Owens v. Blue Shield of California

CourtDistrict Court, N.D. California
DecidedMarch 20, 2025
Docket4:24-cv-00400
StatusUnknown

This text of Owens v. Blue Shield of California (Owens v. Blue Shield of California) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Owens v. Blue Shield of California, (N.D. Cal. 2025).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 STEPHANIE OWENS, Case No. 24-cv-00400-HSG

8 Plaintiff, ORDER GRANTING IN PART AND DENYING IN PART MOTIONS TO 9 v. DISMISS

10 BLUE SHIELD OF CALIFORNIA, et al., Re: Dkt. Nos. 15, 19, 22 11 Defendants.

12 13 Pending before the Court are three motions to dismiss filed by Defendants. Dkt. Nos. 15, 14 19, 22. The Court finds these matters appropriate for disposition without oral argument and the 15 matters are deemed submitted. See Civil L.R. 7-1(b). For the reasons detailed below, the Court 16 GRANTS IN PART and DENIES IN PART the motions to dismiss. 17 I. BACKGROUND 18 Plaintiff Stephanie Owens alleges that she was employed by Defendant Valerie 19 Fredrickson and Company (“Frederickson”) until her termination on March 12, 2020. See Dkt. 20 No. 1 (“Compl.”) at ¶¶ 1, 4, 25. While employed by Frederickson, Plaintiff received health 21 insurance benefits through The Frederickson Partners Group Health Plan (the “Frederickson 22 Plan”), which was insured by Blue Shield of California. See id. at ¶¶ 2, 28. Plaintiff’s health 23 insurance benefits “ceased” on March 31, 2020. See id. at ¶ 4. However, Defendant California 24 Physicians’ Service dba Blue Shield of California (“Blue Shield”) sent letters to Plaintiff, 25 notifying her that she may be entitled to continued coverage under the California Continuation of 26 Benefits Replacement Act (“Cal-COBRA”). See id. at ¶ 5; Dkt. No. 1-1, Ex. 1. The letter stated 27 that “[u]nless otherwise indicated, the benefits available under this Cal-COBRA extension of 1 See Dkt. No. 1-1, Ex. 1 at 7. The letters further noted that “Cal-COBRA coverage will terminate 2 should the contract between the above employer group and Blue Shield terminate[].” See id. at 9. 3 Plaintiff submitted her Cal-COBRA election form to Blue Shield on April 27, 2020. See Compl. 4 at ¶ 6; see also Dkt. No. 1-1, Ex. 1 at 13. The form states that “I hereby elect Blue Shield of 5 California subscriber coverage,” and “Blue Shield benefits, dues, and contract modifications will 6 be in accordance with the group service contract and as allowed under Cal-COBRA.” Id. For the 7 next two and a half years, Plaintiff paid monthly premiums and received her Cal-COBRA benefits. 8 See Compl. at ¶ 7. 9 In 2022, Plaintiff was diagnosed with throat cancer and underwent treatment. See id. at 10 ¶¶ 8–9. She was prescribed a radiation treatment program, which Blue Shield preapproved by 11 letter dated December 9, 2022. See id. at ¶ 9; Dkt. No. 1-2, Ex. 2. Plaintiff’s final radiation 12 treatment was in January 2023. See Compl. at ¶ 10. 13 During this time and unbeknownst to Plaintiff, Frederickson was acquired by Defendant 14 Gallagher & Co. (“Gallagher”) in May 2022. See id. at ¶ 11. Gallagher offered its own health 15 insurance program. See id. at ¶¶ 11–12, 29. Accordingly, in June 2022, Frederickson advised 16 Blue Shield to cancel its insurance coverage effective July 1, 2022. Id. at ¶ 12. The cancellation, 17 however, did not happen right away and took until December 2022. See id. at ¶ 14. On December 18 15, 2022, Blue Shield finally terminated Frederickson’s health insurance coverage retroactive to 19 July. See id. Blue Shield notified Plaintiff via letter dated December 15, 2022, that Plaintiff’s 20 coverage had been terminated retroactively. See id. at ¶ 15. The letter stated that Plaintiff’s 21 “coverage has been cancelled effective 10/01/22.” Id.; see also Dkt. No. 1-3, Ex. 3. Plaintiff did 22 not receive any advance notice of the cancellation. See id. at ¶¶ 13, 18, 33, 41. Plaintiff further 23 alleges that although Blue Shield ceased making any payments for covered claims as of October 1, 24 Blue Shield had continued to receive and deposit her premium payments. See id. at ¶ 34. Plaintiff 25 alleges that as a result, she was without coverage from December 2022 to February 2023, and 26 incurred medical bills for her cancer treatment during that time. Id. at ¶¶ 19–20, 35, 37. 