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Morehouse v. Shake

United States Court of Appeals, Sixth Circuit

September 13, 2019

Rebecca Morehouse; William Morehouse, Plaintiffs-Appellees,
v.
Steak N Shake, Defendant-Appellant.

          Argued: May 8, 2019

          Appeal from the United States District Court for the Southern District of Ohio at Columbus. No. 2:16-cv-00789-Edmund A. Sargus, Jr., District Judge.

         ARGUED:

          Eric P. Mathisen, OGLETREE DEAKINS, NASH, SMOAK & STEWART, PLLC, Valparaiso, Indiana, for Appellant.

          Sonia T. Walker, CALIG LAW FIRM, LLC, Columbus, Ohio, for Appellees.

         ON BRIEF:

          Eric P. Mathisen, OGLETREE DEAKINS, NASH, SMOAK & STEWART, PLLC, Valparaiso, Indiana, for Appellant.

          Sonia T. Walker, CALIG LAW FIRM, LLC, Columbus, Ohio, for Appellees.

          Before: BOGGS, BATCHELDER, and BUSH, Circuit Judges.

          OPINION

          BOGGS, CIRCUIT JUDGE.

         Defendant Steak N Shake ("SNS") appeals a grant of summary judgment in favor of Plaintiffs Rebecca and William Morehouse. The Morehouses sued to recover damages stemming from SNS's failure to send them a notification under the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA") after SNS put Mrs. Morehouse on workers' compensation and allowed her to take a leave of absence. The district court agreed that SNS had not fulfilled this obligation and consequently awarded damages to the Morehouses. However, we now reverse because the terms and conditions of Mrs. Morehouse's insurance coverage did not change upon her taking a leave of absence and therefore no "qualifying event" occurred that would have obligated SNS to send her a COBRA notification.

         I

         Mrs. Morehouse began working for SNS as an Assistant Manager in October 2011. After her husband lost his job and insurance coverage following his hospitalization, Mrs. Morehouse enrolled both herself and her husband in SNS's health-benefits coverage with coverage beginning on September 1, 2012 ("the Plan").

         The Plan's terms are set forth in benefit booklets issued each September 1 for the following year. The Plan states:

You have coverage provided under the Plan because of your employment with . . . the Employer. You must satisfy certain requirements to participate in the Employer's benefit plan. These requirements may include . . . Actively At Work standards as determined by the Employer or state and/or federal law and approved by the Administrator, on behalf of the Employer.

         To be eligible to enroll as a Subscriber, an individual must:

• Be either: An employee, Member, or retiree of the ...

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