Atlantic Health Care Benefits Trust v. Foster

809 F. Supp. 365, 16 Employee Benefits Cas. (BNA) 1503, 1992 U.S. Dist. LEXIS 19953, 1992 WL 383755
CourtDistrict Court, M.D. Pennsylvania
DecidedDecember 23, 1992
DocketCiv. A. 3:CV-92-0551
StatusPublished
Cited by9 cases

This text of 809 F. Supp. 365 (Atlantic Health Care Benefits Trust v. Foster) is published on Counsel Stack Legal Research, covering District Court, M.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Atlantic Health Care Benefits Trust v. Foster, 809 F. Supp. 365, 16 Employee Benefits Cas. (BNA) 1503, 1992 U.S. Dist. LEXIS 19953, 1992 WL 383755 (M.D. Pa. 1992).

Opinion

MEMORANDUM

RAMBO, Chief Judge.

Before the court is Defendants’ motion to dismiss Plaintiffs’ complaint pursuant to Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6). Plaintiffs seek a declaration that Pennsylvania insurance laws regulating its benefits plan are preempted by ERISA, and further seek to enjoin the Commissioner from interfering with their benefits plan. Defendants assert that they are immune from suit pursuant to the Eleventh Amendment, and that Plaintiffs’ complaint fails to state a claim since state licensing regulations are not preempted by ERISA as Plaintiffs allege. The matter has been fully briefed and is now ripe for consideration.

Background

The following facts are undisputed by the parties; any contested points will be noted by the court: On February 1, 1991, Edward Zinner and William Moulton created Atlantic Health Care Benefits Trust (“Atlantic”). Plaintiff United Health Care Association of America is a group of employers who provide their employees coverage through Atlantic. Plaintiff National Insurance Consultants administers Atlantic. Plaintiffs Zimmerman and King are insurance agents working with Atlantic. On June 28, 1991, the Pennsylvania Insurance Department claimed that Plaintiffs were operating an insurance company without the proper license required by 40 Pa. Stat.Ann. § 46. Subsequently, on November 27, 1991, the Commissioner ordered Atlantic to cease and desist solicitation of subscribers, renewal of policies, or acceptance of premium payments.

Defendants in the captioned case are Cynthia M. Maleski, the Commissioner for the Pennsylvania Insurance Department, who has been sued both in her individual and official capacities, and the Insurance Department itself. 1

Plaintiffs seek declaratory relief, to obtain clarification of the interplay between federal and state law, and injunctive relief, to prevent Defendants’ allegedly unlawful interference in the benefits plan. Plaintiffs contend that Pennsylvania’s regulation of Atlantic is preempted, and thus precluded by the Employee Retirement Security Act of 1974 (“ERISA”), which purportedly governs Plaintiffs’ scheme.

Discussion

I. Eleventh Amendment

A. INTRODUCTION

Defendants assert that this court has no subject matter jurisdiction over the captioned action because of Eleventh Amendment immunity afforded states and their agencies. As the present suit implicates a state body and a state official, Defendants seek dismissal of the captioned case pursuant to Federal Rule of Civil Procedure 12(b)(1).

The Eleventh Amendment provides:

The Judicial power of the United States shall not be construed to extend to any suit in law or equity commenced or prosecuted against any one of the United States by citizens of another State, or by citizens or subjects of any Foreign State.

This amendment, while facially applicable to both states and state officials, has been differentially interpreted in the -two instances.

B. SUIT AGAINST PENNSYLVANIA INSURANCE DEPARTMENT

The Eleventh Amendment has always been interpreted as precluding suit against a state without a waiver of immuni *368 ty by the state. Furthermore, the Ex Parte Young doctrine, discussed below, does not alter the fundamental prohibition against directly suing a state. Ex Parte Young, 209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (1908). See also Alabama v. Pugh, 438 U.S. 781, 782, 98 S.Ct. 3057, 3058, 57 L.Ed.2d 1114 (1978).

Nor may a state body be sued without a waiver of immunity. This bar to suit just as clearly applies to Commonwealth agencies as it does to the Commonwealth itself. See Helfrich v. Pennsylvania, Department of Military Affairs, 660 F.2d 88, 90 (3d Cir.1981) (Department of Military Affairs immune from suit due to Eleventh Amendment); Pugh, 438 U.S. at 782, 98 S.Ct. at 3057-58 (Board of Corrections immune due to Eleventh Amendment). Plaintiffs concede that the Pennsylvania Insurance Department is an arm of the Commonwealth. Complaint at ¶ 8. Moreover, there is no indication that the Commonwealth has consented to this suit. Thus, Defendants are correct that Plaintiffs’ suit must fail as to defendant Insurance Department of Pennsylvania. The Insurance Department will be dismissed from the case.

C. SUIT AGAINST PENNSYLVANIA INSURANCE COMMISSIONER

The words of the Eleventh Amendment would appear to preclude federal courts from granting injunctive relief to ensure that states, through state officials, conform to constitutional or federal law. However, case law has not so interpreted the Eleventh Amendment.

The seminal case, Ex Parte Young, held that any state official acting inconsistently with the federal Constitution is “stripped of his official or representative character and is subjected in his person to the consequences of his individual conduct.” Ex Parte Young, 209 U.S. at 160, 28 S.Ct. at 454. Thus, Ex Parte Young created a fiction to enable state officials to be required to comply with federal law — if a state officials’s actions are not in compliance with federal law, the acts are deemed not to be sanctioned by the state, thereby permitting a personal suit against the officials to go forward. Because of the fiction of Ex Parte Young, technically, injunctive relief is only available against officials in their individual capacity; however, courts have gradually approached this fiction more leniently and permitted claims against state officials acting solely in their official capacity.

The principle enunciated in Ex Parte Young, permitting suits for injunctive relief against state officials who violate federal constitutional rights, has been expanded to apply to violations of federal statutes as well. See Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96 n. 14, 103 S.Ct. 2890, 2899 n. 14, 77 L.Ed.2d 490 (1983); Almond Hill School v. United States Dept. of Agric., 768 F.2d 1030, 1034 (9th Cir.1985); Allegheny County Sanitary Auth. v. United States Envtl. Protection Agency, 732 F.2d 1167, 1174 (3d Cir.1984).

Moreover, declaratory relief, ancillary to injunctive relief, against a state official is not barred by the Eleventh Amendment. Green v. Mansour, 474 U.S. 64, 72-73, 106 S.Ct. 423, 427-28, 88 L.Ed.2d 371 (1985), reh’g denied, 474 U.S. 1111, 106 S.Ct.

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Bluebook (online)
809 F. Supp. 365, 16 Employee Benefits Cas. (BNA) 1503, 1992 U.S. Dist. LEXIS 19953, 1992 WL 383755, Counsel Stack Legal Research, https://law.counselstack.com/opinion/atlantic-health-care-benefits-trust-v-foster-pamd-1992.