New Hampshire-Vermont Health Service v. Whaland

410 A.2d 642, 119 N.H. 886, 1979 N.H. LEXIS 416
CourtSupreme Court of New Hampshire
DecidedDecember 28, 1979
DocketNo. 78-158
StatusPublished
Cited by7 cases

This text of 410 A.2d 642 (New Hampshire-Vermont Health Service v. Whaland) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New Hampshire-Vermont Health Service v. Whaland, 410 A.2d 642, 119 N.H. 886, 1979 N.H. LEXIS 416 (N.H. 1979).

Opinion

PER CURIAM.

This is an appeal brought under RSA 541:6 whereby the plaintiff, New Hampshire-Vermont Health Service, agent in this State for certain foreign insurers, seeks to overturn the order of the commissioner of insurance requiring it to provide coverage for mental illnesses as required by RSA 419:5-a and RSA 420:5-a (Supp. 1977). The principal issues presented by this appeal are whether the State may regulate the contents of employee benefit plans and whether RSA 419:5-a and RSA 420:5-a (Supp. 1977) apply to such employee welfare benefit contracts executed and delivered outside the State but which cover certificate holders residing and employed within New Hampshire. We conclude both issues affirmatively and uphold the commissioner’s order.

Under New Hampshire law, every licensed hospital service corporation and every licensed medical service corporation must include in every contract with a subscriber to its services a provision that it “shall provide to each group, or to the portion of each group-comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, coverage for expenses arising from the treatment of mental illnesses and emotional disorders.” RSA 419:5-a; RSA 420:5-a (Supp. 1977). Such benefits are to be at least as favorable as the other minimum hospital and medical benefits specified. Id.

Massachusetts Blue Cross, Inc., and Massachusetts Blue Shield, Inc. (hereinafter Massachusetts Blues), as a result of a collective bargaining agreement between New England Telephone Company and its employees, entered into a contract executed and delivered at Boston, Massachusetts, to provide a program of hospital and medical benefits for all telephone employees in New England, except Connecticut. Massachusetts Blues did not, however, contract to provide the benefits for mental illnesses and mental disorders required by New Hampshire law. The plaintiff, as agent on a “cost plus a fee” basis, performs in New Hampshire the obligations of Massachusetts Blues, a corporation not licensed to do business in this State.

Associated Hospital Service of New York (hereinafter Associated), pursuant to a contract with E. F. Hutton executed and delivered at New York, agreed to provide hospital benefits for Hutton employees in about twenty-two states. Associated is to be paid by Hutton on a [889]*889“retrospective experience-rated basis, with adjustments at the end of the year.” Because Associated is not licensed to do business in New Hampshire, it entered into a written agreement with the plaintiff whereby plaintiff agreed, as agent, to provide medical benefits in this State.

Under the above “national accounts,” enrollment in the two-state area covered by the plaintiff involves approximately 50,188 persons eligible for coverage, of which approximately 72 percent reside and work in New Hampshire. It was also estimated that for the year 1978 the cost of adding New Hampshire mandated mental health benefits on all “national accounts” in the two-state area amounts to $324,075. Massachusetts Blues and Associated, the prime insurers, have so far declined to reimburse the plaintiff for the costs of complying with the commissioner’s order to provide the mental health benefits required by RSA 419:5-a and RSA 420:5-a (Supp. 1977).

These proceedings began when New Hampshire residents employed in this State and covered by the above programs complained to the insurance commissioner that their beneficiaries had not received the mandated benefits in question. Following a hearing, the commissioner ruled that the record was not clear whether the two plans in question were welfare benefit plans within the meaning of the Employee Retirement Income Security Act of 1974 (Pub. L. 93-406,88 Stat. 829, 29 U.S.C. § 1001 et seq. (1976)) (hereinafter ERISA). The commissioner ruled, however, that even if these plans came within the purview of ERISA, application of RSA 419:5-a and 420:5-a (Supp. 1977) was not thereby preempted.

The commissioner further ruled that the above statutes were intended to and do apply to the benefit plans in question, and that insured residents employed within the State were entitled to the benefits.

The plaintiff first argues that the provisions of RSA 419:5-a and RSA 420:5-a (Supp. 1977), as interpreted and applied, have been preempted by ERISA. 29 U.S.C. § 1001 et seq. (1976). This same issue with regard to RSA 415:18-a (Supp. 1977) has been thoroughly considered and resolved adversely to plaintiff’s position in Metropolitan Life Insurance Co. v. Whaland, 119 N.H. 895, 410 A.2d 635 (1979).

In Metropolitan we first analyzed the ERISA preemption clause, 29 U.S.C. § 1144 (a), together with the savings clause, 29 U.S.C. 1144 (b) (2) (A), which exempts from preemption state laws regulating, inter alia, insurance. Considered also was the so-called “deemer clause,” 29 U.S.C. § 1144(b)(2)(B), which provides that a state may not consider a welfare benefit plan as an insurer simply for the purpose of regulating [890]*890it as such. Thus, we concluded that there was no preemption byERISA of state laws, regulating benefits to be granted by group insurers of benefit plans covered by ERISA. Wadsworth v. Whaland, 562 F.2d 70, 78 (1st Cir. 1977), cert, denied, 435 U.S. 980 (1978). Moreover, the present case is different from Hewlett-Packard Co. v. Barnes, 571 F.2d 502 (9th Cir. 1978) where the statute held to have been preempted by ERISA was one “that directly regulates employee benefit plans.” Id. at 504.

Regarding preemption by ERISA, we see no material difference between the plans here at issue and that described in the Wadsworth case. ERISA imposes reporting and disclosure requirements for welfare benefit plans, 29 U.S.C. §§ 1021-31, as well as fiduciary standards for their management. 29 U.S.C. §§ 1101-14. RSA 419:5-a and 420:5-a (Supp. 1977), on the other hand, merely restrict the features of the welfare benefit plans that can lawfully be purchased from an insurer. We find no conflict with, nor an invasion of, a regulatory domain preempted by ERISA. See Old Stone Bank v. Michaelson, 439 F. Supp. 252 (D.R.I. 1977).

Plaintiff argues that, as regards New England Telephone Company employees, RSA 419:5-a and RSA 420:5-a (Supp. 1977) have been preempted by the National Labor Relations Act, 29 U.S.C. § 51 et seq. (1970) (hereinafter NLRA). In Metropolitan v. Whaland, 119 N.H. 895,

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Bluebook (online)
410 A.2d 642, 119 N.H. 886, 1979 N.H. LEXIS 416, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-hampshire-vermont-health-service-v-whaland-nh-1979.