Poffenbarger v. Hawaii Management Alliance Ass'n

892 F. Supp. 2d 1288, 54 Employee Benefits Cas. (BNA) 1553, 2012 WL 3808419, 2012 U.S. Dist. LEXIS 124416
CourtDistrict Court, D. Hawaii
DecidedAugust 31, 2012
DocketCivil No. 12-00172 LEK-KSC
StatusPublished
Cited by1 cases

This text of 892 F. Supp. 2d 1288 (Poffenbarger v. Hawaii Management Alliance Ass'n) is published on Counsel Stack Legal Research, covering District Court, D. Hawaii primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Poffenbarger v. Hawaii Management Alliance Ass'n, 892 F. Supp. 2d 1288, 54 Employee Benefits Cas. (BNA) 1553, 2012 WL 3808419, 2012 U.S. Dist. LEXIS 124416 (D. Haw. 2012).

Opinion

ORDER DENYING PLAINTIFFS’ MOTION TO REMAND TO STATE COURT

LESLIE E. KOBAYASHI, District Judge.

Before the Court is Plaintiffs Robert Poffenbarger’s and Clareen Poffenbarger’s (“Plaintiffs”) Motion to Remand to State Court (“Motion”), filed on April 27, 2012. Defendants Hawaii Management Alliance Association, doing business as HMAA, a Hawaii Nonprofit Corporation (“HMAA”), and Hawaii-Western Management Group, Inc., doing business as HWMG, a Foreign Profit Corporation (“HWMG”, collectively “Defendants”), filed their memorandum in opposition on July 27, 2012, and Plaintiffs filed their reply on August 6, 2012. This matter came on for hearing on August 20, 2012. Appearing on behalf of Plaintiffs was Mark Reck, Esq., and appearing on behalf of Defendants was Kenneth Mansfield, Esq. After careful consideration of the Motion, supporting and opposing memoranda, and the arguments of counsel, Plaintiffs’ Motion is HEREBY DENIED for the reasons set forth below.

BACKGROUND

Plaintiffs filed their Complaint in the instant action in state court on March 6, 2012. [Notice of Removal, filed 3/29/12, Exh. A (dkt. no. 1-2) at 5-18.] According to the Complaint, on December 1, 2010, Clareen Poffenbarger submitted an Enrollment Application for healthcare coverage through HMAA. Her employer, Jaro Baranik, doing business as La Boheme (“Baranik”) submitted the application to HMAA. HMAA issued Clareen Poffenbarger a member identification card for coverage effective January 1, 2011 pursuant to an employee health and welfare benefit plan (“the Plan”). Clareen Poffenbarger maintained her employment and paid her premiums, as required to maintain her coverage. [Complaint at ¶¶ 9-14.]

On February 21, 2011, Clareen Poffenbarger was diagnosed with a brain tumor. She received treatment at Maui Memorial Medical Clinic (“MMMC”) from February 21, 2011 to March 6, 2011, Stanford Medical Center (“Stanford”) from March 7, 2011 to March 30, 2011, and Santa Clara Valley Medical Center (“SCVMC”) from March 30, 2011 to June 1, 2011. On June 1, 2011, Clareen Poffenbarger returned home to Maui, where she received home health care through Hale Makua. HMAA authorized all of her treatment at MMMC, Stanford, and SCVMC, as well as her treatment through Hale Makua until June 30, 2011. [Id. at ¶¶ 16-21, 24-27, 29-30.]

During Clareen Poffenbarger’s treatment at Stanford, HMAA began a review of her eligibility. HMAA sent Clareen [1291]*1291Poffenbarger a letter dated May 16, 2011 verifying her coverage through June 30, 2011. [Id. at ¶¶ 22-23.] On June 3, 2011, HMAA issued her a Certificate of Group Coverage stating that her coverage began on January 1, 2011 and would end on June 30,2011. [Id. at ¶ 28.]

