W. v. California Physicians Service

CourtCourt of Appeals for the Tenth Circuit
DecidedMay 21, 2026
Docket25-4029
StatusUnpublished

This text of W. v. California Physicians Service (W. v. California Physicians Service) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
W. v. California Physicians Service, (10th Cir. 2026).

Opinion

Appellate Case: 25-4029 Document: 70-1 Date Filed: 05/21/2026 Page: 1 FILED United States Court of Appeals Tenth Circuit UNITED STATES COURT OF APPEALS May 21, 2026 FOR THE TENTH CIRCUIT _________________________________ Christopher M. Wolpert Clerk of Court KIRSTEN W., individually and on behalf of C.W., a minor,

Plaintiff - Appellant,

v. No. 25-4029 (D.C. No. 2:19-CV-00710-DBB) CALIFORNIA PHYSICIANS’ (D. Utah) SERVICE, d/b/a Blue Shield of California; TRINET GROUP, INC. SECTION 125, SECTION 129, AND FLEXIBLE SPENDING ACCOUNT PLAN,

Defendants - Appellees. _________________________________

ORDER AND JUDGMENT * _________________________________

Before BACHARACH, EBEL, and FEDERICO, Circuit Judges. _________________________________

After examining the briefs and appellate record, this panel has *

determined unanimously that oral argument would not materially assist in the determination of this appeal. See Fed. R. App. P. 34(a)(2); 10th Cir. R. 34.1(G). The case is therefore ordered submitted without oral argument.

This order and judgment is not binding precedent, except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Federal Rule of Appellate Procedure 32.1 and Tenth Circuit Rule 32.1. Appellate Case: 25-4029 Document: 70-1 Date Filed: 05/21/2026 Page: 2

Kirsten W. filed the operative complaint in this case on behalf of

herself and her minor son, C.W., after their health benefits plan denied

claims for medical expenses arising out of C.W.’s treatment at two

behavioral health facilities. On cross-motions for summary judgment, the

district court granted summary judgment to the plaintiffs on one claim, to

one defendant on another claim, and granted summary judgment as to

another defendant on all claims. But the district court remanded one issue

– the determination of benefits – back to the health benefits plan

administrator.

Kirsten filed a notice of appeal, but we noted a possible jurisdictional

defect and ordered the parties to address whether the district court’s

summary judgment order constituted a final judgment for the purposes of

our appellate jurisdiction. See 28 U.S.C. § 1291. Having reviewed the briefs

and the record, we conclude that we lack jurisdiction and accordingly

dismiss the appeal.

I

This appeal arises out of a case stretching back to 2019, when Kirsten

W. first filed suit against California Physicians’ Service (doing business as

Blue Shield of California) and Trinet Group, Inc. The second amended and

currently operative complaint alleges that in denying benefits to Kirsten

and her son under their health plan, Blue Shield and Trinet violated the

2 Appellate Case: 25-4029 Document: 70-1 Date Filed: 05/21/2026 Page: 3

Employee Retirement Income Security Act of 1974 (ERISA) and the Mental

Health Parity & Addiction Equity Act of 2008 (the Parity Act). As alleged,

Trinet is the plan covered by ERISA and the Parity Act, while Blue Shield

is the agent and administrator of the plan. Blue Shield concluded that C.W.

could have been treated in an outpatient setting and so his treatment at

two residential facilities was not medically necessary. Blue Shield denied

benefits for each treatment facility on this basis.

On August 2, 2024, both parties moved for summary judgment.

Kirsten argued first that Blue Shield’s conclusion that C.W. could have been

treated in an outpatient setting was arbitrary and capricious in violation of

ERISA, and second that Blue Shield’s criteria for determining whether to

grant or deny benefits for mental health care was more restrictive than

criteria for comparable medical or surgical care in violation of the Parity

Act. Kirsten acknowledged that the record was insufficient for the district

court to award benefits directly, so she asked the court to “remand the case

solely for the purpose of allowing Defendants to consider the amount at

issue.” Aplt. App. I at 102. 1

1 The record disclosed the amount of benefits owed with respect to one

treatment facility but not the other, so the total amount of benefits was still uncertain.

3 Appellate Case: 25-4029 Document: 70-1 Date Filed: 05/21/2026 Page: 4

Blue Shield and Trinet argued in their motion that they were entitled

to summary judgment on all claims, but at a minimum, Kirsten had “failed

to supply any claims or proof of payment upon which the Court could

determine entitlement to benefits” with respect to one residential treatment

facility. Aple. App. I at 61. Independently, Trinet contended that Kirsten

had no evidence of wrongdoing specific to it, so Trinet was entitled to

summary judgment on all claims against it. In response, Kirsten reiterated

her request for a limited remand and argued that Trinet was culpable for

Blue Shield’s conduct because the health benefits plan was self-funded.

The district court granted summary judgment to Kirsten on the

ERISA claim but granted summary judgment to Blue Shield on the Parity

Act claim. With respect to the ERISA claim, the district court found

“remand is the appropriate remedy to consider Plaintiff’s claims regarding

coverage.” Aplt. App. I at 221. Nonetheless, the district court warned that

remand was not an opportunity for Blue Shield “to reevaluate a claim based

on a rationale not raised in the administrative record, and not previously

conveyed to plaintiffs.” Id. (quoting David P. v. United Healthcare Insurance

Company, 77 F.4th 1293, 1316 (10th Cir. 2023)). Additionally, the district

court granted summary judgment to Trinet because “Plaintiff did not

request – and the court will not order – an award of benefits for which Trinet

could be responsible at this time.” Aplt. App. I at 230.

4 Appellate Case: 25-4029 Document: 70-1 Date Filed: 05/21/2026 Page: 5

The district court entered judgment on February 10, 2025. This timely

appeal followed.

II

With few exceptions not relevant here, the courts of appeals have

jurisdiction over “all final decisions of the district courts of the United

States.” 28 U.S.C. § 1291. The so-called final judgment rule is deceptively

simple: we have jurisdiction to review the judgments of the district court

only after the work of the district court is completed. In re Motor Fuel

Temperature Sales Practices Litigation, 641 F.3d 470, 481 (10th Cir. 2011).

“A decision is ‘final’ when it ‘ends the litigation on the merits and leaves

nothing for the court to do but execute the judgment.’” S.E.C. v. Merrill

Scott & Associates, Ltd., 600 F.3d 1262, 1270 (10th Cir. 2010) (quoting

Boughton v. Cotter Corp., 10 F.3d 746, 748 (10th Cir. 1993)); Frank v.

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