Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-3_05-cv-00810/USCOURTS-almd-3_05-cv-00810-3/pdf.json

Parties Involved:
Shawn Brown
Plaintiff
Wal-Mart Stores, Inc., Associates Health and Welfare Plan
Defendant

Document Text:

IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF ALABAMA

EASTERN DIVISION

SHAWN BROWN, individually and as )

mother and next friend of A.B., a minor )

 )

Plaintiff, )

 )

v. ) CASE NO. 1:05-cv-810-MEF

 ) (WO)

WAL-MART STORES, INC., )

ASSOCIATES HEALTH AND )

WELFARE PLAN, )

 )

Defendant. )

MEMORANDUM OPINION AND ORDER

I. INTRODUCTION

At issue in this case is whether an employee benefits plan covered by the Employee

Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq., properly

denied benefits to one of its covered employees. Plaintiff Shawn Brown (“Brown”), who is

a carrier of a genetic disorder capable of being passed down to her children, sought coverage

from Defendant Wal-Mart Stores, Inc., Associates Health and Welfare Plan (the “Plan”) for

surgical sterilization but was denied benefits. The Plan also denied coverage for a nutritional

supplement therapy for Brown’s daughter, who suffers from the genetic disorder. Brown

also alleges she was denied coverage for genetic testing, but the Plan contends that it paid

the benefits for this testing pursuant to Brown’s policy. This cause is before the Court on

Defendant’s Motion to Affirm the Determination of the Administrative Committee or,

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 1 of 16
2

Alternatively, Motion for Summary Judgment (Doc. # 36). The Motion, which the Court will

construe as a motion for summary judgment, is due to be GRANTED. 

II. JURISDICTION

The court has subject matter jurisdiction over this matter pursuant to 28 U.S.C. § 1331

(federal question) and 29 U.S.C. §1132(e)(1) (ERISA). The parties do not contest personal

jurisdiction or venue, and the court finds sufficient factual basis for each.

III. STANDARD OF REVIEW

Under Rule 56(c) of the Federal Rules of Civil Procedure, summary judgment is

appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file,

together with the affidavits, if any, show that there is no genuine issue as to any material fact

and that the moving party is entitled to a judgment as a matter of law.” Celotex Corp. v.

Catrett, 477 U.S. 317, 322 (1986). “An issue of fact is ‘genuine’ if the record as a whole

could lead a reasonable trier of fact to find for the nonmoving party. An issue is ‘material’

if it might affect the outcome of the case under the governing law.” Redwing Carriers, Inc.

v. Saraland Apartments, 94 F.3d 1489, 1496 (11th Cir. 1996) (quoting Anderson v. Liberty

Lobby, Inc., 477 U.S. 242, 248 (1986)). 

The party asking for summary judgment “always bears the initial responsibility of

informing the district court of the basis for its motion, and identifying those portions of ‘the

pleadings, depositions, answers to interrogatories, and admissions on file, together with the

affidavits, if any,’ which it believes demonstrate the absence of a genuine issue of material

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3

fact.” Celotex, 477 U.S. at 323. The movant can meet this burden by presenting evidence

showing there is no dispute of material fact, or by showing the non-moving party has failed

to present evidence in support of some element of its case on which it bears the ultimate

burden of proof. Id. at 322-23. 

Once the moving party has met its burden, Rule 56(e) “requires the nonmoving party

to go beyond the pleadings and by her own affidavits, or by the ‘depositions, answers to

interrogatories, and admissions on file,’ designate ‘specific facts showing that there is a

genuine issue for trial.’” Id. at 324. To avoid summary judgment, the nonmoving party

“must do more than simply show that there is some metaphysical doubt as to the material

facts.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). On the

other hand, a court ruling on a motion for summary judgment must believe the evidence of

the non-movant and must draw all justifiable inferences from the evidence in the non-moving

party’s favor. Anderson v. Liberty Lobby, Inc., 477 U.S. at 255. After the nonmoving party

has responded to the motion for summary judgment, the court must grant summary judgment

if there is no genuine issue of material fact and the moving party is entitled to judgment as

a matter of law. See Fed. R. Civ. P. 56(c).

