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Koblentz v. UPS Flexible Employee Benefit Plan

United States District Court, Ninth Circuit

August 23, 2013



LARRY ALAN BURNS, District Judge.

I. Introduction

This is an ERISA case. Sara Koblentz, a United Parcel Service employee, has sued her employer's Flexible Benefits Plan ("the Plan") for its refusal to cover inpatient treatment she received for alcoholism and an eating disorder. Now pending before the Court is the Plan's motion to dismiss. The Plan alleges, first, that Koblentz assigned her right to sue to her treatment center, and second, that Koblentz's claim is contractually time-barred. The Court disagrees with the Plan on the first point, but agrees with it on the second. It therefore GRANTS the Plan's motion to dismiss.

II. Factual and Procedural Background

On December 16, 2009, Koblentz enrolled in an inpatient alcoholism and eating disorder treatment program at Timberline Knolls Residential Treatment Center. (FAC ¶¶ 9-10.) Fifteen days later, she learned that the Plan was refusing to pay for her treatment, and she left the program immediately. (FAC ¶ 10.) In the following months the Plan communicated with Koblentz through its claims administrator, ValueOptions, and the Plan's Claims Review Committee. The Plan denied Koblentz's first level appeal, filed by Timberline Knolls, and initiated an automatic second level appeal. On April 1, 2010, the Plan wrote Koblentz a letter denying her second level appeal, which Koblentz alleges she did not initially receive, at least in full. (FAC ¶ 16.) On April 29, the Plan again wrote to Koblentz, "[Y]our appeal rights have been exhausted through ValueOptions and the Plan." (FAC ¶ 20.) On May 28, the Claims Review Committee sent Koblentz a second copy of the April 1 letter denying her second level appeal. (FAC ¶ 25.) And on July 22, 2010, the Plan informed Koblentz of the denial of her second level appeal a fourth time, stating that all her appeals had been exhausted. (FAC ¶ 27.) Koblentz filed this ERISA lawsuit on January 12, 2012.

III. Legal Standard

A motion to dismiss under Rule 12(b)(6) tests the legal sufficiency of a complaint and allows a court to dismiss a complaint upon a finding that the plaintiff has failed to state a claim upon which relief may be granted. See Navarro v. Block, 250 F.3d 729, 732 (9th Cir. 2001). A complaint survives a motion to dismiss if it contains "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570. "Factual allegations must be enough to raise a right to relief above the speculative level." Twombly, 550 U.S. at 555. In deciding a motion to dismiss, the court accepts all factual allegations in the complaint as true, and draws all reasonable inferences in favor of the nonmoving party. al -Kidd v. Ashcroft, 580 F.3d 949, 956 (9th Cir. 2009) (citations omitted). Nevertheless, the reviewing court need not accept "legal conclusions" as true. Ashcroft v. Iqbal, 556 U.S. 662, 678, (2009).

IV. Consideration of Extrinsic Documents

The Plan asks the Court to consider thirteen documents attached to its motion, none of which are attached to the FAC itself. They are the provisions of the Plan, various correspondences with Koblentz, and documents related to the handling of her claim.[1] This is acceptable.

"Documents whose contents are alleged in a complaint and whose authenticity no party questions, but which are not physically attached to the pleading, may be considered in ruling on a Rule 12(b)(6) motion to dismiss." Branch v. Tunnell, 14 F.3d 449, 454 (9th Cir. 1994). A court may treat such documents as "a part of the complaint, and thus may assume that [their] contents are true for purposes of a motion to dismiss under Rule 12(b)(6)." United States v. Ritchie, 342 F.3d 903, 908 (9th Cir. 2003).

The Court can consider the documents in question because Koblentz's complaint necessarily relies on them. Koblentz's claims are based primarily on the Plan's alleged violation of appeal procedures described in the Summary Plan Description (SPD) and incorporated by the terms of Plan. She purports to quote substantial text from these procedures and alleges that the contents of her correspondence with the Plan substantiate her claims. The Plan attaches the very same documents to its motion and Koblentz does not challenge their authenticity. The Court can therefore consider them. See Parrino v. FHP, Inc., 146 F.3d 699, 706 (9th Cir. 2003) (on a motion to dismiss an ERISA claim, documents governing plan membership, coverage, and administration were "essential to the complaint"); Pension Ben. Guar. Corp. v. White Consol. Indus., inc., 998 F.2d 1192, 1197 (3d Cir. 1993).

IV. Discussion

As the Court said at the outset, the Plan's motion to dismiss presents two questions. The first is whether Koblentz assigned away her right to sue to Timberline Knolls. The ...

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