SIMPSON v. T.D. WILLIAMSON INC.
FILED
United States Court of Appeals
Tenth Circuit
July 11, 2005
PATRICK FISHER
Clerk PUBLISH
UNITED STATES COURT OF APPEALS
TENTH CIRCUIT
ZEDA SIMPSON,
Plaintiff-Appellee,
v. No. 04-5084
T.D. WILLIAMSON INC., a corporation,
Defendant-Cross-Defendant -Appellant,
&
JEFFERY SIMPSON,
Defendant- Cross-Claimant.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OKLAHOMA.
(D.C. No. 02-CV-682-J)
(321 F. Supp. 2d 1240 & 321 F. Supp. 2d 1247)
Submitted on the briefs:(1)
Jay C. Baker, Tulsa, Oklahoma, for Plaintiff-Appellee.
J. Daniel Morgan, Gable & Gotwals, Tulsa, Oklahoma, for Defendant-Appellant.
Before LUCERO, PORFILIO, and BALDOCK, Circuit Judges.
BALDOCK, Circuit Judge.
The Consolidated Omnibus Budget Reconciliation Act, 29 U.S.C. 1161-
68 (COBRA), an amendment to ERISA, authorizes a qualified beneficiary of an
employer's group health insurance plan to maintain coverage when she might
otherwise lose coverage upon the occurrence of a "qualifying event." See id.
1161(a); Geissal v. Moore Med. Corp., 524 U.S. 74, 76 (1998). A "qualifying
event" requires the health plan administrator to notify the beneficiary that she
may elect to continue health insurance coverage in return for premium payments.
See 29 U.S.C. 1166(a)(4); Smith v. Rogers Galvanizing Co., 128 F.3d 1380,
1383 (10th Cir. 1997). "[D]ivorce or legal separation of the covered employee
from the employee's spouse" constitutes a "qualifying event" under COBRA.
See 29 U.S.C. 1163(3).
The issue in this case is whether an Oklahoma divorce court's interlocutory
(1) After examining the briefs and appellate record, this panel has determined
unanimously to grant the parties' request for a decision on the briefs without oral
argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore
ordered submitted without oral argument.
protective orders requiring a husband, a "covered employee," to stay away from
his wife, a "qualified beneficiary," pending their divorce qualified as a "legal
separation," thereby triggering COBRA's notice requirement and the wife's corresponding
obligation to pay premiums in exchange for continued coverage.
A magistrate judge twice answered no Ä once in denying the plan administrator's/
employer's motion for summary judgment and once after a bench trial. Simpson
v. T.D. Williamson, Inc., 321 F. Supp. 2d 1240 (N.D. Okla. 2003) (Simpson I);
Simpson v. T.D. Williamson, Inc., 321 F. Supp. 2d 1247 (N.D. Okla. 2004)
(Simpson II). On appeal, the plan administrator/employer claims otherwise.
We have jurisdiction, 28 U.S.C. 636(c)(3), review this question of statutory
interpretation de novo, see Keys Youth Servs., Inc. v. City of Olathe, 248 F.3d
1267, 1274 (10th Cir. 2001), and affirm.
I
The facts are undisputed and ably set out in Simpson II, 321 F. Supp. 2d
at 1248-51. In sum: Defendant T.D. Williamson (TDW) issued a group health
insurance policy to Plaintiff's husband, a TDW employee. The policy covered
Plaintiff Zeda Simpson as a beneficiary. Plaintiff filed for divorce in July 2000.
Over the course of that summer, the divorce court entered three interlocutory
protective orders requiring Plaintiff's husband to stay away from her and the
marital residence. Prior to entry of a final divorce decree, Plaintiff sent a letter
to TDW. Plaintiff requested that TDW reveal no information to her "estranged
husband" about medical services she received. TDW concluded a "legal
separation" had occurred based on Plaintiff's letter and the divorce court's
interlocutory orders. TDW determined the parties' "legal separation" was a
"qualifying event" under COBRA. As plan administrator, TDW sent Plaintiff
notice that she could elect continued health insurance coverage under COBRA.
Plaintiff objected to TDW's determination but nonetheless elected coverage.
Neither Plaintiff nor her husband paid the premiums due under her COBRA
election. In June 2002, TDW notified Plaintiff that it had canceled her health
insurance for non-payment of premiums. The following month, Plaintiff notified
TDW that the divorce court had entered a final divorce decree and she wished
to elect COBRA coverage. See 29 U.S.C. 1166(a)(3) (requiring notice to the
employer of a 1163(3) "qualifying event" within 60 days). TDW replied that
Plaintiff's COBRA rights had expired under her prior election due to nonpayment
of premiums and could not be reinstated.
Plaintiff filed suit in federal court alleging TDW denied her rights under
COBRA.(1) Plaintiff sought health insurance coverage from TDW, reimbursement
for uninsured medical expenses and alternate health insurance premiums, and
attorney fees. The magistrate judge held the divorce court's protective orders
did not constitute a "legal separation" and, therefore, did not constitute a
(1) Although Plaintiff urged the Oklahoma divorce court to address theCOBRA
issue, the court declined to do so,stating on the record that the "matter regarding
COBRA is found to beacivil matter and irrelevant to this court." SeeSimpson
II, 321 F. Supp. 2d at 1250.
"qualifying event" under COBRA. Accordingly, TDW's notice to Plaintiff of
her COBRA rights prior to entry of the final divorce decree was invalid. The
district court granted Plaintiff's requested relief and imposed a statutory penalty
against TDW. See 29 U.S.C. 1132(c)(1).
II.
