 (9th Cir. 2008). Nonetheless, we have imposed

a prudential exhaustion requirement. Amato v. Bernard, 618 F.2d 559,

568 (9th Cir. 1980); Vaught, 546 F.3d at 626 n.2 (clarifying that the

exhaustion requirement in cases under ERISA’s civil enforcement

provision are prudential, not jurisdictional).

 

2

 We have jurisdiction pursuant to 28 U.S.C. § 1291.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 5 of 22
6 LEGRAS V. AETNA LIFE INS. CO.

the claim.” 29 U.S.C. § 1133(2). The regulation

implementing 29 U.S.C. § 1133 states that a “reasonable

opportunity for a full and fair review” is “at least 180 days

following receipt of a notification of an adverse benefit

determination within which to appeal . . . .” 29 C.F.R.

§ 2560.503-1(h)(3), (h)(3)(i), (h)(4). Neither the governing

statute, nor the implementing regulation, “specify a method

of computing time.”3 Cf. Fed. R. Civ. P. 6(a). This leaves a

number of unresolved ambiguities. For instance, did the 180

days begin on April 18, 2011, the day LeGras received the

notice, or on the following day? Does the final day end at

1:23 p.m., 5:00 p.m., or midnight? And, as is relevant here,

if the final day lands on a weekend or holiday, is the

participant permitted to file his appeal on the next business

day? The widespread understanding that a deadline falling on

a Saturday, Sunday, or holiday extends to the next business

day answers this question.

Congress, in enactingERISA, has “empowered the courts

to develop, in light of reason and experience, a body of

federal common law governing employee benefit plans.” 

Menhorn v. Firestone Tire & Rubber Co., 738 F.2d 1496,

1499. (9th Cir. 1984). This federal common law

“supplement[s]the explicit provisions and general policies set

out in ERISA . . . governed by the federal policies at issue.” 

Id. at 1500. One of ERISA’s declared policies is to “protect

the interest of [plan] participants” and to provide “adequate

safeguards . . . [that are] desirable in the interests of

employees.” 29 U.S.C. § 1001. Indeed, we have repeatedly

stated that ERISA is remedial legislation that should be

3 Similarly, the parties do not suggest that the LTD Plan contains an

explanation of how the appeal period is to be computed. We therefore

assume that it does not contain such a provision.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 6 of 22
LEGRAS V. AETNA LIFE INS. CO. 7

construed liberally to “protect[] participants in employee

benefits plans.” McElwaine v. US West, Inc., 176 F.3d 1167,

1172 (9th Cir. 1999); Batchelor v. Oak Hill Med. Grp.,

870 F.2d 1446, 1449 (9th Cir. 1989); Smith v. CMTA-IAM

Pension Trust, 746 F.2d 587, 589 (9th Cir. 1984).

We have developed ERISA federal common law

furthering these interests several times before. See, e.g.,

Security Life Ins. Co. of America v. Meyling, 146 F.3d 1184,

1191 (9th Cir. 1998) (recognizing under ERISA federal

common law that a recission remedy exists when an insured

makes material false representations about his health);

Schikore v. BankAmerica Supplemental Ret. Plan, 269 F.3d

956 (9th Cir. 2001) (invoking federal common law to

incorporate the mailbox rule into ERISA). For example, we

adopted the doctrine of reasonable expectations as a principle

to apply when interpreting ERISA-governed insurance

contracts. Saltarelli v. Bob Baker Grp. Med. Trust, 35 F.3d

382 (9th Cir. 1994). In so holding, we reasoned that

“protecting the reasonable expectations of insureds

appropriately serves the federal policies underlying ERISA.” 

Id. at 386. Further, express incorporation of the principle

elsewhere demonstrated “its widespread acceptance and

vitality.” Id. at 387.4

There is nothing novel about the principle we adopt here

that when a deadline falls on a weekend, it extends to the

4 The dissent argues that we have extended the holding of Saltarelli to

“read an insured’s ‘reasonable expectations’ into any term of an ERISA

plan without limits.” Dissent at 19. Contrary to the dissent’s argument,

we do nothing more than cite Saltarelli as an example of incorporating a

widely accepted principle—the reasonable expectations doctrine—as part

of ERISA’s federal common law.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 7 of 22
8 LEGRAS V. AETNA LIFE INS. CO.

