Plaintiff, Gertrude Poole, a former employee of Monmouth College, brings this action pursuant to 29 U.S.C.A. § 1132(a)(1)(B) to recover health benefits due to her under the terms of her employee health benefit plan, to enforce her rights under the terms of the plan and to clarify her rights to future benefits under the terms of the plan. Jurisdiction in this court is predicated on 29 U.S.C.A. § 1132(e). The following constitutes the undisputed facts in this case:
Gertrude M. Poole had been employed by Monmouth College, a private employer, since 1982. She had health problems before her employment and was evaluated for open heart surgery during her employment. In 1987, she applied for and was considered for medical leave of absence. By November 1989, it was clear that she would be terminated on or about January 2,
1990 due to failure to achieve tenure and the expiration of her last contract period. At that time, she was provided with a COBRA benefit letter, describing her entitlement to 18 months of eligibility for group health coverage following termination, so called "COBRA continuation coverage." Poole acknowledged receipt of the notice on November 13, 1989 and elected to continue coverage thereunder on or about February 27, 1990.
On December 19, 1989, certain amendments became effective which allowed a person eligible for COBRA continuation benefits to obtain an additional 11 months of eligibility, i.e. a total of 29 months, if the participant is determined eligible for disability benefits under the Social Security Act after termination of employment. Poole was not notified of this amendment and the possibility of extended benefits prior to her termination on January 2, 1990 or prior to her election of benefits on February 27, 1990, or at any time prior to her inquiry in August 1990. Shortly after January 2, 1990, Poole applied for Social Security disability insurance. On March 5, 1990, Poole was determined by the Social Security Administration to be entitled to Social Security disability insurance payments, and it was also determined that she had been disabled as of December 29, 1989, prior to her termination.
Poole learned of the amendment and the extended benefits on her own in August 1990, which was within the existing 18-month COBRA coverage, and promptly notified Monmouth College of her right to an extension. Monmouth College replied in November 1990, denying Poole was entitled to coverage for 29 months, stating that the college did not have a record of her disability at the time of her termination.
Two issues are before this court: 1) whether this court has jurisdiction to grant the requested relief; and 2) whether, assuming jurisdiction, Gertrude Poole is entitled to 29 months of COBRA continuation benefits.
The threshold issue is jurisdiction. Defendant argues that, having filed a complaint with the United States Department
of Labor, plaintiff is precluded from initiating this action. Defendant does not dispute that, but for the administrative claim, this court has jurisdiction pursuant to 29 U.S.C.A. § 1132(e) for civil ...