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2011 WI 60
SUPREME COURT OF WISCONSIN
CASE NO.:                                                                   2009AP1558
COMPLETE TITLE:                                                             John  R.  Steffens,
                                                                            Plaintiff-Appellant,
                                                                            v.
BlueCross  BlueShield  of  Illinois,
Defendant-Respondent-Petitioner,
v.
Wesley  D.  Dishno,  AIG  National  Insurance
Company,  Inc.,  BlueCross  BlueShield  of  Wisconsin
and  The  Farmers  Automobile  Insurance
Association,
Defendants.
REVIEW  OF  A  DECISION  OF  THE  COURT  OF  APPEALS
Reported  at  329  Wis.  2d  710,  790  N.W.  2d  543
(Ct.  App.  2010-Unpublished)
OPINION FILED:                                                              July  8,  2011
SUBMITTED ON BRIEFS:
ORAL ARGUMENT:                                                              March  1,  2011
SOURCE OF APPEAL:
COURT:                                                                      Circuit
COUNTY:                                                                     Outagamie
JUDGE:                                                                      Dee  R.  Dyer
JUSTICES:
CONCURRED:
DISSENTED:                                                                  ABRAHAMSON,  C.  J.  dissents  (Opinion  filed).
BRADLEY,  J.  joins  dissent.
NOT PARTICIPATING:
ATTORNEYS:
For  the  defendant-respondent-petitioner  there  were  briefs
by  Sheila  M.  Sullivan,  Sarah  Germonprez  and  Bell,  Moore,  and
Richter,  S.C.,  Madison,  and  oral  argument  by  Ms.  Germonprez.
For  the  plaintiff-appellant  there  was  a  brief  by  Amy  M.
Risseeuw,  John  C.  Peterson,  and  Peterson,  Berk,  and  Cross,  S.C.,
Appleton,  and  oral  argument  by  Ms.  Risseeuw.




2011  WI  60
NOTICE
This  opinion  is  subject  to  further
editing  and  modification.    The  final
version   will   appear   in   the   bound
volume of the official reports.
No.                                                                          2009AP1558
(L.C.  No.                                                                   2008CV16)
STATE  OF  WISCONSIN                                                         :                 IN  SUPREME  COURT
John  R.  Steffens,
Plaintiff-Appellant,
v.
                                                                                               FILED
BlueCross  BlueShield  of  Illinois,
Defendant-Respondent-Petitioner,                                                               JUL  8,  2011
v.                                                                           A. John Voelker
Acting Clerk of Supreme
Court
Wesley  D.  Dishno,  AIG  National  Insurance
Company,  Inc.,  BlueCross  BlueShield  of
Wisconsin  and  The  Farmers  Automobile  Insurance
Association,
Defendants.
REVIEW  of  a  decision  of  the  Court  of  Appeals.    Reversed.
¶1    PATIENCE    DRAKE    ROGGENSACK,    J.      We    review    an
unpublished   opinion   of   the   court   of   appeals1   reversing   the
circuit  court's  order2  granting  BlueCross  BlueShield  of  Illinois'
1  Steffens  v.  BlueCross  BlueShield  of  Ill.,  No.  2009AP1558,
unpublished  slip  op.  (Wis.  Ct.  App.  Aug.  3,  2010).
2  The  Honorable  Dee  R.  Dyer  of  Outagamie  County  presided.




