# U ni te d S ta te s Co ur t of A pp ea ls For the Eig hth Circu it

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No. 1 6- 32 60

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CeC el ia Cat he rin e Ib so n

ll ll ll ll ll ll ll ll ll ll l Pla in ti

ff - App el la nt

v.

Uni te d Hea lt hc are S erv ic es , Inc

.

ll ll ll ll ll ll ll ll ll ll l Defe nd

an t - Ap pe ll ee

__ __ __ __ __ __ App eal fro m

Uni te d S ta te s Di st ric t Co ur t fo r th e So ut he rn Dis tri ct of I owa - Des M oi ne s

__ __ __ __ __ __
Su bm it te d: Octo be r 18 , 20 17 Fil ed : Dec em

be r 6, 2 01 7

__ __ __ __ __ __
Befo re WOL LMAN, BEAM, an d S HEPHERD, Circ ui t J ud ge s.

__ __ __ __ __ __ SHEPHERD, Cir cu it Ju dg e.

A th or ny di sp ut e be twee n CeC el ia Ib so n an d Uni te d Heal th Care Serv ic es , In c. (“ UHS”) has ret ur ne d on ce m or e to th is co ur t. Afte r we de ci de d ERISA pr eem pt ed
he r st at e-l aw cl ai m s, Ib so n fil ed cl ai m s un de r ERISA ag ai ns t UHS. The di st ric t co ur t
di s mi s s e d h er co m

pl ai nt , whi le no ti ng th at —i f he r al le ga ti on s were tru e—UHS

tre at ed he r “ ho rri bl y .” The q u e s t i o n be fo re us , th en , is whe th er Ib so n ha s pl ed a vi ab le cl ai m ag ai ns t UHS un de r ER ISA. W e la rg el y ag ree wit h th e di st ric t co ur t’sdi sm is sa l of he r cl ai m s, bu t rem an d fo r fu rth er in q u i r y in to he r eq ui ta bl e cl ai m fo r

pr em iu m s s he pa id to UHS.

I.

Ib so n was at o ne ti m e a s ha reh ol de r in an Io wa la w f irm th at co nt ract ed wit h
UHS to pr ov id e he al th in su ran ce fo r it s em pl o yees

. On Ib so n’s pr io r ap pe al

, we

no te d th at th e “ la w fir m rem it te d pa y m en t to th e in su ran ce co m pa ny an d di st rib ut ed
in fo rm at io n fro m UHS

. . . bu t pe rfo rme d n o ot he r ad m in is tra ti on rel at in g to th e in su ran ce.” I b so n v. Uni te d Heal th care Serv s., In c., 77 6 F.3 d 94 1, 94 3 (8 th Ci r. 20 14 ). UHS, ho wev er, ex pr es sl y di sa vo wed th e “ pl an ad m i n i s t r a t o r ” ro le in th e
po li cy do cu m en t, an d n o o th er en ti ty w as na m ed to fil l t ha t ro le . J.A. 11 2.

Ib so n en ro ll ed he rs el f an d he r fam il y , in cl ud in g he r la te hu sb an d, Ja y W ag ne r, in he r em pl oyer-s po ns or ed UHS he al th care pl an in Mar ch 20 04

. In earl y 20 08
, UHS
be ga n de nyin g cl ai m s an d s ta rte d in st it ut in g reco up m en t act io ns fo r cl ai m s al read y
pa id

. Thi s was at a ti m e of gr eat ha rd sh ip fo r Ib so n’s fam il y : W ag ne r was ba tt li ng 1

m et as ta ti c m el an om a. In Apr il 20 08
, UHS se nt an em ai l pr om is in g to ret ur n Ib so n’s

po li cy an d co ve rag e to no rm al cy

. Ib so n’s la w fir m can cel le d th e po l i c y in Ju ne 2

20 08
, bu t UHS co nt in ue d reco up m en t act io ns —d es pi te it s earl ie r em ai l— in to 20 10

. UHS ev en tu al ly pa id $3 6,4 17 .29 fo r ou ts ta nd in g cl ai m s. Ib so n m ai nt ai n s in th is

act io n, ho wev er, th at th ey st il l owe $1 90 ,57 9.9 1 in rel at io n to care W ag ne r rece iv ed

.