On June 23, 2011, HMAA issued a letter rescinding Clareen Poffenbarger’s coverage effective January 1, 2011. HWMG’s Research & Investigation and Subrogation Supervisor signed the letter as HMAA’s Third Party Administrator. Plaintiffs submitted a timely appeal to HMAA on September 2, 2011. HMAA issued a letter, dated October 19, 2011, upholding the rescission. HWMG’s Customer Service Administrator signed the letter as HMAA’s Third Party Administrator. [Id. at ¶¶ 31-35.]

The Complaint alleges the following claims: insurance bad faith against HMAA (“Count I”); violations of Hawai’i Revised Statutes Chapter 480 by HMAA and HWMG (“Count II”); breach of fiduciary duty by HMAA (“Count III”); breach of contract by HMAA and HWMG (“Count IV”); negligent misrepresentation by HMAA (“Count V”); negligent infliction of emotional distress (“NIED”) against HWMG (“Count V”);1 NIED against HMAA (“Count VI”); and a claim based on HMAA’s vicarious liability (“Count VII”). The Complaint seeks: general and special damages; treble damages pursuant to Haw.Rev.Stat. § 480-13; punitive damages; fees and costs; and any other legal and/or equitable relief the Court' deems appropriate.

Defendants filed their Notice of Removal on March 29, 2012, based on federal question jurisdiction. Defendants assert that Plaintiffs’ claims arise under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq.

1. Motion

In the instant Motion, Plaintiffs argue that all of their claims arise under state common law or state statutes and that ERISA does not preempt their claims. Plaintiffs argue that, because Defendants unilaterally rescinded the insurance contract, Defendants are estopped from claiming that the case involves an insurance contract subject to ERISA.

In addition, Plaintiffs argue that their claims are exempt from preemption pursuant to 29 U.S.C. § 1144(b)(5) because Clareen Poffenbarger obtained the Plan pursuant to the Hawaii Prepaid Health Care Act (“HPHCA”).2 Plaintiffs argue that, because Clareen Poffenbarger was entitled to the Plan pursuant to the HPHCA, and this right is the basis of Plaintiffs’ action, ERISA preemption does not apply.

Plaintiffs acknowledge that the Hawai’i Supreme Court has recognized that the exemption does not apply to all claims related to employee benefit plans which employers maintain to comply with the HPHCA. [Mem. in Supp. of Motion at 9 (citing Garcia v. Kaiser Found. Hosps., 90 Hawai’i 425, 435, 978 P.2d 863, 873 (1999)).] Plaintiffs, however, argue that Garcia is distinguishable because that case involved an action for monetary damages for the denial of benefits. Plaintiffs contend that the issue in their case is whether Clareen Poffenbarger was entitled to the Plan in the first instance.

Plaintiffs also argue that, even pursuant to Ninth Circuit case law, ERISA does not preempt their claims. Plaintiffs argue that the Ninth Circuit uses a “relationship test” to determine whether ERISA pre[1292]*1292emption applies. [Id. at 10 (citing Geweke Ford v. St Joseph’s Omni Preferred Care Inc., 130 F.3d 1355 (9th Cir.1997)).] Plaintiffs assert that state laws which encroach upon relationships that ERISA regulates are preempted, but ERISA does not preempt claims based upon relationships in which the plan operates as any other commercial entity. [Id. at 10-11.] Plaintiffs argue that their claims are based upon contract and tort case law, as well as Chapter 480, and these are laws of general application which do not necessarily affect ERISA relationships. Plaintiffs emphasize that the merits of their claims will not require a determination of the contents, administration, creation, operation, or failure of the Plan.

Finally, Plaintiffs argue that their claims are outside of the scope of 29 U.S.C. § 1132. Plaintiffs are not seeking to recover Clareen Poffenbarger’s benefits or rights under the Plan, nor are they seeking an injunction or other equitable relief to redress ERISA violations. Plaintiffs argue that the United States Supreme Court has held that § 1132(a)(3)(B) only authorizes claims for typical equitable relief, not claims that essentially seek compensatory damages. [Id.

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892 F. Supp. 2d 1288, 54 Employee Benefits Cas. (BNA) 1553, 2012 WL 3808419, 2012 U.S. Dist. LEXIS 124416, Counsel Stack Legal Research, https://law.counselstack.com/opinion/poffenbarger-v-hawaii-management-alliance-assn-hid-2012.