No.                                                                          2009AP1558
(BlueCross)  motion  for  declaratory  judgment.     BlueCross  is  a
subrogated   party   in   plaintiff   John   R.   Steffens'                  (Steffens)
lawsuit  based  on  a  June                                                  2005  car  accident.     BlueCross's  motion
requested   a   declaration   that   Steffens   reimburse   BlueCross
$67,477.57,  the  amount  BlueCross  paid  pursuant  to  BlueCross's
ERISA   benefits   plan                                                      (the   Plan)   that   covered   Steffens   for
accident-related  injuries.     The  issues  presented  to  this  court
are:                                                                         (1)  whether  the  Plan  administrator's  determination  that
under   the   Plan   BlueCross   is   entitled   to   reimbursement   is
arbitrary   and   capricious;   and                                          (2)   whether   Steffens'   prior
representations   that   the   surgery-necessitating   injuries   arose
out  of  the  automobile  accident  judicially  estop  him  from  now
claiming  that  a  degenerative  condition  caused  the  injuries  for
which  surgery  was  performed.
¶2    We                                                                     conclude                                                        that   the   Plan   administrator's
determination  that  BlueCross  is  entitled  to  reimbursement  was
not  arbitrary  and  capricious.    The  Plan  states  that  BlueCross  is
entitled  to  reimbursement  from  the  beneficiary  of  the  Plan  for
"expenses  incurred  as  the  result  of,  or  that  arose  out  of,  an
accident"  when  a  third  party  "may  be  liable"  for  the  payment  of
those  expenses  and  the  beneficiary  obtains  a  settlement  from  the
third  party.     The  Plan  gives  the  Plan  administrator  discretion
to  interpret  the  clause.
¶3    Prior   to   settlement,   Steffen   consistently   asserted
that  the  surgery-necessitating  injuries  arose  out  of  a  June  2005
automobile  accident.     Consequently,  it  was  not  arbitrary  and
capricious  for  the  Plan  administrator  to  interpret  the  Plan  and
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No.                                                                           2009AP1558
conclude  that  BlueCross  is  entitled  to  reimbursement  because  the
expenses  that  BlueCross  paid  arose  from  an  accident  for  which  a
third  party  may  be  liable.
¶4    Our    conclusion    that    the    Plan    administrator's
determination  that  BlueCross  is  entitled  to  reimbursement  is  not
arbitrary   and   capricious   is   dispositive   of   the   case.            We,
therefore,  do  not  reach  the  judicial  estoppel  issue.
I.    BACKGROUND
A.    The  Accident
¶5    On   June  29,                                                          2005,   Steffens   was   involved   in   an
automobile  accident  in  Outagamie  County.    According  to  Steffens,
he  was  stopped  at  a  traffic  light  when  Wesley  Dishno's  (Dishno)
vehicle  hit  him  from  behind.    This  pushed  Steffens  into  the  van
in  front  of  him.    Steffens  suffered  injuries  as  a  result  of  the
accident.
¶6    Steffens  visited  the  emergency  room  approximately  two
hours  after  the  accident.    He  complained  of  a  headache,  as  well
as   shoulder   and   neck   pain.                                            No   significant   procedures   were
performed  during  this  visit.     Various  doctors'  notes  from  July
of                                                                            2005  to  March  of                            2006  indicate  that  Steffens  continued  to
suffer  from  pain  and  stiffness  in  his  neck,  upper  back,  thorax,
and  shoulders.     Moreover,  in  the  months  immediately  following
the  accident,  Steffens  suffered  from  headaches.
¶7    In   early   March   of                                                 2006   Steffens   was   beginning   to
experience  lower  back  pain  with  intermittent  radiation  to  his
lower   extremities.      This   low   back   pain   continued   throughout
2006.     In  December  of                                                    2006,  Steffens  had  a  Magnetic  Resonance
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No.                                                                           2009AP1558
Imaging                                                                       (MRI)  of  his  spine.     The  MRI  revealed  that  at  L5-S1,
Steffens  had  a  grade-one  spondylolisthesis.3     On  May  22,             2007,
Steffens  underwent  L5-S1,  lumbosacral  fusion  surgery.
¶8    The   medical   notes   indicate   that   Steffens'   pain
improved  following  the  surgery.    Moreover,  Steffens  had  asserted
that  he  did  not  have  any  back  pain  prior  to  the  June               2005
accident.
B.    The  Plan
¶9    As  aforementioned,  Steffens  was  a  beneficiary  under  an
ERISA4   plan   provided   by   BlueCross.                                    BlueCross   paid   for   a
significant  portion  of  Steffens'  back  and  neck  related  medical
expenses,  including  the  lumbosacral  fusion  surgery,  as  it  was
required  to  do  under  the  Plan.     The  Plan  has  a  "Reimbursement,
Subrogation,   and/or   Right   of   Reduction"   clause.      The   clause
gives  the  administrator  discretion  to  interpret  its  terms.     It
states:     "The  Plan/Plan  administrator  has  sole  discretion  to
interpret  the  terms  of  this  provision  in  its  entirety  .  .  .        ."
¶10   The   clause   details   when   BlueCross   is   entitled   to
subrogation:
If  any  benefits  payable  under  the  Plan  to  you  or
your   dependents   were   for   expenses   incurred   as   the
result  of,  or  that  arose  out  of,  an  accident  or  other
situation  such  that  other  party  or  parties,  may  be
3  Spondylolisthesis  is  a  "[f]orward  movement  of  the  body  of
one  of  the  lower  lumbar  vertebrae  on  the  vertebra  below  it,  or
upon  the  sacrum."     Stedman's  Medical  Dictionary                        1678                                                              (27th  ed.
2000).
4  ERISA  is  the  acronym  for  the  Employee  Retirement  Income
Security  of  Act  of  1974.
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No.                                                                         2009AP1558
liable    for    the    payment    of    expenses    and    you
subsequently  obtain  a  settlement  from  or  a  judgment
against   such   other   party   or   parties,   you   or   your
dependents  are  obligated  to  reimburse  the  Plan.     The
Plan's    right    to    reduction,    reimbursement    and
subrogation  apply  regardless  of  whether  the  settlement
or  award  is  designated  as  payment  for,  but  not  limited
to  pain  and  suffering,  wage  loss,  loss  of  consortium,
medical  benefits,  and  other  specified  damages.     The
Plan  has  first  priority  with  respect  to  its  right  to
reduction,  reimbursement  and  subrogation.
¶11   In  addition,  the  clause  explicitly  gives  BlueCross  a
right    of    first    priority,    notwithstanding    the    make-whole
doctrine:
The  Plan's  right  to  reduction,  reimbursement  and
subrogation  will  not  be  reduced  even  if  the  recovery
does  not  fully  compensate  you  or  your  dependents,  or
you  or  your  dependents  were  not  made  whole,  for  all
losses  sustained  or  alleged,  or  the  recovery  is  not
described   as   being   related   to   medical   costs.      The
amount   the   Plan   is   entitled   to   will   also   not   be
reduced   by   legal   fees   or   court   costs   incurred   in
seeking  the  recovery.     Any  so-called  "make-whole"  or
"full-compensation"    rule    or    doctrine    is    hereby
explicitly  rejected  and  disavowed.
C.    Pre-Settlement  Litigation
¶12   On  January  2,  2008,  Steffens  filed  a  complaint  against
Dishno  demanding  compensatory  damages  for  the  accident.     The
complaint  was  later  amended  on  February  25,  2008.    According  to
the   amended   complaint,   the   accident   caused   Steffens   severe,
permanent,  and  costly  injuries:
As   a   direct   and   proximate   consequence   of   the
negligence  of  the  defendant,  Wesley  D.  Dishno,  the
plaintiff,    John    R.    Steffens,    was    severely    and
permanently  injured,  has  been  unable  to  undertake  his
usual   activities   and   occupations   for   a   sustained
period  of  time,  has  incurred  significant  expenses  for
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No.                                                                            2009AP1558
the  care  and  treatment  of  his  injuries,  and  has  been
otherwise  permanently  injured  and  damaged.5
¶13   In  addition  to  Dishno,  Steffens  named  AIG  National
Insurance  Company                                                             (AIG),  BlueCross,  and  the  Farmers  Automobile
Insurance  Association  (Farmers)  as  defendants.    AIG  was  named  as
a  defendant  because  Dishno  carried  AIG's  automobile  liability
insurance.     Steffens  named  both  BlueCross  and  Farmers6  due  to
their   potential   rights   of   subrogation.                                 According   to   the
complaint,   both   insurers   "paid   some   of   the   medical   bills
incurred  by  John  R.  Steffens  as  a  result  of  injuries  sustained
in  the  collision."7     Despite  naming  them  as  subrogated  parties,
Steffens   asked   in   the   complaint   for   a   "judgment   against
[BlueCross  and  Farmers],  foreclosing  any  claim  they  may  have  for
subrogation."
¶14   Subsequent   to   the   amended   complaint,   on   March  17,
2008,  BlueCross  filed  a  cross-claim  against  Dishno  and  AIG,  and
a   counterclaim   against   Steffens.                                         BlueCross's   cross-claim
alleged  that  it  "has  paid  medical  bills  on  behalf  of  John  R.
Steffens  for  treatment  of  injuries  suffered  in  the  accident  of
June  29,                                                                      2005,   in   the   amount   of                      $67,477.57."8   Moreover,
BlueCross   asserted   that   because   the   Plan   is   an   ERISA   plan,
BlueCross's  subrogated  interest  is  not  subject  to  the  "make-
5  Am.  Compl.,  ¶8.
6  The  Farmers  policy  does  not  come  within  ERISA.
7  Id.,  ¶¶4-5.
8  BlueCross's  Cross-cl.  &  Countercl.,  ¶2b.
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No.                                                                           2009AP1558
whole"  doctrine.9     BlueCross's  counterclaim  alleged  that  under
the  Plan,  Steffens  is  obligated  to  reimburse  BlueCross,  out  of
any   recovery   in   the   action   for   the                                $67,477.57   paid   by
BlueCross.10     BlueCross  attached  a  "Medical  Itemization  Report"
stating  the  amounts  billed  for  injuries  related  to  the  accident
and  the  lien  amounts  held  by  BlueCross.     Steffens'  surgery  was
listed.
¶15   On   April  10,                                                         2008,   Steffens   replied   to   BlueCross's
counterclaim,  asserting  that  "BlueCross  .  .  .  is  entitled  to  no
reimbursement  for  medical  expenses  paid  in  this  matter  until  and
unless  Plaintiff  is  made  whole."11     This  was  the  only  assertion
Steffens  made  in  his  reply.     Notably,  Steffens  did  not  contest
the  dollar  amount,  i.e.,  the                                              $67,477.57  that  BlueCross  claimed
it  had  paid  "for  treatment  of  injuries  suffered  in  the  accident
of  June  29,  2005."12    To  the  contrary,  throughout  the  first  year
of   litigation,   Steffens   asserted   that   BlueCross   had   paid
$67,477.57  and  that  the  surgery-necessitating  injuries  arose  out
of  the  accident.
9  Id.,  ¶2e-f.
10  Id.,                                                                      ¶3.      Farmers  filed  a  similar  response,  however,
Farmers  alleged  that  it  had  only  paid  $2,000  to  or  on  behalf  of
Steffens   for   medical   expenses   incurred   as   a   result   of   the
accident.    Farmers  is  no  longer  involved  in  this  lawsuit.
11  Steffens'  Reply  to  Countercl.
12  BlueCross's  Cross-cl.  &  Countercl.,  ¶2b.
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No.                                                                           2009AP1558
¶16   In  particular,  Steffen  responded  to  interrogatories  in
April  of                                                                     2008.     Steffens  described  the  extent  of  his  injuries
from  the  accident:
I  sustained  a  back  injury  that  resulted  in  a  lumbo-
sacral   fusion   surgery.                                                    Initially,   following   the
accident,  I  primarily  had  pain  that  radiated  down  my
leg  all  the  way  to  my  toes.     After  the  surgery,  my
pain  was  primarily  isolated  in  my  low  back  at  the
surgery  site.     The  injuries  have  affected,  impaired
and  changed  my  life  in  numerous  ways.     For  example,
prior  to  the  accident  I  enjoyed  golfing,  snowboarding
and  snowmobiling,  however,  since  the  accident  I  have
not   been   able   to   participate   in   those   activities.
Additionally,  normal  day-to-day  activities  have  been
difficult  for  me  since  the  accident.     Specifically,
activities  that  require  bending  over  are  difficult  and
I  have  pain  even  when  I  try  to  tie  my  shoes.    Standing
for  prolonged  periods  of  time  is  painful  as  well.
¶17   Steffens   made   other   relevant   assertions   in   his
responses  to  interrogatories.     First,  he  averred  that  his  back
injury  was  permanent  and  that  his  surgeon,  Dr.  Randall  Johnson,
M.D.                                                                          (Dr.   Johnson),   "ha[s]   or   will"   diagnose   the   permanent
injury.     Second,  he  asserted  that  he  made  a  claim  for  medical
coverage   to   BlueCross   "arising   out   of   the   incident,"   and
specifically,   that   BlueCross   has   made   "payments   totaling
$64,751.40."    Finally,  Steffens  claimed  that  he  was  entitled  to
medical  expenses  totaling  $130,712.19.
¶18   In  addition  to  his  April                                            2008  interrogatory  answers,
on  May  9,                                                                   2008,  Steffens  sent  a  request  for  admissions  to  all
counsel  of  record.  In  his  request,  he  asked  that  all  parties
admit  that  the  surgery  expense  "was  necessary                           .  .  .  to  provide
the  essential  care  and  treatment  for  injuries  sustained  by  .  .  .
8




