Bolssen v. Unum Life Insurance Co. of America

629 F. Supp. 2d 878, 46 Employee Benefits Cas. (BNA) 2651, 2009 U.S. Dist. LEXIS 44365, 2009 WL 1307781
CourtDistrict Court, E.D. Wisconsin
DecidedMay 7, 2009
DocketCase 09-C-202
StatusPublished
Cited by3 cases

This text of 629 F. Supp. 2d 878 (Bolssen v. Unum Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, E.D. Wisconsin primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bolssen v. Unum Life Insurance Co. of America, 629 F. Supp. 2d 878, 46 Employee Benefits Cas. (BNA) 2651, 2009 U.S. Dist. LEXIS 44365, 2009 WL 1307781 (E.D. Wis. 2009).

Opinion

ORDER DENYING MOTION TO REMAND

WILLIAM C. GRIESBACH, District Judge.

Plaintiff Dennis A. Bolssen sued Defendant Unum Life Insurance Company of America (“Unum”) in Brown County Circuit Court, alleging Unum breached a contract to provide disability insurance benefits. Bolssen also asserted claims for breach of fiduciary duty, fraud, conversion, and violation of Wis. Stat. § 628.46. Unum timely removed the case to this court on February 25, 2009, asserting federal jurisdiction under the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”). (Doc. # 1.) The matter is now before me on Bolssen’s motion to remand the case back to state court for a lack of federal jurisdiction. Bolssen, who worked for the Oneida Casino, contends that the contract under which he makes his claim is not covered by ERISA because the “governmental plan” exception to ERISA applies.

Unum asserts that the fact Bolssen was employed by the tribe is not dispositive of whether the plan is a governmental plan which would take it outside of ERISA. In support of this argument, Unum notes that Bolssen was actually employed by the Oneida Tribe’s casino and his janitorial duties at the casino were commercial activities and not essential governmental functions. Unum also contends that ERISA governs as the plan itself provides that it was governed by ERISA, and because Unum administered Bolssen’s claim in accordance with ERISA. (Def.’s Br. in Opp. at 6 n. 2.)

BACKGROUND

According to the complaint filed in Brown County Circuit Court, Bolssen worked for the Oneida Tribe of Indians of Wisconsin. (Compl. ¶ 3.) On September 1, 1997, Unum issued a group disability insurance policy to the tribe. (Id.) Bolssen fell on October 23, 2004 and sustained injuries to his head, arms and torso. (Compl. ¶4.) On March 25, 2005, Bolssen notified Unum of his disability, and payments under the policy began soon thereafter. (Compl. ¶ 5.) On November 27, 2007, Unum requested that Bolssen attend an “independent medical examination” to perform an Activities Daily Living Assessment (“ADLS”). (Compl. ¶ 8.) Based upon the results of the ADLS, which indicated Bolssen had lost only one activity of daily living (bathing), Unum notified Bolssen on February 28, 2008, that it would no longer continue to pay disability benefits under the long term disability claim. (Compl. ¶ 10.)

ANALYSIS

“The party seeking a federal forum has the burden of establishing jurisdiction.” Wellness Community-National v. Wellness House, 70 F.3d 46, 49 (7th Cir.1995) (citation omitted); see also Hart v. FedEx Ground Package Sys., Inc., 457 F.3d 675, 679 (7th Cir.2006) (“In general, of course, the party invoking federal jurisdiction bears the burden of demonstrating its existence. Federal courts are courts of limited jurisdiction: ‘It is to be presumed that a cause lies outside this limited jurisdiction, and the burden of establishing the contrary rests upon the party asserting jurisdiction.’ ”) (some citations omitted) (quoting Kokkonen v. Guardian Life Ins. Co. of America, 511 U.S. 375, 377, 114 S.Ct. 1673, 128 L.Ed.2d 391 (1994)). Unum therefore has the burden of establishing that federal jurisdiction exists.

*881 The provisions of ERISA do not apply to a “governmental plan” as defined by 29 U.S.C. § 1002(32). 29 U.S.C. § 1003(b)(1). In pertinent part, section 1002(32) defines “governmental plan” as:

... a plan which is established and maintained by an Indian tribal government (as defined in section 7701(a)(40) of Title 26), a subdivision of an Indian tribal government (determined in accordance with section 7871(d) of Title 26), or an agency or instrumentality of either, and all of the participants of which are employees of such entity substantially all of whose services as such an employee are in the performance of essential governmental functions but not in the performance of commercial activities (whether or not an essential government function)

29 U.S.C. § 1002(32). Thus, employee plans established and maintained by an Indian tribal government are exempt only if substantially all of the employees’ services are in the performance of essential government functions, as opposed to commercial activities-even if the commercial activities are essential government functions.

The amendment to section 1002(32), which made certain plans established and maintained by Indian tribal governments exempt from ERISA, took effect on August 17, 2006. Pub. L. No. 109-280, § 906(a)(2)(A), 120 Stat. 780, 1051 (2006). Prior to the amendment of § 1002(32), the Seventh Circuit held that because ERISA is a statute of general application, tribal sovereignty did not insulate plans established and maintained by tribes from ERISA. Smart v. State Farm Ins. Co., 868 F.2d 929 (7th Cir.1989). Since the policy at issue here and the accident precede the effective date of the amendment making some plans offered by tribal governments exempt, it is questionable whether section 1002(32) even applies. See Dobbs v. Anthem Blue Cross and Blue Shield, Case No. 04-cv-02283, 2007 WL 2439310, *3 (D.Colo. Aug. 23, 2007) (holding that the new definition of governmental plan under § 1002(32) does not apply retroactively). Even assuming the amendment applies, however, the exemption it created does not seem to cover the plan at issue here.

“The amendment’s legislative history suggests that Congress expanded the definition to clarify the legal ambiguity regarding the status of employee benefit plans established and maintained by tribal governments.” Dobbs v. Anthem Blue Cross & Blue Shield, 475 F.3d 1176, 1178 (10th Cir.2007) (citing 150 Cong. Rec. S9526, 9533). The Tenth Circuit further explained,

Because the amended provision makes a distinction between “essential governmental functions” and “commercial activities,” not all plans established and maintained by tribes will fall under the governmental plan exemption. The determination of whether a tribal plan qualifies as a governmental plan under § 1002(32) requires a fact-specific analysis of the plan at issue and the nature of its participants’ activities.

Dobbs, 475 F.3d at 1178. Since the 2006 amendment there has been little comment from the courts on the difference between “essential governmental functions” and “commercial activities.”

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629 F. Supp. 2d 878, 46 Employee Benefits Cas. (BNA) 2651, 2009 U.S. Dist. LEXIS 44365, 2009 WL 1307781, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bolssen-v-unum-life-insurance-co-of-america-wied-2009.