Christina Russell v. Comcast Corporation , 381 F. App'x 657 ( 2010 )

FILED
NOT FOR PUBLICATION JUN 02 2010
MOLLY C. DWYER, CLERK
UNITED STATES COURT OF APPEALS U .S. C O U R T OF APPE ALS
FOR THE NINTH CIRCUIT
CHRISTINA RUSSELL, an individual, No. 09-35435
Plaintiff - Appellant, D.C. No. 2:08-cv-00309-TSZ
v.
MEMORANDUM *
COMCAST CORPORATION, a foreign
corporation, Short Term Disability Plan
and Long Term Disability Plan sponsor for
the Comcast Short Term Disability and
Long Term Disability Plans; et al.,
Defendants - Appellees.
Appeal from the United States District Court
for the Western District of Washington
Thomas S. Zilly, Senior District Judge, Presiding
Argued and Submitted April 8, 2010
Seattle, Washington
Before: HAWKINS, LUCERO,** and N.R. SMITH, Circuit Judges.
*
This disposition is not appropriate for publication and is not precedent
except as provided by 9th Cir. R. 36-3.
**
The Honorable Carlos F. Lucero, Circuit Judge for the Tenth Circuit
Court of Appeals, sitting by designation.
We review de novo an order granting summary judgment and a district
court’s determination of the appropriate standard of review of an ERISA
administrator’s decision. Sznewajs v. U.S. Bancorp Amended & Reinstated
Supplemental Benefits Plan, 572 F.3d 727, 732 (9th Cir. 2009). “In the absence of
a conflict, judicial review [of an ERISA administrator’s decision] . . . involves a
straightforward application of the abuse of discretion standard.” Montour v.
Hartford Life & Accident Ins. Co., 588 F.3d 623, 629 (9th Cir. 2009). When a
conflict of interest exists, we apply “abuse of discretion review, tempered by
skepticism commensurate with the plan administrator’s conflict of interest.”
Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 959 (9th Cir. 2006).
When a plan insurer is also the administrator, there is a structural conflict of
interest. Montour, 588 F.3d at 630. Here, Comcast delegated administration of the
Short Term Disability Plan (“STD” Plan) to Broadspire, though Comcast retained
authority to review Broadspire’s determinations. We need not determine here
whether this arrangement creates a structural conflict (as to Comcast) under
Montour, because—even if there were a conflict—the “skepticism commensurate”
with the conflict is slight. Abatie, 458 F.3d at 959. It is common for an ERISA
administrator to be both a plan insurer and administrator, and “[t]he level of
skepticism with which a court views a conflicted administrator’s decision may be
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low if a structural conflict of interest is unaccompanied, for example, by any
evidence of malice, of self-dealing, or of a parsimonious claims-granting history.”
Id. at 968. There is no evidence in the record that suggests heightened scrutiny is
appropriate. Rather, the record reflects the opposite, that Comcast did not interfere
with Broadspire’s administration of the STD plan. Thus, Comcast’s conflict—if
there is one at all—only merits limited skepticism.
In addition to administering the STD plan, Broadspire also insured 1 the Long
Term Disability Plan (“LTD” Plan). Because Russell was not eligible for STD
benefits for 26 weeks, she was never eligible for LTD benefits. Russell argues that
Broadspire acted as a “gatekeeper” with regard to LTD benefits, denying STD
benefits in order to prevent eligibility for LTD benefits. While there is no case law
suggesting that such an arrangement is inherently a conflict, this situation is
analogous to situations where the plan administrator is also the insurer. Again,
such a conflict, without more, does not require much skepticism. Thus, it is of
little importance to the outcome of this case if there is technically a conflict as to
Broadspire. Because there is no evidence in the record of self-dealing or malice,
1
Though Comcast and Broadspire argue that another entity insured the plan,
the record before this panel contains no such evidence and suggests that Broadspire
insured the plan.
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we find that only minimal skepticism should temper our abuse of discretion review
of Broadspire’s determinations.
Finally, we note that the district court decided this case before our decision
in Montour, 588 F.3d at 623. Though the district court did not have the benefit of
Montour, we find the district court’s analysis consistent with that opinion. The
district court properly reviewed Broadspire’s determinations for an abuse of
discretion. We also find ample evidence on the record to support Broadspire’s
determination under this standard. Comcast made no administrative decisions for
this panel to review, and no determinations were made by either defendant under
the LTD plan. Accordingly, the district court is AFFIRMED.
4