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Thomas Sturges v. Hy-Vee Employee Benefit Plan and Trust, Thomas Sturges v. Hy-Vee Employee Benefit Plan and Trust

Thomas STURGES, Appellee, v. HY-VEE EMPLOYEE BENEFIT PLAN AND TRUST, Appellant; Thomas STURGES, Appellant, v. HY-VEE EMPLOYEE BENEFIT PLAN AND TRUST, Appellee

Thomas Sturges v. Hy-Vee Emp. Benefit Plan & Trust, Thomas Sturges v. Hy-Vee Emp. Benefit Plan & Trust, 991 F.2d 479 (8th Cir. 1993)
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Court
Court of Appeals for the Eighth Circuit · U.S. Courts of Appeals
Decided
April 16, 1993
Docket
Nos. 92-2579, 92-2633
Judges
Fagg, Magill, Hansen
Citations
991 F.2d 4791993 WL 1147111993 U.S. App. LEXIS 7879

Opinion — Per Curiam

PER CURIAM.

Thomas Sturges, a Hy-Vee employee, brought this action against the Hy-Vee Employee Benefit Plan and Trust (Hy-Vee), the administrator of an ERISA plan, after Hy-Vee denied health care coverage for Sturges’s newborn daughter, Andrea, under Sturges’s preexisting dependent coverage. Recognizing the plan gives Hy-Vee discretionary authority to construe the plan, the district court reviewed Hy-Vee’s plan interpretation under the deferential standard of review delineated by the Supreme Court in Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 111, 115 , 109 S.Ct. 948, 954, 956 , 103 L.Ed.2d 80 (1989) and explained by this court in Cox v. Mid-America Dairymen, Inc., 965 F.2d 569 , 571-72 & n. 3 (8th Cir.1992). Applying this deferential standard, the district court rejected Hy-Vee’s interpretation of the plan and ordered Hy-Vee to pay Andrea’s covered medical bills. The district court then awarded Sturges attorney fees, but in an amount less than requested. On appeal, Hy-Vee asserts its interpretation of the plan was not unreasonable. On cross-appeal, Sturges asserts the district court should have awarded the full amount of attorney fees requested.

We review de novo the district court’s application of the deferential Firestone standard to Hy-Vee’s interpretation of the plan.

Bernards v. United of Omaha Life Ins. Co., 987 F.2d 486, 488-89 (8th Cir.1993). Having carefully reviewed the plan documents, we conclude Hy-Vee abused its discretion in interpreting the plan to deny dependent coverage for Andrea. We agree with the district court that the plan in effect when Andrea was born, which Hy-Vee concedes applies, clearly and unambiguously provides newborns with coverage from birth. Although the plan summary is at odds with the plan, the summary states that the plan controls when the summary and plan conflict.

See *481 Glocker v. W.R. Grace & Co., 974 F.2d 540, 542-43 (4th Cir.1992) (when summary favors employer, employer cannot disavow a disclaimer in the summary stating the plan controls). We also agree with the district court that the later plan revision adding the summary language favorable to Hy-Vee was a change in the plan, not a “clarification.” We thus conclude the district court properly reversed Hy-Vee’s coverage denial, which was based on an interpretation contrary to the clear language of the plan.

See Finley v. Special Agents Mutual Benefit Ass’n, 957 F.2d 617, 621 (8th Cir.1992).

As for the cross-appeal, we conclude the district court did not abuse its discretion in awarding $12,600.00 in attorney fees rather than the requested amount of $17,-583.74.

See Gunderson v. W.R. Grace & Co. Long Term Disability Income Plan, 874 F.2d 496, 501 (8th Cir.1989) (amount of attorney fee award is within district court’s discretion). Although the district court did not specify its reasons for awarding less than the amount requested or explain how it arrived at the lesser amount, Hy-Vee’s specific objections to the fee request indicate the district court excluded hours that were not reasonably expended.

See Hensley v. Eckerhart, 461 U.S. 424, 434 , 103 S.Ct. 1933, 1939 , 76 L.Ed.2d 40 (1983).

Accordingly, we affirm.

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Cited by 12 cases

View all citing references →
1993: 11994: 11995: 21997: 22004: 22006: 12007: 12010: 12015: 119932026peak 1995 · 2

Relies on it most ⓘ

  1. Jobe v. Medical Life Insurance598 F.3d 478 (8th Cir. 2010)
  2. Paulson v. Paul Revere Life Ins. Co.323 F. Supp. 2d 919 (S.D. Iowa 2004)
  3. Gaspar v. Linvatec Corp.952 F. Supp. 1274 (N.D. Ill. 1997)
  4. John Cottillion v. United Refining Co781 F.3d 47 (3d Cir. 2015)
  5. Springs Valley Bank & Trust Co. v. Carpenter885 F. Supp. 1131 (S.D. Ind. 1993)
  6. Camarda v. Pan American World Airways, Inc.956 F. Supp. 299 (E.D.N.Y. 1997)

Most recent

  1. John Cottillion v. United Refining Co781 F.3d 47 (3d Cir. 2015)
  2. Jobe v. Medical Life Insurance598 F.3d 478 (8th Cir. 2010)
  3. Administrative Committee for the Wal-Mart Stores, Inc. Associates' Health & Welfare Plan v. Salazar525 F. Supp. 2d 1103 (D. Ariz. 2007)
  4. Hopkins v. Prudential Insurance Company of America432 F. Supp. 2d 745 (N.D. Ill. 2006)
  5. Morrison v. Marsh & McLennan Companies, Inc.326 F. Supp. 2d 833 (E.D. Mich. 2004)
  6. Paulson v. Paul Revere Life Ins. Co.323 F. Supp. 2d 919 (S.D. Iowa 2004)

Citing references are not a citator: they show that a later opinion cites this case, not whether it followed, distinguished, or overruled it. Check negative history before relying on this case.

Authorities cited 7

DepthCaseCited by
Hensley v. Eckerhart, 461 U.S. 424 (1983) 16,543
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989) 5,975
Drexel Finley v. Special Agents Mut. Benefit Ass'n, 957 F.2d 617 (8th Cir. 1992) 192
Cox v. Mid-Am. Dairymen, Inc., 965 F.2d 569 (8th Cir. 1992) 80
Glocker v. W.R. Grace & Co. Aetna Life Ins. Co., 974 F.2d 540 (4th Cir. 1992) 59
Gunderson v. W.R. Grace & Co. Long Term Disability Income Plan, 874 F.2d 496 (8th Cir. 1989) 43
Bernards v. United of Omaha Life Ins. Co., 987 F.2d 486 (8th Cir. 1993) 14

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