following business day. The Supreme Court recognized this

general understanding in 1890. Street v. United States,

133 U.S. 299, 306 (1890) (“. . . a power that may be exercised

up to and including a given day of the month may generally,

when that day happens to be Sunday, be exercised on the

succeeding day”). Further, the Fifth Circuit has stated that

this “rubric has universal acceptance.” Armstrong v. Tisch,

835 F.2d 1139, 1140 (5th Cir. 1988). LeGras faces the

possibility of losing his long-term disability benefits because

of a two-day difference in the computation of the time period

to pursue an administrative appeal. Although the stricter

time-computation method may be convenient for AETNA’s

purposes, it would be contrary to the purposes of ERISA to

adopt a method that is decidedly protective of plan

administrators, not plan participants.

Further, that a deadline extends to the next business day

when it falls on a Saturday, Sunday, or holiday is widespread. 

For example, Federal Rule of Civil Procedure 6 (“Rule 6”)

states that this principle applies to “any local rule or court

order, or in any statute that does not specify a method of

computing time.”

5 Fed. R. Civ. P. 6(a).6 We have

 

5

 The relevant part of Rule 6(a)(1)(C) provides as follows:

When the period is stated in days or a longer unit of

time: . . . include the last day of the period, but if the

last day is a Saturday, Sunday, or legal holiday, the

period continues to run until the end of the next day that

is not a Saturday, Sunday, or legal holiday.

6

In addition to his federal common law argument, LeGras argued that

Rule 6(a) should apply directly. However, because LeGras presented two

alternative arguments that could warrantreversal, we need not address that

argument. Further, even though LeGras did not make a federal common

law argument in district court, he is permitted to make that argument on

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 8 of 22
LEGRAS V. AETNA LIFE INS. CO. 9

consistently applied Rule 6 when interpreting time periods in

various statutory contexts. See, e.g., Minasyan v. Mukasey,

553 F.3d 1224, 1227–28 (9th Cir. 2009) (addressing the

beginning of the one-year period of limitations for filing an

asylum application); Payan v. Aramark Mgmt. Servs. Ltd.

P’ship, 495 F.3d 1119, 1125–26 (9th Cir. 2007) (addressing

the timeliness of a Title VII action after receipt of a right-tosue letter from the Equal Employment Opportunity

Commission); Patterson v. Stewart, 251 F.3d 1243, 1246 (9th

Cir. 2001) (addressing the “appropriate ending” of the oneyear grace period under the Anti-terrorism and Effective

Death Penalty Act of 1996); Cooper v. City of Ashland,

871 F.2d 104, 105 (9th Cir. 1989) (per curiam) (holding that

because the last day of Oregon’s two-year statute of

limitations in a personal injury suit under 42 U.S.C. § 1983

ended on the Saturday preceding Columbus Day, the plaintiff

could file on the following Tuesday); Hart v. United States,

817 F.2d 78, 80 (9th Cir. 1987) (holding that where the last

day of the six-month limitations period under the Federal Tort

Claims Act ended on a Saturday, the plaintiff could file on the

following Monday). Additionally, many regulations

explicitly incorporate this method for computing time.7

appeal because he properly preserved his claim. See Lebron v. Nat’l R.R.

Passenger Corp., 513 U.S. 374, 379 (1995) (“Our traditional rule is that

once a federal claim is properly presented, a party can make any argument

in support of that claim; parties are not limited to the precise arguments

they made below.”) (internal quotation marks and brackets omitted).

7

See, e.g., 15 C.F.R. §§ 280.206(e) (expressly computing time such that,

if the last day is a Saturday, Sunday, or legal holiday, the period runs until

the end of the next day that is not a Saturday, Sunday, or legal holiday),

719.8(e) (same), 766.5(e) (same), 785.6(e) (same); 17 C.F.R. § 171.4(a)

(same); 22 C.F.R. § 103.8(c) (same); 30 C.F.R. § 700.15(b) (same); 38

C.F.R. § 42.27(a) (same); 29 C.F.R. § 2200.2(b) (applying the Federal

Rules of Civil Procedure, which includes Rule 6(a), where no specific

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 9 of 22
10 LEGRAS V. AETNA LIFE INS. CO.

Incorporating this time-computation method into

ERISA’s federal common law protects the interests of

insureds, thereby effectuating the policy goals of ERISA. 