IV. FACTS

The Court has carefully considered all deposition excerpts and documents submitted

in support of and in opposition to the motion. The submissions of the parties, viewed in the

light most favorable to the non-moving party, establish the following facts:

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 3 of 16
 Under the section outlining the duties and powers of the Plan Administrator, the 1

Plan’s “Wrap Document” states:

The Plan Administrator shall have complete discretion to

interpret the provisions of the Plan, make findings of fact,

correct errors, supply omissions, and determine the benefits

payable under a Welfare Program.

Doc. 37 at 7. Brown does not dispute that the Plan Administrator has such delineated

powers, but she argues that the Wrap Document is not controlling since she never received

a copy of it. Instead, Brown argues that the Summary Plan Description, which she refers to

in her brief as the “My Benefits” handbook, controls.

4

Brown is an employee of Wal-Mart Stores, Inc. Brown and her daughter, A.B., have

medical coverage under the Plan. Brown has had this coverage since she began working for

Wal-Mart in February 2000. A.B., who was born in February 2001, started suffering seizures

when she was only eight months old. Doctors diagnosed A.B. with cellular mitochondria

complex one defect. In October 2004, genetic testing of A.B.’s parents pinpointed Brown,

A.B.’s mother, as the carrier of the gene responsible for A.B.’s condition.

The Plan, which is covered by ERISA, is self-funded. Wal-Mart Stores, Inc., the plan

sponsor, funds the Plan through a separate trust. Blue Cross Blue Shield of Alabama (“Blue

Cross”) performs the initial claims processing but all payments of claims are paid from the

trust and not from Blue Cross’s coffers. In the event that a plan member disputes a claim

determination, the member may appeal directly to the Plan. At that point, the Administrative

Committee, which is the Plan’s administrator and its fiduciary, makes a final benefit

determination. 

1

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 4 of 16
These notes and memorandum are not part of the administrative appellate record. 2

Brown argues that she is entitled to these notes or memorandum. 

According to Lisa Woods, the Director of Benefits for Wal-Mart Stores, Inc., these 3

notes do not document discussions the Committee had about the cases. 

5

Administrative Committee members are paid by Wal-Mart Associates, Inc., a

subsidiary of Wal-Mart Stores, Inc. However, committee members serve on a volunteer basis

and do not receive any extra money or bonuses for doing so. Committee members maintain

notes and memorandum about their meeting. For the most part, these meeting notes state 2

only who was in the meeting and what was decided.3

Committee members are required to file semi-annual reports with the Executive VicePresident of Benefits at Wal-Mart Stores, Inc. The content of the reports consist of

information about who serves on the committee, when they’ve met, and delegations or

resolutions to the Plan. The reports do not state how many claims were reviewed. 

A. Brown’s Claim for A.B.’s Treatment

One proposed treatment for A.B.’s condition involved taking a nutritional supplement

called Carnitor. Brown’s claim for coverage for this treatment was initially denied by Blue

Cross. The Plan’s 2004 Summary Plan Description listed the following under the section

“Charges Not Covered”:

Vaccines, Vitamins, or Preventative Care: Charges for

vaccines, vitamins (whether oral or injectable), minerals,

nutritional supplements, immunizations, or preventive medical

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 5 of 16
 Brown’s position on whether Carnitor is a nutritional supplement is very unclear and 4

inconsistent. At one point in her response to the Plan’s Motion for Summary Judgment,

Brown disputes whether Carnitor is actually a nutritional supplement. For this point, she

submits a letter from a treating physician in Alexandria City, Alabama, Dr. Billy B. Sellers.

Although Dr. Sellers notes that Brown had been “prescribed carnitor” by a doctor at Emory

University in Atlanta, Georgia, at no time does Dr. Seller dispute the fact that Carnitor is a

nutritional supplement. At another point in her response, as to the Plan’s “undisputed

statements of material fact” that Carnitor is a nutritional supplement, Brown states that she

“does not assert that [the Plan] misstates the material.”

6

care.

Doc 42-11. The Clinical Pharmacology-World Class Drug Information lists Carnitor as a

nutritional supplement.4

Brown does not dispute that the 2004 Summary Plan Description excludes nutritional

supplements from coverage but argues that such an exclusion was not contained within the

2003 Summary Plan Description and thus was added in 2004 without notice to her. This is

not correct. In fact, the same exclusion can also be found in the 2003 Plan Summary

Description, albeit under a slightly different subheading. See Doc. 42-10 at 4. 

