NOT FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
MARTIN LUTHER KING, JR., No. 19-55053 COMMUNITY HOSPITAL, D.C. No. Plaintiff-Appellee, 2:16-cv-03722-ODW-RAO
v. MEMORANDUM* COMMUNITY INSURANCE COMPANY, DBA Anthem Blue Cross and Blue Shield; et al.,
Defendants-Appellants.
Appeal from the United States District Court for the Central District of California Otis D. Wright II, District Judge, Presiding
Argued and Submitted May 13, 2020 Pasadena, California
Before: SCHROEDER and COLLINS, Circuit Judges, and BAYLSON,** District Judge. Dissent by Judge COLLINS
* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The Honorable Michael M. Baylson, United States District Judge for the Eastern District of Pennsylvania, sitting by designation. I. Introduction
This ERISA appeal considers an award of damages in favor of the Plaintiff,
Martin Luther King, Jr. Community Hospital (“MLK”), for services rendered to
employees of Budco 1— the sponsor of the ERISA plan (the “Plan”), and one of the
appellants. Budco’s employees made covered visits to MLK. Although the
employees had assigned their benefit payments to MLK, Anthem2—the Plan
administrator, and also an appellant—ignored the assignments, and made payments
directly to the employees, who were beneficiaries under the Plan. The employees
retained these payments.
When MLK sought payment, Anthem ignored the request. Anthem, in
refusing to pay MLK, asserted that an “anti-assignment” provision was part of the
Plan and justified its payments directly to the employees. To recover the assigned
payments, MLK filed this lawsuit. In the District Court, MLK asserted two grounds
in support of its claims.
First, MLK asserted that the language of the anti-assignment provision did not
prohibit the assignments. The District Court did not rule on this contention.
1 This Memorandum refers to Budco Group, Inc. and Budco Group, Inc. Employee Benefit Plan, collectively as “Budco.” 2 This Memorandum refers to Community Insurance Company (doing business as Anthem Blue Cross and Blue Shield) and Anthem, Inc., collectively as “Anthem.”
2 19-55053 Second, MLK asserted that the District Court should ignore the anti-
assignment provision because it was not part of the Plan.
The District Court awarded summary judgment and undisputed damages to
MLK by construing the Plan documents to include benefits, but ruling that the anti-
assignment language was not part of the Plan documents.
This Court affirms on two grounds. First that the language of the anti-
assignment provision did not allow Anthem to ignore the assignments. Although
this contention was raised in the District Court, the District Court did not rely on it
in support of its judgment. Second, and alternatively, that the District Court
correctly ignored the anti-assignment provision.
II. Undisputed Facts
Between 2015 and 2017, Budco employees visited MLK’s emergency room
at least seventy-five times, and assigned their benefits under Budco’s ERISA plan
to MLK as a condition of receiving care. Anthem, the administrator of the Plan, had
a policy of paying in-network providers directly. However, when beneficiaries
visited an out-of-network hospital such as MLK, Anthem would pay the beneficiary.
This forced out-of-network providers, specifically including MLK, to attempt to
recover from the beneficiary. According to MLK, the purpose and effect of these
policies was to coerce hospitals into joining Anthem’s network.
3 19-55053 Because MLK was an out-of-network provider, when Budco employees
received care at MLK, Anthem made payments directly to Budco’s employees.
Even though Budco’s employees had assigned these payments to MLK, the
employees deposited the payments into their personal accounts, and did not remit
any of the benefit payments to MLK. In the course of this practice, Budco employees
discovered they could “game the system” by visiting out-of-network hospitals, such
as MLK, and collecting benefit payments without paying the hospital.
Budco regularly issues a Summary Plan Description (“SPD”) for its ERISA
plan, which all parties agree is a Plan document. Budco issued new or amended
SPDs each year from 2015–2017, but the relevant language as it relates to this case
is identical in all of them. The SPD states that it incorporates a document called
“Certificates of Coverage” into the Plan, which are supposed to be provided by the
insurance company (in this case, Anthem), and describe the Plan’s “healthcare or
other welfare benefits, and the terms and conditions for receiving those
benefits . . . .” However, there was no document entitled “Certificates of Coverage”
in the documents that Budco and Anthem asserted constituted the Plan.