Further, the concept is generally accepted and vital. See

Saltarelli, 35 F.3d at 387. Therefore, we hold that, where the

deadline for an internal administrative appeal under an

ERISA-governed insurance contract falls on a Saturday,

Sunday, or legal holiday, the period continues to run until the

next day that is not a Saturday, Sunday, or legal holiday.

AETNA attempts to skirt the issue byminimizing the role

that ERISA plays in our analysis of this case. It argues that

LeGras’s “appeal was pursuant to the . . . Plan—not ERISA

or any ERISA regulation.” In other words, AETNA contends

that we should not apply the above time-computation method

because the 180-day period for appeal is set by contract,

rather than by statute or regulation. What AETNA overlooks

is that the 180-day appeal period is part of ERISA’s

mandatory claims processing standards. As noted above,

under ERISA’s implementing regulations, the minimum

amount of time that must be afforded to a claimant to file an

administrative appeal is 180 days. 29 C.F.R. § 2560.503-

1(h)(3), (h)(3)(i), (h)(4). Although the 180-day appeal period

is imposed by the Plan, the Plan is ultimately governed by

ERISA. Any ambiguity in calculating the 180 days should be

resolved to further the purposes and goals of ERISA.

As support for its position that the LTD Plan is a private

contractual arrangement and therefore should not be subject

to the time-computation method we adopt, AETNA relies

provision exists); 40 C.F.R. § 304.12 (applying the time-computation

manner as described in Rule 6(a)); 45 C.F.R. § 1630.13(a) (same); 49

C.F.R. § 240.7 (applying the time-computation provisions of Rule 6).

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 10 of 22
LEGRAS V. AETNA LIFE INS. CO. 11

heavily upon a Fifth Circuit case, Jones v. Georgia Pacific

Corp., 90 F.3d 114 (5th Cir. 1996). In Jones, a decedent’s

heirs brought suit when the decedent’s former employer and

life insurance company refused to pay life insurance benefits. 

Id. at 115. The ERISA-covered group plan expired on the

decedent’s sixty-fifth birthday, id., but included an option

provision that allowed him to convert the employer-provided

policy to a non-ERISA individual policy within “the thirtyone day period immediately following the date of [] cessation

[of coverage],” id. n.1. If the employee died within thirty-one

days, then he would be covered under the group policy as if

he had purchased the new policy. Id. at 114. The decedent

died on the thirty-second day after his sixty-fifth birthday

without having applied for the individual life insurance

policy. Id. at 115. When the insurance company declined to

pay the death benefit, his heirs brought suit and argued that,

because the thirty-first day was a Sunday, the option period

should have continued to Monday, the next business day. Id.

The district court applied Rule 6(a)’s next-business-day

provision, and granted summary judgment to the heirs. Id. at

117. Reversing, the Fifth Circuit held that the provision did

not apply because the option to convert the group plan to an

individual plan was a private contractual agreement. Id. at

117–18.

Jones is distinguishable and does not support AETNA’s

argument. First, unlike this case, Jones did not interpret a

contractual provision that was required by ERISA. In fact,

the court emphasized that defendants, as offerors of a private

option contract, had “full control of . . . the length of time

during which the power of acceptance shall last.” Id. at 117. 

By contrast, AETNA set the appeal period at 180 days to

achieve the minimum possible compliance with a statutory

and regulatorymandate. In doing so, AETNA did not “full[y]

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 11 of 22
12 LEGRAS V. AETNA LIFE INS. CO.

control” the length of time by which an appeal could be filed. 

See id. Second, the Jones court’s reasoning hinged on its

determination that there was no ambiguity in the contractual

provision. Id. at 116. In particular, the court explained that

“[t]he qualifying phrase ‘immediately following’ can have no

other meaning than the 31 days in their normal and natural

sequence, without concern as to the days of the week . . . .”8

Id. In contrast, AETNA’s April 18, 2011 denial letter

contains no such qualifying clause or explanation of how

LeGras should calculate the 180-day appeal period.

