Court Finds Fraud in Failure to Investigate Participant Concern

A retirement plan participant questioned his projected retirement benefit and a plan representative assured him it was correct, without further investigating.

A federal court has found a retirement plan representative’s failure to investigate a participant’s concerns about his retirement benefit calculations amounted to “constructive fraud.”

U.S. District Judge Sean F. Cox of the U.S. District Court for the Eastern District of Michigan rejected Detroit Edison’s argument that its retirement plan representative made an “honest mistake” when assuring John R. Paul Jr. and his wife that the calculations of his retirement benefits presented on four different statements were based on the correct number of years of credited service.

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According to the court opinion, Paul began his years with the company as a temporary employee in 1984. Starting in July 1988, he was a regular employee, but switched during his years of service from being a union employee to a non-union employee then back again. Paul began considering retirement in late 2007, and requested and received a Pension Calculation Statement estimating his potential retirement benefits from Aon Hewitt, the third-party administrator (TPA) for the plan. He also requested and received three more statements, the last one at his May 6, 2009, retirement interview.

During that interview, Paul and his wife met with a representative and reviewed a number of documents. They discussed the lump-sum payment and monthly annuity payment Paul would receive upon retirement, as well as Paul’s hire date and the calculation of his years of credited service. Given the union and non-union positions Paul held during his employment, he questioned the representative about the computation of his years of credited service—specifically the effect the transfers between union and non-union jobs would have on the accrual of his years of credited service.

The representative indicated that the information on the Retirement Interview Statement was correct, as Paul’s pension was calculated using the March 5, 1984, hire date listed among the baseline information. The representative further explained that, from Paul’s original hire date of March 5, 1984, his four pensions would all be bridged together. After the discussion, Paul and his wife signed an authorization form.

Paul retired on July 1, 2009, two years prior to when he would have been eligible to receive an unreduced early retirement benefit under his retirement plan. Sometime during an audit in 2011, Aon Hewitt discovered that the years of credited service used to calculate Paul’s pension benefit were overstated by 3.00365 years. Paul received an overpayment notice that stated his monthly annuity would be reduced by $54.42 per month and his lump-sum payment was overstated by $14,429.36; it offered him several options for repaying a total of $17,776.35 in excess benefits plus investment earnings.

Paul filed a claim with the benefits committee, which was denied. He appealed that decision, and the committee decided his monthly benefit would still be lowered, but he would not have to repay the $14,429.36 if he forfeited a special benefit of $6,884.49 he was still due.

Paul filed a lawsuit seeking payment of all monies owed to him, as well as $25,000.00 in costs and damages. Detroit Edison filed a counterclaim seeking repayment of the overstated initial lump-sum payment of $14,429.36.

Paul did not challenge the plan administrator’s interpretation of the retirement plan, but claims that the plan should be estopped from enforcing the terms of the plan. Estoppel “precludes a party from exercising contractual rights because of his own inequitable conduct toward the party asserting the etoppel,” the court noted in its opinion. “Equitable estoppel operates to place the person entitled to its benefit in the same position he would have been in had the representations been true.”

Cox found Paul was misled when the retirement plan representative assured him that the years of credited service calculations on the Retirement Interview Statement were correct and that his various pensions would be bridged together. He also found that Paul relied on these statements when he decided to retire.

According to Cox, for equitable estoppel, Paul must must show that the defendants’ “actions contained an element of fraud, either intended deception or such gross negligence as to amount to constructive fraud.” Detroit Edison argued that the case is similar to a previous case, Stark v. Mars Inc., in which a District Court found there was no intent by the plan to deceive the beneficiary, but that the person responsible for calculating the benefits made an honest mistake.

But, Cox said, what transpired in this case was more complicated than the “honest mistake” in Stark. “Cognizant that the different union and non-union positions Plaintiff held during his employment complicated the calculation of his years of credited service, Plaintiff sought clarification of those calculations from the company representative at the retirement interview. The company representative assured Plaintiff that the calculation of his years of credited service was correct… The Court finds that the company representative’s assurances, which were a crucial aspect of Plaintiff’s decision to retire effective July 1, 2009, were so grossly negligent as to amount to constructive fraud upon Plaintiff,” he wrote in his opinion.

Cox noted that, in the Stark case, the 6th U.S. Circuit Court of Appeals reasoned that the plaintiff failed to show gross negligence because the defendant “properly investigated the exact concern” raised by plaintiff. However, in the current case, Cox said, “the representative’s failure to properly investigate the concern raised by plaintiff was not an honest mistake but was precisely the sort of malfeasance that may give rise to constructive fraud.”