As we no te d in ou r pr ev io us op in io n, “ th e reco rd is un cl ear as to why UHS 1 be ga n de nyin g co ve rag e.” Ib so n, 77 6 F.3 d at 94 3. The re co rd ha s n ot be co m e an y cl eare r in th e in st an t ac ti on

.
The em ai l, in pa rt, st at ed th at UHS wou ld “ st op reco up m en t pro ceed in gs

. 2

. . rep ro ces s [in co rrec tl y de ni ed ] cl ai m s,” an d “ co nt act a l l o f Ib so n’s m ed ic al
pr ov id ers to ex pl ai n UHS’s erro r an d to pr o mi s e t h a t Ib so n’s cl ai m s wou ld be

co rrec tl y pro ces se d.” Id.

-2

-Ib so n fil ed su it in it ia ll y in Sep te m be r 20 12 , all eg in g s ta te -la w cla im s aga in st
U HS. As no te d ab ov e, on ap pe al

, we he ld th at Ib so n’s cl ai m s were pr eem pt ed b y ERISA. Id

. at 94 6. Sh e r e-fi le d a co m pl ai nt ag ai ns t UHS in Ju ly 20 15 an d

su bs eq ue nt ly am en de d it in Nov em be r 20 15

. The fir st th ree co un ts of th e am en de d

3

c o mp l a i nt were ERISA ba se d, an d th e la st co un t was ag ai n a st at e-l aw cl ai m. Th e

co m pl ai nt so ug ht th e va lu e of al le ge d un pa id be ne fit s an d of pr em iu m s pa id by Ib so n

to UHS (Co un t I), st at ut or y da m ag es fo r UHS’s fai lu re to du ti fu ll y carr y ou t th e ta sk
of “ pl an ad m in is tra to r” (Co un t II), at to rn ey fe e s ( C ou nt III), an d da m ag es ari si ng fro m a br each of co nt ract in rel at io n to th e Apr il 20 08 em ai l (Co un t IV). On a pa rti al

m ot io n to di sm is s, th e di st ric t co ur t di sm is se d Co un t IV as pr eem pt ed by ERISA, an d
la te r, on su m

m ary jud gm en t, i t d is m is se d C ou nt s I, II , and III. Ib so n n ow ap pe al s. 4

II.

W e rev ie w th e di st ric t co ur t’s di sm is sa l on su m m ary jud gm en t of Co un ts I an d

I I
, an d di sm is sa l of Co un t IV fo r fai lu re to st at e a cl ai m , de no vo

. S e e O d o m v

. Kaiz er , 86 4 F.3 d 92 0, 92 1 (8 th Ci r. 20 17 ) (s u mm a r y jud gm en t); K.T. v. Cu lv er-S to ck to n Co ll

., 86 5 F.3 d 10 54
, 10 57 (8 th Ci r. 20 17 ) (fai lu re to st at e a cl ai m ).

A.

Viewe d in a li gh t m os t fav or ab le to Ib so n, Kaiz er, 86 4 F.3 d at 92 1, Co un t I of
he r am en de d co m

pl ai nt se ek s rel i e f un de r two di ffer en t, in te rrel at ed se ct io ns of
ERISA. W e d eal wit h e ach in tu rn

.

UHS op po se d he r m ot io n to am en d, bu t Ib so n was al lo wed to fil e he r am en de d 3

co m pl ai nt in Decem

be r 20 15

.
Ib so n d oe s n ot ap pe al th e d is tri ct co ur t’s d is m is sa l o f Co un t II I. 4

-3

-1.

