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Costello v. UNITE H.E.R.E.I.U Local 54

May 10, 2010

THOMAS COSTELLO PLAINTIFF,
v.
UNITE H.E.R.E.I.U LOCAL 54, UNITE H.E.R.E.I.U. LOCAL 54 BENEFITS OFFICE, H.E.R.E.I.U. WELFARE AND PENSION FUND, AND CAESAR'S ENTERTAINMENT D/B/A HARRAH'S ENTERTAINMENT D/B/A BALLY'S D/BA/ CAESAR'S ATLANTIC CITY DEFENDANTS.



The opinion of the court was delivered by: DuBOIS, J.

MEMORANDUM

I. INTRODUCTION

This is a case brought pursuant to the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq., in which plaintiff, Thomas Costello, pro se, alleges that defendants, UNITE H.E.R.E.I.U. Local 54 ("Local 54"), H.E.R.E.I.U. Welfare and Pension Fund ("the Fund") and Caesar's Entertainment ("Caesar's") are liable for bills Costello incurred in 2003 and 2004 for various medical problems.*fn1 Each of the defendants has moved to dismiss the Complaint or, alternatively, for summary judgment.

Costello has filed several documents in addition to the Complaint, including portions of the collective bargaining agreement between Local 54 and Caesar's and numerous records describing his medical problems and the cost of treatment. At a telephone conference held on April 19, 2010 Costello stated that he had provided all of the evidence in his possession and had no need for additional discovery.

The Fund filed several affidavits describing Costello's eligibility for benefits under the plan, and exhibits containing Explanation of Benefits ("EOB") letters sent to Costello describing the reason for the denial or partial denial of each of his claims. All of the defendants have relied on these affidavits in their submissions. In addition, by letter dated May 3, 2010, counsel for the Fund and Costello jointly reported that a settlement agreement in principle had been reached with respect to all of Costello's claims against the Fund.

By reason of the pending settlement, the Court defers ruling on the Fund's motion and will deny the motion as moot when a settlement is finalized. After reviewing the evidence presented, and the motion papers provided by Caesar's and Local 54, the Court concludes that there are no genuine issues of material fact as to Costello's claims against those parties. Accordingly, the motions for summary judgment filed by Caesar's and Local 54 are granted, for the reasons set forth below.

II. BACKGROUND*fn2

Caesar's hired Costello as a cook in May 2003. (Compl. ¶ 2; Affidavit of Gary Odenweller dated Jan. 11, 2010 ¶ 4. ("Odenweller Aff.")) From the date of his hire, Costello paid union dues as a member of UNITE H.E.R.E.I.U Local 54. (Compl. ¶ 3.)

Pursuant to a collective bargaining agreement between Local 54 and Caesar's, Caesar's agreed to contribute to the H.E.R.E.I.U. Welfare and Pension Fund. (Local 54 Ex. A.) The Fund, in turn, provided coverage to eligible members of Local 54 employed by Caesar's as described in its June 2003 Summary Plan Description ("SPD"). (Fund Ex. A.)

According to the SPD, an employee working for an employer who is required to contribute to the Fund is not eligible for coverage from the Fund unless the employee has been employed for the "Work Period" -- six consecutive calendar months in which the employee has worked at least one hour each month and for a total of at least 720 hours -- and the "Lag Period" -- the two consecutive calendar months following the Work Period. (Fund Ex. A. at 52.) Costello became eligible for benefits on January 1, 2004. (Odenweller Aff. ¶ 4.) The Fund mailed a "welcome packet," comprised of a cover letter, the SPD, and Costello's ID cards to an address in Conshohocken, Pennsylvania sometime after December 2, 2003. That package was returned with a label stating that Costello had moved. The Fund then sent another welcome package to a different Conshocken address on February 25, 2004. That package was never returned. (Affidavit of Susan Craighead ¶ 7,8.)

Costello sought treatment for various medical problems in 2003 and 2004:

* Between April and June, 2003, Costello had several dental procedures performed at the University of Pennsylvania Dental School. (Compl. ¶ 3.)

* On July 3, 2003, Costello was treated at Montgomery Hospital for muscle pain in his left ...


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