The District Court considered a “Benefit Booklet” issued by Anthem, which
contained a provision that restricted Budco employees’ ability to assign benefit
payments in certain ways. Anthem construed this provision to bar the assignments
4 19-55053 by Budco employees to MLK, and thus when MLK sought payment from Anthem
on account of the benefit assignments, its claims were ignored.
III. Proceedings in the District Court
MLK brought suit against Budco and Anthem under ERISA’s civil
enforcement provision seeking benefit payments and declaratory relief. With the
exception of the benefit payments associated with one emergency room visit, the
District Court granted summary judgment in favor of MLK on its claim for ERISA
benefits. The District Court found that the Benefit Booklet was not the Certificates
of Coverage referenced in the SPD, and thus the Benefit Booklet was not an official
Plan document. Although the District Court did incorporate into the Plan the parts
of the Benefit Booklet that specified the basis on which payments were made in
order to satisfy all the requirements of creating an ERISA plan, the District Court
did not incorporate the anti-assignment provision. After the parties came to an
agreement concerning the one outstanding emergency room visit, the District Court
entered judgment in favor of MLK, and Budco and Anthem appealed.
IV. Contentions on Appeal
On appeal, Budco and Anthem contend that the District Court erred in finding
that the Benefit Booklet was not the Certificates of Coverage referenced in the SPD.
Even if the Benefit Booklet is not the Certificates of Coverage, Budco and Anthem
argue that when the District Court incorporated terms from the Benefit Booklet, it
5 19-55053 should have incorporated the entire document, including the anti-assignment
provision.
MLK argues that the District Court properly effectuated Budco’s intent in
creating the Plan by incorporating only a portion of the Benefit Booklet, and
excluding the anti-assignment provision. But even if the Benefit Booklet is a Plan
document, MLK asserts that, by its very terms, the anti-assignment provision did not
bar the assignments in this case. The District Court did not rule on this latter
contention.
V. Standard of Review on Appeal3
This Court reviews de novo a district court’s grant of summary judgment.
Mongeluzo v. Baxter Travenol Long Term Disability Benefit Plan, 46 F.3d 938, 942
(9th Cir. 1995). Under the standard set forth in Fed. R. Civ. P. 56(c), this Court
“view[s] the evidence in the light most favorable to the nonmoving party,
determine[s] whether there are any genuine issues of material fact, and decide[s]
whether the district court correctly applied the relevant substantive law.” Animal
Legal Def. Fund v. U.S. Food and Drug Admin., 836 F.3d 987, 989 (9th Cir. 2016)
(en banc) (per curiam). “We may affirm a grant of summary judgment on any basis
3 The District Court had subject matter jurisdiction under 28 U.S.C. § 1331. The District Court’s entry of summary judgment in favor of MLK is a final order, Abend v. MCA, Inc., 863 F.2d 1465, 1482 n.20 (9th Cir. 1988), and thus this court has jurisdiction under 28 U.S.C. § 1291.
6 19-55053 the record supports, including one the district court did not reach.” Venetian Casino
Resort, L.L.C. v. Local Joint Exec. Bd. of Las Vegas, 257 F.3d 937, 941 (9th Cir.
2001).
VI. Analysis
A. The Anti-Assignment Provision Did Not Bar the Assignments in this Case Although the District Court did not address the language of the anti-
assignment provision, we find that it did not bar the assignments in this case. The
provision restricted assignment as follows:
You authorize the Plan to make payments directly to Providers for Covered Services. Payments may also be made to, and notice regarding the receipt and/or adjudication of claims sent to, an Alternative Recipient (any child of a Subscriber who is recognized, under a Qualified Medical Child Support Order (QMSCO), as having a right to enrollment under the Employer’s Plan), or that person’s custodial parent or designated representative. Any payments made by the Plan will discharge the Plan’s obligation to pay for Covered Services. You cannot assign your right to receive payment to anyone else, except as required by a “Qualified Medical Child Support Order” as defined by ERISA or any applicable state law.
Once a Provider performs a Covered Service, the Plan will not honor a request to withhold payment of the claims submitted.
“In interpreting the terms of an ERISA plan[,] we examine the plan documents
as a whole . . . .” Vaught v. Scottsdale Healthcare Corp. Health Plan, 546 F.3d 620,
626 (9th Cir. 2008) (alteration in original) (quoting Welch v. Unum Life Ins. Co. of
Am., 382 F.3d 1078, 1082 (10th Cir. 2004)). We apply “principles derived from
7 19-55053 state law but [are] guided by the policies expressed in ERISA and other federal labor
laws.” Richardson v. Pension Plan of Bethlehem Steel Corp., 112 F.3d 982, 985
(9th Cir. 1997) (citing Scott v. Gulf Oil Corp., 754 F.2d 1499, 1502 (9th Cir. 1985)).