On April 18, 2005, Brown appealed Blue Cross’s denial of her claim for Carnitor. On

May 20, 2005, the Plan’s Administrative Committee affirmed this denial and cited the 2004

Summary Plan Description. On June 20, 2005, Brown appealed again and, on July 6, 2005,

the Administrative Committee reaffirmed the denial. In its decision, the Administrative

Committee also cited the Clinical Pharmacology-World Class Drug Information which states

that Carnitor is a nutritional supplement. 

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 6 of 16
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B. Brown’s Claim for Surgical Sterilization

Brown is a carrier of G1178 gene, which is the cause of A.B.’s condition. Because

the genetic disorder is maternally transferred, any further children Brown had would certainly

suffer from the disorder. For this reason, Brown’s doctors advised her not to have anymore

children. Brown’s doctor concluded that “it was ... medically necessary to perform

permanent sterilization on this patient.”

On November 22, 2004, Brown underwent surgery for laparoscopic tubal ligation, a

form of surgical sterilization. Blue Cross denied Brown’s claim for tubal ligation. On

December 21, 2004, Brown appealed and, on January 6, 2005, the Administrative Committee

affirmed the denial. The Administrative Committee cited to the 2004 Plan Summary

Description. Under “Charges Not Covered,” the Summary Description listed the following:

Reproductive Systems:

Charges for or relating to any treatment or service for

sterilization, sexual dysfunction, impotence, or family planning,

and any complications arising therefrom.

Doc. 42-13. The Administrative Committee also relied on the Plan’s Coverage Policy

Manual. The Manual states the following:

Hysteroscopic Placement of Micro-Inserts in the Fallopian

Tubes as a Form of Permanent Sterilization,

Policy/Coverage:

Charges for or relating to any treatment or service for

sterilization or reversal of sterilization, sexual dysfunction,

impotence, or family planning, and any complications arising

therefrom are a contract exclusion.

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Doc. 37 at 18. Brown does not dispute that the laparoscopic tubal ligation, which involved

blocking the fallopian tubes, would be a contract exclusion pursuant to the Coverage Policy

Manual. However, Brown argues that since she never received the manual, and only

received the Summary Plan Description, she was not on notice of this exclusion.

Furthermore, according to Brown, the surgery “is not specified in this manner in the

exclusions listed in the 2004 [Summary Plan Description],” the document that Brown

contends is controlling.

C. The Genetic Testing

On January 8, 2003, Blue Cross denied Brown’s claim for the genetic testing which

was used to identify Brown as the carrier of the genetic disorder. Blue Cross argued that

“benefits are not payable for treatment or servicesrelating to genetic or chromosomal testing,

counseling, or therapy, even if standard medical treatment.” Doc. 42-2. Brown appealed this

denial and, on March 3, 2003, the Plan’s Administrative Committee made an exception to

the plan guidelines and permitted payment of benefits for Brown’s visit to Dr. John Shoffner

(“Dr. Shoffner”) at Emory University. Brown contends, however, that she was not

reimbursed for the $7,100 she had already paid for the genetic testing. Brown does not,

however, present any evidence of this payment, save for assertions in her affidavit. 

The Plan counters that it paid benefits for genetic testing pursuant to the Plan terms.

In fact, as evidenced by six separate claim reports, the Plan paid $8,870.20 to Dr. Shoffner

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 8 of 16
 As explained in Brown’s Summary Plan Description, even where a member of the 5

plan receives benefits, that member may be responsible for charges over the “usual,

customary, and reasonable” rates. For example, the Description states that “[a]ll expenses

that exceed usual, customary, and reasonable fees will be your responsibility and are not

considered covered medical charges by the Plan.” Doc. 46 at 17.

The individual amounts owed by Brown are as follows: $1,103.00, $83.00, $921.00, 6

$128.00, $2,054.00, and $31.00. 

 The Plan asserts that Dr. Shoffner has not clarified whether the disputed claims were 7

in fact duplicates and, further, “[i]f Dr. Shoffner’s office ever does present evidence that

these claims are not duplicates, the Plan would process these claims for payment in

accordance with the Plan terms.” Doc. 46-1 at 16.

