Whether a court reviewing an ERISA § 1132(a)(1)(B) action challenging a denial of benefits based on plan interpretation should apply an arbitrary-and-capricious standard or de novo review.
Holding
A denial of benefits is reviewed de novo unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe plan terms.
Reasoning
ERISA does not itself specify a standard of review for benefit-denial suits under § 1132(a)(1)(B). Although many lower courts had borrowed arbitrary-and-capricious review from cases under the Labor Management Relations Act, that analogy was incomplete. Under the LMRA, the standard had served largely as a jurisdictional device because the statute did not expressly authorize suits by beneficiaries challenging trustee decisions. ERISA, by contrast, expressly creates causes of action against administrators and fiduciaries, so that jurisdictional rationale does not carry over.
The Court turned instead to trust-law principles, which ERISA's text and legislative history incorporate. Trust law gives deference when the trust instrument grants a trustee discretionary power, including power to interpret uncertain terms. But absent such a grant, courts construe the terms of a trust instrument for themselves, just as they ordinarily construe contractual language without deferring to either party's interpretation.
Firestone's termination-pay plan did not grant the administrator authority to interpret ambiguous provisions or make eligibility decisions conclusively. Firestone could not obtain deferential review merely because ERISA fiduciaries exercise some discretionary authority in managing a plan. A person is a fiduciary only to the extent that the person exercises discretionary authority; ERISA does not make every administrative decision discretionary.
De novo review also preserves the protection employees had before ERISA, when courts generally resolved benefit disputes under ordinary contract principles unless a plan expressly conferred final interpretive authority on the employer. The Court rejected the argument that later congressional inaction on a proposed de novo-review amendment demonstrated approval of arbitrary-and-capricious review.
The Court did not base its rule on Firestone's dual role as employer and administrator or on whether the plan was funded. Those facts do not determine the standard of review. If a plan does confer discretionary authority, however, an administrator's conflict of interest remains a factor in deciding whether the administrator abused that discretion.