                                                                              No.                                                         2009AP1558
Steffens,   which   were   caused   by   the   June  29,                      2005   automobile
accident."
¶19   Likewise,  on  May  13,  2008,  Steffens  filed  a  scheduling
conference  statement  with  the  court  that  reiterated  that  he  was
seeking  the  cost  of  his  surgery  as  damages.     Namely,  in  the
statement,   when   asked   to   "itemize   claimed   special   damages,"
Steffens  stated:     "The  plaintiff  incurred  medical  expenses  in
the  amount  of                                                               $132,282.19."     On  the  same  day,  Steffens  filed  a
"Disclosure  of  Expert  Witnesses"  list  with  the  court.     In  this
disclosure,  Steffens  listed  Dr.  Johnson  as  his  expert  witness.
D.    The  Settlement  and  Post-Settlement  Litigation
¶20   In   January   of                                                       2009,   Steffens   reached   a   settlement
agreement  with  Dishno  and  AIG.    Under  the  settlement,  AIG  was  to
pay  Steffens  $100,000,  the  AIG  policy  limits.    BlueCross  was  not
advised  of  the  settlement  negotiations.
¶21   Subsequently,   on   February  9,                                       2009,   Steffens   mailed
BlueCross   amended   answers   to   the   interrogatories.                   In   the
amended  answers  Steffens  no  longer  claimed  that  the  surgery-
necessitating  injuries  arose  out  of  the  accident.     Steffens,
instead,  described  the  extent  of  his  injuries  from  the  accident
as  follows:
I  sustained  injuries  to  my  upper  back  and  neck  which
resulted  in  what  the  records  describe  as  occipital
headaches.                                                                    The   injuries   caused   me   substantial
discomfort,  and  I  had  multiple  visits  to  my  doctor  as
well  as  prescribed  physical  therapy.     I  subsequently,
in  the  following  year,  developed  a  serious  problem
with   my   low   back.                                                       I   subsequently   received   the
evaluation    of    Independent    Medical    examiner,    Dr.
William   T.   Monacci,   which   I   am   attaching   to   these
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No.                                                                         2009AP1558
amended  answers  and  incorporating  by  reference.    I  now
have  learned  that  my  low  back  pain  and  surgery  was  not
related  to  the  accident.
With  regard  to  the  specific  treatment  that  Steffens  received  for
the  accident  related  injuries,  he  stated,  "I  was  seen  at  the
emergency  room  of  Appleton  Medical  Center  on  the  day  of  the
accident.     I  was  subsequently  treated  by  my  family  doctor,  Dr.
John   Ganser,   and   his   associates.                                    Finally,   in   January   and
February,  2006,  I  received  physical  therapy  at  Appleton  Medical
Center."
¶22   Steffens'   amended   answers   to   the   interrogatories
included  these  additional  distinctions  from  his  first  answers:
  The   accident   did   not   result   in   any   permanent
injury.
  BlueCross  made  payments  totaling  only                                $1,934.50
for  medical  expenses  arising  out  of  the  accident.
  The  total  amount  of  medical  expenses  to  which
Steffens  was  entitled  because  of  the  accident  was
$2,441.50.
  Dr.  William  T.  Monacci  was  listed  as  Steffens'
expert  witness.    Dr.  Johnson  was  no  longer  listed
as  a  treating  physician  or  an  expert.
¶23   Notably,   Dr.   Monacci   had   performed   an   independent
medical   evaluation   of   Steffens   on   October  2,                     2008.                           In   his
report,  filed  with  the  circuit  court  on  October  13,                 2008,  Dr.
Monacci   concluded   that   the   L5-S1   spondylolisthesis   was   a
progressive  degenerative  condition  unrelated  to  the  accident.
Prior  to  the  settlement,  Dr.  Monacci  had  been  named  as  the
defendant   tortfeasor   Dishno   and   his   insurer   AIG's   expert
10