We “first look to explicit language of the agreement to determine, if possible, the
clear intent of the parties,” id. (quoting Armistead v. Vernitron Corp., 944 F.2d
1287, 1293 (6th Cir. 1991)), and interpret terms “in an ordinary and popular sense
as would a [person] of average intelligence and experience,” Evans v. Safeco Life
Ins. Co., 916 F.2d 1437, 1441 (9th Cir. 1990) (per curiam) (alteration in original)
(quoting Allstate Ins. Co. v. Ellison, 757 F.2d 1042, 1044 (9th Cir. 1985)).
When the anti-assignment provision is considered as a whole, its language
does not bar assignments to “providers” such as MLK. The provision lists three
entities other than the beneficiary that Anthem may pay directly. Providers are
included among those entities. In the same paragraph, and only two sentences later,
the anti-assignment provision forbids beneficiaries from assigning benefits to
“anyone else.” This sentence restricting assignment must be read consistently with
the entire paragraph, which concerns benefit payments to entities other than the
beneficiary. Thus, we interpret the anti-assignment provision’s reference to “anyone
else” to permit assignments to those entities, including “providers.”
Budco and Anthem contend that the reference to “anyone else,” should be
interpreted to restrict the assignment of benefits to “anyone other than the
8 19-55053 beneficiary.” Interpreting the anti-assignment provision in this way, however,
makes little sense because a beneficiary need not assign benefits to him- or herself.
Budco and Anthem’s argument would essentially interpret the sentence to forbid
assignment to “anyone.” But that would read the word “else” out of the sentence
entirely. We will not interpret the anti-assignment provision in this way. See
Babikian v. Paul Revere Life Ins. Co., 63 F.3d 837, 840–41 (9th Cir. 1995) (rejecting
an interpretation of an ERISA plan that would render part of the plan superfluous).
Budco and Anthem also contend that interpreting “anyone else” to refer to the
entities in the previous sentences would make the second reference to QMSCOs
superfluous, because QMSCOs are already covered in the preceding sentences. But
at most, this would make the term “anyone else” ambiguous. If the term “anyone
else” were ambiguous, we would still interpret the anti-assignment provision to
permit the assignments here because Budco and Anthem drafted the anti-assignment
provision, and we “construe ambiguities in an ERISA plan against the drafter and in
favor of the insured.” Barnes v. Indep. Auto Dealers Ass’n of California Health and
Welfare Benefits Plan, 64 F.3d 1389, 1393 (9th Cir. 1995) (citing Mongeluzo, 46
F.3d at 942). Thus, we conclude that the term “anyone else” in the anti-assignment
provision refers to the entities in the preceding sentences. Budco’s employees
therefore validly assigned their benefit payments to MLK as a provider, and MLK
was entitled to their benefit payments.
9 19-55053 B. Alternatively, the District Court Properly Excluded the Anti- Assignment Provision from the Plan Documents Alternatively, we agree with the District Court that the anti-assignment
provision is not part of the Plan documents. In affirming the anti-assignment
provision’s exclusion from the Plan, we are guided by the Supreme Court’s decision
in CIGNA Corp v. Amara, 563 U.S. 421 (2011). In CIGNA, the Supreme Court
reviewed a district court’s decision to equitably reform a pension plan because of
omissions and misrepresentations by the plan’s sponsor. Id. at 432–33. In addition
to highlighting the division of authority between the plan sponsor, which “creates
the basic terms and conditions of the plan,” and the plan administrator, which
“manages the plan, [and] follows its terms in doing so,” id. at 437, the Supreme
Court approved of the equitable approach taken by the district court to reform the
plan, because it “essentially held CIGNA to what it had promised,” id. at 441.