Cox granted Paul’s Motion for Summary Judgment and denied Detroit Edison’s, and ordered that the retirement plan be estopped from reducing Paul’s retirement benefits and return him to “the same position he would have been in had the representations been true.”

Too Soon to Assume the Worst About Fiduciary Rule

Plan sponsors and advisers should keep in mind the fiduciary rule language issued by the DOL is just a proposal.

Some industry groups have contended the new fiduciary investment advice rule from the Department of Labor (DOL) will result in higher costs for plan sponsors and participants and the loss of some services, but others say it is too early to tell.

Hattie Greenan, director of research for the Plan Sponsor Council of America (PSCA), says the council is just digging into the rule and trying to determine the impact would have on plan sponsors and participants. “We’re not sure what the impact will be. We’re most concerned about the impact on small employers, because we feel it will disproportionately affect them,” she tells PLANSPONSOR. “We want to be careful not to give a knee-jerk reaction. A lot of folks are speculating, but we are going to talk to plan sponsors and ask them how it will affect them.”

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Michael Davis, director of institutional client relationships at Calvert Investments, and a former Deputy Assistant Secretary of the DOL’s Employee Benefit Security Administration, agrees it is hard to say with certainty at this point what will change because it is only a proposed rule. He notes that the DOL itself lays out in the proposal situations that may be adjusted before a final rule is issued.

The agency has allowed for 75 days to comment and will also hold a hearing at which people will be able to ask questions. After considering comments and the hearing discussion, it will issue a final rule.

What Davis will say is he thinks the DOL did a good job. The agency observed that the retirement plan landscape has changed from when defined benefit (DB) plans dominated the marketplace and plan sponsors were dedicated to retirement portfolios to the current defined contribution (DC) plan-dominated marketplace. “The rules currently in place are more focused on a sophisticated plan sponsor investor model,” he tells PLANSPONSOR.

While the new proposal keeps the same focus as the one issued in 2010, Davis calls the best interest contract exemption in the new rules an “even more elegant solution.” The DOL recognizes there are certain business models with certain types of compensation, and provides a path for advisers to get exemptions but make conflicts and revenue models clear to plan sponsors, he says.

Advisers will have to determine if the rules can fit into their business models or not—will they be able to incorporate these elements into their processes, according to Davis. He says the DOL does not want people to lose advice and the best interest contract exemption shows flexibility. But, it is too early to say at this point what the downstream impacts will be; more time and interpretive guidance from DOL are needed.

Jason Roberts, an attorney and chief executive officer of Pension Resource Institute, says plan sponsors should keep in mind that the DOL is not changing what it means to be a fiduciary—a fiduciary still has to act solely in the best interest of participants, use a prudent process, and not do all the things that will get fiduciaries in trouble. “What we’re really looking at is the impact for someone who may not have been a fiduciary under the old rules that will become one under new rules,” he points out.

He tells PLANSPONSOR a non-fiduciary could decide to levelize its compensation and become a fiduciary, but that may not be easy and some products and models just don’t lend themselves to that. On the other hand, a non-fiduciary may pull back on its services; whatever would make it a fiduciary, it would eliminate from services offered.

The alternative for a person or entity that wants to continue with a service that makes it a fiduciary but cannot level compensation is to enter into a contract with the plan sponsor, participant or IRA account holder and expose compensation. Roberts says contracts with participants or IRA account holders concern him. “That creates a nebulous standard by which an adviser’s conduct will be judged and may trigger more arbitration or lawsuits. Market losses trigger litigation,” he says.

Roberts also has concerns that non-fiduciary advisers that provide education-only services to plan participants will have to change or withdraw their services. (See “Changes Plan Sponsors Would See with New Fiduciary Rule.”) For its part, the DOL says it understands and respects the difference between advice and more general education under the rule language—for instance by providing a blanket exemption for provider call center employees who field incoming questions and concerns from participants.

Just as he believes it is too early to tell what the proposed fiduciary investment adviser rule’s effect on adviser services will be, Davis believes it is premature to say costs will go up; interpretive guidance is needed for more understanding of what the requirements are to comply. “I do think that, overall, the impact will be that plans are offered in a cost-conscious way,” he says. “Costs have been and are going to be a much greater focus in terms of how plans are delivered and what investments are offered.” He says the DOL’s question about including an exemption for recommendations of lowest-fee offerings signals the DOL’s concern about costs.

“I think, overall, plan sponsors should welcome the efforts the department is putting forward because it is meant and designed to give them greater confidence that the advice received is in their, and their participants’, best interest. It’s hard to argue that’s not a great goal,” Davis says.

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