Pu rs ua nt to 29 U.S.C. § 11 32 (a)( 1) (B), Ib so n se ek s to reco ve r $1 90 ,57 9.9 1 in
al le ge d “ un pa id be ne fit s,” whi ch st em so le ly fro m care W ag ne r rece iv ed

. The di st ric t

co ur t ch arac te riz ed he r cl ai m as se ek in g “ ex t ra-c on tra ct ua l da m ag es ”—f or bi dd en

un de r ERISA. Reg ard le ss , th e co rrec t p art y to bri ng th is cl ai m is W ag ne r’s es ta te

.

We b e g i n wit h th e st at ut e. Sect io n 11 32 (a)( 1) (B) pr ov id es a cau se of act io n fo r an ERISA “ pa rti ci pa nt or be ne fic ia ry

. . . to reco ve r be ne fit s du e to hi m un de r th e

te rm s of hi s pl an .” (em

ph as is ad de d)

. Fl owi ng fro m th at st at ut or y la ng ua ge , we ha ve

5

he ld th at it is “ th e rep res en ta ti ve of a de ceas ed pa rti ci pa nt ’s es ta te [th at ha s] st an di ng

to su e fo r br each of ERISA fid uc ia ry du ti es .” Geis sa l ex rel

. Geis sa l v. Mo or e Med

. Co rp ., 33 8 F.3 d 92 6, 93 1 (8 th Ci r. 20 03 ) (ci ti ng Sh ea v. Esen st en , 10 7 F.3 d 62 5, 62 8 (8 th Ci r. 19 97 )). Thi s co m po rts wit h th e g en eral pri nc ip le th at “ de at h us ua ll y do es

no t m oo t a cl ai m fo r m on et ary co m pe ns at io n

. . . be c a u se th e in di vi du al ’s es ta te or

so m eo ne el se le ga ll y el ig ib le to reco ve r th e m on et ary cl ai m ” m ay br in g it

. Co be ll v. Je well , 80 2 F .3d 12 , 23 (D.C. Cir . 20 15 ).

The fact th at Ib so n wa s t h e p la n “ pa rti ci pa nt ” is of no si gn ifi can ce. The

a l l e ge d be ne fit s accr ue d to W ag ne r fo r hi s tre at m en t as a “ be ne fic ia ry ,” an d § 11 32 (a)( 1) (B) pr ov id es a cau se of act io n to th e “ pa rti ci pa nt or be ne fic ia ry ” to who m be ne fit s were “ du e.” Bo ls te rin g th is c o n c l u s io n is th e op in io n in Harro w v. Pru de nt ia l In su ran ce Co m pa ny of Am eri ca, 27 9 F.3 d 24 4 (3 d Ci r. 20 02 )—a de ci si on ci te d as su pp o r t f

o r o u r ho ld in g in Geis sa l. The re, a pl an pa rti ci pa nt was gr an te d

st an di ng to su e fo r be ne fit s owe d a de ceas ed be ne fic ia ry so le ly be cau se sh e was th e

Und er ERISA, a “ pa rti ci pa nt ” i s a n “em pl oyee

. . . who is or m ay be co m e 5 el ig ib le to rece iv e a b en efi t o f an y type fro m

an em pl oyee be ne fit pl an .” 29 U.S.C. § 10 02 (B)( 7)

. A “ be ne fic ia ry ” is a “ pe rs on de si gn at ed by a pa rti ci pa nt , or b y t h e te rm s of an em

pl oyee be ne fit pl an , who i s o r may be co m e en ti tl ed to a be ne fit th ereu nd er.” 2 9 U.S.C. § 10 02 (B)( 8)

.
-4

-ad m in is tra to r of th e d eced en t-b en efi ci ary’ s es ta te , and th us “ [s to od ] in th e sh oe s o f

th e de ced en t.” Id

. at 24 8 & n.7 (in te rn al qu ot at io n m ark s om it te d)

. Thu s, fo r be ne fit s

“ du e to [Wagn er],” § 11 32 (a)( 1) (B), a le ga l rep res en ta ti ve of hi s es ta te m us t br in g th e cl ai m , no t Ib so n i n h er p ers on al cap aci ty.

2.

