Opinion ID: 149598
Heading Depth: 3
Heading Rank: 1

Heading: Dean is a plan fiduciary

Text: Apropos of the first element, Kenseth's claim focuses on the actions and omissions of Dean rather than Detmer. Of course, it was Detmer who advised Kenseth that her Roux-en-Y procedure would be covered by Dean. But ERISA provides that a person is a fiduciary to the extent (i) he exercises any discretionary authority or discretionary control respecting management of such plan or exercises any authority or control respecting management or disposition of assets, (ii) he renders investment advice for a fee or other compensation, direct or indirect, with respect to any moneys or other property of such plan, or has any authority or responsibility to do so, or (iii) he has any discretionary authority or discretionary responsibility in the administration of such plan. 29 U.S.C. ง 1002(21)(A). Detmer fits none of these categories: she had no authority or discretion in terms of managing the Dean plan, she did not render investment advice or exercise any control over the assets of the plan, nor did she possess any discretionary authority or responsibility in the administration of the plan. Her role as a customer service representative was ministerial in nature. See 29 C.F.R. ง 2509.75-8, D-2 (a person who performs purely ministerial functions ... for an employee benefit plan within a framework of policies, interpretations, rules, practices and procedures made by other persons is not a fiduciary ...); see also, e.g., Kannapien, 507 F.3d at 639 (neither plant manager nor human resources manager acted as plan fiduciary in discussing early retirement plan benefits with employees); Tegtmeier v. Midwest Operating Eng'rs Pension Trust Fund, 390 F.3d 1040, 1047-48 (7th Cir.2004) (administrative manager of pension fund did not act as fiduciary in communicating with employee regarding ability to put pension application on hold); Schmidt v. Sheet Metal Workers' Nat'l Pension Fund, 128 F.3d 541, 547 (7th Cir.1997) (benefits analyst did not act as plan fiduciary in advising pension plan participant how to designate beneficiary). And although Detmer was Dean's employee, and Dean, as we are about to explain, does qualify as an ERISA fiduciary, Dean cannot be held liable on the basis of respondeat superior. As we observed in Kannapien, Finding that [p]lan administrators may breach a fiduciary duty vicariously through the actions of a non-fiduciary would vitiate our requirement that an ERISA claim for breach of a fiduciary duty must be asserted against plan fiduciaries. 507 F.3d at 640 (citing Jenkins v. Yager, 444 F.3d 916, 924 (7th Cir.2006), and Bowerman v. Wal-Mart Stores, Inc., supra, 226 F.3d at 590-91). Dean is another matter, however. As an HMO and a claims administrator possessed of discretion in construing and applying the provisions of its group health plan and assessing a participant's entitlement to benefits, Dean is an ERISA fiduciary. See ง 1002(21)(A)(i) and (iii); Aetna Health Inc. v. Davila, 542 U.S. 200, 220, 124 S.Ct. 2488, 2502, 159 L.Ed.2d 312 (2004); Mondry v. Am. Fam. Mut. Ins. Co., 557 F.3d 781, 803 (7th Cir.), cert. denied, ___ U.S. ___, 130 S.Ct. 200, 175 L.Ed.2d 241 (2009). As a fiduciary, Dean is obliged to carry out its duties with respect to the plan solely in the interest of the participants and beneficiaries andโ(A) for the exclusive purpose of: (i) providing benefits to participants and their beneficiaries; ... [and] (B) with the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent man acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims.... 29 U.S.C. ง 1104(a)(1). Dean thus owes the participants in its plan and their beneficiaries a duty of loyalty like that borne by a trustee under common law, ง 1104(a)(1)(A), and it must exercise reasonable care in executing that duty, ง 1104(a)(1)(B). Mondry, 557 F.3d at 807.