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Revised August 4, 1998
IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
No. 97-30422
KAYE L. ROBIN,
Plaintiff-Appellant,
versus
METROPOLITAN LIFE
INSURANCE COMPANY,
Defendant-Appellee.
Appeal from the United States District Court
for the Western District of Louisiana
July 30, 1998
Before GARWOOD, JONES and WIENER, Circuit Judges.

WIENER, Circuit Judge:
At the vortex of this appeal is a group life insurance policy
("the Policy") issued by Defendant-Appellee Metropolitan Life
Insurance Company ("MetLife") to St. Paul Fire & Marine Insurance
Company ("St. Paul") as one facet of St. Paul's comprehensive
employee benefit package, the Policy concededly being a "plan

regulated by ERISA."1 In bringing this appeal, Plaintiff-Appellant
Kaye L. Robin, widow of Randy Robin ("Decedent"), asks us to
reverse the adverse results of a lawsuit she filed in a state court
of Louisiana, which was removed to federal district court where she
was denied recovery.2 For the reasons set forth below, we affirm.
I
FACTS AND PROCEEDINGS
St. Paul sponsors a multi-faceted employee benefit program
("the St. Paul Plan") which includes, inter alia, group life
insurance coverage for its participating employees. At all times
relevant to this case, the life insurance coverage under the
St. Paul Plan was provided by MetLife, which was vested with full
discretionary authority to interpret the provisions of the Policy
and determine entitlement to benefits under it.
While he was employed by St. Paul, Decedent had life insurance
coverage of $187,000 under the Policy, with the proceeds payable to
Robin as his designated beneficiary. After working for St. Paul
for approximately seven years, Decedent voluntarily terminated his
employment effective May 13, 1994, to accept a job with another
insurance company, starting three days later.
1Employment Retirement Income Security Act of 1974, as
amended, 29 U.S.C. 壯 1001-1461.
2The district court's federal removal jurisdiction was
grounded in the federal question under ERISA and diversity of
citizenship.
2

As an employee covered under the Policy, Decedent was required
to contribute a portion of the premium for his coverage. Decedent
made his monthly contribution through payroll deductions withheld
by St. Paul as his employer. Neither Decedent nor any other
participating employee paid premiums directly to MetLife. Rather,
St. Paul remitted a single monthly premium payment to MetLife for
all covered employees for the calendar month in question. Such a
monthly lump sum premium payment to MetLife from St. Paul comprised
its share and each covered employee's share of the aggregate
premium cost for that month.
As explained in the St. Paul Plan's Summary Plan Description
(SPD), a participating employee's life insurance coverage
terminates at "[t]he end of the period for which you made the last
required contribution."3 Other relevant provisions of the Policy,
as explained in the SPD, include (1) conversion rights, under which
a departing employee could acquire an individual life insurance
policy from MetLife by applying directly to MetLife "within 31 days
of the day your coverage ends" under the St. Paul Plan;
(2) continuation rights for employees not domiciled in Minnesota,
under which the insurance proceeds would be paid if the employee
should die "within 31 days after coverage with the St. Paul Company
ends ---- even if you do not apply for a conversion policy"; and
(3) for Minnesota residents only, the right to continue group life
3(Emphasis added).
3

coverage for up to eighteen months after termination of employment,
provided such a Minnesota resident notifies St. Paul's COBRA
administrator, DCA, Inc. ("DCA").4 At no time relevant to this
case was Decedent ever a resident of Minnesota.5
Decedent died suddenly and unexpectedly on July 3, 1994. The
record contains no direct evidence that Decedent ever stated that
he was seriously considering exercising his conversion right under
the Policy or that he ever contacted MetLife, St. Paul, or DCA
about that matter. In fact, he acquired $100,000 group life
coverage by virtue of his new employment, indicating that if he
ever considered continuation or conversion he had abandoned such
thoughts.
After Decedent's death, Robin came across a June 4, 1994,
notice that Decedent had received from DCA, which she construes as
indicative that Decedent had sixty (60) days following May 13, 1994
(the effective date of his severance of employment with St. Paul),
to continue coverage under the Policy or convert to an individual
policy. Apparently DCA inadvertently sent Decedent the notice
intended for Minnesota residents. Although the form notice
received by Decedent identified the continuation and conversion
4ERISA was amended in part by the Consolidated Omnibus Budget
Reconciliation Act (COBRA) without, however, affecting life
insurance.
5Another provision applicable to each Minnesota resident was
that his continuation coverage would terminate automatically upon
acquisition of life insurance coverage under a new group policy.
4