COBRA does not define the term "legal separation," and we have not found
any circuit court authority defining the term as used in 1163(3).(2) The case we
find most analogous is Nehme v. I.N.S., 252 F.3d 415 (5th Cir. 2001). In that
case, the Fifth Circuit interpreted the term "legal separation" in the context of an
immigration case. The relevant portion of the applicable statute provided that
"when there ha[d] been a legal separation of the parents," a minor child born
outside the United States became a citizen if the parent having legal custody
was naturalized. Noting the lack of any "ready-made federal body of law on
domestic relations," the court looked to the various state laws to formulate a
federal standard. Nehme, 252 F.3d 426 & n.11 (citing state laws providing
for legal separation); see also De Sylva v. Ballentine, 351 U.S. 570, 580 (1956).
(2) An employer's insurance plan might purport to define the term "legal
separation." TDW's health insurance plan does not do so. We express no
opinionon how a plan's definition might affect the outcome of a similar case.
Cf.Goodall v. The Gates Corp., 1994 WL 584555, at **2-3 (10th Cir. 1994)
(unpublished disposition).
The Fifth Circuit concluded that a "legal separation" is uniformly
understood to mean "a formal, judicial alteration of the marital relationship."
Nehme, 252 F.3d at 426; see also Brissett v. Ashcroft, 363 F.3d 130, 134 (2d
Cir. 2004). In other words, state laws allowing "legal separation" uniformly
"contemplate a judicial decree." Nehme, 252 F.3d at 426. A decree is "a judicial
decision in a court of equity, admiralty, divorce, or probate Ä similar to a
judgment of a court of law." Black's Law Dictionary 419 (7th ed. 1999).
Like a judgment, a decree connotes finality.
The Fifth Circuit's view is consistent with the fact that an action for "legal
separation" is separate and distinct from an action for divorce or dissolution of
marriage. See, e.g., Okla. Stat. tit. 43, 103, 105 (referring to actions "for
divorce, annulment of a marriage, or legal separation") (emphasis added). The
genesis of such action lies in the common law's divorce "mensa et thoro," Ä or
divorce "from bed and board," Ä the forebearer of the modern day action for
"legal separation." See Holleyman v. Holleyman, 78 P.3d 921, 932 n.17 (Okla.
2003) (Opala, V.C.J., concurring). A decree of legal separation directs the parties
to live apart and defines the parties legal rights and obligations in regard to
custody, support, property division, and/or maintenance. See, e.g., Okla. Stat.
tit. 43, 129 (authorizing an action for alimony without a divorce); see also id.
108 (authorizing order for custody, maintenance and/or property division where
the court refuses to grant a divorce). But unlike a divorce decree, a decree of
legal separation does not dissolve the marriage bond.(3)
When defining a "qualifying event" in COBRA 1163(3) to include
"divorce or legal separation" (emphasis added), Congress undoubtedly was
cognizant of state domestic laws and the distinction they draw between an action
for divorce and an action for legal separation. Surely then, a divorce court's
interlocutory protective order pending a divorce does not constitute a "legal
separation" under 1163(3). As illustrated by the numerous protective orders
entered in the subject divorce proceeding, such a rule not only would engender
uncertainty for employees, employers, qualified beneficiaries, and plan
administrators as to what constitutes "legal separation," but also would
jeopardize the continuation of the group health insurance coverage which
Congress sought to ensure in enacting COBRA. See H.R. Rep. No. 99-241,
pt. I, at 44 (1985), reprinted in 1986 U.S.C.C.A.N. 579, 622.
TDW's contrary interpretation would place qualified beneficiaries of
an employer's group health insurance plans at the mercy of plan administrators
by allowing the latter to determine what constitutes a "qualifying event" under
1161(a). Yet 1166(a)(3) places the initial burden on the "covered employee
or qualified beneficiary" to notify the plan administrator of a "qualifying event"
as defined in 1163(3). COBRA's purpose to ensure beneficiaries continuing
affordable health care coverage during transitional periods is best served by
relieving, to the extent possible, all interested parties from the responsibility
of making legal judgments. See Phillips v. Saratoga Harness Racing, Inc., 240
F.3d 174, 179 (2d Cir. 2001). We conclude a "legal separation," and thus a
"qualifying event," occurs within the meaning of COBRA 1161(a) and 1163(3)
only upon entry of a final court decree adjudicating the parties legal rights and
obligations but preserving the marriage bond.
AFFIRMED.(4) (3) At the time Plaintiff filed her divorce petition,
Oklahoma's domestic relations
statutes referred to an action for legal separation as an action for "separate
maintenance." During the pendency of the divorce proceedings, Oklahoma
amended its domestic relations laws to refer specifically to actions for "legal
separation." See LeCrone v. LeCrone, 596 P.2d 1262, 1264 (Okla. 1979)
(equating separate maintenance action with legal separation). Like COBRA,
Oklahoma law does not define "legal separation" despite the use of the term
indomestic relations statutes and case law. Compare Nehme, 252 F.3d at 426
(identifying four states that provide a statutory definition for "legal separation.").
(4) TDW also challenges the district court's awards to Plaintiff of out-ofpocket
expenses, attorney fees, and a statutory penalty. TDW argues generally that
Plaintiff failed to mitigate her damages and that it acted in good faith. This is
inadequate appellate argument. TDW hasnot cited a single authority to support
its arguments; nor has TDW argued thatits positions are sound despite a lack of
supporting authority or in the face ofcontrary authority. See Brownlee v. Lear
Siegler Mgmt. Servs. Corp., 15 F.3d 976, 977-78 (10th Cir. 1994) (holding
appellate argument inadequate where party failed to "cite a single authority
oreven present a developed argument"). Accordingly, we decline toconsider
these arguments.