Bandy v. Alliance for Shared Health Inc

CourtDistrict Court, E.D. Washington
DecidedSeptember 16, 2022
Docket2:22-cv-00025
StatusUnknown

This text of Bandy v. Alliance for Shared Health Inc (Bandy v. Alliance for Shared Health Inc) is published on Counsel Stack Legal Research, covering District Court, E.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bandy v. Alliance for Shared Health Inc, (E.D. Wash. 2022).

Opinion

1 FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 2 Sep 16, 2022

3 UNITED STATES DISTRICT COURT SEAN F. MCAVOY, CLERK EASTERN DISTRICT OF WASHINGTON 4 MARTIN BANDY, No. 2:22-cv-00025-SMJ 5 Plaintiff, 6 v. ORDER DENYING IN PART AND 7 GRANTING IN PART ALLIANCE FOR SHARED HEALTH, DEFENDANTS’ MOTION TO 8 INC., and CHRISTIAN DISCOUNT DISMISS ALLIANCE, LLC d/b/a SHARED 9 HEALTH ALLIANCE,

10 Defendants.

11 Before the Court are Defendant Alliance for Shared Health Inc.’s Motion to 12 Dismiss, ECF No. 15, and Defendant Christian Discount Alliance’s Motion to 13 Dismiss, ECF No. 18. On August 23, 2022, the Court heard argument from the 14 parties on the motions and reserved judgment. After reviewing the motions and the 15 file, the Court is fully informed and grants in part and denies in part each of the 16 motions. The Court declines to dismiss Plaintiff’s claims in full but agrees that 17 Plaintiff’s deceptive practices claim sounds in fraud but fails to meet Federal Rule 18 of Civil Procedure 9(b) heightened pleading standard. As such, that claim is 19 dismissed with leave to replead. 20 // 1 BACKGROUND 2 Plaintiff Martin Bandy brings this class action under the Washington

3 Consumer Protection Act (CPA), WASH. REV. CODE §19.86, and contract law, 4 against Defendants Alliance for Shared Health, Inc. (ASH), and Christian Discount 5 Alliance, LLC d/b/a Shared Health Alliance (SHA), on behalf of himself and other

6 Washington consumers who were allegedly marketed and sold unauthorized health 7 insurance plans that were deceptively marketed as being offered by a Health Care 8 Sharing Ministry in Washington by Defendants. ECF No. 1 at 1–2. 9 Plaintiff enrolled in an ASH healthcare plan on April 24, 2020, paying a $125

10 one-time enrollment fee and a monthly premium of approximately $355.50. Id. at 11 14. Once enrolled, Plaintiff received what he believed was an insurance card from 12 ASH. Id. The insurance card purportedly certified Plaintiff’s membership in a

13 “Health Care Sharing” community. Id. In June 2021, after experiencing symptoms 14 of a stroke, Plaintiff received care at the emergency room and was admitted to the 15 hospital, where he continued to receive extensive care. Id. at 15. When Plaintiff 16 tried to have these costs covered by what he believed was his insurance, Defendants

17 denied Plaintiff’s claims for coverage of services in the emergency room and during 18 his overnight stay at the hospital. Id.. The complaint alleges Plaintiff was forced to 19 pay out-of-pocket for services he believed would be covered by ASH, and now has

20 more than $40,000 in medical debt, which he continues to pay. Id. 1 Plaintiff alleges Defendants entered into illegal contracts and engaged in 2 unfair and deceptive business practices by illegally acting as insurers and selling

3 sham plans to more than 3,000 Washingtonians in violation of contract law and the 4 Washington CPA. Id. at 1, 15. Defendants both now move to dismiss this action. 5 See generally ECF Nos. 15, 18. Defendant ASH argues Plaintiff’s three claims

6 should be dismissed as (1) the illegal contract claim fails because Plaintiff has not— 7 and cannot—establish the plan as an insurance contract, (2) Plaintiff cannot state a 8 claim for unfair business practices, as ASH’s disclosures bar this claim, and (3) the 9 deceptive business practices claim is deficient because it does not comply with Rule

10 9(b). ECF No. 15 at 6. Defendant SHA argues Plaintiff’s claims should be dismissed 11 because (1) Plaintiff did not have a contract with SHA, and (2) Plaintiff cannot sue 12 under the CPA because he never interacted with or had a relationship with SHA.