27 Based on these allegations, Plaintiff brings several causes of action against Frederickson, 1 (“ERISA”). See id. at ¶¶ 43–65. Defendants have each moved to dismiss the complaint. See Dkt. 2 Nos. 15, 19, 22. 3 II. LEGAL STANDARD 4 Federal Rule of Civil Procedure 8(a) requires that a complaint contain “a short and plain 5 statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2). A 6 defendant may move to dismiss a complaint for failing to state a claim upon which relief can be 7 granted under Rule 12(b)(6). “Dismissal under Rule 12(b)(6) is appropriate only where the 8 complaint lacks a cognizable legal theory or sufficient facts to support a cognizable legal theory.” 9 Mendiondo v. Centinela Hosp. Med. Ctr., 521 F.3d 1097, 1104 (9th Cir. 2008). To survive a Rule 10 12(b)(6) motion, a plaintiff need only plead “enough facts to state a claim to relief that is plausible 11 on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). A claim is facially plausible 12 when a plaintiff pleads “factual content that allows the court to draw the reasonable inference that 13 the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). 14 In reviewing the plausibility of a complaint, courts “accept factual allegations in the 15 complaint as true and construe the pleadings in the light most favorable to the nonmoving party.” 16 Manzarek, 519 F.3d at 1031. Nevertheless, courts do not “accept as true allegations that are 17 merely conclusory, unwarranted deductions of fact, or unreasonable inferences.” In re Gilead 18 Scis. Secs. Litig., 536 F.3d 1049, 1055 (9th Cir. 2008) (quoting Sprewell v. Golden State Warriors, 19 266 F.3d 979, 988 (9th Cir. 2001)). 20 III. DISCUSSION 21 Each Defendant attempts to shift responsibility, arguing that the others are ultimately 22 responsible for the lack of notice and Plaintiff’s lost coverage. This is the same tactic that 23 Defendants allegedly employed before Plaintiff filed this case. See Compl. at ¶¶ 16, 17. In any 24 event, Defendants’ legal arguments overlap considerably. First, Defendants urge that California 25 law—and not ERISA—governs this case. Second, they argue that even if ERISA does apply, 26 Plaintiff has failed to state a claim for relief against them under the cited provisions. 27 A. Application of ERISA 1 ERISA claims therefore fail, because this case involves the termination of a Cal-COBRA plan. 2 See Dkt. No. 15 at 4–5; Dkt. No. 19 at 4–7; Dkt. No. 22 at 5–6. The Court notes that the parties 3 provide only a cursory analysis of this issue, which alone is reason to deny the motions. 4 Critically, Defendants offer no discussion about the nature of Cal-COBRA or the scope of ERISA. 5 Rather, Defendants’ briefs are nearly identical and cite a single, non-binding district court case: 6 Charnaux v. Health Net, No. C 03-05875 SI, 2004 WL 2645976, at *4 (N.D. Cal. Nov. 16, 2004). 7 Defendants’ reliance on Charnaux is misplaced. 8 In Charnaux, the plaintiff alleged that he had enrolled in a health insurance plan offered 9 through his employer. See Charnaux, 2004 WL 2645976, at *1.

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Owens v. Blue Shield of California, Counsel Stack Legal Research, https://law.counselstack.com/opinion/owens-v-blue-shield-of-california-cand-2025.