Phillips v. Wellpoint, Inc.

900 F. Supp. 2d 870, 2012 WL 4490688, 2012 U.S. Dist. LEXIS 139623
CourtDistrict Court, S.D. Illinois
DecidedSeptember 27, 2012
DocketCase No. 10-cv-357-JPG
StatusPublished
Cited by1 cases

This text of 900 F. Supp. 2d 870 (Phillips v. Wellpoint, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Phillips v. Wellpoint, Inc., 900 F. Supp. 2d 870, 2012 WL 4490688, 2012 U.S. Dist. LEXIS 139623 (S.D. Ill. 2012).

Opinion

MEMORANDUM AND ORDER

J. PHIL GILBERT, District Judge.

This matter comes before the Court on defendants’ motion to dismiss (Doc. 26). Plaintiffs filed a response (Doc. 60) to which defendants replied (Doc. 61). For the following reasons the Court grants in part and denies in part defendants’ motion to dismiss.

BACKGROUND

This case consists of substantially the same facts as Cima v. WellPoint Health Networks, Inc., No. 05-cv-4127, a case previously before this Court. Drawing the facts from plaintiffs’ well-pleaded complaint, the Court will once again recount the events leading up to the filing of Cima and the present case.

I. Factual Background

During the course of expanding its business, defendant WellPoint, Inc. (‘WellPoint”)1 acquired defendants RightCHOICE Managed Care, Inc. (“RightCHOICE Managed Care”) and RightCHOICE Insurance Company in 2002. RightCHOICE Managed Care “was an independent company that operated in two markets,” one in Illinois and one in Missouri. Doc. 1-1, p. 27. In Missouri, RightCHOICE Managed Care operated as Blue Cross Blue Shield of Missouri. In [873]*873Illinois, RightCHOICE Managed Care operated as RightCHOICE Insurance Company, servicing approximately 300,000 Illinoisans.

Illinois law required WellPoint to obtain the approval of the Illinois Department of Insurance (“IDOI”) prior to completing the Illinois portion of the transaction. WellPoint made the following representations to the IDOI:

WellPoint has no present plans to cause [RightCHOICE Managed Care], [RightCHOICE Insurance Company], or any Acquired Subsidiary ... to merge or consolidate them with any person or person, other than the Merger. There also are presently no plans to make any other material change in [RightCHOICE Managed Care], [RightCHOICE Insurance Company], or any other Acquired Subsidiary’s business operation or corporate structure, other than as may be provided herein or as may arise in the ordinary course of business, and other than to achieve the synergies that normally arise in substantial acquisitions.

The IDOI ultimately approved the transaction and the merger closed on January 31, 2002. Plaintiffs in both the Cima and present case, however, contend that Well-Point had intentions from the beginning of the transaction to re-price or get rid of Illinois policyholders, but misrepresented their intentions to the IDOI to obtain approval. According to Plaintiffs, WellPoint only desired to acquire the more profitable Missouri Blue Cross business and was not interested in the less-profitable Illinois RightCHOICE Insurance Company operations.

It was only four months later, on May 31, 2002, that Unicare/WellPoint wrote a letter to the IDOI informing them of the conversion, and providing the IDOI with a copy of the proposed letter to be sent to policyholders. Thereafter, WellPoint effected a market withdrawal of RightCHOICE Insurance Company, leaving the Illinois insureds with following options in the transition process: (a) reapply for a Unicare2 policy, subject to underwriting; (b) be automatically converted to a Uni-care policy (with an accompanying 250% premium increase and lesser coverage); or (c) seek coverage elsewhere. The transition process began on December 31, 2002. The practical effect of this transition was to leave the ill and infirm with significantly higher premiums after being forced to convert to a Unicare policy or going through the underwriting process. Thus, as a result of these drastically higher costs, many insureds were forced to withdraw from their insurance policies altogether and either forego insurance coverage or turn to the state for support. In Cima, this Court described defendants’ actions as “immoral, oppressive, unethical and unscrupulous.”