Ib so n al so as ks “ fo r a fu ll refu nd of th e pr em iu m s sh e pa id UHS, as well as th e fu nd s po ss es se d by UHS whi ch sh ou ld ha ve be en pa id on cl ai m s su bm it te d, pu rs ua nt

to 29 U.S.C. § 11 32 (a)( 3) (B).” Thi s pr ov is io n al l o w s f or “ ap pr op ri at e eq ui ta bl e

re li ef to red res s vi ol at io ns

. . . of ERISA or th e te rm s of the pl an .” CIGNA Co rp

. v. Am ara, 56 3 U.S. 42 1, 43 8 (2 01 1) (in te rn al qu ot at io n m ark s om it te d)

. The di st ric t

co ur t fo un d th at sh e was se ek in g “ co m pe ns at or y rel ie f” whic h “ do es no t fa ll wit hi n th e am bi t of ‘app ro pr ia te eq ui ta bl e rel ie f.’” B e c au se of th is

, it di d no t co ns id er whe th er a pl an vi ol at io n ha d oc cu rred

. As an in it ia l m at te r, we rem an d to de te rm in e 6

whe th er th ere is a red res sa bl e pl an vi ol at io n in li gh t of UHS’s ad m i s s i o n i n th is

act io n th at it owe s, an d ha s no t pa id

, $1 90 ,57 9.9 1 to W ag ne r’s m ed ic al pr ov id e rs

. See App el la nt ’s Br. 28 (“ The $1 90 ,57 9.9 1 be ne fit th at [UHS] r e cei ve d fro m th e writ in g of f of Mr. W ag ne r’s m ed ic al bi ll s aft er hi s de at h

. . . [was ] a be ne fit co nf erre d by th e pr ov id ers ”). Thi s de te rm in at io n is ne ces sa ry be cau se , as ex pl ai ne d be lo w, we 7

fin d t ha t Ib so n h as a co gn iz ab le eq ui ty clai m to pre m iu m s p ai d t o UHS.

Ib so n b as es he r cl ai m

for eq ui ta bl e rel ie f so le ly on a ll eg ed pl an vi ol at io ns

. 6

A “ ch arg e of

f” (o r “ writ e of

f”) do es no t ex ti ng ui sh de bt or a le ga l ob li ga ti on 7

to pa y

. In st ead

, th is is an acco un ti ng pr oc ed ur e th at al lo ws a cred it or to tre at a de bt

“ as a lo ss or ex pe ns e be cau se pa y m en t is un li ke ly.” See Ch ar g e O f f

, Bl ack ’s Law Dict io na ry

(10 th ed . 20 14 ).

-5

-Equ it ab le rel ie f un de r §1 13 2( a)(3 )(B) “ is li m it ed to th os e cat eg or ie s o f rel ie f

th at were ty

pi ca ll y av ai la bl e in eq ui ty du rin g th e da y s of th e di vi de d be nc h (m ean in g, th e pe rio d be fo re 19 38 whe n co ur ts of la w an d eq ui ty were se pa rat e).” Mo nt an il e v. Bd

. of Trus te es of Nat’l. Elev at or In du s. Heal th Ben efi t Pl an , 13 6 S. Ct

. 65 1, 65 7 (2 01 6) (in te rn al qu ot at io n m ark s om it te d)

. W e lo o k t o “ca s e s an d se co nd ary le ga l

m at eri al s to de te rm in e if th e rel ie f wou ld ha ve be en eq ui ta b l e i n t h e da y s of th e di vi de d be nc h.” Sere bo ff v. Mi d Atl

. Med

. Serv s., In c., 54 7 U.S. 35 6
, 36 2 (2 00 6) (in te rn al qu ot at io n m ark s om it te d)

. Usi ng th is fram ewo rk

, we as se ss Ib so n’s cl ai m s

to (1 ) al le ge d un pa id be ne fit s rel at in g to W ag ne r’s care an d (2 ) pr em iu m s sh e pa id

to UHS whi le sh e h ad a po li cy wit h i t.

i.