Finally, AETNA warns that applying the timecomputation method advocated by LeGras to the calculation

of deadlines under ERISA’s claims procedures would create

confusion and great administrative burden. Specifically,

AETNA contends that it would “put claims processors for

ERISA-governed plans in the unenviable position of keeping

up with all state holidays for all [fifty] states . . . .” AETNA’s

argument is unpersuasive. The plan administrator is

responsible for identifying, and clarifying, applicable due

dates in compliance with ERISA.9 Although we recognize

8 The operative text in Jones provided that “[t]he acquirement period is

the thirty-one day period immediately following the date of such

cessation,” and that “[i]f a Participant . . . dies within the thirty-one day

period immediately following the date he ceased to be a covered

individual, the amount of insurance which he would have been entitled to

. . . will be paid . . . .” Jones, 90 F.3d at 115 n.1.

9

 ERISA’s regulations require that plan administrators establish claims

procedures that set forth the “applicable time limits” for challenging

denied claims. 29 C.F.R. § 2520.102-3(s). The administrator must do so

in a “sufficiently comprehensive” manner that is “calculated to be

understood by the average plan participant.” Id. § 2520.102-2(a). For

instance, the regulations instruct administrators to use “clarifying

examples and illustrations” where necessary. Id. Here, there is no

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 12 of 22
LEGRAS V. AETNA LIFE INS. CO. 13

the burden placed on administrators to “keep[] up” with state

holidays, this burden must be counter-balanced with the

clarity and consistency attained by applying the timecomputation method that we hold applies to calculating the

180-day period within which LeGras had to mail his notice of

appeal.

III.

Although the 180-day appeal period specified in the April

18, 2011 denial letter ended on Saturday, October 15, 2011,

ERISA federal common law required that AETNA accept

LeGras’s appeal as timely as he mailed it on the first weekday

following the weekend. It was error for AETNA and the

district court to conclude that LeGras’s administrative appeal

was untimely. We reverse and remand to the district court

with directions to remand to AETNA, the Plan’s Claims

Paying Administrator, for consideration of LeGras’s appeal.

REVERSED AND REMANDED.

indication that AETNA took any steps to clarify the time limit for appeal. 

Similarly, AETNA did not specify a date certain before which LeGras had

to mail his request for appeal. Nor did it provide an illustration or

example of how LeGras should calculate the 180-day period.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 13 of 22
14 LEGRAS V. AETNA LIFE INS. CO.

N.R. SMITH, Circuit Judge, dissenting:

Mr. LeGras had 180 days to appeal an adverse decision

from AETNA Life Insurance Company (“AETNA”), denying

him long-term disability benefits under a Long Term

Disability Plan (“Plan”) provided by his employer, Federal

Express (“FedEx”). He lost his opportunity to appeal as a

result of his own conduct; he sent his appeal to AETNA two

days after the appeal period expired. Even LeGras agrees that

he sent his appeal two days late. To excuse LeGras’s

untimeliness, the majority turns a simple case of contract

interpretation into an opportunity to (without precedent)

expand federal common law surrounding the Employee

Retirement Income SecurityAct (“ERISA”) to rewrite private

contracts. I cannot go along with them in “bailing LeGras

out.”

“An ERISA plan is a contract that we interpret in an

ordinary and popular sense as would a person of average

intelligence and experience. We look first to the explicit

language of the agreement to determine, if possible, the clear

intent of the parties . . . .” Harlick v. Blue Shield of Cal.,

686 F.3d 699, 708 (9th Cir. 2012) (internal quotation marks,

citations, and alterations omitted). In general, “[c]ontract

terms are to be given their ordinary meaning, and when the

terms of a contract are clear, the intent of the parties must be

ascertained from the contract itself.” Klamath Water Users

Protective Ass’n v. Patterson, 204 F.3d 1206, 1210 (9th Cir.

1999). “That the parties dispute a contract’s meaning does

not render the contract ambiguous; a contract is ambiguous if

reasonable people could find its terms susceptible to more

than one interpretation.” Doe 1 v. AOL LLC, 552 F.3d 1077,

1081 (9th Cir. 2009) (internal quotation marks omitted).

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 14 of 22
LEGRAS V. AETNA LIFE INS. CO. 15

The terms of this contract are not ambiguous. By the

Plan’s terms, LeGras had 180 days to file his appeal with

AETNA by mail. All parties agree that LeGras received

notice from AETNA that his long-term disability claim had

been denied on April 18, 2011. It is also undisputed that

October 15, 2011, is 180 days from the date of the notice. 

