Bd. of Trustees v. Moore, 800 F.3d 214 (6th Cir. 2015), considered whether a summary plan description (SPD) that was the only document containing a subrogation provision was a binding plan document. The Board of Trustees of the National Elevator Industry (NEI Board) established a health benefits plan, pursuant to two relevant documents. The first was a Trust Agreement between the NEI Board and participating elevator companies, which provided for the establishment and funding of a health benefit plan. The Trust Agreement did not, however, contain any details of a health plan. The NEI Board never created a plan document, but did create an SPD, which details the terms of the plan, and contains a subrogation provision. The Plan’s director of health claims administration testified that the SPD constituted both the plan and the summary of that plan.
The defendant argued that, under Amara, the SPD could not be the plan, so that the Trust Agreement, which did not have a subrogation provision, had to be the governing plan document.
The Sixth Circuit began by noting that the Third and Eleventh Circuits had previously held that the same NEI SPD was the controlling ERISA plan in the absence of a separate plan document, and that it authorized subrogation (certiorari has been granted in the Eleventh Circuit case, Bd. of Trustees of the Nat’l Elevator Indus. Health Ben. Plan v. Montanile, 593 Fed.Appx. 903, 910 (11th Cir.2014), on the question whether a subrogation claim is equitable when the beneficiary had dissipated the fund).
Ultimately, the court adopted a holding of the Second Circuit in an unrelated case, stating: “an SPD describing employee benefits that anticipates the existence of a Plan, but is issued long in advance of the Plan, constitutes the actual plan, as well as a summary of a plan ‘that is nowhere else in writing.’” Quoting Feifer v. Prudential Ins. Co. of America, 306 F.3d 1202, 1209 (2d Cir. 2002). The Sixth Circuit then stated: “Nothing in the Supreme Court’s later opinion in Amara has any negative effect on the Second Circuit’s analysis in Feifer.