Hall v. Maine Municipal Employees Health Trust

93 F. Supp. 2d 73, 2000 U.S. Dist. LEXIS 8065, 2000 WL 381562
District Court, D. Maine·Decided March 15, 2000·No. 2:99-cv-00208·Published·Cited by 9 cases

Opinion

ORDER AND MEMORANDUM

BRODY, District Judge.

Plaintiffs, John and Margaret Hall, filed this action in state court on behalf of their daughter, Abigail Hall. Claiming that Plaintiffs’ case amounted to a claim for benefits subject to the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq., Defendant, Maine Municipal Employees Health Trust (“MMEHT” or the “Trust”) removed the case to this Court. Before the Court is Plaintiffs’ Motion to Remand. For the reasons discussed below, Plaintiffs’ Motion is GRANTED.

I. BACKGROUND

John Hall (“Hall”) works as a police officer for the Town of Winthrop (the “Town”). As a benefit of his employment with the Town, Hall receives health insurance for himself and his family. The only insurance the Town offers its employees is through Defendant MMEHT. Although the Town directly pays most of the MMEHT premium for insuring the Halls, *74 it does require Hall to make a small contribution toward his family’s coverage. The Town deducts this contribution from Hall’s paycheck.

In their complaint filed in state court, Plaintiffs charge MMEHT with breach of contract and violations of Maine’s Unfair Claims Settlement Practices Act, 24-A M.R.S.A. § 2436-A. Plaintiffs’ claims arise out of MMEHT’s decision to terminate speech therapy benefits for Abigail Hall, who receives treatment for a severe speech disorder. In removing the case to federal court, MMEHT asserts that the Halls’ state claims are preempted because MMEHT is an ERISA plan. See 29 U.S.C. § 1132(a).

MMEHT was established as the successor to a group insurance plan previously maintained by the Maine Municipal Association (“MMA” or the “Association”). The MMA is a voluntary association of municipalities and its voting membership is open to cities, towns, and plantations within Maine, The Association has been recognized by the Maine Legislature as “an instrumentality of its member municipal and quasi-municipal corporations.” 30-A M.R.S.A. § 5721. 1 In 1982, many MMA members were concerned about the rapidly escalating costs of medical care. As a result of these concerns, an advisory committee was formed. Based on the advisory committee’s report, the MMA designated a group of individuals to establish MMEHT.

As a member of MMA, the Town of Winthrop is one of 404 employers who participate in the Trust. The overwhelming majority of these employers are other municipalities and, like the Town of Winthrop, governmental employers. Nonetheless, some non-governmental employers are eligible to participate in MMEHT. 2 Thus, while MMEHT primarily provides medical insurance to governmental employees, like Hall, it also offers its medical plan to 98 employees of 17 non-governmental employers, who qualify for MMEHT through their non-voting, associate memberships in MMA. 3 Pursuant to the Trust Agreement under which MMEHT operates (the “Trust Agreement”), eligible employers enter into the Trust “for the benefit of Employees.” Pursuant to the Trust Agreement, these Employees are then considered “members” of MMEHT.

An independent board of trustees (the “Trustees”) controls and directs the operations of MMEHT. All Trustees are MMEHT members and receive some form of benefits through the Trust. Currently, *75 a five person Trustee Selection Committee appoints each of the eleven trustees to a three year term. The Selection Committee itself consists of representatives appointed by the Board of Trustees and MMA’s executive council. Pursuant to the Trust Agreement, the Selection Committee considers geographical distribution as well as the size of the employer in selecting the Trustees who will administer MMEHT. In making its selections, the Committee “attempt[s] to ensure that at least two (2) Trustees are non-management members and one (1) Trustee is a retiree member receiving continued coverage under the Trust.” 4 (Second Amendment to Trust Agreement section 4.04.)

Since its establishment in 1982, MMEHT has operating on the assumption that it qualifies as an ERISA plan and filed all of the necessary papers with the IRS and the Department of Labor. In fact, the Trust Agreement makes repeated references to complying with ERISA. (,See Trust Agreement section 5.01(k)(l), 5.06, and 8.1). Relying on its authority under ERISA, the Department of Labor audited MMEHT in 1993. During that audit, MMEHT asked the Department of Labor whether it might be exempt from ERISA as a governmental plan. The Department of Labor responded to this inquiry by saying that MMEHT “may be a Governmental Plan as defined by ERISA” and suggested that the Trust seek a formal letter ruling on this question. Despite the Department of Labor’s suggestion, the Trustees decided not to seek a formal opinion and simply continued to comply with ERISA.

II. STANDARD FOR REMOVAL OF AN ERISA CASE

When a defendant removes a case under 28 U.S.C. § 1441, the defendant carries the burden of establishing the Court’s subject matter jurisdiction. See Danca v. Private Health Care Systems, Inc., 185 F.3d 1, 4 (1st Cir.1999). This burden requires “a colorable showing that a basis for federal jurisdiction exists.” See id. (citations and internal quotations omitted).

When the basis for federal jurisdiction is a federal statute, such as ERISA, that allows for complete preemption, the Court looks beyond the face of the complaint to determine whether the plaintiffs state law claim is actually preempted under federal law. See id. at 5. Therefore, to justify removal on the basis of ERISA preemption, Defendant must make a colorable showing that Plaintiffs’ allegations give rise to claims for benefits under ERISA.

III. DISCUSSION

ERISA provides for the uniform, comprehensive federal regulation of private employee benefit plans. Therefore, state claims against benefit plans subject to ERISA regulation are generally preempted. See id. at 7. In this case, the parties agree that Plaintiffs’ claims arising out of a denial of benefits would fall under ERISA § 502(a), if MMEHT is a plan subject to ERISA. See 29 U.S.C. § 1132(a). In their Motion to Remand, Plaintiffs claim that MMEHT is an not ERISA plan because it falls under the governmental plan exception. See 29 U.S.C. §§ 1003(b)(1) & 1002(32). In response, MMEHT argues that it is, in fact, an ERISA plan and does not fit within the statute’s definition of governmental plan.

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Hall v. Maine Municipal Employees Health Trust, 93 F. Supp. 2d 73, 2000 U.S. Dist. LEXIS 8065, 2000 WL 381562 (D. Me. 2000).

93 F. Supp. 2d 73 (Hall v. Maine Municipal Employees Health Trust) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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