To st art , Ib so n’s cl ai m i n eq ui ty fo r al le ge d un pa id be ne fit s fai ls be cau se it
vi ol at es a fu nd am en ta l maxi m of eq ui ty juri sp ru de nc e: “ eq ui ty fo ll ows th e la w.”
1 Jo se ph St or y , Co m

m en ta rie s on Equ it y Ju ris pr ud en ce § 6 4 (1 2t h ed

. 18 77 ). As
Ju st ic e St or y ex pl ai ne d, “ [w]here a ru le [o f]

. . . th e st at ut e la w is di rect an d go ve rn s th e cas e wit h al l it s ci rcu m st an ces , or th e pa rti cu la r po in t, a co ur t of eq ui ty is as m uc h
bo un d by it

, as a co ur t of law.” Id

. Here, the re is a st at ut or y pr ov is io n th at go ve rn s th e reco ve ry of be ne fit s, § 11 32 (a)( 1) (B), an d— as di sc us se d ab ov e—t ha t pr ov is io n al lo ws on ly th e pe rs on to who m be ne fit s were du e t o r e c o v e r. Fo r th at reas on , gr an ti ng Ib so n’s cl ai m i n eq ui ty fo r al le ge d un pa id be ne fit s fo r W ag ne r’s care —a cl ai m th at W ag ne r’e es ta te wou ld ha ve to br in g in la w—wo ul d vi ol at e a co re te ne t
of eq ui ty j ur is pr ud en ce.

Fu rth erm or e, th is reas on in g is co ns is te nt wit h ou r du ty “ to co ns id er th e en ti re

te xt , in vi ew of it s st ru ct ur e an d of th e ph y si cal an d lo gi cal rel at io n of it s m an y pa rts .”
Doe s v. G il le sp ie

, 86 7 F.3 d 10 34
, 10 43 (8 th Ci r. 20 17 ) (q uo ti ng Ant on in Scal ia & Bryan A. Garne r, Read in g Law: The In te rp ret at io n o f Leg al Text s 1 67 (20 12 )). As

a res ul t, “ we are he si ta nt to ad op t a n in te rp ret at io n of a co ng res si on al en act m en t

-6

-whi ch ren de rs su pe rfl uo us an ot he r po rti on of th at sa m e la w.” U n i t e d St at es v.

Ji cari ll a Apa ch e Nati on , 56 4 U.S. 162, 185 (2 01 1) (in te rn al qu ot at io n m ark s om it te d)

. In de ed

, al lo win g Ib so n to se ek in eq ui ty wha t sh e can no t se ek at la w wou ld ren de r th e

te xt ua l st ric tu res of ex act ly who m ay se ek un pa id be ne fit s un de r § 11 32 (a)( 1) (B)
“s u pe rfl uo us .” Our read in g of § 11 32 (a)( 3) (B) in li gh t of th e m ax im s of e q u i t y, th eref or e, al ig ns wit h be dr oc k s ta tu to ry in te rp ret at io n pr in ci pl es , a nd we de cl in e to

co ns id er Ib so n’s cl ai m

for all eg ed be ne fit s d ue to W ag ne r in eq ui ty.

ii

.

Nex t, we ex am in e Ib so n’s cl ai m s fo r pr em iu m s pa id to UHS. Sh e as se rts two
th eo rie s of eq ui ty to reco ve r th em : refo rm at io n an d res ti tu ti on

. The “ refo r mati on

rem ed y av ai la bl e un de r § 11 32 (a)( 3) ,” ho wev er, “ al lo w[s] co ur ts to refo rm co nt ract s th at fa i l e d t o ex pr es s th e ag reem en t of th e pa rti es .” Si lv a v. Met ro po li ta n Life In s. Co
., 76 2 F.3 d 71 1, 72 3 (8 th Ci r. 20 14 ) (in te rn al qu ot at io n mar k s o mitt ed ). Here,
Ib so n an d UHS do no t di sa gr ee as to th e co nt ou rs of th e po li cy —i n ot he r wor ds