No.                                                                            2009AP1558
witness.    Dr.  Monacci  was  not  listed  as  a  witness  on  an  amended
expert  witness  list  Steffens  filed  in  December  of  2008.
¶24   In  response  to  Steffens'  changed  position  regarding
the  cause  of  the  surgery-necessitating  injuries,  BlueCross  moved
for  declaratory  judgment  to  determine  its  rights  under  the  Plan.
BlueCross    requested    a    declaration    that    Steffens    had    an
obligation  to  reimburse  BlueCross  the                                      $67,477.57  "it  paid  to
treat  injuries  Steffens  claimed  he  suffered  in  the  car  accident
of   June  29,                                                                 2005"   and   that   under   the   Plan,   Steffens   owed
BlueCross  attorney  fees.     BlueCross  argued  that  it  is  entitled
to  reimbursement  before  Steffens  is  made  whole  because  the  Plan
is   an   ERISA   plan   that   explicitly   disavows   the   make-whole
doctrine.
¶25   Next,  BlueCross  argued  that  the  doctrine  of  judicial
estoppel  barred  Steffens  from  now  asserting  that  the  surgery-
necessitating   injuries   did   not   arise   out   of   the   accident.
BlueCross  listed  the  three  elements  of  judicial  estoppel  as  set
                                                                               forth  in  Salveson  v.  Douglas  County,                    2001  WI                                                 100,   245  Wis.  2d
497,                                                                           630  N.W.2d                                                  182,  and  argued  that  all  elements  had  been  met
in  this  case.    The  elements  are:    "(1)  the  later  position  must
be  clearly  inconsistent  with  the  earlier  position;  (2)  the  facts
at  issue  should  be  the  same  in  both  cases;  and  (3)  the  party  to
be  estopped  must  have  convinced  the  first  court  to  adopt  its
position."    Id.,  ¶38.
¶26   Finally,  BlueCross  argued  that  it  is  not  required  to
prove  that  the  surgery-necessitating  injuries  were  caused  by  the
accident.     Specifically,  BlueCross  underscored  the  language  of
11




No.                                                                           2009AP1558
the   Plan   that   states,   "[t]he   Plan's   right   to   reduction,
reimbursement  and  subrogation  will  not  be  reduced  even  if  .  .  .
the   recovery   is   not   described   as   being   related   to   medical
costs."                                                                       Therefore,   BlueCross   argued   that   "the   only   facts
required  to  trigger  BlueCross's  right  to  reimbursement  are             (1)
that  it  paid  for  medical  benefits  and                                   (2)   that  the  medical
benefits  were  used  to  invoke  a  settlement."    Finally,  BlueCross
contended   that   the   Plan   gives   the   Plan   administrator   "sole
discretion"  to  interpret  the  relevant  terms  of  the  Plan,  and
that   the   Plan   administrator's   interpretation   of   BlueCross's
rights  under  the  Plan  was  not  arbitrary  and  capricious.
¶27   In  his  response,  Steffens  argued  that  the  doctrine  of
judicial  estoppel  did  not  apply  to  this  case  because  he  had  not
taken  inconsistent  positions.    In  particular,  he  argued  that  he
changed  his  position  after  he  received  the  independent  medical
evaluation   of   Dr.   Monacci   and   that   his   interrogatories   were
amended  in  accordance  with  Wisconsin's  discovery  statutes.
¶28   Steffens  acknowledged  in  his  response  that  the  Plan
trumps  the  Wisconsin  make-whole  doctrine.     He  argued,  however,
that  BlueCross  is  entitled  to  reimbursement  only  if  BlueCross
can  prove  that  the  accident  caused  the  surgery-necessitating
injuries.
¶29   The   circuit   court   ordered   Steffens   to   reimburse
BlueCross  $64,751.40,13  plus  attorney  fees  and  costs.    The  court
13  Prior   to   the   order,   the   parties   debated   whether   the
amount   BlueCross   paid   for   the   accident-related   injuries   was
$66,353.57  or                                                                $64.751.40.     BlueCross  agreed  to  the                     $64.751.40
figure  for  the  sake  of  getting  the  matter  resolved  quickly.
12




