Steuer
Steuer v. Pool Co.
Opinion
Lead Opinion
MEMORANDUM *
Pool Company’s (“Pool”) Comprehensive Medical Expense Plan (“Medical Plan”) is a self-funded ERISA plan in which the plan administrator has express discretionary authority. Pool’s decision to deny Steuer’s benefits under the Medical Plan is therefore reviewed for abuse of discretion, unless Steuer provides material, probative evidence, beyond the mere fact of the apparent conflict of interest inherent in a self-funded plan, tending to show that self-interest caused a breach of the administrator’s fiduciary obligations to Steuer. 1 See Atwood v. Newmont Gold Co., Inc., 45 F.3d 1317, 1323 (9th Cir.1995). In that case, the administrator’s decision is reviewed de novo, unless Pool can prove that *669 the conflict did not taint the administrator’s decision to deny Steuer’s benefits. See id.
We need not decide which standard of review is applicable in this case, however, because we conclude that Pool abused its discretion in denying Steuer’s Medical Plan benefits. See Schikore v. BankAmerica Supplemental Ret. Plan, 269 F.3d 956, 961 (9th Cir.2001). The administrator’s decision was not based upon a reasonable interpretation of the Medical Plan’s terms. See McDaniel v.…