, th ey
ag ree on wha t it act ua ll y co ve red

. The y di sa gr ee ab ou t whe th er UHS is in vi ol at io n of th e po li cy

. Thu s, refo rm at io n is in ap po si te he re be cau se th ere is no ne ed to refo rm th e po li cy to “ cap tu re th e te rm s up on whi ch th e pa rti es ha d a m eet in g of th e m in ds .”
Gab rie l v. Alas ka Elec

. P e n s i o n Fu nd

, 77 3 F.3 d 94 5, 95 5 (9 th Ci r. 20 14 ) (in te rn al

qu ot at io n m ark s o m it te d)

.

As fo r Ib so n’s cl ai m fo r pr em iu m s un de r res ti tu ti on , “ no t al l rel ie f fal li ng un de r th e ru br ic of res ti tu ti on is av ai la bl e in eq ui ty.” Great -W. Life & Ann ui ty In s. Co

. v. Knu ds on , 53 4 U.S. 20 4, 21 2 (2 00 2)

. A res ti tu ti on cl ai m is co gn iz ab le in eq ui ty on ly
if “ m on ey or pr op ert y be lo ng in g in go od co ns ci en ce to th e pl ai nt iff [can ] cl earl y be

tra ced to pa rti cu la r fu nd s o r pr op ert y in th e d efen da nt ’s po ss es si on .” Id

. at 21 3. In
S e r e b o f f, th e Co ur t fo un d an act io n eq ui ta bl e whe re reco ve ry was so ug ht on “a

sp eci fic al ly i de nt ifi ed fu nd , n ot fro m th e [d efen da nt ’s] as se ts g e n e r a l l y .” 54 7 U.S.

at 36 3. Mu ch li ke in S e r e b o f f, Ib so n ha s id en ti fie d sp eci fic fu nd s— he r

-7

-pr em iu m s— th at are po te nt ia ll y in UHS’s po ss es si on

. As a res ul t, the res ti tu ti on ary

rem ed y s he se ek s fo r he r pr em iu m s is eq ui ta bl e. Cf. Cen t. St at es , S e. & Sw. Areas
Heal th & W el fa r e F u n d v

. Fi rs t Age nc y , In c., 75 6 F.3 d 95 4, 96 0 (6 th Ci r. 20 14 ) (fi nd in g reli ef requ es te d to be le ga l rath er tha n eq ui ta bl e be cau se pl ai nt iff ’s req ue st
ha d “ no co nn ect io n to an y pa rti cu la r fu nd at al l,” an d de fen da n t co ul d “ sa ti sf y th at
ob li ga ti on by dip pi ng in to an y po t i t ch oo se s” ).

Bu t, th at d o e s n o t en d th e in qu iry. Ib so n m us t st il l sh ow th at th e fu nd s (h er
pr em iu m s) ha ve no t “ di ss ip at ed .” Mo nt an il e, 13 6 S. Ct

. at 65 9 (res ti tu ti on in ap pr op ria te whe re “ de fen da nt on ce po ss es se d a se pa rat e, id en ti fia bl e fu nd

. . . bu t
th en di ss ip at ed it al l” ). The cri ti cal qu es ti on is whe th er Ib so n’s pr em iu m s are

“ se pa rat e fro m [UHS’s] ge ne ral as se ts ”—r at he r th an “ m ix ed ” wit h th os e as se ts —“ or di ss ip at ed

. . . on no nt race ab le ass et s.” Id . at 6 62 . If th e fu nd s ar e in de ed sep arat e,

an eq ui t ab le rem ed y to he r pr em iu m s is po te nt ia ll y av ai la bl e to Ib so n un de r § 1 13 2( a)(3 )(B)

.

3.