No.                                                                         2009AP1558
concluded  that,  based  on  Steffens'  previous  assertions  that  the
surgery-necessitating  injuries  arose  from  the  accident,  he  was
judicially  estopped  from  now  arguing  that  the  injuries  were  the
result  of  a  degenerative  condition.     In  its  oral  decision,  the
court  opined:
[T]o  not  find  today  that  the  ERISA  plan  is  entitled  to
their  payment  from  this  plaintiff  would  be  essentially
the  plaintiff  perpetrating  a  fraud  on  the  Court.
This  plaintiff  said  in  answers  sworn  under  oath
that   the   medical   bills   that   Blue   Cross   paid   were
related   to   his   accident.                                                                                                               He   stated   that   in   the
                                                                            accident  I  sustained  a  back  injury  that  resulted  in  a
                                                                            lumbosacral  fusion  surgery.      Under  oath  he  stated,
                                                                            yes,  I  have  made  a  claim  for  injuries  arising  out  of
the   accident.                                                             According   to   the   records   of   my
attorneys,                                                                  [BlueCross]    made    payments    totalling
$64,751.40.                                                                 He   said   when   asked   about   injuries
received  as  a  result  of  the  accident,  he  said,  on
May  22,  2007,  I  had  a  lumbosacral  fusion  surgery;  and
he  further  said  my  medical  expenses  resulting  from  the
accident  total  $130,712.19.
I   realize   that   he   changed   his   letter——his
responses   to   his   interrogatories   after   he   made
settlement  in  this  case.     And  it's  got  to  be  noted
that    the    total    medical    expense    for    which    the
settlement  of                                                              $100,000  was  paid  is  now  over                               $2,000.
It  just  bears  no  credibility  to  say  that  this  did  not
have  some  relatedness,  that  is,  the  surgery  had  some
relatedness  to  this  settlement.     There's  no  question
about  that.    The  fact  that,  of  course,  there  was  only
$100,000   available——That's  a  fact  of  this  case  and
that's   perhaps   why   the   case   was   settled   for   that.
Still  we  know  that  ERISA  trumps  everything.
So   in   this   case   this   party,                                       [BlueCross],   is
entitled   to   their   money   back   under   all   of   the
circumstances  here.     Not  to  do  so  I  find  that——that
Mr.   Steffens   is   judicially   estopped   from   taking   a
contrary  position  because  he  played  it  for  all  it  was
worth  in  the  settlement  of  this  case;  and  it's  the
same,  you  know,  had  no  action  even  been  started  and  he
13




No.                                                                            2009AP1558
settled  for  that  amount.     ERISA  would  still  have  a
claim   back,   and   it's   clear   here   that   we   have   the
testimony  of  the  very  person  himself  linking  it  to
those  very  expenses.
¶30   Steffens  appealed.      In  an  unpublished  opinion,  the
court  of  appeals  reversed  the  circuit  court's  order.     Steffens
v.  BlueCross  BlueShield  of  Ill.,  No.                                      2009AP1558,  unpublished
slip  op.                                                                      (Wis.  Ct.  App.  Aug.  3,                        2010).     First,  with  regard  to
judicial  estoppel,  the  court  concluded  that,  while  there  was  no
question  that  Steffens  took  inconsistent  positions,  the  third
element  of  judicial  estoppel  had  not  been  met  because  Steffens
had  "never  convinced  any  court  to  adopt  his  position  that  the
surgery  was  related  to  the  accident."    Id.,  ¶9.    The  court  noted
that  no  Wisconsin  court  has  ever  construed  a  position  taken  at
settlement  as  satisfying  the  third  element.    Id.,  ¶10.
¶31   The  court  of  appeals  also  held  that  BlueCross  must
prove  that  the  surgery-necessitating  injuries  were  related  to
the  accident.     Id.,                                                        ¶¶11-15.     The  court  acknowledged  that  it
owed  substantial  deference  to  BlueCross's  interpretation.     Id.,
¶15.    Nonetheless,  the  court  concluded  that  nothing  in  the  Plan
authorized  reimbursement  for  benefits  BlueCross  paid  that  were
not  related  to  the  accident.    Id.    Therefore,  the  court  reversed
and   remanded   the   declaratory   judgment   to   give   BlueCross   an
opportunity  to  prove  that  it  is  entitled  to  reimbursement.    Id.,
¶16.
¶32   We   granted   review   and   now   reverse   the   court   of
appeals.
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No.                                                                          2009AP1558
II.    DISCUSSION
A.    Standard  of  Review
¶33   We  review  the  court  of  appeals  decision  regarding  the
Plan  administrator's  interpretation  of  rights  and  obligations
under  BlueCross's  ERISA  plan  documents.     In  turn,  our  review
encompasses  a  review  of  the  Plan  administrator's  interpretation
and  application  of  the  Plan  in  regard  to  whether  Steffens  was
required   to   reimburse   BlueCross   for   the   cost   of   his   back
surgery.     Summers  v.  Touchpoint  Health  Plan,  Inc.,                   2008  WI                             45,
¶¶16-17,  309  Wis.  2d  78,  749  N.W.2d  182.
¶34   As  discussed  in-depth  below,  when  an  ERISA  plan  gives
the  plan  administrator  the  discretion  to  interpret  and  apply  the
plan,    we    review    the    administrator's    decisions    under    a
discretionary  standard.     Firestone  Tire  &  Rubber  Co.  v.  Bruch,
489  U.S.                                                                    101,                                 111              (1989);  Summers,                                                                                                          309  Wis.  2d   78,                            ¶16.     Under
                                                                                                                                                                                      the  discretionary  standard  of  review,  we  will  not  reverse  a
                                                                                                                                                                                      decision  of  a  plan  administrator  unless  the  decision  was  not
reasonable.                                                                                                       Firestone,                                                          489   U.S.   at                                                                         111;   Cutting   v.   Jerome
Foods,  Inc.,                                                                                                     993   F.2d       1293,                                              1299                                                                    (7th  Cir.      1993).                         A  plan
                                                                                                                                                                                      administrator's  discretionary  decision  is  not  reasonable  if  it
                                                                                                                                   is  "arbitrary  and  capricious."     Firestone,                                                                                           489  U.S.  at                  114-15;
                                                                             Summers,  309  Wis.  2d  78,  ¶16.
¶35   However,    whether    the    plan    at    issue    gives    the
administrator  interpretive  discretion,  such  that  his  decision
will  be  reviewed  under  a  discretionary  standard,  requires  us  to
construe  the  written  plan  documents  to  determine  the  authority
of   the   plan   administrator.                                             Summers,                             309   Wis.  2d   78,                                                ¶16.
15




