Opinion ID: 723147
Heading Depth: 2
Heading Rank: 3

Heading: Grant of Summary Judgment on the Remaining ERISA Claims

Text: 12 Ms. Bowers sought a declaration that she was entitled to receive medical benefits without a maximum lifetime benefit ceiling as provided in both the Active Plan and Plan D. Ms. Bowers asserts that misrepresentations made to her by Sears estopped Sears from providing otherwise. The issue of Sears' representations is hotly contested by both sides. One of the elements of an estoppel claim in an ERISA action is detrimental reliance. Armistead v. Vernitron Corp., 944 F.2d 1287, 1298 (6th Cir.1991). Once again, we agree with the district court: The lack of evidence concerning [the detrimental reliance] element negates plaintiff's claim. Plaintiff simply did not have the opportunity to elect an alternative plan more attractive than Plan D, and therefore she can prove no detrimental reliance upon the representations allegedly made by Sears. 13 Judge Bell correctly noted that regardless of the option Ms. Bowers chose when the Active Plan terminated, she would have been in the present predicament when she became eligible for Medicare in January 1993. Since the conversion plans all terminated coverage upon Medicare eligibility, the factual determination regarding the representations would not affect the outcome of her claim and is, therefore, not material. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247 (1986).
14 Since the Sears' plans gave the plan administrator discretionary authority to interpret the terms of the plans, we review the plan administrator's determinations under an arbitrary and capricious standard of review. Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101 (1989). Judge Bell found no genuine issue of material fact regarding the alleged arbitrary and capricious nature of the plan administrator's determinations. Neither do we. 15 Interpretation of an ERISA plan is guided by traditional principles of contract interpretation according to federal law. See Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 56-57 (1987). [E]ach provision of a contract should be interpreted as part of an integrated whole, to the end that all of the provisions may be given effect if possible. Musto v. American General Corp., 861 F.2d 897, 906 (6th Cir.1988), cert. denied, 490 U.S. 1020 (1989). 16 The plan administrator's interpretation reasonably harmonized the coordination and termination provisions of Plan D: when read together, it becomes clear that Plan D coordinates Medicare benefits received by the dependent, not the covered employee, and that when the employee receives Medicare benefits she is switched to Plan E. This was the interpretation adopted by the plan administrator and it is neither arbitrary nor capricious. Ms. Bowers' contentions do not raise a genuine issue of material fact regarding the plan interpretation.