rights as guaranteed under Minnesota law, it failed to add that
those statutory rights inured to the benefit of Minnesota residents
only.6
Nothing in the SPD, the Policy, or anything else in the record
reflects either a legal or factual relationship between DCA and
MetLife: DCA is St. Paul's agent for some functions under the
St. Paul Plan. On the other hand, MetLife is the issuer and
administrator of the Policy which, as noted, provides the life
insurance aspect of the St. Paul Plan.
St. Paul had advised MetLife early on that the first two
payroll deductions in each calendar month satisfy the entire
employee contribution obligation toward his total premium cost of
coverage for that month. Following Decedent's resignation, MetLife
was informed by St. Paul that two such deductions ---- his "last
required contribution"7 ---- had been withheld from Decedent's
paychecks to cover his contribution for May 1994, his final
calendar month of coverage. On the basis of this information and
applicable provisions of the SPD and the Policy, MetLife determined
that Decedent's coverage under the Policy ended on May 31, 1994,
6Robin contends that she received advice to the effect that
she could complete the continuation or conversion form even after
Decedent's death and that she completed and mailed the forms to DCA
on July 8, together with a premium for future periods. In her
appellate brief, Robin asserts that this advice was furnished by
"St. Paul and/or MetLife," but MetLife flatly denies ever having
given such counsel.
7See text accompanying n.3 supra.
5

the last day of the calendar month in which his employment and his
participation in the St. Paul Plan ceased. MetLife received no
premium payment from St. Paul ---- its only source ---- for coverage of
Decedent after the group premium remitted by St. Paul for the month
of May 1994.
Decedent's final paycheck was issued on May 22, 1994, some
nine days following the effective date of his employment
termination with St. Paul. From this paycheck St. Paul made a
deduction identified as Decedent's portion of the premium for his
group life coverage until the next payroll period, which would have
ended on June 5, 1994, St. Paul's next payday, had Decedent still
been employed there. To the extent St. Paul, as Decedent's
employer, may have erroneously deducted premium costs from his last
paycheck or misidentified a coverage term after May 31, 1994, or
both, any estoppel claim would involve St. Paul (and, possibly,
DCA) ---- with which Robin has settled ---- but not MetLife. Moreover,
as Decedent was ineligible for coverage (other than continuation
coverage) under the Policy after he left St. Paul's employ, any
excess employee contribution deducted from his last paycheck could
not ---- by SPD definition ---- have been "required."
Robin demanded payment of death benefits under the Policy from
MetLife. The claim was rejected by MetLife which, based on the
information supplied to it by St. Paul and construed in light of
the SPD and the Policy, determined that Decedent's group coverage
expired May 31, 1994, thirty-three days prior to his death, thereby
6

eschewing both conversion and continuation. MetLife interpreted
the provisions, both conversion and continuation, to require the
triggering events ---- notice and premium payment for conversion;
death of the formerly insured ex-employee for continuation benefits
---- to occur within thirty-one days following the May 31 termination
of coverage, pointing out that, when Decedent died thirty-three
days after May 31 without having converted, both his continuation
benefits and his conversion option evanesced.
After her claim was denied, Robin filed suit against MetLife
in state court seeking life insurance proceeds under the Policy and
penalties under Louisiana statutory provisions, plus court costs
and attorneys' fees. MetLife removed the case to district court on
alternative jurisdictional grounds of federal question and
diversity of citizenship, then filed a motion for summary judgment.
Robin subsequently impleaded St. Paul and DCA as additional
defendants. The district court eventually granted summary judgment
for MetLife on Robin's state law breach of contract and statutory
penalty claims, holding that they are preempted by ERISA; but the
court deferred ruling on the substantive ERISA portion of MetLife's
summary judgment motion except to acknowledge that abuse of
discretion is the appropriate standard of review for MetLife's
policy interpretation and coverage determinations. Ultimately, the
district court granted MetLife's summary judgment motion to dismiss
Robin's remaining claims against it, concluding that MetLife had
7