Here, as the Plan’s sponsor, it was Budco’s responsibility to “create[] the basic
terms and conditions of the plan . . . .” Id. at 437. Accordingly, Budco drafted the
SPD, which states that it incorporates the Certificates of Coverage into the Plan. The
Certificates of Coverage, as defined by the SPD, are the “Plan booklets provided by
the insurance company that provide contract administration services for the Plan,”
and “describe[] the healthcare or other welfare benefits, and the terms and conditions
for receiving those benefits . . . .” Defining the Certificates of Coverage in this way
supported the purposes of ERISA by explaining the benefits to which beneficiaries
10 19-55053 were entitled, 29 U.S.C. § 1021(a), and ensuring that beneficiaries received the
benefits they were promised, Michael v. Riverside Cement Co. Pension Plan, 266
F.3d 1023, 1026 (9th Cir. 2001) (quoting Alessi v. Raybestos-Manhattan, Inc., 451
U.S. 504, 510 (1981)).
Budco and Anthem assert that the entire Benefit Booklet constitutes the
Certificates of Coverage. There is no language in the Plan to warrant this conclusion.
Further, Budco and Anthem provide no authority that requires documents to be
incorporated as a whole into an ERISA plan, when governing plan documents say
nothing about complete incorporation. Here, the Benefit Booklet does not use the
term “Certificates of Coverage.” Also, the SPD does not state that incorporation of
the entire Benefit Booklet is required. The District Court’s partial incorporation of
the Benefit Booklet, and its exclusion of the portions that do not fit the SPD’s
definition of Certificates of Coverage, was consistent with its application of
CIGNA’s holding that ERISA principles allow equitable considerations to preserve
an ERISA plan for the benefit of Budco’s employees.
The District Court incorporated the parts of the Benefit Booklet that “specify
the basis on which payments are made to and from the plan,” as required by 29
U.S.C. § 1102(b). We do not find that the District Court erred in its analysis or
holding. Another acceptable way of reviewing the record of this case is to find that
the Benefit Booklet, in part, was the functional equivalent of what the Certificates
11 19-55053 of Coverage was supposed to cover. We do not find these two positions
irreconcilable.
Parts of the Benefit Booklet do appear to cover the same ground as the SPD
stated would be covered in the Certificates of Coverage. However, parts of the
Benefit Booklet go far beyond describing the healthcare benefits under the Plan, and
the terms and conditions for receiving those benefits. Thus, the District Court did
not err in determining that the portions of the Benefit Booklet that specify the basis
on which payments are made to and from the Plan are incorporated into the Plan, but
that the terms in the Benefit Booklet that go beyond describing the Plan benefits, and
the terms and conditions for receiving those benefits, are not.
The anti-assignment provision is plainly not a benefit, and therefore the
District Court correctly determined it should not be incorporated as a description of
the Plan’s benefits. The anti-assignment provision is also not a term and condition
of receiving benefits. Terms and conditions of receiving benefits are the
requirements that a beneficiary must meet to receive a benefit payment. For
example, when a beneficiary receives services from an out-of-network provider, the
Benefit Booklet requires the beneficiary to submit a claim, or have the provider
submit a claim on the beneficiary’s behalf. Because a claim must be submitted for
the beneficiary to receive a benefit payment, that portion of the Benefit Booklet is a
12 19-55053 term and condition of receiving benefits, and is therefore within the SPD’s definition
of Certificates of Coverage.
As exemplified by the facts of this case, Anthem will make benefit payments
regardless of whether the beneficiary assigned his or her Plan benefits. In this
regard, the payments remain the same whether or not the beneficiary has made an
assignment, and therefore Anthem’s duty to make payments is not dependent on
whether the benefits have been assigned. Thus, the anti-assignment provision does
not relate to the terms and conditions of receiving benefits, and therefore the District
Court did not err by refusing to incorporate it into Budco’s ERISA plan.
VII. Conclusion
For the foregoing reasons, we AFFIRM the District Court’s entry of
judgment in favor of MLK.
13 19-55053 FILED Martin Luther King, Jr. Community Hosp. v. Community Ins. Co., No. 19-55053 OCT 2 2020 COLLINS, Circuit Judge, dissenting: MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS
Under the plain language of the plan documents governing Defendant-
Appellant Budco Group, Inc. Employee Benefit Plan (“Plan”)—an ERISA plan
established for employees of Defendant-Appellant Budco Group, Inc. (“Budco”)—
Plan beneficiaries are generally prohibited from assigning their right to benefits to
a third party, such as Plaintiff-Appellant Martin Luther King, Jr. Community
Hospital (the “Hospital”). The district court erred in concluding otherwise, and I
would therefore reverse its grant of partial summary judgment to the Hospital.
Because the majority instead affirms that judgment, I respectfully dissent.