9

for this testing. The Plan paid the $8,870.20 in the following amounts: $1,267.00, $152.00,

$1,378.00, $3,600.00, $2,346.00, $127.20. Doc. 47-2.

The claim reports also indicate that some of the submitted charges “exceed the eligible

charge which is the maximum allowance for this service.” Consequently, the reports 5

indicate that Brown still owed Dr. Shoffner $4,320 after the Plan paid its share of the claim.6

Some charges were not considered because they were duplicate claims. The duplicate claims

total $2,532.00. 

7

V. DISCUSSION

A. The Benefits Determinations

Brown’s state law claim for benefits from an employee welfare benefit claim covered

by ERISA is construed as a claim brought under 29 U.S.C. § 1132(a) because Brown states

a claim seeking relief “akin to” that provided for in section 1132(a). Ervast v. Flexible

Prods. Co., 346 F.3d 1007, 1014 (11th Cir. 2003). Section 29 U.S.C. 1132(a)(1)(b) permits

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a civil action by a participant or beneficiary “to recover benefits due to him under the terms

of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future

benefits under the terms of the plan.”

While denials of ERISA benefits are governed by 29 U.S.C. § 1132(a)(1)(B), the

statutory scheme does not set forth a standard of review. In Firestone Tire & Rubber Co. v.

Bruch, 489 U.S. 101 (1989), the United States Supreme Court held that “a denial of benefits

challenged under § 1132(a)(1)(B) is to be reviewed under a de novo standard unless the

benefit plan gives the administrator or fiduciary discretionary authority to determine

eligibility for benefits or to construe the terms of the plan.” Firestone, 489 U.S. at 114. The

Supreme Court cautioned, however, that “if a benefit plan gives discretion to an

administrator or fiduciary who is operating under a conflict of interest, that conflict must be

weighed as a ‘facto[r] in determining whether there is an abuse of discretion.'” Id. (quoting

Restatement (Second) of Trusts § 187, Comment d (1959)).

The Eleventh Circuit “has adopted the following standards for reviewing

administrator’ plan interpretations: (1) de novo where the plan does not grant the

administrator discretion[;] (2) arbitrary and capricious [where] the plan grants the

administrator discretion; and (3) heightened arbitrary and capricious where there is a conflict

of interest.” HCA Health Servs. of Ga., Inc. v. Employers Health Ins. Co., 240 F.3d 982, 993

(11th Cir. 2001) (quoting Buckley v. Metropolitan Life, 115 F.3d 936, 939 (11th Cir. 1997)

(emphasis omitted); see also Levinson v. Reliance Standard Life Ins. Co., 245 F.3d 1321

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 10 of 16
 Brown inexplicably argues that the Wrap Document and other Plan documents 8

should not be considered and the Court should rely instead solely on the Summary Plan

Description, the only document Brown received. Brown makes no legal arguments for this

contention. In fact, ERISA specifically provides that the Summary Plan Description “shall

be written in a manner calculated to be understood by the average plan participant, and shall

be sufficiently accurate and comprehensive to reasonably apprise such participants and

beneficiaries of their rights and obligations under the plan.” 29 U.S.C. § 1022. Thus, while

the Summary Plan Description must reasonably apprise Brown of her rights and obligations,

there is no requirement that the Summary Plan Description include everything possibly

related to the Plan. Therefore, the Court finds Brown’s argument unpersuasive as to the

Wrap Document and other sources of information that the Plan relied upon in making its

benefit determinations. 

11

(11th Cir. 2001). When a court reviews a claims administrator's benefits determination, the

court must follows a series of steps. Id. At each step, the court makes a determination that

results in either the progression to the next step or the end of the inquiry. Id.

First, a court begins by looking at the plan documents to determine whether the plan

documents grant the claims administrator discretion to interpret disputed terms. Id. Here,

the Plan unequivocally gives the Plan Administrator discretion to interpret disputed terms.

The Wrap Document specifically provides for the Plan Administrator to have “complete

discretion to interpret the provisions of the Plan, make findings of fact, correct errors, supply

omissions, and determine the benefits payable under a Welfare Program.” Therefore, the 8

Court will apply arbitrary and capricious review and possibly heightened arbitrary and

capricious review. 