not abused its discretion in rejecting her claims.8 After the
court entered judgment in favor of MetLife, Robin timely filed a
notice of appeal.
II
ANALYSIS
A.
Standard of Review
The district court disposed of Robin's claims against MetLife
by granting summary judgments, first as to her state law breach of
contract and statutory claims, which the court held to be preempted
by ERISA; second by holding that MetLife had correctly interpreted
and rejected Robin's conversion and continuation claims under the
applicable Louisiana statute,9 which the court found to be exempt
from ERISA preemption as regulating insurance; and third, by
holding that MetLife had not abused the discretion with which it
was vested by provisions of the Policy and the St. Paul Plan when,
based on all information furnished to it, MetLife denied death
benefits under the Policy. We review these legal and ERISA
preemption rulings of the district court on summary judgment under
the well known de novo standard.
B.
Scope of Review
Robin has not appealed the district court's holdings that
8The district court denied motions for summary judgment filed
by St. Paul and DCA seeking dismissal of Robin's claims against
them, but she eventually settled with both of those defendants.
9La. Rev. Stat. Ann. � 22:176 (West 1995).
8

(1) ERISA preempts the penalty claims she advanced under state
law,10 (2) abuse of discretion is the proper standard for the
district court to apply in reviewing MetLife's determination of
Robin's entitlement to life insurance benefits under the Policy,
and (3) a jury trial is not available on ERISA claims.
Consequently, on appeal we need address only Robin's contentions
that the district court erred in (a) sustaining MetLife's decisions
on state law insurance matters not preempted by ERISA, and
(b) holding that her claim of estoppel or detrimental reliance
against MetLife, grounded in the purportedly misleading notice sent
to Decedent ---- not by MetLife but by St. Paul's agent, DCA ---- is
preempted by ERISA. We proceed to review these remaining claims de
novo.
C. Continuation and Conversion under the Louisiana Insurance
Code11
Here, as in the district court, Robin insists that her claims
for continuation of coverage under the Policy, through and
including the date of Decedent's death and thereafter for the
continued viability of his right to convert, even after his death,
are grounded in the provisions of the Louisiana Insurance Code that
govern continuation and conversion rights.12 As such, she contends,
her claim is not preempted by ERISA because state statutes that
10See id. 壯 22:656-57.
11Id. � 22:176.
12Id.
9

regulate the business of insurance are excepted from ERISA's
otherwise pervasive preemption of all state law "related to" an
employee benefit plan.13 On appeal, MetLife notes but does not
complain that the district court likely erred as a matter of law in
holding that ERISA preemption does not trump the Louisiana statute
in question on this particular claim. Although we might or might
not agree with that ruling on preemption were we to address it, we
need not and therefore do not. Rather, we assume arguendo that the
district court got it right on this preemption issue and proceed to
review the court's holding.
Section 176 of the Louisiana Insurance Code14 mandates the
inclusion of thirteen specific provisions in virtually every policy
of group life insurance. Relevant to the instant consideration are
the three among those thirteen mandated provisions that are found
in paragraphs (9), (10), and (12). They list, in pertinent part:
(9)
Continuation to end of premium period: A
provision . . . that the termination of the
employment of any employee . . . shall not
terminate the insurance of such employee . . .
under the group policy until the expiration of
such period for which the premium for such
employee or member has been paid, not
exceeding thirty-one days.
(10) Conversion on termination of eligibility: A
provision that if the insurance . . . on an
1329 U.S.C. � 1144(b)(2)(A); Metropolitan Life Ins. Co. v.
Massachusetts, 471 U.S. 724, 728 n.2 (1985).
14La. Rev. Stat. Ann. � 22:176.
10

individual covered under the policy ceases
because of termination of employment . . . ,
such individual shall be entitled to have
issued to him by the insurer . . . an
individual policy of life insurance without
disability or other supplementary benefits,
provided application for the individual policy
shall be made and the first premium paid to
the insurer within thirty-one days after such
termination [of employment].
. . .
(12) Death pending conversion: A provision that if
a person insured under the group policy dies
during the period within which he would have
been entitled to have an individual policy
issued
to
him
in
accordance
with
Paragraph[](10) . . . of this Section and
before such an individual policy shall have
become effective, the amount of life insurance
which he would have been entitled to have
issued to him under such individual policy
shall be payable as a claim under the group
policy, whether or not application for the
individual policy or the payment of the first
premium therefor has been made.