                                                                                                                                                                                                                                                                                                                                 No.                           2009AP1558
                                                                                                                                                                                                          Review  of  a  plan  administrator's  decision  is  limited  "to  the
                                                                                                                                                                                                          record   available   to   the   plan   administrator   at   the   time   the
                                                                                                                                                                                                          decision  was  made."     Rekowski  v.  Metro.  Life  Ins.  Co.,                                                                                     417  F.
Supp.                                                                        2d               1040,                           1047                                                                        (W.D.  Wis.                                                                    2006)                                   (citing  Hess  v.  Hartford
                                                                                              Life  &  Accident  Ins.  Co.,                                                                               274  F.3d                                                                      456,                      462           (7th  Cir.                    2001);
                                                                                                                              Smart  v.  State  Farm  Ins.  Co.,                                                                                                                         868   F.2d                929,          936                           (7th  Cir.
1989));  see  also  Brown  v.  Ret.  Comm.  of  Briggs  &  Stratton  Ret.
Plan,                                                                        575  F.  Supp.   1073,                           1076                                                                        (E.D.  Wis.                                                                    1983).     "Deferential
review  is  accorded  to  the  plan  administrator's  interpretation  of
the  plan's  terms  and  its  factual  findings."     Rekowski,              417  F.
Supp.  2d  at  1047  (citing  Paramore  v.  Delta  Air  Lines,  Inc.,  129
F.3d  1446,  1450-51  (11th  Cir.  1997)).
B.    Foundational  Principles
¶36   BlueCross  claims  it  is  entitled  to  reimbursement  for
expenses  paid  for  Steffens'  back  surgery  under  the  Plan's  right
of  subrogation.    Subrogation  is  "[t]he  substitution  of  one  party
for  another  whose  debt  the  party  pays,  entitling  the  paying
party  to  rights,  remedies,  or  securities  that  would  otherwise
belong  to  the  debtor."    Black's  Law  Dictionary  1563-64  (9th  ed.
2009).
¶37   There   are   three   basic   types   of   subrogation:                (1)
contractual  subrogation,  Millers  National  Insurance  Co.  v.  City
of  Milwaukee,                                                               184  Wis.  2d    155,                            167,                                                                        516  N.W.2d                                                                    376                       (1994);       (2)
                                                                                                                              statutory  subrogation,  Ellsworth  v.  Schelbrock,  2000  WI  63,  ¶19,
                                                                                                                              235  Wis.  2d  678,  611  N.W.2d  764;  and  (3)  equitable  subrogation,
Berna-Mork  v.  Jones,                                                                        174  Wis.  2d                   645,                                                                        652-53,                                                                                                  498  N.W.2d   221
(1993).                                                                                                                       We   also   note   that   it   has   been   opined   that   all
16




No.                                                                            2009AP1558
subrogation  "rights  are  governed  by  equitable  principles"  to
some  degree.    Russell  M.  Ware,  The  Law  of  Damages  in  Wisconsin,
§  32.6,  p.  6  (5th  ed.  2010).    The  ERISA  case  before  us  involves
a  species  of  contractual  subrogation  because  BlueCross's  right
of  subrogation  arises  under  the  Plan  documents.
¶38   All  parties  agree  that  the  Plan  is  governed  by  ERISA.
ERISA  was  enacted,  in  part,  to  set  forth  "minimum  standards
.  .  .  assuring  the  equitable  character  of                               [employee  benefit]
plans   and   their   financial   soundness."                                  29   U.S.C.                                                 §  1001(a)
(2008).14    In  other  words,  "Congress  enacted  ERISA  to  ensure  that
employees   would   receive   the                                              [contractually   defined]   benefits
they  had  earned."      Conkright  v.  Frommert,                              556   U.S.                                                  __,          130
S.  Ct.  1640,  1648  (2010);  Firestone,  489  U.S.  at  113.
¶39   ERISA  applies  to  "any  plan,  fund,  or  program  which  was
heretofore   or   is   hereafter   established   or   maintained   by   an
employer  or  by  an  employee  organization"  for  the  purpose  of
providing    participants    specified    benefits.15                          29    U.S.C.
§  1002(1).                                                                    However,   ERISA   does   not   "require   employers   to
establish  benefit  plans  in  the  first  place."     Conkright,              130
S.  Ct.  at  1648.
14  All  references  to  the  United  States  Code  are  to  the  2008
version  unless  otherwise  noted.
15  Those  benefits  include:    "medical,  surgical,  or  hospital
care   or   benefits,   or   benefits   in   the   event   of   sickness,
accident,   disability,   death   or   unemployment,   or   vacation
benefits,  apprenticeship  or  other  training  programs,  or  day  care
centers,   scholarship   funds,   or   prepaid   legal   services."            29
U.S.C.  §  1002(1)(A).
17




No.                                                                            2009AP1558
¶40   Therefore,   ERISA   strives   to   ensure   the   equitable
enforcement  of  employees'  rights  under  employee  benefit  plans
while,  at  the  same  time,  encouraging  employers  to  create  such
plans.    As  the  Supreme  Court  recently  explained:
ERISA  represents  a  careful  balancing  between  ensuring
fair  and  prompt  enforcement  of  rights  under  a  plan  and
the   encouragement   of   the   creation   of   such   plans.
Congress  sought  to  create  a  system  that  is  not  so
complex   that   administrative   costs,   or   litigation
expenses,   unduly   discourage   employers   from   offering
ERISA   plans   in   the   first   place.                                      ERISA   induces
employers  to  offer  benefits  by  assuring  a  predictable
set  of  liabilities,  under  uniform  standards  of  primary
conduct   and   a   uniform   regime   of   ultimate   remedial
orders  and  awards  when  a  violation  has  occurred.
Id.   at                                                                       1649                            (internal   quotations,   brackets   and   citations
                                                                                                               omitted).     See  also  Varity  Corp.  v.  Howe,      516  U.S.   489,   497
(1996)  (describing  the  competing  congressional  goals  of  ERISA  as
the  "desire  to  offer  employees  enhanced  protection  for  their
benefits,  on  the  one  hand,  and,  on  the  other,  its  desire  not  to
create  a  system  that  is  so  complex  that  administrative  costs,  or
litigation  expenses,  unduly  discourage  employers  from  offering
welfare  benefit  plans  in  the  first  place").
¶41   ERISA  commands  that  a  plan  "specify  the  basis  on  which
payments  are  made  to  and  from  the  plan,"  29  U.S.C.  §  1102(b)(4),
and  that  the  plan's  fiduciary  "discharge  his  duties  with  respect
to  a  plan  .  .  .  in  accordance  with  the  documents  and  instruments
governing  the  plan."                                                         29  U.S.C.  §  1104(a)(1)(D).
¶42   Under  all  ERISA  plans,  a  plan  fiduciary,  often  termed
the   plan   administrator,   determines   whether   participants   are
eligible  for  requested  benefits.    Diaz  v.  Prudential  Ins.  Co.  of
18