Where is the ambiguity? A person of average intelligence

and experience would understand 180 days to mean precisely

what LeGras understood it to mean here.1 LeGras knew that

the 180-day period ended on October 15, 2011; our only

question: whether he should be allowed to extend that time by

two days solely because the deadline for the 180-day appeal

period happened to be on a Saturday.

In other words, LeGras messed up; he failed to abide by

his contract and now seeks an excuse to set aside his failure. 

LeGras has never offered any reason to explain why he failed

to timely appeal. He could have mailed that appeal on any

one of 180 days after April 18, 2011, including October 15,

2011. He offers no explanation why he did not. Post offices

around the nation (even in Pocatello, Idaho) are open on

Saturdays. LeGras offers no evidence to the contrary and no

explanation why he did not send his appeal on that Saturday. 

All LeGras had to do (in order to preserve his rights) was

mail the appeal within a six-month window. Instead, he flatly

argues that he does not need to comply with his contract. 

Because the terms of the Plan are clear, the district court did

1 The majority’s attempt to distinguish Jones v. Georgia Pacific Corp.,

90 F.3d 114 (5th Cir. 1996), by holding that the terms of the plan at issue

in Jones were not ambiguous, is not persuasive. Slip Op. at 11–12. In the

only respect in which Jones is relevant to this case, this Plan is no more

ambiguous than the plan in Jones; neither plan specifies what happens if

the last day falls on a Saturday.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 15 of 22
16 LEGRAS V. AETNA LIFE INS. CO.

not err when it dismissed LeGras’s action with prejudice for

failure to exhaust his administrative remedies. Our analysis

should end here, with the contract.

To get around the plain terms of the contract, the majority

is forced to create federal common law, in light of the ERISA

regulations applicable to the Plan.2 These regulations provide

that an employee benefit plan “shall establish and maintain a

procedure by which a claimant shall have a reasonable

opportunity to appeal an adverse benefit determination.” 29

C.F.R. § 2560.503-1(h)(1). In order to have a reasonable

opportunity, an employee benefit plan must “[p]rovide

claimants at least 180 days following receipt of a notification

of an adverse benefit determination within which to appeal

the determination.” § 2560.503-1(h)(3)(i).

No one argues that the Plan did not comply with the

ERISA regulations. Applying these regulations, the

majority’s logic “hits a dead end.” The 180-day time limit in

this case arises from the contract between LeGras, FedEx,

and AETNA, and complies with the ERISA regulations. The

Plan gave LeGras 180 days following receipt of the letter

denying long term disability benefits to file his appeal, as the

regulations outline. For that reason, LeGras never even

asserted that the Plan, which incorporates the regulation’s

2

In doing so, the majority appears to go beyond the relief requested by

LeGras. LeGras’s briefing was focused on incorporating Fed. R. Civ. P.

6 into all time limits in insurance plans regulated by ERISA; LeGras

would use the federal common law to accomplish that incorporation only

if we determined Rule 6 did not directly apply, and then only to get him

a couple of extra days to file. Although the basis for the majority’s

holding is not clear, it appears to have recognized that LeGras’s Rule 6-

based approach is not tenable and has instead opted to impose a rule of

reasonableness on all terms in all ERISA insurance plans.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 16 of 22
LEGRAS V. AETNA LIFE INS. CO. 17

language, was in violation of ERISA or its implementing

regulations. LeGras’s only contentions in the district court

and on appeal (prior to oral argument) were that Fed. R. Civ.

P. 6 should be applied in some manner to the terms of the

Plan and that AETNA breached the contract by denying his

claim. In the absence of a claim that the Plan is nonconforming to the regulations, we do not have occasion to

determine whether the 180-day time limit provided in the

Plan and interpreted by AETNA is reasonable within the

meaning of § 2560.503-1(h)(1). See United States v.

Pallares-Galan, 359 F.3d 1088, 1094–95 (9th Cir. 2004)

(noting that claims raised for the first time on appeal are

deemed waived). Accordingly, the majority does not hold

that the Plan violates ERISA; instead it undertakes to rewrite

the terms of the contract.

The majority declines to accept LeGras’s primary

contention at oral argument and on appeal: that Rule 6 should

be directly applied to compute the 180-day appeal period

provided in the Plan. Instead, the majority suggests we must

rewrite the unambiguous terms of the Plan, a private contract

between the parties, in light of the federal common law and

the purpose of ERISA.3I have no doubt that the majority is

correct that we should construe ERISA liberally “in favor of

protecting participants in employee benefit plans.” Batchelor

v. Oak Hill Med. Grp., 870 F.2d 1446, 1449 (9th Cir. 1989). 