1. Contrary to what the majority concludes, see Mem. Dispo. at 10–13, the
anti-assignment provision at issue here is an express term of the written plan
documents that govern the Budco Plan.
Section 402(a)(1) of ERISA requires that any ERISA plan must be
“established and maintained pursuant to a written instrument.” 29 U.S.C.
§ 1102(a)(1). All parties agree that the Budco Summary Plan Description (“SPD”)
is such a Plan document, but they disagree as to what (if any) other documents also
qualify. The SPD itself states that the SPD, “in conjunction with the Certificates of
Coverage for your elected medical or welfare benefits options, constitutes both the
official plan document and the required summary plan description” under ERISA (emphasis added). The SPD defines the “Certificates of Coverage” as “Plan
booklets provided by the insurance company that provide[s] contract
administration services for the Plan,” and it further states that they “describe[] the
healthcare or other welfare benefits, and the terms and conditions for receiving
those benefits, which are offered to employees of [Budco] and their families by the
Plan.” The “Benefit Booklets” issued by Plan administrator Defendant-Appellant
Community Insurance Company (dba Anthem Blue Cross and Blue Shield
(“Anthem”)) meet this description exactly. They are literally “Plan booklets”; they
are “provided by the insurance company that provide[s] contract administration
services for the Plan,” viz., Anthem; and they “describe[] the healthcare or other
welfare benefits, and the terms and conditions for receiving those benefits.” They
are therefore the “Certificates of Coverage” described by the SPD and, under the
plain language of the SPD, they are Plan documents.
Because, however, the Plan sponsor (Budco) must be the one to “create[] the
basic terms and conditions of the plan,” CIGNA Corp. v. Amara, 563 U.S. 421, 437
(2011), I agree that the SPD cannot properly be construed to mean that anything
that Anthem chose to insert into the Benefit Booklets would thereby become part
of the Plan documents. But this principle provides no basis for disregarding the
anti-assignment provision in the Benefit Booklets, because Budco did expressly
provide (in its contract with Anthem) that the Plan documents would contain such
2 an anti-assignment provision. Anthem therefore did not usurp Budco’s role as plan
sponsor by adding an anti-assignment provision to the Benefits Booklets; on the
contrary, it properly implemented the plan terms specified by Budco. Id.
The majority nonetheless suggests that the anti-assignment provision in the
Benefits Booklets is not part of the “Certificates of Coverage,” because that
provision is not a “term” or “condition of receiving benefits.” According to the
majority, these words must be narrowly construed as applying only to
“requirements that a beneficiary must meet to receive a benefit payment,” see
Mem. Dispo. at 12, and the anti-assignment provision is not such a precondition
because “Anthem’s duty to make payments is not dependent on whether the
benefits have been assigned,” id. at 13. But a provision as to how benefits will
actually be paid over and to whom is obviously a “term” for the receiving of
benefits, and the majority’s unduly narrow reading of that word ignores its
ordinary meaning. Term, WEBSTER’S THIRD NEW INT’L DICTIONARY (“WEBSTER’S
THIRD”) (1981) (“propositions, limitations, or provisions stated or offered for the
acceptance of another and determining (as in a contract) the nature and scope of
the agreement”). More importantly, the majority’s narrow reading of “term”
cannot be squared with the fact that the terms of an ERISA plan must set forth the
“‘procedures for paying and administering benefits.’” Cinelli v. Security Pac.
Corp., 61 F.3d 1437, 1441 (9th Cir. 1995) (emphasis added) (quoting Watkins v.
3 Westinghouse Hanford Co., 12 F.3d 1517, 1523 (9th Cir. 1993)). Because the anti-
assignment provision is a rule about the procedures for receiving benefits, it is a
“term[] . . . for receiving those benefits” under any reasonable reading of that
phrase.
2. I also disagree with the majority’s alternative conclusion that the
language of the anti-assignment provision did not bar the assignments that the
Plan’s beneficiaries made to the Hospital here. See Mem. Dispo. at 7–9.
The anti-assignment provision is included within the following paragraph
from the section of the Benefit Booklets entitled “Payment of Benefits”:
[1] You authorize the Plan to make payments directly to Providers for Covered Services. [2] Payments may also be made to, and notice regarding the receipt and/or adjudication of claims sent to, an Alternate Recipient (any child of a Subscriber who is recognized, under a Qualified Medical Child Support Order (QMSCO), as having a right to enrollment under the Employer’s Plan), or that person’s custodial parent or designated representative. [3] Any payments made by the Plan will discharge the Plan’s obligation to pay for Covered Services. [4] You cannot assign your right to receive payment to anyone else, except as required by a “Qualified Medical Child Support Order” as defined by ERISA or any applicable state law.
