Kennedy v. Deere & Co.

514 N.E.2d 171, 118 Ill. 2d 69, 112 Ill. Dec. 705, 8 Employee Benefits Cas. (BNA) 2393, 1987 Ill. LEXIS 224
CourtIllinois Supreme Court
DecidedSeptember 21, 1987
Docket63702
StatusPublished
Cited by11 cases

This text of 514 N.E.2d 171 (Kennedy v. Deere & Co.) is published on Counsel Stack Legal Research, covering Illinois Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kennedy v. Deere & Co., 514 N.E.2d 171, 118 Ill. 2d 69, 112 Ill. Dec. 705, 8 Employee Benefits Cas. (BNA) 2393, 1987 Ill. LEXIS 224 (Ill. 1987).

Opinion

JUSTICE WARD

delivered the opinion of the court:

The plaintiffs, T. J. Kennedy, Terry Burke, Michael Hurst, Stephen Miner and James Woods, who are chiropractors, filed actions in the circuit court of Rock Island County against the defendant, Deere & Company, to recover damages under the Employee Retirement Income Security Act of 1974 (29 U.S.C. sec. 1001 et seq. (1982)) (ERISA). The defendant moved to dismiss the suits, alleging that the plaintiffs lacked standing to sue under ERISA. After consolidating the suits, the circuit court granted the defendant’s motion and dismissed the actions. The appellate court reversed (142 Ill. App. 3d 781), and we allowed the defendant’s petition for leave to appeal under Supreme Court Rule 315 (103 Ill. 2d R. 315(a)).

In substantially similar complaints, the plaintiffs allege that they provided chiropractic services to several of the defendant’s employees who are covered by its health and welfare plan (the plan) which is subject to the provisions of ERISA. (See 29 U.S.C. sec. 1002(1) (1982).) They allege that these employees assigned to the plaintiffs their rights to benefits under the plan which here consist of the right to reimbursement for medical care. The complaints set out that the plaintiffs submitted claims to the plan for payment and that the trustees of the plan refused to honor certain of the assignments. When considering a motion to dismiss, all facts properly pleaded in a complaint and the exhibits will be taken as true in deciding whether to grant the motion. State Bank v. A-Way, Inc. (1986), 115 Ill. 2d 401, 404; Soules v. General Motors Corp. (1980), 79 Ill. 2d 282, 284.

The plaintiffs claim that they are entitled to recover under ERISA because of the defendant’s failure to honor the assignments. The plaintiffs assert that they are “beneficiaries” as defined in section 2(8) of ERISA (29 U.S.C. sec. 1002(8) (1982)) and entitled to file an action under sections 502(a)(1)(B) and 502(e)(1) (29 U.S.C. secs. 1132(aXlXB),(eXl)(1982)).

Under section 502(aXl)(B) of ERISA:

“A civil action may be brought ***
(1) [B]y a participant or beneficiary ***
***
(B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights *** under the terms of the plan ***.” (29 U.S.C. sec. 1132(aXlXB) (1982).)

ERISA defines a “participant” as:

“[A]ny employee or former employee of an employer, or any member or former member of an employee organization, who is or may become eligible to receive a benefit of any type from an employee benefit plan which covers employees of such employer or members of such organization, or whose beneficiaries may be eligible to receive any such benefit.” (29 U.S.C. sec. 1002(7) (1982).)

A “beneficiary” is defined as:

“[A] person designated by a participant, or by the terms of an employee benefit plan, who is or may become entitled to a benefit thereunder.” (29 U.S.C. sec. 1002(8) (1982).)

Section 502(e)(1) provides that State and United States district courts shall have concurrent jurisdiction of actions brought under section 502(a)(lXB).

Count I of the complaints alleges that the defendant violated section 540 of ERISA (29 U.S.C. sec. 1140 (1982)), in that, though the defendant made payments directly to certain other health care providers, it refused payment to the plaintiffs, claiming that as simply assignees, the plaintiffs were not beneficiaries. Section 540 provides:

“It shall be unlawful for any person to *** discriminate against a participant or beneficiary *** for the purpose of interfering with the attainment of any right to which such participant may become entitled under the plan ***.” (29 U.S.C. sec. 1140 (1982).)

Count II asserts that the plaintiffs as “beneficiaries” are entitled to file an action based on assignments under section 502(aXlXB) to enforce their rights to benefits against the plan. The plaintiffs also claim attorney fees under section 502(gXl) (29 U.S.C. sec. 1132(gXl) (1982)).

The circuit court held that the plaintiffs lack standing to sue under ERISA on the ground that only “participants” or “beneficiaries” of a health benefit plan are entitled to bring an action under section 502(aXl)(B) and that the plaintiffs are neither beneficiaries nor participants as those terms are defined in sections 3(7) and (8) of ERISA. The appellate court reversed, holding that the plaintiffs, as assignees of a participant’s right to receive benefits under the plan, are “beneficiaries” within section 3(8) of ERISA. Finding there was no restriction against the assignment of claims for benefits under a health care plan covered by ERISA, the court concluded that “where an ERISA plan participant or beneficiary voluntarily elects in a signed writing to assign his rights to claim health insurance benefits to the provider of health care services, such assignee has standing to sue as the ‘participant’ or ‘beneficiary’ in whose shoes he stands for purposes .of [section 502(aXl)(B)].” 142 Ill. App. 3d 781, 787.

The defendant, arguing that the appellate court erred, contends that although plan participants may “designate” a “beneficiary” who will then be entitled to benefits under the plan, a participant may designate only members of his family or other dependents. The defendant’s position is that the express purpose of ERISA is to protect participants, their families and other dependents who are covered by a plan and is not to protect health care providers. It follows, the defendant says, only those intended to be protected under ERISA are entitled to bring an action under ERISA to recover benefits under a health benefit plan. Since health care providers, like the plaintiffs, are not within this limited class to be protected, the defendant argues, they cannot be designated by a participant to receive benefits under a plan.

The defendant contends further that even if a plan participant could assign his right to benefits under a health care plan to a health care provider, an assignment to a health care provider should not create an enforceable right to sue under ERISA. The defendants argue that allowing a simple assignee to bring an action under ERISA would encourage a flood of suits against employers and plan administrators. The defendant sees a deluge of actions by bill collectors, who under section 502(gXl) of ERISA, could also be awarded attorney fees. It says that Congress did not intend the statute to be given so broad a construction that any assignee could sue under ERISA to obtain benefits under a health benefit plan and attorney fees as well. Permitting such suits, the defendant states, will discourage employers from establishing health benefit plans.

From the statute’s preamble it is clear that the principal concern of Congress in enacting ERISA was “to protect *** the interests of participants in employee benefit plans and their beneficiaries.” (29 U.S.C. sec. 1001(b) (1982).) Congress did not proscribe any qualifications for a beneficiary.

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Bluebook (online)
514 N.E.2d 171, 118 Ill. 2d 69, 112 Ill. Dec. 705, 8 Employee Benefits Cas. (BNA) 2393, 1987 Ill. LEXIS 224, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kennedy-v-deere-co-ill-1987.