Court Opinion

ID: 990463
Source: CourtListenerOpinion
Date Created: 2013-07-03 23:21:52.433244+00
Date Added: 2024-06-11T15:35:28.356507
License: Public Domain

UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

WILLIAM N. HOMAN,
Plaintiff-Appellant,

v.

T. W. GARNER FOOD COMPANY,
Defendant-Appellee,                                                 No. 95-1936

v.

BLUE CROSS AND BLUE SHIELD OF
NORTH CAROLINA, INC.,
Third Party Defendant-Appellee.

Appeal from the United States District Court
for the Middle District of North Carolina, at Winston-Salem.
N. Carlton Tilley, Jr., District Judge.
(CA-91-520)

Submitted: September 10, 1996

Decided: September 23, 1996

Before MURNAGHAN and MOTZ, Circuit Judges, and PHILLIPS,
Senior Circuit Judge.

_________________________________________________________________

Affirmed by unpublished per curiam opinion.

_________________________________________________________________

COUNSEL

Charles O. Peed, Jr., CHARLES PEED & ASSOCIATES, Winston-
Salem, North Carolina, for Appellant. Jack E. Thornton, Jr.,
CANADY, THORNTON, BROWN & LAWS, L.L.P., Winston-
Salem, North Carolina; Lindsay R. Davis, Jr., HILL, EVANS, DUN-
CAN, JORDAN & DAVIS, P.L.L.C., Greensboro, North Carolina,
for Appellees.

_________________________________________________________________

Unpublished opinions are not binding precedent in this circuit. See
Local Rule 36(c).

_________________________________________________________________

OPINION

PER CURIAM:

Appellant William N. Homan appeals the district court's dismissal
of his claims for medical benefits under the Consolidated Omnibus
Budget Reconciliation Act ("COBRA"), 29 U.S.C.A. § 1161-69
(West Supp. 1996). Following his divorce, Homan elected to continue
insurance coverage through his former wife's employer, T. W. Garner
Food Company ("Garner"). Under Garner's written medical benefits
plan, Homan could continue his medical insurance coverage by pay-
ing his premiums by the twenty-fifth of each month preceding the
coverage month. Also, if payment was not received within thirty days
of the due date his coverage would automatically terminate retroac-
tively. Homan was aware of these provisions.

Homan did not tender payment for August 1989, which was due by
July 25, 1989, until September 8, 1989.* Accordingly, Garner can-
celled Homan's coverage on September 20, retroactive to August 1.
Meanwhile, Homan incurred medical expenses on August 25 which
were denied by Garner's insurance carrier, Blue Cross and Blue
Shield of North Carolina, Inc. ("Blue Cross"), because Homan was
not covered by Garner's medical plan at the time.

On appeal, Homan claims his untimely payment was waived by
_________________________________________________________________
*A third party tendered payment to a Garner representative. The check
was never cashed.

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Garner because it accepted his payment on September 8, and that Gar-
ner is estopped from terminating his coverage. We review the district
court's grant of summary judgment de novo. Higgins v. E. I. Du Pont
de Nemours & Co., 863 F.2d 1162, 1167 (4th Cir. 1988).

Enacted in 1986, COBRA amended the Employment Retirement
Income Security Act, 29 U.S.C.A. §§ 1001-1169 (West 1985 & Supp.
1996) ("ERISA"), providing for limited continuation of coverage
rights under employer-provided group health insurance. See 29
U.S.C.A. §§ 1161-69 (West Supp. 1996). Coverage may cease, how-
ever, upon late payment of premiums, which COBRA defines as
thirty days past the due date as stated in a plan. 29 U.S.C.A.
§ 1162(2)(C) (West Supp. 1996). A company may automatically and
retroactively terminate benefits for failure of timely payment.
Coleman v. Nationwide Life Ins. Co., 969 F.2d 54, 57-58 (4th Cir.
1992), cert. denied, 506 U.S. 1081 (1993).

The district court properly granted summary judgment to Garner
because the record was uncontroverted that Homan failed to make his
August payment by the July 25 due date or within thirty days after the
due date. See 29 U.S.C.A. § 1162(2)(C); Coleman, 969 F.2d at 57-58.
Homan's claims that Garner waived its right or is estopped from
demanding timely payment fail because benefits plans governed by
ERISA must be maintained pursuant to a written instrument, 29
U.S.C. § 1102(A)(1) (1988), and oral or informal communications are
inadequate to alter the written terms of the plan. See Biggers v. Wittek
Indus. Inc., 4 F.3d 291, 295-96 (4th Cir. 1993) (oral or informal writ-
ten amendments are inadequate to alter written terms of an ERISA
plan because this practice would undermine certainty). Further, the
doctrine of estoppel cannot be used to circumvent this requirement.
See Pierce v. Security Trust Life Ins. Co., 979 F.2d 23, 29 (4th Cir.
1992) (the requirement that ERISA plans be maintained in writing
precludes oral modifications of the plan; common law doctrine of
estoppel cannot be used to alter this result). For these reasons, we
affirm the district court's dismissal of the action.

AFFIRMED

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