13 ECF No. 18 at 1–2. 14 LEGAL STANDARD 15 A complaint must contain “a short and plain statement of the claim showing 16 that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2). Under Federal Rule of

17 Civil Procedure 12(b)(6), the Court must dismiss the complaint if it “fail[s] to state 18 a claim upon which relief can be granted.” 19 In deciding a Rule 12(b)(6) motion, the court construes the complaint in the

20 light most favorable to the plaintiff and draws all reasonable inferences in the 1 plaintiff’s favor. Ass’n for L.A. Deputy Sheriffs v. County of Los Angeles, 648 F.3d 2 986, 991 (9th Cir. 2011). Thus, the Court must accept all factual allegations

3 contained in the complaint as true. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). 4 However, the Court may disregard legal conclusions couched as factual allegations. 5 See id.

6 To survive a Rule 12(b)(6) motion, the complaint must contain “some viable 7 legal theory” and provide “fair notice of what the claim is and the grounds upon 8 which it rests.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 562 (2007) (internal 9 quotation marks and ellipsis omitted). While the complaint need not contain

10 detailed factual allegations, threadbare recitals of a cause of action’s elements, 11 supported only by conclusory statements, do not suffice. Iqbal, 556 U.S. at 663. 12 Thus, the complaint must contain “sufficient factual matter, accepted as true, to

13 ‘state a claim to relief that is plausible on its face.’” Id. at 678 (quoting Twombly, 14 550 U.S. at 570). Facial plausibility exists where the complaint pleads facts 15 permitting a reasonable inference that the defendant is liable to the plaintiff for the 16 misconduct alleged. Id. Plausibility does not require probability but demands more

17 than a mere possibility of liability. Id. Whether the complaint states a facially 18 plausible claim for relief is a context-specific inquiry requiring the Court to draw 19 from its judicial experience and common sense. Id. at 679.

20 // 1 While a court generally does not consider any material beyond the pleadings 2 in ruling on a Rule 12(b)(6) motion to dismiss, there are certain exceptions.

3 Relevant here, the Court may consider documents incorporated by reference in the 4 complaint. United States v. Ritchie, 342 F.3d 903, 908 (9th Cir. 2003). A document 5 “may be incorporated by reference into a complaint if the plaintiff refers extensively

6 to the document or the document forms the basis for the plaintiff’s claim.” Id. “In 7 other words, a court ‘may consider a document the authentic of which is not 8 contested, and upon which the plaintiff’s complaint necessarily relies.’” Lopez v. 9 Stages of Beauty, LLC, 307 F. Supp. 3d 1058, 1064 (S.D. Cal. 2018) (quoting

10 Parrino v. FHP, Inc., 146 F.3d 699, 706 (9th Cir. 1998), superseded by statue on 11 other grounds in Abrego v. Dow Chem. Co., 443 F.3d 676, 681–82 (9th Cir. 2006)). 12 In this case, the Court relies on ASH’s Membership Guidelines, ECF No. 15-2, as

13 they are repeatedly cited and quoted in the Complaint and form the basis of 14 Plaintiff’s claims. 15 DISCUSSION 16 A. The Illegal Contract Claim

17 Plaintiff alleges that the insurance plans he and other Washingtonians entered 18 with Defendants are illegal contracts because Defendants were not authorized to 19 issue health insurance in Washington. ECF No. 24. Any entity that sells insurance

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Bluebook (online)
Bandy v. Alliance for Shared Health Inc, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bandy-v-alliance-for-shared-health-inc-waed-2022.