                                                                                                                                                                                                                                                                                                                                                No.   2009AP1558
                                                                                                        Am.,  424  F.3d  635,  637  (7th  Cir.  2005).    No  provision  of  ERISA
                                                                                                        sets  forth  the  appropriate  standard  a  court  should  employ  when
                                                                                                        reviewing    a    plan    administrator's    benefit    determinations,
Firestone,                                                                     489  U.S.  at                                                                                         108-09,  or  determinations  regarding  the
                                                                                                        enforcement  of  plan  terms.    Ronald  J.  Cooke,  ERISA  Practice  and
Procedure                                                                      §  8:14,  at             8-104                                                                        (2d  ed.                                                                     2010)                                        [hereinafter  "Cooke,
ERISA   Practice"].                                                                                                                                                                  However,   the   Supreme   Court   did   so   in
Firestone.16
¶43   In   Firestone,   when   presented   the   question   of   what
standard  courts  should  employ  when  reviewing  an  administrator's
benefit  determinations,  the  Court  refused  to  adopt  a  uniform
standard  of  review  to  be  applied  in  all  ERISA  cases.     Instead,
the  Court  concluded  that  the  language  of  the  plan  itself  should
govern   the   standard   of   review,   thereby   allowing   parties   to
bargain  for  the  applicable  standard.     In  instances  when  a  plan
does  not  specify  a  standard,  however,  the  Court  held  that  courts
should  review  the  administrator's  determination  under  a  de  novo
standard.      In  particular,  the  Court  held  that  "a  denial  of
benefits  challenged  under                                                    [29  U.S.C.]             §  1132(a)(1)(B)  is  to  be
reviewed  under  a  de  novo  standard  unless  the  benefit  plan  gives
the   administrator   or   fiduciary   discretionary   authority   to
16  Pronouncements   of   the   United   States   Supreme   Court   on
federal  law  bind  this  court.    State  v.  Webster,  114  Wis.  2d  418,
426  n.4,                                                                      338  N.W.2d              474                                                                          (1983).                                                                                                                   Moreover,  we  look  to  other
                                                                                                                                                                                     applicable  federal  case  law  in  reviewing  actions  of  ERISA  plan
                                                                                                                                                                                     administrators.    Evans  v.  W.E.A.  Ins.  Trust,  122  Wis.  2d  1,  14,
361  N.W.2d                                                                    630                      (1985).                                                                                                                                                   See  also  Schultz  v.  NEPCO  Emps.  Mut.
                                                                               Benefit  Ass'n,  Inc.,   190  Wis.  2d                                                                742,                                                                         746  n.5,                                    528  N.W.2d                      441
(Ct.  App.  1994).
19




No.                                                                             2009AP1558
determine  eligibility  for  benefits  or  to  construe  the  terms  of
the  plan."17    Firestone,  489  U.S.  at  115.
¶44   Notably,  Firestone  explicitly  limited  its  discussion
and  holding  to  actions  challenging  the  denial  of  benefits  under
29  U.S.C.                                                                      §  1132(a)(1)(B).18     Id.  at                        108.     However,  we  are  not
faced  with  an  action  brought  by  a  plan  participant  challenging
the  denial  of  benefits  under                                                §  1132(a)(1)(B).     Rather,  this  is
an     action     brought     by     the     Plan     administrator     under
§  1132(a)(3)(B)19  to  enforce  the  subrogation  terms  of  the  Plan.
See  Mank  ex  rel.  Hannaford  Health  Plan  v.  Green,  297  F.  Supp.  2d
297,  301  (D.  Me.  2003).
¶45   The  Seventh  Circuit  and  Wisconsin  courts  apply  the
Firestone  test  when  deciding  the  appropriate  level  of  review  of
a   plan   administrator's   interpretation   and   application   of   an
17  The  Firestone  standard  of  review  applies  even  if  the
administrator  is  operating  under  a  conflict  of  interest.    Metro.
Life   Ins.   Co.   v.   Glenn,                                                 554   U.S.                                             105,                                      115   (2008).   When
considering  the  lawfulness  of  an  administrator's  determination,
a  reviewing  court,  however,  should  consider  the  conflict  as  one
factor  in  the  analysis.    Id.  at  117.
18  Pursuant  to                                                                29  U.S.C.                                             §  1132(a)(1)(B):     "A  civil  action
may  be  brought——(1)  by  a  participant  or  beneficiary  .  .  .  (B)  to
recover  benefits  due  to  him  under  the  terms  of  his  plan,  to
enforce  his  rights  under  the  terms  of  the  plan,  or  to  clarify
his  rights  to  future  benefits  under  the  terms  of  the  plan."
19  Pursuant  to                                                                29  U.S.C.  §  1132(a)(3):    "A  civil  action  may
be  brought  .  .  .  (3)  by  a  participant,  beneficiary,  or  fiduciary
(A)  to  enjoin  any  act  or  practice  which  violates  any  provision
of  this  subchapter  or  the  terms  of  the  plan,  or                        (B)  to  obtain
other    appropriate    equitable    relief                                     (i)    to    redress    such
violations  or  (ii)  to  enforce  any  provisions  of  this  subchapter
or  the  terms  of  the  plan."
20




No.                                                                           2009AP1558
ERISA  plan's  subrogation  clause.    See  Cutting,  993  F.2d  at  1296;
Schultz  v.  NEPCO  Emps.  Mut.  Benefit  Ass'n,  Inc.,                       190  Wis.  2d
742,  747-48  &  n.6,  528  N.W.2d  441  (Ct.  App.  1994).
¶46   Under  Firestone,  determining  the  appropriate  standard
of  review  for  the  administrator's  subrogation  determination  that
is   at   issue   here   is   "a   matter   of   contract."                                                                                                      Williams   v.
Interpublic  Severance  Pay  Plan,                                            523  F.3d                                                    819,           821    (7th  Cir.
2008).                                                                        Firestone   prescribes   that   "[b]y   using   particular
language,  the  plan's  sponsors  can  require  deferential  review."
Id.     As  such,  the  Firestone  test  is  consistent  with  contract
law.  Under  contract  law,  contracting  parties  are  entitled  to
receive  the  benefits  of  their  bargain.     Daanen  &  Janssen,  Inc.
v.   Cedarapids,   Inc.,                                                      216   Wis.  2d                                               395,           404,   573   N.W.2d    842
(1998).     "[T]he  best  indication  of  the  parties'  intent  is  the
language  of  the  contract  itself."    Town  Bank  v.  City  Real  Estate
Dev.,  LLC,                                                                   2010  WI                                                     134,           ¶33,   330  Wis.  2d   340,   793  N.W.2d   476.
Therefore,  when  enforcing  an  unambiguous  contract,  the  court
looks  to  the  contract  terms,  and  it  is  those  terms  that  are
enforced.    See  Mackenzie  v.  Miller  Brewing  Co.,  2001  WI  23,  ¶28,
241  Wis.  2d  700,  623  N.W.2d  739.
¶47   Allowing   parties   to   bargain   for   the   amount   of
deference  given  to  the  plan  administrator  is  also  consistent
with  the  policies  underlying  ERISA.     As  aforementioned,  one  of
ERISA's  primary  goals  is  to  encourage  employers  to  offer  benefit
plans  to  their  employees.     Conkright,                                   130  S.  Ct.  at                                             1649.     In
order   to   encourage   employers   to   adopt   these   plans,   Congress
sought   to   create   a   system   that   is   straightforward,   thereby
21




