Acosta v. Board of Trustees of UNITE HERE Health

CourtDistrict Court, N.D. Illinois
DecidedMarch 31, 2025
Docket1:22-cv-01458
StatusUnknown

This text of Acosta v. Board of Trustees of UNITE HERE Health (Acosta v. Board of Trustees of UNITE HERE Health) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Acosta v. Board of Trustees of UNITE HERE Health, (N.D. Ill. 2025).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

JOSE LUIS ACOSTA, MARIA BUENROSTRO,) ARMANDO GARCIA, MARIA SANCHEZ, ) and GLYNNDANA SHEVLIN, ) ) Plaintiffs, ) No. 22 C 01458 ) v. ) Judge Rebecca R. Pallmeyer ) BOARD OF TRUSTEES OF UNITE HERE ) HEALTH and DOES 1 through 10, inclusive, ) ) Defendants. )

MEMORANDUM OPINION AND ORDER

Jose Luis Acosta, Armando Garcia, Maria Sanchez, Glynndana Shevlin, and Maria Buenrostro (“Named Plaintiffs”) move to certify a class of current and former plan participants of UNITE HERE Health (“UHH”), an ERISA-covered healthcare plan. The Named Plaintiffs allege that the Board of Trustees of UHH (“Defendant”) breached its fiduciary duties by taking on exorbitant administrative costs and distributing costs disproportionately among “Plan Units.” They seek relief under ERISA §§ 409, 502(a)(2), 502(a)(3), codified at 29 U.S.C. §§ 1109, 1132(a)(2), and 1132(a)(3), respectively. The proposed class includes “at least” 7,513 individuals who were members of two allegedly overcharged Units between March 2016 and present. For the reasons stated below, Plaintiffs motion for certification is granted in part. BACKGROUND I. Factual Background The facts underlying this action are set out in two prior opinions ruling on Defendant’s motions to dismiss. See Acosta v. Bd. of Trs. of UNITE HERE Health, No. 22 C 1458, 2023 WL 2744556, at *1–2 (N.D. Ill. Mar. 31, 2023) (Leinenweber, J.); Acosta v. Bd. of Trs. of UNITE HERE Health, No. 22 C 1458, 2024 WL 3888862, at *1–2 (N.D. Ill. Aug. 21, 2024). The court, nonetheless, summarizes the facts relevant to the parties’ arguments for and against certification. A. UHH’s Structure and Cost Allocation UHH is a Taft-Hartley multiemployer trust fund providing healthcare coverage to approximately 110,000 employees working for hundreds of employers nationwide. (Am. Compl. [46] ¶¶ 1–2.) Given the discrepancies in cost and coverage needs across geography and industries, UHH divides its coverage into “Plan Units,” which function as independent, self- sustaining benefit programs with different benefit options and independent operating budgets. (Simon Decl. [84-3] ¶ 4.) The Plan Units are divided in different ways, some by geography (e.g. Boston Plan, Detroit Plan), some by industry (e.g. Food Service Plan, Chicago Hotels/Casinos Plan). (See generally UHH 2022-23 Dashboard [78-18] at UHH040200.) The health plans offered in each Plan Unit fall into three categories: fully-insured plans, self-insured plans, and partially- insured plans. (Am. Compl. ¶¶ 46–49); see also Acosta, 2023 WL 2744556, at *2. In fully-insured plans, benefits claims are paid through third-party insurance, and UHH funds are used to pay the insurance premiums. (Id.) In self-insured plans, UHH funds are used to directly pay for the cost of benefits, without the use of third-party insurance. (Id.) Partially-insured plans are hybrid plans in which some benefits are fully-insured and others are self-insured by UHH. (Id.) Three Plan Units are relevant to the claims in this case: Unit 178, Unit 278, and Unit 150. Plan Unit 178 covers employers in Los Angeles County, California. (Id. ¶ 109.) Plan Unit 278 covers employers in Orange County and Long Beach, California. (Id. ¶ 126.) Both Unit 178 and Unit 278, for all relevant times, have been fully-insured plans with respect to medical, vision, and life insurance benefits. (Id. ¶¶ 110, 127.) Until June 1, 2021, participants of Units 178 and 278 could obtain self-insured dental care through the UHH-operated Los Angeles Dental Center. (Id.) Since June 1, 2021, dental benefits have been fully-insured as well for both plans. (Id.) Unit 150, also known as the “Las Vegas Plan” or the “Culinary Health Plan,” covers employers in Las Vegas, Nevada. (Id. ¶ 89.) Unit 150 is a partially insured plan—UHH operates a medical clinic called the “Culinary Health Center,” where Unit 150 participants can exclusively obtain primary, pediatric, dental, and vision care free of charge. (Id. ¶ 90–94.) In addition to contributing funds to UHH for the payment of benefits to plan-members, each Plan Unit must also contribute funds for the payment of UHH’s administrative expenses. The amount that each Unit must pay towards administrative expenses is calculated at two stages: first, the allocation of projected administrative expenses when UHH generates minimum contribution rates employers must contribute to the fund, and, second, when UHH actually allocates expenses by using contributions to pay off administrative expenses at the end of the fiscal year. 1. Projection of Administrative Expenses UHH is funded almost exclusively by the periodic contributions paid into it by participant employers and employees. (See Pls. Mem. [78-1] at 3, O’Donnell Decl. [78-2] ¶ 53.) Employers contribute to the fund at rates set by collective bargaining with the employee unions. (See Minimum Standards [78-6] at UHH0406694–96.) But while the precise contributions made by employers to UHH are set by collective bargaining, there is a floor: UHH sets a minimum threshold (also known as a “target contribution rate” or “published rate”) that each employer must contribute to cover the cost of benefits, maintain a surplus, and account for administrative expenses. (See id. at UHH0406696; see also Simon Dep. Tr. [78-37] at 56:15–57:2.) In bargaining with the union, an employer may agree to contribute more than the minimum threshold set by UHH but may not contribute less than the target rate without UHH’s permission. (See Simon Decl. [84-3] ¶ 17, Minimum Standards at UHH056696.) Alternatively, some employers come to “bucket allocation” agreements through collective bargaining. In bucket allocations, in contrast to the previously described “published-rate” agreements, an employer does not agree to pay a specific rate in contributions to UHH, but instead agrees to provide a pool of funds to the union and leaves it to the union’s discretion to divide the available funds for payment of healthcare costs (i.e. contributions to UHH), wages, pension funds, and other benefits. (Simon Decl. ¶ 16.) In the bucket-allocation scenario, UHH does not create a minimum requirement, but provides a target rate as a recommendation to the union to maintain the self-sufficiency of the fund; the union has the final say on how much to contribute. Simon Dep. Tr. at 191:24–192:5.) In calculating target employer contribution rates, Units 178 and 278 are treated differently than other Plan Units; they are subdivided further into “employer categories,” for which UHH’s underwriters develop different target contribution rates as if each category were a Plan Unit itself. (See Simon Decl.

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Bluebook (online)
Acosta v. Board of Trustees of UNITE HERE Health, Counsel Stack Legal Research, https://law.counselstack.com/opinion/acosta-v-board-of-trustees-of-unite-here-health-ilnd-2025.