Regardless of whether the Court applies an arbitrary and capricious standard of review

or one that is “heightened,” the Court must evaluate the claims administrator's interpretation

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 11 of 16
12

of the plan to determine whether it is “wrong.” Id. (citing Godfrey v. BellSouth Telecomm.,

Inc., 89 F.3d 755, 758 (11th Cir. 1996); Brown v. Blue Cross & Blue Shield of Ala., Inc., 898

F.2d 1556, 1566 n. 12 (11th Cir. 1990) (“[i]t is fundamental that the fiduciary's interpretation

first must be ‘wrong’ from the perspective of de novo review before a reviewing court is

concerned with the self-interest of the fiduciary.”)).

“Wrong” is the label used to describe the conclusion a court reaches when, after

reviewing the plan documents and disputed terms de novo, the court disagrees with the

claims administrator's plan interpretation. Id. at 993-94 (citing Yochum v. Barnett Banks,

Inc., 234 F.3d 541 (11 Cir. 2000); Marecek v. BellSouth Telecomm., Inc., 49 F.3d 702, 705 th

(11 Cir.1995) (explaining a court must decide if the administrator correctly interpreted the th

plan); Brown, 898 F.2d at 1566 n. 12 (citations omitted) (explaining that the first step in

application of arbitrary and capricious standard is determining legally correct interpretation

of disputed plan provision)). If the court agrees with the ultimate decision of the

administrator, it will not decide whether a conflict exists. Id. at 993-94 & n. 23 (citing

Marecek, 49 F.3d at 705). Only when the court disagrees with the decision, i.e. the decision

is wrong, does it look for a conflict and, when it finds such a conflict, it reconsiders the

decision in light of this conflict. Id.

First, as to the denial of benefits for Carnitor, it is important to note that the 2004

Summary Plan Description lists “vitamins (whether oral or injectable), minerals, [or]

nutritional supplements” under the heading “charges not covered,” Doc. 42-11, and The

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 12 of 16
Oddly, Brown contradicts herself later in her response to the Plan’s Motion for 9

Summary Judgment by trying to argue that Carnitor is not a nutritional supplement afterall.

See supra note 4 for a discussion of the letter from one of Brown’s treating physicians. 

Likewise, in that same portion of her response, Brown describes Carnitor as a “vitamin

therapy,” something explicitly not covered in the Summary Plan Description. 

13

Clinical Pharmacology-World Class Drug Information states that Carnitor is a nutritional

supplement. Brown does not dispute the fact that Carnitor is a nutritional supplement but

bases her objection to this finding on the fact that this finding “reference[s] material Plaintiff

was never furnished.” Doc. 42-1 at 3 (as ¶ 8 of the Plan’s undisputed statements of material

fact, “Plaintiff does not assert that Defendant misstates the material, but rather argues the

material is not applicable or is subject to a different interpretation when compared with the

[Summary Plan Description].”). Brown does not give any legal reason, either controlling 9

precedent or provisions from the Plan, why the Clinical Pharmacology-World Class Drug

Information should not be consulted or why it is not controlling if Brown wasn’t furnished

it. ERISA does not require a health benefits plan to recite every exclusion and inclusion in

the Summary Plan Description, see 29 U.S.C. § 1022, and this makes sense. Otherwise, the

document would not be called a “summary.” The Court concludes that the Plan’s

determination that Brown was not entitled to benefits for Carnitor was not “wrong.”

The Court also finds that the Plan’s denial of benefits for Brown’s claim for the

sterilization procedure was not “wrong.” Given that the Summary Plan Description clearly

excludes charges for “sterilization” and the tubal ligation is a form of sterilization, an

admission even Brown makes in her briefs and a fact affirmed by her doctors, the procedure

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 It is worth noting had the Court found the benefits determinations “wrong”and thus 10

gone to the next step in the analysis, the Court would have applied an arbitrary and capricious

standard of review and not, as Brown suggests, a heightened arbitrary and capricious

standard. Brown’s allegations of a conflict of interest are not persuasive. While Brown cites

to Brown v. Blue Cross & Blue Shield for the proposition that “[b]ecause an insurance

company pays out to beneficiaries from its own assets rather than the assets of a trust, its

fiduciary role lies in perpetual conflict with its profit-making role as a business,” 898, F.2d

14

was not covered by the Plan.

