Longoria v. Cearley

796 F. Supp. 997, 15 Employee Benefits Cas. (BNA) 2199, 1992 U.S. Dist. LEXIS 9298, 1992 WL 140820
CourtDistrict Court, W.D. Texas
DecidedJune 18, 1992
DocketA-91-CA-955
StatusPublished
Cited by4 cases

This text of 796 F. Supp. 997 (Longoria v. Cearley) is published on Counsel Stack Legal Research, covering District Court, W.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Longoria v. Cearley, 796 F. Supp. 997, 15 Employee Benefits Cas. (BNA) 2199, 1992 U.S. Dist. LEXIS 9298, 1992 WL 140820 (W.D. Tex. 1992).

Opinion

ORDER

NOWLIN, District Judge.

Before the Court is the Plaintiffs’ Motion to Remand, filed February 18, 1992. On June 4, 1992, this Court held a hearing to address the various issues relating to removal and remand in this case. Having reviewed and considered this motion, the responses thereto, and the applicable law, the Court finds that this motion should be GRANTED.

I. BACKGROUND

The plaintiffs initiated this lawsuit in state court. The plaintiffs allege various state law claims relating to the initial enrollment by them (or their employer of them) into a group insurance program of the defendant insurance company.

The plaintiffs’ employer is Community Action, Incorporated, a nonprofit corporation. Community Action already had group health insurance for its employees from another insurance company. That company, however, declined to insure the plaintiffs and some other employees because of their poor medical histories.

The defendant insurance agent, Jo Ann Cearley, then advised Community Action to apply for coverage of these employees with *1001 the defendant Celtic Life Insurance Company. The plaintiffs claim that the insurance agent Cearley promised coverage by defendant Celtic despite the plaintiffs’ preexisting conditions. The plaintiffs allege that defendant Cearley intentionally concealed those conditions by entering false data on the enrollment cards submitted to defendant Celtic. The plaintiffs also assert that Defendant Cearley was at all times acting in an agency relationship for Defendant Celtic Life Insurance Company.

Subsequently, upon discovery of the alleged misrepresentations of the preexisting conditions and of the number of people employed by Community Action, defendant Celtic rescinded the policy and refunded the premiums paid, less claims paid, to the employer.

To determine whether removal is proper in this case, the following issues must be addressed:

(1) Does a plan exist?
(2) If a plan does exist, is the plan covered under ERISA?
(3) Is the plan a “governmental plan” and, therefore, excluded from coverage under ERISA?

II. THE RELEVANT ERISA LAW

General Removal Issues

Pursuant to 28 U.S.C. § 1446(c)(5), this Court held an evidentiary hearing to determine whether to grant the petition to remove filed by the Defendant Celtic and joined in by the other defendant or to grant the motion to remand filed by the plaintiffs. 28 U.S.C. § 1446(c)(5).

Removing defendants generally have the burden to show that the federal court would have jurisdiction over the lawsuit if the plaintiff initially sued in federal court. See Franchise Tax Board v. Construction Laborers Vacation Trust, 463 U.S. 1, 19 and n. 18, 103 S.Ct. 2841, 2851 and n. 18, 77 L.Ed.2d 420 (1983). However, reiterating an independent corollary to the well-pleaded complaint rule, the Supreme Court stated that a plaintiff may not defeat removal by omitting to plead necessary federal questions in a complaint. See id., 463 U.S. at 22, 103 S.Ct. at 2853 (citations omitted). Also, original federal jurisdiction is available if either: (1) some substantial, disputed question of federal law is a necessary element of one of the well-pleaded state claims; or, (2) one of the claims is effectively one of federal law. See id., 463 U.S. at 13, 103 S.Ct. at 2848. The Court explained:

[A]ny state action coming within the scope of § 502(a) [29 U.S.C. § 1132(a) of ERISA] would be removable to federal district court, even if an otherwise adequate state cause of action were pleaded without reference to federal law.

See id., 463 U.S. at 24, 103 S.Ct. at 2854. When the federal claim arises only as a defense to a state created action, federal declaratory judgment jurisdiction is lacking. See id., 463 U.S. at 16, 103 S.Ct. at 2850 (citing to and quoting from 10A C. Wright, A. Miller, & M. Kane, Federal Practice and Procedure § 2767, pp. 744-745 (2d. ed. 1983)). If the state courts reject a claim of federal preemption, that decision may ultimately be reviewed on appeal by the United States Supreme Court. See id., 463 U.S. at 12 n. 12, 103 S.Ct. at 2848 n. 12.

Although noting that the Construction Laborers Vacation Trust decision involved a suit seeking a declaration that state laws were not preempted by ERISA, the Supreme Court stated that the pending action involved companies subject to ERISA regulation that sought injunctions against claims that are preempted by ERISA. See Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96 n. 14, 103 S.Ct. 2890, 2899 n. 14, 77 L.Ed.2d 490 (1983) (emphasis in original). Similarly to Shaw v. Delta Air Lines, the issue in this action is whether the plaintiffs’ claims “relate to” employee benefit plans within the meaning of 29 U.S.C. § 1144(a) and, if so, whether any exception in ERISA saves these claims from preemption. See id., 463 U.S. at 96, 103 S.Ct. at 2899.

The Fifth Circuit has attempted to clarify the “relates to” requirement of ERISA preemption:

[T]he most important factor for a court to consider in deciding whether a state *1002 law affects an employee benefit plan “in too tenuous, remote, or peripheral a manner to be preempted” is whether the state law affects relations among ERISA’s named entities. “[Cjourts are more likely to find that a state law relates to a benefit plan if it affects relations among the principal ERISA entities — the employer, the plan, the plan fiduciaries, and the beneficiaries — than if it affects relations between one of these entities and an outside party, or between two outside parties with only an incidental effect on the plan.”

Memorial Hospital System v. Northbrook Life Insurance Co., 904 F.2d 236, 249 (5th Cir.1990) (citing Sommers Drug Stores Co. Employee Profit Sharing Trust v. Corrigan Enterprises, Inc., 793 F.2d 1456, 1467 (5th Cir.1986) cert. denied 479 U.S. 1034, 107 S.Ct. 884, 93 L.Ed.2d 837 (1987)) (footnote omitted).

This lawsuit does not “relate to” an ERISA plan under the distinct facts and circumstances of this case.

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796 F. Supp. 997, 15 Employee Benefits Cas. (BNA) 2199, 1992 U.S. Dist. LEXIS 9298, 1992 WL 140820, Counsel Stack Legal Research, https://law.counselstack.com/opinion/longoria-v-cearley-txwd-1992.