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MAROTTA v. ROAD CARRIER LOCAL 707 WELFARE FUND

March 16, 2000

JACK F. MAROTTA, PLAINTIFF,
V.
ROAD CARRIER LOCAL 707 WELFARE FUND, DEFENDANT.



The opinion of the court was delivered by: Orenstein, United States Magistrate Judge.

    MEMORANDUM AND ORDER

Plaintiff Jack F. Marotta ("plaintiff" or "Marotta") brings this action against defendant Road Carrier Local 707 Welfare Fund ("defendant" or the "Welfare Fund"), alleging that the Welfare Fund violated the Employee Retirement Income Security Act of 1974, as amended, ("ERISA"), Section 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), when defendant failed to provide plaintiff with health insurance coverage for his spouse, whom plaintiff married approximately one year after he retired. Defendant moves the Court for an order granting summary judgment pursuant to Fed.R.Civ.P. 56 and dismissing the complaint. Plaintiff cross-moves for an order granting summary judgment in his favor on his claims against defendant pursuant to Fed.R.Civ.P. 56. For the reasons set forth below, the Court grants defendant's motion and denies plaintiffs cross-motion.

FACTUAL BACKGROUND

On April 1, 1989, Marotta retired from the employ of Tose Fowler, Inc., after having completed thirty-three years of service in the Teamsters Local Union No. 707. (Compl. Par; 10-11). At the time of his retirement, Marotta was a participant in the Welfare Fund and the Road Carriers Local 707 Pension Fund (the "Pension Fund").*fn1

In connection with his retirement, Marotta submitted to the Pension Fund Office an acknowledgment dated March 17, 1989, confirming that his pension would commence on May 1, 1989, (Alimena Aff. ¶ 18, Exh. J) and an "Election of Medical Benefits or Death Benefit Option," dated April 14, 1989 in which there was no recorded entry under "wife's name" "[wife's] date of birth," and "Spouse's S.S. #," (Alimena Aff. ¶ 19, Exh. K). At the time of these submissions, Marotta's first wife was deceased. (Compl. ¶ 13).

In a letter dated October 3, 1989, the Pension Funds Manager, Albert J. Alimena, notified Marotta that he was eligible for medical and hospital benefits pursuant to the Welfare Fund Plan (the "Welfare Plan"). (Compl. ¶ 12, Exh. 2). The letter stated:

Effective 10/01/89, you are eligible for medical & hospital benefits as a retiree enrolled in our 00714M [Pensioners Medical-Surgical Option] plan. This entitles you and your spouse benefits (until the last day of the month prior to each of your 65th birthdays. If either the participant or the spouse is age 65 at the time this coverage is elected then only that individual who is less than age 65 will be eligible for this coverage). . . .

(Compl. ¶ 12, Exh. 2). On March 30, 1990, Marotta married Marie Elaine Shaw. (Compl. ¶ 14; Alimena Aff., Exh. M).

Shortly thereafter, Marotta "was advised that his spouse was not covered for medical benefits by the Welfare Plan." (Compl. ¶ 15). In March 1991, the Welfare Fund Office received a verbal inquiry from Marotta concerning the eligibility of his current spouse, Marie (Shaw) Marotta for coverage under the Pensioners Medical-Surgical Option. (Compl.Exh. 3; Dft. 56.1 Statement at ¶ 30).*fn2 By letter dated March 7, 1991, the Fund Manager Alimena responded:

Pursuant to your request, I have reviewed the eligibility requirements for medical benefits of a pensioner's spouse. For the purpose of entitlement to coverage, a spouse is defined as the lawful husband or wife at the effective date of retirement, of the eligible pensioner.
Consequently, if an eligible pensioner remarries after the effective date of his or her retirement, no medical coverage will be provided for the spouse.
If you have any questions, please do not hesitate to contact me.

(Compl.Exh.3) (emphasis in original).

On August 12, 1996, approximately seven years after his retirement, Marotta wrote the following letter to the Board of Trustees of the Welfare Fund and Pension Fund:

I Jack Marotta was a dedicated union member and shop steward for local 707. I retired in April 1989, because Tose Fowler who I worked for was unable to conduct business after a teamster strike which took place Feb. 1989. I retired at the age of 52 because jobs were scarce and I would have lost my seniority and vacation time.
My first wife passed away and I remarried March 30, 1990. I assumed my present wife would be covered under my health insurance plan.
I wrote the union several times on this issue and Mr. Albert Alimena responded with a form letter stating that my wife was not eligible for medical benefits. To date I have paid over $15,000 for medical insurance for my wife which has been a great hardship.
I would appreciate a copy of all literature stating that my wife was not entitled to my medical benefits. Please be more specific on your denial. I would like to meet with the Board of Trustees concerning this matter.

(Compl.Exh.4).

In a letter dated August 21, 1996, Fund Manager Alimena informed Marotta that "the rules of the Pension Plan are used to define who meets the requirements for coverage as an `eligible spouse,'" enclosed copies of the relevant plan provisions and denied Marotta's request for a meeting with the Board of Trustees. (Compl. ¶ 18, Exh. 5; Alimena Aff. ¶ 39, Exh. Q). After reviewing the enclosed provisions, Marotta wrote Alimena on September 12, 1996, stating that pursuant to the terms of the Welfare Plan, his spouse should have been receiving medical benefits. (Compl. ¶ 20, Exh. 6).

Thereafter, defendant requested that its counsel review Marotta's request for medical benefits for his spouse and respond to Marotta. (Compl.Exh.7). Counsel for the Welfare Fund advised Marotta by letter dated September 18, 1996 that

Generally, the Welfare Fund provides medical benefits to pensioners and their spouses until they reach age 65. To determine who is a pensioner's spouse, the Welfare Fund uses the same rules as the Pension Fund. According to those rules, coverage is only provided to the spouse that you were married to at the time you began receiving benefits. Therefore, since you were not ...

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