However, as already noted, we must begin with the contract. 

The terms of the contract are paramount, because “applying

federal common law doctrines to alter ERISA plans is

inappropriate where the terms of an ERISA plan are clear and

3

Indeed, the majority’s discussion of Rule 6, so central to LeGras’s

argument, is merely used to provide evidence that its preferred approach

is “widespread” in other contexts. Slip Op. at 8–9.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 17 of 22
18 LEGRAS V. AETNA LIFE INS. CO.

unambiguous.” Zurich Am. Ins. Co. v. O’Hara, 604 F.3d

1232, 1237 n.4 (11th Cir. 2010). The majority’s holding

ignores this limit on the reach of our power to craft federal

common law for ERISA-regulated plans and drastically

expands doctrines, meant to protect lay persons from

deceptive plan drafting, to impose a “reasonableness” rule on

every provision of an ERISA insurance plan. In doing so, the

majority improperly conflates the requirement that an insured

be given a reasonable opportunity to appeal an adverse

decision with doctrines requiring an insurance contract to be

interpreted in light of an insured’s reasonable expectations.

Although the majority is correct that we have used the

federal common law in cases interpreting ERISA plans, we

have never used it in these circumstances. This is not a case,

for example, where we are called upon to determine whether

common law remedies are available regarding ERISA plans. 

See Security Life Ins. Co. of Am. v. Meyling, 146 F.3d 1184,

1191 (9th Cir. 1998). Further, in Meyling, we importantly

noted that the plan terms limited whether the common law

remedy was available in that particular case. Id. at 1192; see

Greany v. W. Farm Bureau Life Ins. Co., 973 F.2d 812, 822

(9th Cir. 1992) (“Because the plan was unambiguous, the

Greanys cannot avail themselves of the federal common law

claim of equitable estoppel.”).

The limiting power of unambiguous plan terms to the use

of the federal common law also frames any discussion of the

case that is the linchpin of the majority’s holding: Saltarelli

v. Bob Baker Group Medical Trust, 35 F.3d 382 (9th Cir.

1994). In that case, we endorsed the “reasonable

expectations” doctrine for ERISA insurance plans, id. at 387,

but we never suggested (as the majority now does) that the

doctrine was available to revise unambiguous plan terms

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 18 of 22
LEGRAS V. AETNA LIFE INS. CO. 19

where those terms did not implicate questions of coverage. 

The majority interprets Saltarelli to mean that it can read an

insured’s “reasonable expectations” into any term of an

ERISA plan without limits. However, the doctrine was never

intended for this purpose. Instead, the “reasonable

expectations” doctrine is meant to protect insureds

“regarding the coverage afforded by insurance carriers even

though a careful examination of the policy provisions

indicates that such expectations are contrary to the expressed

intention of the insurer.” Id. at 386 (internal quotation marks

omitted) (emphasis added). Therefore, in Saltarelli, we

concluded that an exclusionary clause for preexisting

conditions was unenforceable given that it was not plain and

conspicuous. Id. at 386–87. We have never applied the

“reasonable expectations” doctrine outside the context of

determining the reach of insurance coverage. See, e.g., Snow

v. Standard Ins. Co., 87 F.3d 327, 331 n.1 (9th Cir. 1996)

(declining to apply doctrine of reasonable expectations to

plan administrator’s discretion), overruled on other grounds

by Kearney v. Standard Ins. Co., 175 F.3d 1084, 1089 (9th

Cir. 1999) (en banc).

The cases that the majority cites (to support its holding

that an insured’s reasonable expectation that the time period

to mail an appeal would not end on a Saturday) are not

persuasive. In Street v. United States, 133 U.S. 299 (1890),

the Supreme Court held that an executive action taken one

day outside of the Congressionally mandated time frame for

the officer to act was legal in part because the last day was a

Sunday. Id. at 305–06. Far from recognizing any “general

understanding” regarding the performance of a legal act on a

weekend, Slip Op. at 7–8, the Supreme Court grounded its

holding in the purpose of the statute and the special nature of

Sunday as a holiday or a dies non. Id. at 305–07. In

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 19 of 22
20 LEGRAS V. AETNA LIFE INS. CO.