Finally, when it comes to Brown’s claim for genetic testing, the Court is surprised that

Brown made it this far in the process of litigation without examining the claim reports. It

clearly indicates on the reports that the Plan made payments towards the genetic testing and

that charges that went above and beyond the usual, customary, and reasonable rates, Brown

would be responsible for paying. While Brown has submitted no document to conclusively

show how much she actually paid towards the genetic testing, what is clear from the reports

is that she owed the doctor $4,320. Brown attests that she paid $7,100. The overpayment

by Brown can be explained by the $2,532 of apparent duplicate claims. If those claims are

actually not duplicates, and Brown’s doctor refiles, Brown may still get a favorable benefit

determination. If the claims are in fact duplicates, Brown’s grievance lies with the doctor’s

billing department for her overpayment. Therefore, the benefits determination as to the

genetic testing was not “wrong.” 

Because the Plan’s benefit determinations were not “wrong,” it is not necessary to

consider whether an arbitrary and capricious standard is appropriate or if a heightened one

is required instead. The Plan’s Motion for Summary Judgment on the benefit 10

Case 3:05-cv-00810-MEF-CSC Document 52 Filed 03/12/07 Page 14 of 16
1556, 1561 (11th Cir. 1990), that Eleventh Circuit opinion is easily distinguishable. Here,

while Blue Cross Blue Shield of Alabama makes initial coverage determinations, payments

to beneficiaries do not come from Blue Cross’s own assets. Instead, because the Plan is selffunded, payments to beneficiaries come from a trust for which the Administrative Committee

is the fiduciary. As noted in the Plan’s briefs, and, conveniently enough, by the Eleventh

Circuit opinion to which Brown relies on so heavily, it is a totally different scenario where

a plan is “self-insured and the insurance company act[s] as an administrator and receiv[es]

full reimbursement from the plan sponsor for covered medical claims.” Id. at 1562 (citing

Jett v. Blue Cross & Blue Shield, 890 F.2d 1137, 1138 (11th Cir. 1989). In such a case, the

Court would apply the more deferential arbitrary and capricious standard of review. 

15

determinations is due to be GRANTED. 

B. Breach of Fiduciary Duty Claim

Brown’s state law claim for breach of fiduciary duty would be construed as a claim

under the catch-all provision of 29 U.S.C. § 1132(a)(3). See Varity Corp. v. Howe, 516 U.S.

489, 511-12 (1996); Hamilton v. Allen-Bradley Co., 244 F.3d 819, 826 (11th Cir. 2001). 

The Plan argues, however, that Brown’s claim of breach of fiduciary duty would therefore

be barred as a matter of law because another section of 29 U.S.C. § 1132(a) – specifically

section 1132(a)(1)(b) -- provides her with an avenue to seek relief.

While Brown does not specifically contest this in her response to the Plan’s Motion

for Summary Judgment, it is worth noting that the Eleventh Circuit Court of Appeals has

spoken directly on this issue in Ogden v. Blue Bell Creameries U.S.A., Inc., 348 F.3d 1284

(11th Cir. 2003). In Ogden, the Eleventh Circuit held that “an ERISA plaintiff has no cause

of action under [29 U.S.C. 1132(a)] where Congress provided for an adequate remedy

elsewhere in the ERISA framework, even if res judicata now bars the adequate remedy

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16

provided.” Id. at 1285. Therefore, because Brown asserts a claim for benefits under section

1132(a)(1)(B), Brown cannot alternatively plead and proceed under section 1132(a)(3). For

these reasons, the Plan’s Motion for Summary Judgment on this claim for breach of fiduciary

duty is due to be GRANTED. 

VI. CONCLUSION

For the foregoing reasons, it is hereby ORDERED as follows: 

(1) The Motion to Affirm the Determination of the Administrative Committee or,

Alternatively, Motion for Summary Judgment (Doc. # 36) is GRANTED.

(2) The trial scheduled in this matter is CANCELLED.

A separate final judgment will be entered in accordance with this Memorandum

Opinion and Order.

 DONE this the 12 day of March, 2007. 

th

 /s/ Mark E. Fuller 

CHIEF UNITED STATES DISTRICT JUDGE

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