We find nothing ambiguous in the quoted provisions of � 176, and ----
continuing to assume arguendo that Robin's claims under the
Louisiana Insurance Code are not preempted by ERISA ---- hold that
the plain wording of these provisions affords no recovery for
Robin, given the sequence and timing of occurrences pertinent to
this case.
First, as to paragraph (9), MetLife has never questioned that
Decedent's coverage under the Policy continued to the end of the
appropriate premium period, i.e., the expiration of the "period for
which the premium for such employee . . . has been paid [not, as
Robin contends, the period for which such employee has paid his
11

portion of the premium], not exceeding thirty-one days." We begin
by reiterating that the premium for Decedent's coverage, and that
of every other participating St. Paul employee, comprises both
employer and employee contributions, and that neither Robin nor any
other participating employee directly pays MetLife any part of the
premium for his coverage. Instead, as noted earlier, a single
premium for all covered employees is paid to MetLife by St. Paul ----
each calendar month, for that calendar month's coverage. We note
next that, for purposes of paragraph (9), Decedent's employment
terminated during the month of May 1994, and that St. Paul's last
premium payment to MetLife that included coverage for Decedent was
the payment for the calendar month of May 1994. Thus the "period
for which the premium for such employee . . . [was] paid" was the
month of May. Consequently, the continuation of coverage mandated
by paragraph (9) following Decedent's May 13 employment termination
was not required to extend beyond May 31. But even if the "not
exceeding thirty-one days" proviso of paragraph (9) were (mis)read
to tack thirty-one days of continued coverage onto Decedent's
entire last period of coverage, such putative continued coverage
would have commenced on June 1 and expired on July 1, two full days
prior to his death. Clearly, paragraph (9) provides no support for
Robin's continuation claim.
Paragraph (10) of � 176 likewise avails Robin nothing.
Although Decedent was eligible under paragraph (10) to convert to
an individual policy after his group coverage under the Policy
12

"cease[d] because of termination of employment," his option to
obtain an individual replacement policy expired, ipso facto,
"thirty-one days after such termination [of employment.]"
Decedent's termination of employment, by his own election, was
effective May 13, 1994. As May has thirty-one days, June 13 was
the last day of the thirty-one day period following the day on
which Decedent's employment at St. Paul ended. Indeed, as the
Policy afforded Decedent continued coverage of thirty-one days
following his regular coverage, which extended until May 31, the
Policy's continuation was longer than required under paragraph
(10).
Not only did Decedent fail to submit an application and first
premium for such successor individual coverage by or before either
June 13 or July 1, the record is devoid of probative evidence that
he planned to obtain conversion coverage at any time. On the
contrary, his obtaining $100,000 in group life coverage under his
new employer's plan is strong circumstantial evidence that if
Decedent, an experienced insurance professional, ever thought about
acquiring the more expensive coverage that a conversion policy
would have provided, he dropped that thought when he opted for the
new group coverage. We conclude that paragraph (10) of � 176 gains
Robin nothing.
And, finally, paragraph (12) of � 176 is equally unavailing
under the instant sequence of events. Even though Decedent never
applied for a conversion policy between his May 13 departure from
13

St. Paul and his death on July 3, the mandatory group policy
provision of paragraph (12) would have entitled Robin to collect
the proceeds of Decedent's coverage under the Policy if he had died
"during the period within which he would have been entitled to have
an individual policy issued to him in accordance with
paragraph[](10). . . ." We have already demonstrated that June 13,
1994, was the last day of "the period within which he would have
been entitled to have an individual policy issued to him. . . ."
Because Decedent did not die between May 13 and June 13, 1994,
entitlement to death benefits pending conversion, as required by
paragraph (12), never eventuated. As in the case of paragraph (9),
even if, by some wild stretch of interpretation, the conversion
period of paragraph (12) were construed to be thirty-one days
following May 31 instead of May 13, Robin would still gain nothing
because Decedent was alive on and after July 1, 1994, the thirty-
first day following the last day of May. Thus, for purposes of
paragraph (12), Decedent lived beyond the time when he was entitled
to obtain an individual policy and thus outlived the coverage
mandated by that paragraph.
If, in the alternative, we were to review and reverse the
district court and hold that ERISA does preempt Robin's claim under
La. Rev. Stat. Ann. � 22:176, she still would take nothing under
the Policy. Under such an alternative, we would conclude that
MetLife's interpretation of the law and the relevant provisions of
the Policy, and its application of the facts thereto, were correct
14

