Erie County Retirees Ass'n v. County of Erie

220 F.3d 193, 24 Employee Benefits Cas. (BNA) 2390, 2000 U.S. App. LEXIS 18317, 83 Fair Empl. Prac. Cas. (BNA) 941
CourtCourt of Appeals for the Third Circuit
DecidedAugust 1, 2000
DocketNo. 99-3877
StatusPublished
Cited by61 cases

This text of 220 F.3d 193 (Erie County Retirees Ass'n v. County of Erie) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Erie County Retirees Ass'n v. County of Erie, 220 F.3d 193, 24 Employee Benefits Cas. (BNA) 2390, 2000 U.S. App. LEXIS 18317, 83 Fair Empl. Prac. Cas. (BNA) 941 (3d Cir. 2000).

Opinions

OPINION OF THE COURT

GREENBERG, Circuit Judge.

I. INTRODUCTION

This matter comes on before this court on appeal from an order of the district court entered September 30, 1999, granting partial summary judgment in favor of the County of Erie, Pennsylvania (the “County”), dismissing appellants’ claim under the Age Discrimination in Employment Act (“ADEA”), 29 U.S.C. § 621 et seq. See Erie County Retirees Ass’n v. County of Erie, 91 F.Supp.2d 860 (W.D.Pa.1999) (“Erie County”). We are called upon to address the applicability of the ADEA when an employer offers its Medicare-eligible retirees health insurance coverage allegedly inferior to the coverage offered to retired employees not eligible for Medicare. The district court held that the ADEA did not apply in such circumstances. For the reasons set forth herein, we disagree, and accordingly will reverse and remand the case for further proceedings.

A. Factual Background

In 1972, the County implemented a policy pursuant to which it provided its retired employees with health and hospitalization insurance benefits during their retirement. In 1987, the County began utilizing Blue Cross/Blue Shield of Western Pennsylvania, now known as Highmark Blue Cross/ Blue Shield (“Highmark”), to provide the coverage. The County classified employees and retirees into three main coverage groups: one for current employees, one for Medicare-eligible retirees, and one for retirees not eligible for Medicare. Each group had separate but similar traditional indemnity coverage. Erie County, 91 F.Supp.2d at 861-62; App. at 10.

Faced with increasing health insurance costs, the Erie County Employees’ Retirement Board (the “Board”), which administered the medical coverage, decided that employees hired after January 23, 1992, would not be eligible for continued health insurance benefits upon retirement. On December 12, 1995, the Board further restricted eligibility by declaring that persons the County hired prior to January 23, 1992, would remain eligible only if they fell into one of four groups: employees unable to continue their employment due to a disability and who otherwise were eligible for a disability retirement pension; employees who retired from the County government with at least 20 years of service and 55 years of age; employees involuntarily terminated from County government employment with at least eight years of service; and employees who retired from the County with at least eight years of service and 60 years of age. The plaintiff class in this action is composed of retirees who are aged 65 or older — and thus eligible for Medicare — who remain eligible for retiree health coverage under these restrictions. Erie County, 91 F.Supp.2d at 862-63; App. at 10.

In 1997, a change in government accounting standards prevented the County from continuing to use the “excess interest” generated by its pension funds to pay the premiums for retiree health coverage; instead, the County began to pay the premiums from its regular budget. That year, the County took over the Board’s [197]*197responsibility to select retiree health plans. In November 1997, -pressure to reduce costs was enhanced when Highmark announced that it would increase the County’s premiums for medical insurance coverage by an average of 48%. Erie County, 91 F.Supp.2d at 862-63.

In the fall of 1997, the County selected a plan called “SeeurityBlue” for Medicare eligible retirees.1 Effective February 1, 1998, the County required all former County employees qualified for SeeurityB-lue to accept that program or lose all health coverage. The district court described SeeurityBlue as follows:

SecurityBlue is a coordinated health care plan provided through Keystone Health Plan West, Inc., a federally qualified health maintenance organization (“HMO”), and a contract with Medicare. SecurityBlue is available to persons who have Medicare Part B Medical Insurance and who live in the SecurityBlue ‘service area’ [which includes most of western Pennsylvania]. This Plan differs from a traditional indemnity plan primarily in that the health care needs of each member are coordinated by his or her primary care physician (“PCP”), who is selected from a list of physicians provided in the SecurityBlue Provider directory. The PCP is responsible not only for administering care, but also for making referrals to specialists and arranging for hospitalization. Some degree of individual choice is lost under this Plan inasmuch as a member’s PCP must be selected from a list of physicians within the SecurityBlue network and coverage is available only for services provided or authorized by the insured’s PCP. In most cases, the Securi-tyBlue Plan does not pay for services that are not authorized by the insured’s PCP [with the exception of emergencies]. The trade-off for this loss of choice is that, unlike the traditional indemnity plan, the SecurityBlue Plan has no deductibles and little or no co-payment obligation; generally, 100 percent of the covered services are paid for. In addition, SecurityBlue covers pre-exist-ing conditions without a waiting period and also provides benefits for some services — such as eye examinations, dental visits and hearing aids — that are not available under traditional indemnity plans or Highmark’s SelectBlue point-of-service plan.... However, SeeurityBlue members must continue to pay Medicare Part B Medical Insurance premiums.

Erie County, 91 F.Supp.2d at 863 (footnotes omitted).

The County selected a Highmark plan, “SelectBlue,” for its former employees not Medicare-eligible and therefore not eligible for SeeurityBlue. It placed those former employees in SelectBlue effective October 1, 1998. The district court described Se-lectBlue as follows:

The SelectBlue Plan differs from Securi-tyBlue in that it is a hybrid ‘point-of-service’ plan which combines the features of an HMO with those of a traditional indemnity plan. Under Select-Blue an insured can, for any health care incident, select either the HMO option (and accept its benefits and limitations) or the traditional indemnity option. In order to be eligible for SelectBlue, a retiree must be non-eligible for Medicare and must live in the SelectBlue service area [western Pennsylvania].

Erie County, 91 F.Supp.2d at 863.

Retirees who did not qualify for either SeeurityBlue or SelectBlue because they did not reside within the western Pennsylvania service area were offered traditional indemnity health insurance.

Appellants contend that SeeurityBlue provides inferior coverage as compared to SelectBlue and the traditional indemnity coverage previously available to them, but [198]*198they largely focus their argument on the comparison between themselves and SelectBlue retirees. The gravamen of this lawsuit is that the County violated the ADEA by discriminatorily placing members of the plaintiff class into SecurityBIue on the basis of their having attained age 65.

B. Procedural History

The Erie County Retirees Association and Lyman H. Cohen, on behalf of himself and all other similarly situated retirees of the County age 65 or over placed in Secu-rityBIue, filed this action on September 18, 1998, against the County and the Board.

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Bluebook (online)
220 F.3d 193, 24 Employee Benefits Cas. (BNA) 2390, 2000 U.S. App. LEXIS 18317, 83 Fair Empl. Prac. Cas. (BNA) 941, Counsel Stack Legal Research, https://law.counselstack.com/opinion/erie-county-retirees-assn-v-county-of-erie-ca3-2000.