In su m , we ag ree wit h th e di st ric t co ur t th at Ib so n do es n o t h a v e a cl ai m to
al le ge d un pa id be ne fit s du e to W ag ne r un de r § 11 32 (a)( 1) (B). W e al so fin d th at sh e

can no t bri ng th is cl ai m in eq ui ty und er § 11 32 (a)( 3) (B). Bu t, a res ti tu ti on ary cl ai m fo r pr em iu m s sh e pa id un de r § 1 1 3 2( a)(3 )(B) is po te nt ia ll y av ai la bl e to he r if th ere

w a s a p l a n v io la ti on

. W e rem an d to th e di st ric t co ur t to de te rm in e in it ia ll y if th e r e

was su ch a pl an vi ol at io n an d, if so , whe th e r res ti tu ti on of Ib so n’s pr em iu m s is

“ ap pr op ria te eq ui ta bl e rel ie f” u nd er § 11 32 (a)( 3) (B).

B.

Co un t II of Ib so n’s co m

pl ai nt al le ge s th at UHS “ fai le d to di sc ha rg e it s du ti es

an d ob li ga ti on s as [p ]lan [a]dm in is tra to r” an d is su bjec t to a ci vi l pe na lt y of $1 00 pe r

-8

-da y un de r 29 U.S.C. § 11 32 (c)( 1) (B). The di st ric t co ur t di sm is se d th is co un t be cau se

UHS was no t th e “ pl an ad m in is tra to r.” The di st ric t co ur t was co rrec t: th e on ly en ti ty
th at m ay be fin ed un de r § 11 32 (c)( 1) (B) is th e pl an ad m in is tra to r, an d UHS was no t
it in th is cas e.

Ib so n arg ue s th at UHS was th e “ de fact o pl an ad m in is tra to r” be cau se th e pl an

cert ifi cat e an d po li cy do no t na m e UHS as th e pl an ad m in is tra to r. Thi s arg um en t is

, ho wev er, un av ai li ng un de r ou r cas es

. See Bro wn v. J.B . Hu nt Tran sp . S erv s., In c., 58 6 F.3 d 10 79
, 10 88 (8 th Ci r. 20 09 ) (“ Gov ern in g pr eced en t fo recl os es

. . . arg um en t
th at Pru de nt ia l was th e ‘de fac to pl an ad m in is tra to r.’”). 8

Mo re im po rta nt ly, ERISA, by it s pl ai n la ng ua ge , fo re c l o se s th is arg um en t:
whe re a pl an ad m in is tra to r is no t ex pl ic it ly de si gn at ed

, as is th e cas e he re, th e “ pl an
sp on so r” is al so th e pl an ad m in is tra to r. 29 U.S

. C

. § 1 0 0 2 (1 6) (A)(i i). Here, un de r ERISA, Ib so n’s fo rm er la w fir m was th e pl an sp on so r. § 10 02 (1 6) (B)( i). The refo re, it was a ls o t he pl an ad m in is tra to r. W hi le th is m ay se em at od ds wit h t he fun ct io na l

ro le s th e la w fir m an d UHS pl ay ed

, th e st at ut or y la ng ua ge of ERISA c o mp e l s t h e

co nc lu si on th at th e la w f

irm was th e pl an ad m in is tra t o r i n t h i s cas e, an d ou r ro le is

Ib so n ci te s a nu m

be r of ou t-o f-ci rcu it cas es in su pp or t of he r de fact o p l a n 8 ad m in is tra to r arg um en t. Out of th e cas es sh e ci te s, Law v. Erns t & You ng , 95 6 F.2 d 36 4, 37 4 (1 st Ci r. 19 92 ), is pe rh ap s th e st ro ng es t su pp or t fo r he r arg um en t be cau se it reco gn iz ed th at a § 11 32 (c)( 1) (B) pe na lt y co ul d be im po se d o n a de fact o pl an ad m in is tra to r. Bu t, ev en th e co ur t in Law reco gn iz ed it was de al in g wit h a fact ua ll y

un iq ue cas e. As th e Fi rs t Ci rcu it he ld rece nt ly, Law “ was care fu l to di st in gu is h th e

