Mell v. Anthem, Inc.

264 F.R.D. 312, 2009 U.S. Dist. LEXIS 107539, 2009 WL 3698427
CourtDistrict Court, S.D. Ohio
DecidedNovember 4, 2009
DocketNo. 1:08-CV-00715
StatusPublished
Cited by2 cases

This text of 264 F.R.D. 312 (Mell v. Anthem, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mell v. Anthem, Inc., 264 F.R.D. 312, 2009 U.S. Dist. LEXIS 107539, 2009 WL 3698427 (S.D. Ohio 2009).

Opinion

OPINION AND ORDER

S. ARTHUR SPIEGEL, Senior District Judge.

This matter is before the Court on Plaintiffs’ Motion for Class Certification (doc. 28), the City Defendants’ Response in Opposition (doc. 39), the Wellpoint Defendants’ Response in Opposition (doc. 40), and Plaintiffs’ Reply (doc. 44). The Court held a hearing on Plaintiffs’ Motion on October 14, 2009. For the reasons indicated herein, the Court GRANTS Plaintiffs’ motion and conditionally certifies the proposed class.

I. Background

The following facts have been derived from the various pleadings, motions, and discovery created during the course of this litigation. This ease involves Plaintiffs’ allegations that they were cheated out of proceeds as insureds, when Defendant Anthem Insurance (“Anthem”) demutualized in 2001 and issued 870,021 shares of stock to the City of Cincinnati (“the City”), their employer, instead of to Plaintiff policy holders (doc. 1). The City ultimately sold the stock for approximately $55 million, the amount Plaintiffs seek to recover in this action (Id). Plaintiffs allege they are a class of 2,460 individuals named as insured persons, or who were members of a group of insured persons covered under the Group Policy during the relevant time period (Id). In addition to Anthem and the City, Plaintiffs name as Defendants the individual City council members in their individual and official capacities, Anthem Inc. (n/k/a “Well-point Inc.”), the parent corporation company of both Defendant Anthem Insurance and its subsidiary, Defendant Community Insurance Company (“CIC”). Plaintiffs assert seven[314]*314teen state common law claims in diversity for breaches of multiple contracts, conversion, and misappropriation, aiding and abetting conversion and misappropriation, breach of fiduciary duties, breach of agency agreement and fraudulent concealment, and seek compensatory and punitive damages and other relief (Id.).

II. Plaintiffs’ Motion

A. Proposed Class Definition

Plaintiffs currently seek certification of their class under Fed.R.Civ.P. 23 (doc. 28). At the hearing, Plaintiffs’ counsel simplified the proposed definition and explained that it basically encompasses employees and retirees of the City who were named insureds or members of groups named as insureds, insured continuously from June 18, 2001 to November 2, 2001. The class includes two subsets, 1) those who had insurance prior to the merger between Community Mutual Insurance Company and Anthem in 1995, and 2) those who received insurance post-merger. In their motion, Plaintiffs offer a less simple, but comprehensive definition:

Plaintiffs allege they are individual active and retired employees of the City, or their surviving spouses, who were named as insured persons (or who were members of the group of persons named as insureds) continuously from June 18, 2001 through November 2, 2001, inclusive, under a fully-insured Group Policy issued by either:

(A) Community Mutual Insurance Company (“CMIC”) and in force immediately prior to CMIC’s merger with Anthem Insurance Companies (Anthem Insurance) (effective October 1, 1995), which coverage then continued in effect post-merger through November 2, 2001, inclusive, under a Group Guaranty Policy issued by Anthem Insurance/Community Insurance Company (“CIC”) and specifically without limitation:
(i) the City retirees who were covered for medical benefits by the fully-insured Retirement HMP, identified by GID number HI7955-010, at any time from January 1, 1990 through June 30, 2000, inclusive, and whose coverage continued uninterrupted thereafter at least through November 2, 2001, and
(ii) the members of the City Fire Department who were covered for dental benefits by the fully-insured Dental Plan for firefighters, identified by GID number H25993-017, at any time from January 1, 1990 through June 30, 2000, inclusive, and whose coverage continued uninterrupted thereafter at least through November 2, 2001; or

(B) Anthem Insurance/CIC as part of a new full-insurance group coverage begun at any time from October 1, 1995 through June 30, 2000, inclusive, which continued in effect through November 2, 2001, inclusive, and specifically including without limitation:

(i) the City employees enrolled in the firefighter’s Community Preferred Health Plan (“CPHP”), identified by GID number H25993-008, who were covered by the fully-insured Human Organ Transplant (HOT) rider at any time from January 1, 1998 through June 30, 2000, inclusive, and whose coverage continued uninterrupted thereafter at least through November 2, 2001,
(ii) the City employees enrolled in the Management CPHP, identified by GID number H25993-013, who were covered by the fully-insured HOT rider at any time from January 1,1998, through June 30, 2000, inclusive, and whose coverage continued uninterrupted thereafter at least through November 2, 2001, and
(iii) the City employees enrolled in the AFSCME CPHP, identified by GID number H25993-018, who were covered by the fully-insured HOT rider at any time from January 1, 1998 through June 30, 2000, inclusive, and whose coverage continued uninterrupted thereafter at least through November 2, 2001,

but excluding therefrom:

(i) Defendants, and each of them, and their respective successors and assigns; (ii) the elected officials of the City holding office at any time during the period from June 18, 2001 through November 2, 2001, inclusive, and thereafter, and their [315]*315respective parents, spouses, and children;
(iii) the executive officers and directors of Anthem, Inc., Anthem Insurance and CIC, together with their predecessors and successors, and their respective parents, spouses, and children; and
(iv) counsel of record in this action and their respective parents, spouses and children; and
(v) any judicial officer who enters an order in this action, and their respective parents, spouses, and children.

(doc. 28).

Plaintiffs further seek to designate Plaintiffs Robert Espel, James Matacia and Claudette Shank (on behalf of the estate of Frieda Wilmes) to serve as class representatives, and their current counsel as class counsel (Id). At the hearing, counsel indicated that Ronald Mell, Sr., no longer seeks to serve as class representative, due to health reasons.

The district court has broad discretion in deciding whether to certify a class. Gulf Oil Co. v. Bernard, 452 U.S. 89, 100, 101 S.Ct. 2193, 68 L.Ed.2d 693 (1981). A class action may only be certified if the court is satisfied after a “rigorous analysis” that the prerequisites of Rule 23(a) have been met. General Tel. Co. of Southwest v. Falcon, 457 U.S. 147, 161, 102 S.Ct. 2364, 72 L.Ed.2d 740 (1982). Maintainability as a class action may be determined by the pleadings, although it may be necessary for the court to probe behind the pleadings to ensure that the prerequisites of Rule 23 have been met.

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Cite This Page — Counsel Stack

Bluebook (online)
264 F.R.D. 312, 2009 U.S. Dist. LEXIS 107539, 2009 WL 3698427, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mell-v-anthem-inc-ohsd-2009.