and thus in no way constituted an abuse of the discretion vested in
MetLife. The foregoing analysis of Robin's claim under the
Louisiana statute would serve to exonerate MetLife from Robin's
charge of abuse of discretion. MetLife's determinations, free of
the strictures of the Louisiana statute and based instead on the
facts furnished to it by St. Paul, DCA, and Robin, and on the terms
of the St. Paul Plan as set forth in the SPD and the terms of the
Policy, would pass the two-step test of Wildbur v. ARCO Chemical
Co. with flying colors.15 That leaves only Robin's estoppel claim,
to which we now turn.
D.
Estoppel
Conveniently disregarding the interrelationships (or lack
thereof) among St. Paul, DCA, and MetLife,16 Robin grounds her
estoppel claim in the contention that the continuation and
conversion notice furnished to Decedent ---- by DCA, not by MetLife
---- misled him into thinking that Minnesota law gave him the right
15974 F.2d 631, 637-38 (5th Cir. 1992).
16Again, Decedent's employer until May 13, 1994, was St. Paul,
which sponsored a package of ERISA plans for the benefit of its
participating employees, one of which plans was group life
insurance provided by the Policy. The Policy itself, issued by
MetLife, is a plan governed by ERISA. None contest that this plan
vests MetLife with the maximum degree of discretion permitted under
ERISA for interpreting the plan and determining entitlement to
benefits. In contrast, DCA contracts with St. Paul ---- not with
MetLife, with which DCA has no relationship whatsoever ---- to
administer COBRA and other obligations of St. Paul to former
employees after termination of their employment. Among the
administrative functions that DCA performs for St. Paul relative to
such terminated employees is the furnishing of notifications
regarding continuation and conversion of group life insurance.
15

to elect eighteen months of continued group life coverage under the
Policy or a protracted period to convert to an individual Policy.
Even though the summary judgment record contains nothing resembling
probative evidence of Decedent's reliance ---- detrimental or
otherwise ---- on the admittedly wrong notice that DCA sent to him,
or that Decedent had any contemplation of taking action to continue
or convert in accordance with that notice, one thing is clear: Any
such state law estoppel claim could only be asserted against
St. Paul (by virtue of retaining DCA as its agent) or DCA (for its
own error in sending Decedent the notice intended for Minnesota
residents, without including in the notice the information that it
was applicable to Minnesota residents only).17 No such claim could
be asserted against MetLife, which had neither a legal nor a
factual nexus with the erroneous notice or its issuer, DCA. Any
vicarious tarring of St. Paul with DCA's brush cannot reach
MetLife, no matter how broad that agency brush might be.18
We are satisfied that MetLife's denial of Robin's estoppel
claim as well as all of her ERISA claims was correctly approbated
by the district court, given the operable facts of this case and
the provisions of the St. Paul Plan and the Policy. Nothing in
MetLife's interpretation of the applicable provisions or its denial
17As Robin has settled with St. Paul and DCA, her estoppel
claim against those defendants is not before us.
18This disposition of Robin's estoppel claim obviates the need
to address ERISA preemption in this context, even though the
district court found preemption under 29 U.S.C. � 1144(a).
16

of Robin's claims approaches abuse of discretion.
III
CONCLUSION
After reviewing the summary judgment record in this case, the
reasoning of the district court, and the arguments and citations of
counsel as set forth in their appellate briefs and in their oral
arguments to this court, we remain convinced ---- for the reasons
expressed above ---- that the summary judgments of the district court
are free of reversible error and must, therefore, be
AFFIRMED, at appellant's cost.
17