United States District Court, W.D. Washington, Seattle
SWIRE PACIFIC HOLDINGS, INC., and THE EMPLOYEE HEALTH CARE PLAN FOR THE BOTTLING EMPLOYEES OF SWIIRE PACIFIC HOLDINGS, INC. and ITS AFFILIATES, Plaintiffs,
JAMES JONES, and JEFFREY R. CAFFEE LEGAL, PLLC d/b/a THE LAW OFFICES OF JEFFREY R. CAFFEE, Defendants.
ORDER DENYING DEFENDANTS' SECOND MOTION TO
RICARDO S. MARTINEZ CHIEF UNITED STATES DISTRICT JUDGE.
matter comes before the Court on Defendants' Second
Motion to Dismiss under Rule 12(b)(6). Dkt. #29. Plaintiffs
oppose. For the reasons stated below, the Court DENIES
purposes of this Motion to Dismiss, the Court will accept all
facts in the Amended Complaint as true. The Court will
briefly summarize these facts as necessary for ruling on this
are The Employee Health Care Plan for the Bottling Employees
of Swire Pacific Holdings, Inc. and its' Affiliates
(“Plan”) and Swire Pacific Holdings, Inc., d/b/a
Swire Coca-Cola, USA (“Swire”). Swire alleges it
is the Plan Sponsor and Plan Administrator for the Plan.
James Jones worked for Swire and was a covered person and
beneficiary of the self-funded ERISA plan at issue in this
case. On or about July 11, 2018, Jones was injured in a
serious car accident, the details of which are not at issue.
The Plan paid medical benefits on his behalf, at least $407,
provided under the Plan are fully funded by Swire and not
through an insurance carrier, although the plan is
administered by Regence BlueCross BlueShield of Utah.
allege that the applicable Summary Plan Description
(“SPD”), effective from January 1, 2018, to
December 31, 2018, is the controlling document for the Plan,
and that “there is no separate or additional master
plan document for the Plan.” Dkt. #28 at 3.
SPD/Plan contains a “Subrogation and Right of
Recovery” provision, setting forth the self-funded
ERISA Plan's rights of reimbursement and subrogation.
See Dkt. #28-1 (“Summary Plan
Description” or “SPD”) at 53-54 (“If
You receive any payment as a result of an Injury, Illness or
condition, You agree to reimburse the Plan first from such
payment for all amounts the Plan has paid and will pay as a
result of that Injury, Illness or condition, up to and
including the full amount of Your recovery.”).
Jones settled his claims related to the Accident for $150,
000. However, he has refused to reimburse the Plan. The other
Defendant in this case, his counsel Jeffrey R. Caffee Legal,
PLLC, has “dominion and control over all of part of the
Disputed Funds…” Dkt. #28 at 6.
bring claims under 29 U.S.C. § 1132(a)(3) to impose an
equitable lien or constructive trust with respect to the
disputed funds. They seek an Order enforcing the terms of the
Plan and requiring Defendants to turn over the full amount of
the disputed funds, as well as attorneys' fees.
Legal Standard ...