No.                                                                           2009AP1558
minimizing  administrative  and  litigation  expenses.     Varity,            516
U.S.  at                                                                      497.     Affording  employers  the  ability  to  bargain  for  a
deferential  standard  gives  them  the  ability  to  minimize  these
expenses.
¶48   A  critical  question  when  deciding  whether  an  ERISA
plan  affords  discretion  to  the  administrator  is  notice.     Diaz,
424  F.3d  at  637.    "[P]articipants  must  be  able  to  tell  from  the
plan's  language  whether  the  plan  is  one  that  reserves  discretion
for  the  administrator."     Id.     In  other  words,  the  language  of
the   plan   granting   the   plan   administrator   discretion   must   be
clear.    Cooke,  ERISA  Practice  §  8:14,  at  8-113.
¶49   There  are  no  "magic  words"  required  in  order  to  afford
the  administrator  discretion.    Herzberger  v.  Standard  Ins.  Co.,
205  F.3d  327,  331  (7th  Cir.  2000).    However,  a  plan's  provision
stating  that  the  plan  administrator  has  the  authority  to  make
eligibility    determinations    is    insufficient    to    put    the
participant  on  notice  that  the  administrator's  decisions  will  be
reviewed  under  a  discretionary  standard.    Diaz,  424  F.3d  at  637.
A   plan's   requirement   that   an   applicant   submit   "satisfactory
proof  of  entitlement"  also  is  not  sufficient  notice.     Id.     By
contrast,   notice   is   sufficient   when   a   plan   gives   the   plan
administrator  the  "sole  discretion"  to  interpret  the  terms  of
the  plan.     Cutting,                                                       993  F.2d  at                                                      1295-96.     In  such  a  case,  an
22




No.                                                                          2009AP1558
administrator's  decisions  are  reviewed  under  the  discretionary
arbitrary  and  capricious  standard.20    Id.
¶50   When  a  plan  gives  the  plan  administrator  discretion  to
interpret  the  terms  of  the  plan,  a  reviewing  court  will  not
reverse  the  plan  administrator's  interpretation  unless  it  is  not
                                                                             reasonable.                                           See   Firestone,   489   U.S.   at                                                                       111.                                   A   plan
                                                                                                                                                      administrator's  interpretation  of  the  plan  is  not  reasonable  if
                                                                                                                                                      the  interpretation  is  "arbitrary  and  capricious  in  light  of  the
                                                                                                                                                      language  of  the  Plan."    Evans  v.  W.E.A.  Ins.  Trust,  122  Wis.  2d
1,                                                                           14,              361  N.W.2d                          630                (1985)                                                                                (quoting  Wardle  v.  Cent.  States,
                                                                                              Se.  &  Sw.  Areas  Pension  Fund,                      627  F.2d                                                                     820,    823-24                                 (7th  Cir.
1980)  (abrogated  on  other  grounds  by  Firestone,  489  U.S.  101));
see   also   Summers,                                                        309   Wis.  2d   78,                                  ¶16.               Both   the   plan
administrator's  interpretation  of  a  plan's  terms  and  the  plan
administrator's   factual   findings   are   reviewed   under   this
discretionary  standard.      Rekowski,                                      417  F.  Supp.   2d  at                               1047.
Stated  another  way,  a  reviewing  court  will  not  reverse  a  plan
administrator's  decision  unless  it  is  "downright  unreasonable."
Ruiz  v.  Cont'l  Cas.  Co.,                                                 400  F.3d        986,                                 991                (7th  Cir.                                                                    2005)
(internal  quotation  marks  omitted).
20  The  Seventh  Circuit  has  also  suggested  that  employers  use
the  following  "safe  harbor"  language  if  they  want  to  be  sure
their  plan  gives  adequate  notice  that  a  discretionary  standard
will  be  applied:     "'Benefits  under  this  plan  will  be  paid  only
if  the  plan  administrator  decides  in  his  discretion  that  the
applicant  is  entitled  to  them.'"     Herzberger  v.  Standard  Ins.
Co.,  205  F.3d  327,  331  (7th  Cir.  2000)  (internal  quotation  marks
omitted).
23




                                                                                                                                                                                                                                                                                                                                          No.           2009AP1558
                                                                                                                                                                                                                 ¶51   Review  of  a  plan  administrator's  decision  is  limited
                                                                                                                                                                                                                 "to  the  record  available  to  the  plan  administrator  at  the  time
                                                                                                                                                      the  decision  was  made."     Rekowski,                                                                                                417  F.  Supp.                                            2d  at       1047
                                                                                                                                                                                                                 (citing  numerous  Seventh  Circuit  cases).    See  also  Cooke,  ERISA
Practice                                                                                                                                              §  8:14,  at                               8-121                                                                                        (explaining  that  this  limitation  is
                                                                               the  general  rule).
                                                                                                                                                                                                                 ¶52   Subrogation  clauses  in  ERISA  plans  trump  the  Wisconsin
                                                                               make-whole   doctrine.21                                                                                                          Cutting,                                                                     993   F.2d   at                             1298-99                    (Under
                                                                                                                                                                                                                 ERISA,    "the    make-whole    rule    is    just    a    principle    of
                                                                                                                                                                                                                 interpretation,  it  can  be  overridden  by  clear  language  in  the
                                                                                                                                                                                                                 plan.");  see  also    Ruckel  v.  Gassner,  2002  WI  67,  ¶42  n.7,  253
Wis.  2d                                                                       280,                                                                   646  N.W.2d                                                                                                                             11;  Newport  News  Shipbuilding  Co.  v.
                                                                               T.H.E.  Ins.  Co.,                                                                                                187  Wis.  2d   364,                                                                         371-72,                                     523  N.W.2d   270          (Ct.
App.                                                                           1994).     This,  too,  is  in  line  with  the  goal  of  ERISA  to
encourage  employers  to  adopt  benefit  plans  and  the  principle  of
contract  law  that  parties  are  entitled  to  the  benefits  of  their
bargain.    As  one  court  has  explained:
[G]iven  that  an  employer  is  free  to  refuse  to  provide
a   health   benefit   plan   in   the   first   place,   it   is
unclear  why,  if  the  employer  does  provide  such  a  plan,
it  may  not  condition  benefits  on  the  agreement  of  the
21  Wisconsin   has   adopted   the   make-whole   doctri

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