II. Procedural History a. Cima v. WellPoint Healthcare Networks, Inc., 05-cv-4127

The Cima complaint was first filed on March 21, 2003, in the Circuit Court for the Second Judicial Circuit, Jefferson County, Illinois, against Unicare Illinois Services, Inc. and WellPoint Health Networks, Inc. The complaint alleged violations of the Illinois Health Insurance Portability and Accountability Act (“Illinois HIPAA”), breach of contract, violations of the Illinois Consumer Fraud Act (“CFA”) and Uniform Deceptive Trade Practices Act (“UDTPA”), common law fraud, and breach of defendants’ duties of good faith and fair dealing. In their first amended complaint, the Cima plaintiffs added Uni-care National Services, Inc., Unicare Health Insurance Company of the Mid[874]*874west, RightCHOICE Managed Care, Inc., and RightCHOICE Insurance Company as defendants.

On June 28, 2005, the Cima defendants removed the case to federal court. In its order dated July 11, 2006, granting in part and denying in part the Cima defendants’ motion to dismiss, this Court dismissed plaintiffs’ Illinois HIPAA, CFA and UDT-PA deceptive practices, common law fraud, and breach of duty and good faith and fair dealing claims. Cima v. Wellpoint Healthcare Networks, Inc., No. 05-cv-4127, 2006 WL 1914107 (S.D.Ill. July 11, 2006). This Court denied plaintiffs’ motion for class certification on March 18, 2008. Cima v. WellPoint Health Networks, Inc., 250 F.R.D. 374 (S.D.Ill.2008). Thereafter, on October 22, 2008, this Court granted defendants’ motion for partial summary judgment, dismissing plaintiffs’ breach of contract claim. Cima v. Wellpoint Health Networks, Inc., No. 05-cv-4127, 2008 WL 4671707 (S.D.Ill. Oct. 22, 2008). The parties then settled the remaining CFA unfair practices claim, and the Court entered judgment on August 27, 2009. Cima v. WellPoint Healthcare Networks, Inc., No. 05-cv-4127, Doc. 256 (S.D.Ill. Aug. 27, 2009).

b. Current Case — Phillips v. WellPoint, Inc., 10-cv-357

On March 27, 2010, plaintiffs Charlotte Phillips and Bob Myrick filed their four-count class action complaint in the Circuit Court for the Third Judicial Circuit, Madison County, Illinois, against defendants WellPoint, Inc., Unicare National Services, Inc., Unicare Illinois Services, Inc., Uni-care Health Insurance Company of the Midwest, RightCHOICE Managed Care, and RightCHOICE Insurance Company. Plaintiffs alleged violations of Illinois HI-PAA, breach of contract, and violations of the CFA and UDTPA. Thereafter, defendants filed a notice of removal removing this action on the basis of federal question jurisdiction and the Class Action Fairness Act. Presently before the Court is defendants’ motion to dismiss plaintiffs’ complaint for failure to state a claim pursuant to Federal Rule of Civil Procedure 12(b)(6).

ANALYSIS

When considering a Rule 12(b)(6) motion to dismiss, the Court must “construe [the complaint] in the light most favorable to the nonmoving party, accept well-pleaded facts as true, and draw all inferences in [the non-moving] party’s favor.” Reger Dev., LLC v. Nat’l City Bank, 592 F.3d 759, 763 (7th Cir.2010). The complaint must “contain sufficient factual matter, accepted as true to ‘state a claim to relief that is plausible on its face.’ ” Ashcroft v. Iqbal,

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Bluebook (online)
900 F. Supp. 2d 870, 2012 WL 4490688, 2012 U.S. Dist. LEXIS 139623, Counsel Stack Legal Research, https://law.counselstack.com/opinion/phillips-v-wellpoint-inc-ilsd-2012.