Formisano v. Blue Cross of Rhode Island

478 A.2d 167, 6 Employee Benefits Cas. (BNA) 2244
CourtSupreme Court of Rhode Island
DecidedMay 31, 1984
Docket81-459-Appeal
StatusPublished
Cited by6 cases

This text of 478 A.2d 167 (Formisano v. Blue Cross of Rhode Island) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Formisano v. Blue Cross of Rhode Island, 478 A.2d 167, 6 Employee Benefits Cas. (BNA) 2244 (R.I. 1984).

Opinion

OPINION

SHEA, Justice.

This case comes before us on appeal by the plaintiff, Frank J. Formisano, as president of Local Union No. 220, United Rubber, Cork, Linoleum and Plastic Workers of America (Local 220, URW), from a judgment of the Superior Court in a declaratory-judgment action. The case was presented to the court on an agreed statement of facts. The issue before the court is the plaintiffs’ entitlement to reimbursement of two months’ premiums paid as a condition precedent to their obtaining extended health-care coverage following the termination of their employment. We affirm the judgment entered.

On January 30, 1981, P.P. Industries shut down its operations. The parties stipulated that for some time prior to the company’s closing, certain contracts were in effect between Blue Cross and Blue Shield of Rhode Island and the employees of P.F. Industries providing health-care coverage at group rates. Premiums were paid in full by the employer as agent of its employees, pursuant to its collective-bargaining agreement with Local 220, URW. The Blue Cross-Blue Shield contracts provided for automatic termination of coverage following default in payment of premiums after a thirty-day grace period. A series of defaults occurred in the latter part of 1980. Claims that arose during the grace period were honored. Claims that arose after the grace period were “frozen.” After extensive negotiations failed, coverage was discontinued effective December 1, 1980. In February 1981 Blue Cross forwarded conversion notices to the employees, offering them the opportunity to continue their health-care coverage at the previous group rate for up to ten months, provided they paid their proportionate share of the defaulted premiums for the months of December 1980 and January 1981. Approximately one-half of the employees so notified availed themselves of the offer.

On April 23, 1981, Formisano sought declaratory relief in Superior Court, alleging that he and all other former employees of P.F. Industries, Inc., similarly situated, were entitled to a special conversion opportunity for extended coverage as provided in G.L. 1956 (1979 Reenactment). § 27-19.1-1. He further alleged that Insurance Regulation No. 23 issued by the Department of Business Regulation had the effect of automatically amending the existing contract in regard to the minimum standards applicable to notices of discontinuance. He asserted that the procedure adopted by Blue Cross in this instance did not comply with such standards.

In his decision, the trial justice found that § 27-19.1-1 did not apply to employees permanently terminated because of the closing of a business. He also held that Insurance Regulation 23 did not automatically amend the already existing contract between the parties. A judgment was entered denying the relief sought. The plaintiffs appealed.

The plaintiffs take the position that § 27-19.1-1 is controlling in situations in which employees are out of work through no fault of their own and are unprotected *169 against the cost of illness or disability. By its terms, § 27-19.1-1 provides that

“(a) Whenever the employment of an insured member of a group hospital, surgical, or medical insurance plan is terminated because of involuntary lay-off or death, the benefits of such plan may be continued, as provided herein for a period of up to ten (10) months from the termination date of the insured member, but in any event not to exceed the shorter of the period which represents the period of continuous employment preceding termination with the employer under whose contract the member is insured * * (Emphasis added.)

Specifically, plaintiffs claim that they were “involuntarily laid off” within the meaning of § 27-19.1-1. They argue that Blue Cross-Blue Shield’s action in making extended coverage contingent on payment of defaulted premiums attributable to the employer was inconsistent with the meaning and spirit of the statute. We disagree.

We have said time and again that “[w]here the language of a statute is plain and unambiguous, there is no occasion for construction, and the statute must be given effect according to its plain and obvious meaning.” Providence Gas Co. v. Burke, 119 R.I. 487, 499, 380 A.2d 1334, 1340 (1977). “In construing a statute, the court must give the words their plain and ordinary meaning. * * * If the language of the statute is clear and unambiguous and conveys a definite and sensible meaning that does not contradict an evident legislative purpose, the court must apply the words literally.” Rathbun v. Leesona Corp., R.I. 460 A.2d 931, 933 (1983).

At issue here is the meaning of the term “involuntary lay-off” as used in § 27-19.1-1. The plaintiffs acknowledge that the customary layoff involves an employer who terminates for lack of work an employee who is subject to recall when the workload increases. They contend, however, that permanent termination is not excluded from the definition of the term. The defendant, in response, argues that the legislative objective behind § 27-19.1-1 contemplated a continuing “group plan,” not one that had terminated prior to the closing of business because of nonpayment of premiums.

No prior Rhode Island cases have defined the term “lay off.” Webster’s Third New International Dictionary at 1281 (1971) defines the verb “lay off” thus: “to cease to employ [a worker] usu[ally] temporarily because of slack in production *

Other jurisdictions have held that the term “lay off” generally means “temporary cessation of employment with an expectation of eventual return.” Conner v. Phoenix Steel Corp., 249 A.2d 866, 869 (Del.1969). In determining the eligibility of an employee under a company pension plan, the Louisiana Court of Appeals found that this term “has been generally interpreted by the courts to mean a suspension of employment and not a termination of employment.” White v. Crane Co., 147 So.2d 32, 36 (La.Ct.App.1962). “Layoff” ordinarily means “a ‘period of temporary dismissal’ ” with anticipation of recall. CBS Inc. v. International Photographers of the Motion Picture Industries, Local 644, I.A.T.S.E., 603 F.2d 1061, 1063 (2d Cir.1979). Within provisions of the Michigan Employment Security Act governing back-to-work benefits, “[a] ‘layoff’ is a temporary dismissal by the employer which anticipates reemployment and therefore is distinguished from unemployment by reason of discharge, resignation or other permanent termination.’’ (Emphasis added.) General Motors Corp. v. Erves, 399 Mich. 241, 253, 249 N.W.2d 41, 46 (1976). See 24A Words and Phrases at 23 and the many cases cited therein.

We conclude that the term “lay off” as used in § 27-19.1-1 does not include employees permanently terminated from employment by reason of an employer’s going out of business.

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Bluebook (online)
478 A.2d 167, 6 Employee Benefits Cas. (BNA) 2244, Counsel Stack Legal Research, https://law.counselstack.com/opinion/formisano-v-blue-cross-of-rhode-island-ri-1984.