Priddy v. HealthCare Services Corp.

319 F.R.D. 244, 95 Fed. R. Serv. 3d 1950, 62 Employee Benefits Cas. (BNA) 2431, 2016 WL 5923412, 2016 U.S. Dist. LEXIS 140414
CourtDistrict Court, C.D. Illinois
DecidedOctober 7, 2016
DocketNO. 14-3360
StatusPublished

This text of 319 F.R.D. 244 (Priddy v. HealthCare Services Corp.) is published on Counsel Stack Legal Research, covering District Court, C.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Priddy v. HealthCare Services Corp., 319 F.R.D. 244, 95 Fed. R. Serv. 3d 1950, 62 Employee Benefits Cas. (BNA) 2431, 2016 WL 5923412, 2016 U.S. Dist. LEXIS 140414 (C.D. Ill. 2016).

Opinion

OPINION

RICHARD MILLS, U.S. District Judge:

This is a class action case.

In an Order entered on March 22, 2016, the Court Allowed in part and Denied in part the Defendant’s Motion to Dismiss the Plaintiffs’ First Amended Complaint.

Pending before the Court is the Plaintiffs’ Motion to Certify a Class.

It will be so ordered.

I. BACKGROUND

This is an action pursuant to the Employee Retirement Income Security Act (“ERISA), 29 U.S.C. §§ 1132(a)(1)(B) and 1132(a)(3). The Plaintiffs also seek relief under the statutory and common law of the State of Illinois.

Following the Court’s ruling on the Defendant’s Motion to Dismiss, eight individuals remain as Plaintiffs. Plaintiffs Susan Priddy, Craig Fischer and Suraj Demla purchased individual policies from Defendant Health Care Services Corporation (“the Defendant” or “HCSC”), an insurance company licensed by the State of Illinois. Plaintiffs Jan Yard, Mark Sehacht, M.D., Neil Friedman, M.D., Jeffrey Rose and Michael Beiler obtained coverage through a plan purchased by their employers,

The Plaintiffs allege that, through its Blue Cross and Blue Shield divisions, HCSC offers health insurance policies in Illinois, Montana, New Mexico, Oklahoma and Texas for individuals and groups. HCSC enters into financial arrangements with drug providers in order to manage pharmaceutical prices.

Based on then.' Amended Complaint and the Court’s Order on the Defendant’s Motion to Dismiss, the Plaintiffs request class certification under Rule 23 for the following counts of the Amended Complaint:

(a) Count 1, to the extent it alleges breach of fiduciary duty against HEALTH CARE SERVICE CORPORATION (HCSC) as an Illinois Mutual Insurance Company and breach of its fiduciary duty under ERISA, 29 U.S.C. § 1104(a)(1) and 29 U.S.C. § 1106(b)(1) and Illinois common law with respect to its placing its officers and directors on various boards of its affiliates and other entities owned or controlled by HCSC;
(b) Plaintiffs allegations under Counts I and II, to the extent that they allege violations under ERISA, 29 U.S.C. § 1106(a)(1) and (b) by HCSC’s engaging in “prohibited transactions” by HCSC’s non-disclosure of the terms of the contracts that it entered into with providers;
(c) With respect to Count II, to the extent that it alleged violations of ERISA, 29 U.S.C. § 1106 by HCSC’s utilizing plan assets to the detriment of plan participants;
(d) With respect to Count III as to its request for appointment of a receiver under 29 U.S.C. § 1109(a);
(e) With respect to Count VI as to its allegations that Defendant, HCSC, breached its common law fiduciary duty; and with respect to Count VII as to the allegations that there should be an accounting under Illinois Law.

The Plaintiffs seek to bring this class under Federal Rule of Civil Procedure 23 on behalf of themselves and as representatives of four classes of similarly situated persons and entities, defined as follows:

(a) All individuals who sponsored benefit plans providing themselves and any of their employees with healthcare coverage obtained by the purchase of insurance coverage or administration of self-funded plans by Defendant, HCSC, or through a benefit plan underwritten, administered or otherwise provided by Defendant, HCSC in the States of Illinois, Texas, Montana, New Mexico and Oklahoma.
(b) All individuals and their beneficiaries who are or, at all times relevant to this cause of action, were recipients of health care coverage provided to them [248]*248and their beneficiaries through their employers by health care coverage plans underwritten, administered, or otherwise provided by Defendant HCSC in the States of Illinois, Texas, Montana, New Mexico and Oklahoma.
(c) All individuals and their beneficiaries who, at all times relevant to this cause of action, obtained health care coverage by individual purchase of such coverage from Defendant, HCSC, or through a benefit plan underwritten, administered, or otherwise provided by Defendant, HCSC, but not subject to ERISA in the States of Illinois, Texas, Montana, New Mexico and Oklahoma,
(d) All individuals and them beneficiaries who are, or at all times relevant to this cause of action, were covered by health care insurance solely within the borders of the State of Illinois and therefore are protected by the power of the Illinois Department of Insurance to regulate policies issued within its borders by a health care insurer such as Defendant HCSC.
Excluded from the Class are; (1) Defendant, Defendant’s agents, subsidiaries, parents, successors, predecessors, and any entity in which Defendant or its parents have a controlling interest, and those entities’ current and former employees, officers, and directors; (2) the Judge to whom this case is assigned and the Judge’s immediate family; (S) any person who executes and files a timely request for exclusion from the Class; (4) any person who has had their claims in this matter finally adjudicated and/or otherwise released; and (5) the legal representatives, successors and assigns of any such excluded person.

II. DISCUSSION

A. Legal standard

Under Rule 23(a), a class action is appropriate only if:

(1) the class is so numerous that joinder of all members is impracticable;
(2) there are questions of law or fact common to the class;
(3) the claims or defenses of the representative parties are typical of the claims or defenses of the class; and
(4) the representative parties will fairly and adequately protect the interests of the class.

Fed. R. Civ. P. 23(a). “To certify a class, a district court must find that each requirement of Rule 23(a) (numerosity, commonality, typicality and adequacy of representation) is satisfied as well as one subsection of Rule 23(b).” Harper v. Sheriff of Cook County, 581 F.3d 511, 513 (7th Cir. 2009). The class cannot be certified if any requirement is not met. See id.

The class must be defined in a clear manner based on objective criteria. Mullins v. Direct Digital LLC,

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
319 F.R.D. 244, 95 Fed. R. Serv. 3d 1950, 62 Employee Benefits Cas. (BNA) 2431, 2016 WL 5923412, 2016 U.S. Dist. LEXIS 140414, Counsel Stack Legal Research, https://law.counselstack.com/opinion/priddy-v-healthcare-services-corp-ilcd-2016.