cas e be fo re it

, whi ch in vo lv ed an em pl oyer wit h ‘lit tl e, if an y , se pa rat e id en ti ty’ fro m [en ti ty de si gn at ed ] as ‘pla n ad m in is tra to r,’ fro m cas es in vo lv in g ‘atte m pt s to reco ve r ag ai ns t ent it ie s whi ch were cl earl y di st in ct fro m th e pl an ad m in is tra to r.’” Tetr eau lt

v. Rel ia nc e St an da rd Life In s. Co
., 76 9 F.3 d 49
, 60 (1 st Ci r. 20 14 ) (q uo ti ng Law, 95 6 F.2 d a t 3 74 ) (d is m is si ng de fact o p la n a dm in is tra to r arg um en t).

-9

-“ to ap pl y , no t am en d, th e wor k of th e Peo pl e’s rep res en ta ti ve s.” Hen so n v. San ta nd er

Co ns um er USA In c., 13 7 S . Ct. 1 71 8, 1 72 6 (2 01 7)

.

C.

Fi na ll y , Co un t IV of Ib so n’s co m pl ai nt al le ge s a br each of co nt ract in rel at io n

to th e em ai l se nt by UHS in Apr il 20 08

. The d i st ric t co ur t he ld th is co un t was
pr eem pt ed by E RISA. We agre e.

Ib so n arg ue s th at th e em ai l was a “ se tt le m en t ag reem en t” th at UHS br each ed by fai li ng to fo ll ow th ro ug h on th e co m m it m en ts la id ou t in it

. Pu tt in g as id e whe th er th e em ai l was a “ se tt le m en t ag reem en t” or no t, th is cl ai m is pr eem pt ed by ERISA.
Giv en th e “ ex tra or di na ry pr e-em pt iv e po wer” of “ th e ERISA ci vi l en fo rcem en t

m ech an is m ,” Aetn a Heal th

, In c. v. Dav il a, 54 2 U.S. 20 0, 20 9 (2 00 4)

, an y cl ai m “ [1 ]
th at ha [s ] a co nn ect io n wit h or [2 ] refe ren ce[s ] [an ERISA] pl an ” is “ pr eem pt ed ” by
ERISA. Est es v. Fed

. Exp res s Co rp ., 41 7 F.3 d 87 0, 87 2 (8 th Ci r. 20 0 5 ) (fi rs t an d
th ird al te rat io ns i n or ig in al ) (in te rn al qu ot at io n m ark s om it te d)

. Here, as we de sc rib ed be fo re, th e em ai l was so le ly ab ou t th e st ep s UHS wou ld ta ke to en su re th e

s mo o th ad m in is tra ti on of Ib so n’s ERISA pl an

. See su pr a no te 2. Acco rd in gl y,

“ be cau se th e es se nc e of [Ib so n’s] cl ai m rel at es to th e ad m in is tra ti on of pl an be ne fit s, it fal ls wit hi n th e sc op e of ERISA.” Park m an v. Pru de nt ia l In s. Co

. of Am
., 43 9 F.3 d
76 7, 7 71 -7 2 (8 th Cir . 20 06 ).

III.

Fo r th e fo reg oi ng reas on s, we affir m th e di st ric t cou rt’s di sm is sa l of Cou nt I

as it pe rta in s to Ib so n’s cl ai m to be ne fit s un de r §§ 11 32 (a)( 1) (B) an d 11 32 (a)( 3) (B),
Co un t II, an d C o u n t I V

. W e rev ers e th e di st ric t co ur t’s de ci si on on Co un t I wit h

reg ard s to Ib so n’s c l a i m to pr em iu m s pa id un de r § 11 32 (a)( 3) (B). On rem an d,

co ns is te nt wit h th is op in io n, th e di st ric t co ur t sh ou ld co ns id er (1 ) if a pl an vi ol at io n

-1 0-oc cu rred an d if so , (2 ) whe th er res ti tu ti on of I b s on ’s pr em iu m s is “ ap pr op ria te

eq ui ta bl e rel ie f” u nd er § 11 32 (a)( 3) (B).

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