(Emphasis and bracketed numbers added). The plain language of the fourth
sentence clearly bars the assignments that happened here. The beneficiaries
assigned their right to receive payment to someone else—viz., the Hospital—and
no one contends that those assignments were required by a “Qualified Medical
Child Support Order.” Anthem therefore properly declined to honor the Hospital’s
4 requests for direct payment, which were based on a prohibited assignment.
The majority contends instead that, by prohibiting an assignment to “anyone
else,” the fourth sentence only prohibits assignments to persons other than those
mentioned in the preceding three sentences. See Mem. Dispo. at 8–9 (emphasis
added). According to the majority, reading “anyone else” as referring to any
person other than the beneficiary would make the word “else” superfluous,
because the same result could have been achieved simply by prohibiting
assignment to “anyone.” See id. at 9. For multiple reasons, the majority’s
construction is not a plausible reading of the language of the provision.
First, the majority’s surplusage argument ignores the fact that, in ordinary
English usage, the terms “anyone” and “anyone else” are often used
interchangeably. In defining the word “else,” Webster’s Third gives as a usage
example, “did you meet anyone ~.” Else, WEBSTER’S THIRD (emphasis added).
This example, of course, reflects the very same supposed surplusage that the
majority decries: given that one does not “meet” oneself, this usage of “else” adds
nothing, and one could just simply say “did you meet anyone.” This example
confirms that the phrase “anyone else” is commonly used to refer (as in the fourth
sentence here) to any person other than the one being addressed.
Second, the majority’s reading—that “anyone else” refers to anyone other
than the persons mentioned in the prior three sentences—rests on the mistaken
5 premise that the prior three sentences address assignments to those persons. See
Mem. Dispo. at 8. They do not. By “authoriz[ing] the Plan to make payments
directly to Providers,” at the Plan administrator’s discretion, the first sentence
does not effectuate an “assignment,” which (as this case well illustrates) refers to a
transfer by the beneficiary to the provider of a right to demand direct payment
from the Plan administrator. See Assign, WEBSTER’S THIRD (“to transfer to another
in writing (one’s title to or interest in property, esp. intangible property)”); see also
Assign, BLACK’S LAW DICTIONARY (11th ed. 2019) (“To convey in full; to transfer
(rights or property).”). The second sentence likewise does not address
assignments, but instead partially implements the requirements of ERISA § 609,
which mandates that a plan “provide benefits” to any child who is a qualifying
“alternate recipient” under a “qualified medical child support order.” 29 U.S.C.
§ 1169(a). Such an order either “creates or recognizes the existence of an alternate
recipient’s right to, or assigns to an alternate recipient the right to, receive benefits
for which a participant or beneficiary is eligible under a group health plan.” Id.
§ 1169(a)(2)(A)(i) (emphasis added). The above-quoted paragraph’s second
sentence apparently implements the first of these two possibilities by
acknowledging an alternate recipient’s direct rights, while the fourth sentence
provides for the second possibility, in which the alternative recipient’s rights are
acquired by assignment. Finally, the third sentence says nothing about assignment
6 at all, but instead establishes a general rule that Anthem will not pay the same
benefits twice. 1
Third, the majority’s flawed reading itself leads to a significant surplusage
problem. Under the majority’s reading, “anyone else” in the fourth sentence
already exempts payments under a “Qualified Medical Child Support Order,”
thereby rendering wholly superfluous the express “except” clause in the fourth
sentence for such orders. This surplusage issue—which renders a whole clause
superfluous—is much more significant than the majority’s reliance on the
gossamer distinction between “anyone” and “anyone else.”
* * *
For all of these reasons, I would conclude that the anti-assignment provision
is part of the Plan documents and that it bars the assignments on which the
Hospital relies here. I would therefore reverse the district court’s grant of
summary judgment to the Hospital on its first cause of action for ERISA benefits
and would remand for entry of judgment in Defendants’ favor. I respectfully
dissent.
1 Defendants also argued below that this sentence barred the second payment that the Hospital now seeks, but the district court rejected this argument and Defendants have not raised it on appeal.