Armstrong v. Tisch, the Fifth Circuit decided to incorporate

Rule 6 into a regulation, because the deadline could fall on a

date “on which the act cannot be legally done.” 835 F.2d

1139, 1140 (5th Cir. 1988) (internal quotation marks

omitted). The only act, that LeGras was legally required to

do in order to preserve his appeal rights, was to mail a letter

to AETNA. LeGras does not argue he could not legally mail

a letter on a Saturday.

Similarly, the majority’s reliance on Schikore v.

BankAmerica Supplemental Retirement Plan, 269 F.3d 956

(9th Cir. 2001), for the proposition that we must invoke the

federal common law to rewrite the terms of the Plan, is

misplaced. Slip Op. at 7. In Schikore, this court held that the

mailbox rule applied to litigation involving an ERISA plan. 

Id. at 964–65. However, the question before the Schikore

court was fundamentally different than the question before us

now. That difference illuminates why deploying the federal

common law is inappropriate in this case. The question in

Schikore was “not the interpretation of a plan term . . . but,

rather, whether an evidentiary rule of federal common law is

applicable in the absence of a provision in a plan rejecting

that rule.” Id. at 962 n.3. The court in Schikore clearly stated

that the mailbox rule “does not operate as a rule of

construction.” Id. at 961. The court was not tasked with

construing the meaning of plan terms at all but with resolving

“a critical evidentiary question: specifically, who bears the

ultimate burden of establishing receipt when receipt is

disputed and the evidence is inconclusive.” Id. at 963. Our

power to create federal common law with regard to ERISA

plans was well suited to the task in Schikore. Faced with an

evidentiary dispute, the court crafted a presumption to assist

in the resolution of the case. However, our job in this case is

decidedly different: we need only determine the meaning of

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 20 of 22
LEGRAS V. AETNA LIFE INS. CO. 21

180 days within the context of the Plan. There is no dispute

that LeGras failed to comply with this Plan provision.

Further, LeGras is distinguishable from the plaintiff in

Schikore. We must determine, not whether LeGras complied,

but whether we should come to his rescue after he

unambiguously missed the 180-day deadline. The Fifth

Circuit has already answered this question in Jones v.

Georgia Pacific Corp., 90 F.3d 114 (5th Cir. 1996). There,

the Fifth Circuit refused to apply Rule 6 to a private contract

when the terms of that contract were unambiguous. Jones,

90 F.3d at 117. The majority’s attempts, to distinguish the

present case from Jones, compromise its own reasoning. The

majority holds that Jonesis not applicable because it “did not

interpret a contractual provision that was required by ERISA

. . . defendants, as offerors of a private option contract, had

full control of the length of time during which the power of

acceptance shall last.” Slip Op. at 11 (internal quotation

marks and alterations omitted). However, the Jones plan

beneficiary lost his plan benefits, because he died one day

outside of the time to make an election necessary to preserve

his rights. Jones, 90 F.3d at 115. Therefore, the prudential

considerations (the majority now asserts for LeGras) would

be far more appropriate to trigger crafting federal common

law for the beneficiary in Jones. He could not control the

date of his death. On the contrary, LeGras had six months to

mail a letter and failed to do so. The Fifth Circuit did not

rescue Jones with federal common law; our case presents far

less reason to rescue LeGras. The Plan is (similar to the

contract in Jones) a private contract for which we are bound

to apply its unambiguous terms. The Fifth Circuit got it right;

it refused to, “in effect, write into the policy a provision that

would extend the period . . . if [the deadline falls on a

weekend].” Id. at 116.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 21 of 22
22 LEGRAS V. AETNA LIFE INS. CO.

We should do the same here. The Plan terms are clear

and comply in every respect with ERISA regulations. LeGras

had 180 days to notify AETNA that he wanted to appeal its

decision. One can only conclude that LeGras failed to abide

by the clear and unambiguous terms of his contract. The

analysis in this case should end there. But the majority

(intent on “bailing LeGras out”) unnecessarily intrudes upon

the ability of the parties to enforce the terms of their

negotiated private contract.

Therefore, I must respectfully dissent.

 Case: 12-56541, 05/28/2015, ID: 9552109, DktEntry: 25-1, Page 22 of 22