from the United States District Court for the Eastern
District of Texas
SMITH, PRADO, and GRAVES, Circuit Judges.
E. SMITH, Circuit Judge.
Rhea was the beneficiary of an employee benefit plan
organized under the Employee Retirement Income Security Act
of 1974, as amended ("ERISA"), 29 U.S.C. §
1001 et seq. Rhea suffered injuries from medical
malpractice. The plan covered some of her medical expenses.
After she settled the malpractice claim, the plan sought
plan used a single document as both its summary plan
description and its written instrument. That document had a
reimbursement provision. Rhea refused to reimburse the plan,
claiming that it did not have an enforceable written
instrument. She sought a declaratory judgment and appeals an
adverse summary judgment and attorneys' fees. Finding no
error, we affirm.
Ritchey, Inc. ("Alan Ritchey"), is the sponsor and
administrator of an employee benefit program called the
"Alan Ritchey, Inc. Welfare Benefit Plan"
("the Plan"), which purports to comply with ERISA.
Rhea, the wife of an Alan Ritchey employee, was a beneficiary
of the Plan. In November 2011, Rhea underwent surgery and
alleged injury from malpractice. The Plan covered $71, 644.77
of her medical expenses. After she settled the malpractice
claim for more than that amount, the Plan sought
beneficiary, Rhea received a document entitled "Summary
Plan Description UnitedHealthcare Choice Plus Silver Plan for
Alan Ritchey, Inc." The summary plan description
("SPD") contains reimbursement and subrogation
language. It states that "if a third party causes a
Sickness or Injury for which you receive a settlement,
judgment, or other recovery, you must use those proceeds to
fully return to the Plan 100% of any Benefits you received
for that Sickness or Injury." The SPD adds, "If the
Plan incurs attorneys' fees and costs in order to collect
third party settlement funds held by you or your
representative, the Plan has the right to recover those fees
and costs from you."
alludes to the existence of a separate "official Plan
Document" and provides that "[i]n the event of any
discrepancy between this Summary Plan Description and the
official Plan Document, the Plan Document shall govern."
But when the Plan paid Rhea's medical expenses, the SPD
was the only document describing a beneficiary's rights
and obligations under the Plan.When Rhea's attorneys asked to see the
"official Plan Document, " defendants produced an
affidavit signed by Charla Moss, Alan Ritchey's benefits
administrator, stating that the SPD "is the Plan
document that has been accepted, ratified, and maintained by
the Plan Sponsor, that contains all of the ERISA-required
plan provisions, and operates as the Plan's official plan
has refused to reimburse the Plan for the $71, 644.77 it
spent on her medical treatment. She claims that Alan Ritchey
did not have an ERISA-compliant written instrument in place
when the Plan paid her medical expenses. As a result, she
says, the Plan does not have a right to be reimbursed. Rhea
also accuses Alan Ritchey of making "knowing
misrepresentations" about the Plan's compliance with
ERISA. Defendants claim that the Plan was ERISA-compliant at
all relevant times and that it established a right to be
reimbursed for Rhea's medical expenses.
September 2013, Rhea sued Alan Ritchey and the Plan for a
declaratory judgment that she is not required to reimburse
the Plan. Defendants filed a counterclaim requesting
equitable relief and damages under ERISA. Both sides moved
for summary judgment. The magistrate judge ("MJ")
recommended granting summary judgment and $31, 415.50 in
attorneys' fees and costs to defendants. The district
court adopted those recommendations and entered final
judgment against Rhea, who appeals.
requires plan administrators to provide SPDs to
beneficiaries. 29 U.S.C. § 1024(b)(1). An SPD must
"reasonably apprise [plan] participants and
beneficiaries of their rights and obligations under the
plan" and must be "written in a manner calculated
to be understood by the average plan participant."
Id. § 1022(a). ERISA also mandates that plans
"be established and maintained pursuant to a written
instrument." Id. § 1102(a)(1). A
plan's written instrument sets forth its terms and must
do the following:
(1)provide a procedure for establishing and carrying out a
funding policy and method consistent with the objectives of
the plan and the requirements of this subchapter,
(2)describe any procedure under the plan for the allocation
of responsibilities for the operation and administration of
the plan (including any procedure described in section
1105(c)(1) of this title),
(3)provide a procedure for amending such plan, and for
identifying the persons who have authority to amend the plan,
(4)specify the basis on which payments are made to and from
Id. § 1102(b). Courts often refer to written
instruments as "plan ...