United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
M. BODENHAUSEN UNITED STATES MAGISTRATE JUDGE.
matter is before the Court upon the motion of pro se
plaintiff Tracy Lynn Brown for leave to commence this civil
action without prepayment of the required filing fee. Having
reviewed the motion and the financial information submitted
in support, the Court has determined that plaintiff lacks
sufficient funds to pay the filing fee. The Court will grant
the motion and waive the filing fee. Furthermore, after
reviewing the complaint, the Court will direct the Clerk of
Court to issue process upon defendant Express Scripts, Inc.
Standard on Initial Review
28 U.S.C. § 1915(e)(2), the Court is required to dismiss
a complaint filed in forma pauperis if it is
frivolous, is malicious, fails to state a claim upon which
relief can be granted, or seeks monetary relief against a
defendant who is immune from such relief. To state a claim
for relief, a complaint must plead more than “legal
conclusions” and “[t]hreadbare recitals of the
elements of a cause of action [that are] supported by mere
conclusory statements.” Ashcroft v. Iqbal, 556
U.S. 662, 678 (2009). A plaintiff must demonstrate a
plausible claim for relief, which is more than a “mere
possibility of misconduct.” Id. at 679.
“A claim has facial plausibility when the plaintiff
pleads factual content that allows the court to draw the
reasonable inference that the defendant is liable for the
misconduct alleged.” Id. at 678. Determining
whether a complaint states a plausible claim for relief is a
context-specific task that requires the reviewing court to
draw on its judicial experience and common sense.
Id. at 679.
reviewing a pro se complaint under 28 U.S.C. §
1915, the Court accepts the well-pled facts as true,
White v. Clark, 750 F.2d 721, 722 (8th Cir. 1984),
and liberally construes the complaint. Erickson v.
Pardus, 551 U.S. 89, 94 (2007); Haines v.
Kerner, 404 U.S. 519, 520 (1972). A “liberal
construction” means that if the essence of an
allegation is discernible, the district court should construe
the plaintiff's complaint in a way that permits his or
her claim to be considered within the proper legal framework.
Solomon v. Petray, 795 F.3d 777, 787 (8th Cir.
2015). However, even pro se complaints are required
to allege facts which, if true, state a claim for relief as a
matter of law. Martin v. Aubuchon, 623 F.2d 1282,
1286 (8th Cir. 1980). See also Stone v. Harry, 364
F.3d 912, 914-15 (8th Cir. 2004) (refusing to supply
additional facts or to construct a legal theory for the
pro se plaintiff that assumed facts that had not
brings this action under the Employment Retirement Income
Security Act (“ERISA”), 29 U.S.C. § 1001
et seq., against plan administrator Express Scripts,
Inc. for statutory penalties resulting from an alleged
failure to provide requested plan documents.
alleges that she was approved for short-term disability
coverage by defendant Express Scripts' third-party
administrator Sedgwick Claims Management Services on November
21, 2016. However, on June 5, 2017, Sedgwick's
application for long-term disability benefits on
plaintiff's behalf was denied by defendant Express
Scripts' insurance company Metropolitan Insurance
Company. After the denial of long-term benefits, plaintiff
retained an attorney on June 9, 2017, in order to file an
appeal. On June 12, 2017, plaintiff asserts that her retained
attorney requested documents on her behalf by certified
letter, from plan administrator Express Scripts. According to
plaintiff, the requested documents included: “Any and
all summary plan descriptions, policies, certificates of
insurance, complete copy of employment file, pay records and
other plan documents related to short term and long-term
disability policies.” ECF No. 1 at ¶ 10.
receiving no response from defendant Express Scripts,
plaintiff's attorney sent a second request via certified
letter on July 18, 2017, for the same documents. On November
30, 2017, plaintiff's attorney received a copy of a
certificate of insurance from an employee of defendant
Express Scripts via email. Plaintiff's attorney replied
back via email to the defendant employee requesting further
documents including “a plan document for voluntary LTD
benefits, and also the Summary Plan Description for all LTD
benefits, core, voluntary and buy-up.” Id. at
attorney never received a response or any further documents
from Express Scripts. However, due to an imminent deadline,
plaintiff's attorney filed plaintiff's appeal of the
denial of benefits on December 4, 2017, without having
received all the requested documentation. Plaintiff's
appeal was denied on February 7, 2018. Plaintiff states that
as of the date of the complaint filing in this matter, April
1, 2019, none of the requested documents - except the one
certificate of insurance - have been received.
complaint includes one count for statutory penalties against
plan administrator Express Scripts for failure to provide
requested plan documents. Plaintiff asserts that these
documents were needed to afford plaintiff proper
representation for her appeal. For relief, plaintiff seeks
compensatory damages in the amount of $47, 080 and punitive
damages in the amount of $100, 000.
ERISA, 29 U.S.C. § 1132(c), an administrator must
provide a plan participant with requested plan materials
within thirty days of the request. Plaintiff seeks to recover
the statutory penalties of $110 per day authorized by 29
U.S.C. § 1132(c) to be assessed against an administrator
who fails or refuses to furnish to a participant the
information set forth in 29 U.S.C. § 1024(b)(4).
Specifically, under 29 U.S.C. § 1024(b)(4): “The
administrator shall, upon written request of any participant
or beneficiary, furnish a copy of the latest updated summary
plan description, and the latest annual report, any terminal
report, the bargaining agreement, trust agreement, contract,
or other instruments under which the plan is established or
operated.” The Court may award penalties, at its
discretion, for a violation of an administrator's duty to
provide plan documents. See Wesley v. Monsanto Co.,
554 F.Supp. 93, 98 (E.D. Mo. 1982), aff'd, 710
F.2d 490 (8th Cir. 1983) (“Whether an award under
§ 1132(c) should be made is left to the sound discretion
of the Court.”); Wasielewski v. Kirberg Roofing
Inc., 821 F.Supp. 1303, 1305 (E.D. Mo. 1993) (“The
statute authorizes but does not require a penalty in every
instance when ERISA information is not provided within thirty
days of the request.”).
alleges that she is a participant in a plan administered by
defendant Express Scripts, Inc. and that Express Scripts
failed to comply with her multiple requests, beginning June
12, 2017 and made through her attorney, for plan documents
including a summary plan description. According to plaintiff,
not only did Express Scripts fail to comply with the specific
requests within the thirty days allowed by statute, but it
still had not complied by April 1, 2019, when this case was
filed. Based on these ...