Wagoner v. First Fleet Incorporated

District Court, D. Arizona·Decided August 9, 2022·No. 2:22-cv-00990·Unknown

Opinion

WO

Gary L. Wagoner, No. CV-22-00990-PHX-JAT

Plaintiff, ORDER

v.

First Fleet Incorporated,

Defendant. Pending before the Court is Defendant First Fleet, Inc.’s (“First Fleet”) Motion to Dismiss (Doc. 6), and Plaintiff Dr. Gary Wagoner’s (“Plaintiff”) Response to Motion to Dismiss and Motion for Default (Doc. 9). Also pending before the Court is Defendant’s Reply in Support of Its Motion to Dismiss and in Opposition to Plaintiff’s Motion for Default (Doc. 11), and Defendant’s Motion to Strike (Doc. 13). The Court now rules on the motions. Plaintiff is a chiropractor based in Scottsdale, Arizona, and is the designated representative for patient Jeffrey Cagle. (Doc. 1-3 at 5–6). Plaintiff provided medical care to Mr. Cagle on October 10, 2019. (Id. at 6). Mr. Cagle signed an assignment of benefits contract to allow Plaintiff to collect payment from Mr. Cagle’s employee health benefits plan through First Fleet, Inc., an insurance company affiliated with Blue Cross Blue Shield of Tennessee (BCBST). (Id. at 6, 18). Both parties agree that Mr. Cagle’s plan is regulated by the Employee Retirement Income Security Act (ERISA). (Doc. 9 at 1; Doc. 6 at 2). After he provided anesthesiology services to Mr. Cagle, Plaintiff alleges he submitted “a total of 2 demands for payment … to First Fleet without response or payment tendered.” (Doc. 1-3 at 6). On May 3, 2022, Plaintiff filed his Complaint against First Fleet in the Dreamy Draw Justice Court in Phoenix, Arizona, alleging First Fleet had not properly paid him for the services he provided Mr. Cagle and seeking $10,000 in damages, including benefits, court costs, interest, and document preparation expenses. (Doc. 1-3 at 5; Doc. 6 at 3). On June 7, 2022, First Fleet removed Plaintiff’s action to the U.S. District Court for the District of Arizona and filed a Motion to Dismiss under Federal Rule of Civil Procedure 12(b)(6) claiming ERISA preemption. (Doc. 1-4 at 2; Doc. 6). Consequently, Plaintiff filed a Response and Motion for Default on June 28, 2022. (Doc. 9). First Fleet opposed Plaintiff’s Motion for Default on July 5, 2022, and nine days later, First Fleet moved to strike Plaintiff’s Response and Motion for Default (Doc. 9) from the Court record. (Doc. 11; Doc. 13). A. Rule 12(b)(6) Dismissal of a complaint, or any claim within it, for failure to state a claim under Rule 12(b)(6) may be based on either “‘a lack of a cognizable legal theory’ or ‘the absence of sufficient facts alleged under a cognizable legal theory.’” Johnson v. Riverside Heatlhcare Sys., LP, 534 F.3d 1116, 1121–22 (9th Cir. 2008) (quoting Balistreri v. Pacifica Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1990)). In determining whether a complaint states a claim under this standard, the Court regards the allegations in the complaint as true and construes the pleadings in the light most favorable to the nonmovant. Outdoor Media Group, Inc. v. City of Beaumont, 506 F.3d 895, 900 (9th Cir. 2007). A pleading must contain “a short and plain statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2). This statement “need only give the defendant fair notice of what … the claim is and the grounds upon which it rests,” and “[s]pecific facts are not necessary.” Erickson v. Pardus, 551 U.S. 89, 93 (2007) (internal quotation marks omitted). To survive a motion to dismiss, a complaint must state a claim that is “plausible on its face,” which occurs “when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007) (to survive a motion to dismiss, a plaintiff must allege “enough facts to state a claim to relief that is plausible on its face”). Although courts will not generally look beyond the pleadings in a Rule 12(b)(6) motion, a “court may consider material that the plaintiff properly submitted as part of the complaint, or even if not physically attached to the complaint, material that is not contended to be inauthentic and that is necessarily relied upon by the plaintiff’s complaint.” Lee v. City of Los Angeles, 250 F.3d 668, 688 (9th Cir. 2001). The Court may also consider matters of public record, including pleadings, orders, and other papers filed with the Court. Mack v. S. Bay Beer Distribs., 798 F.2d 1279, 1282 (9th Cir. 1986), abrogated on other grounds by Astoria Fed. Savings & Loan Ass’n v. Solimino, 501 U.S. 104 (1991). B. Preemption 1. ERISA ERISA derives its preemptive power from two components. Blue Cross of Cal. v. Insys Therapeutics, 390 F. Supp. 3d 996, 1003 (D. Ariz. 2019). The first component, ERISA section 514(a), preempts all state laws “as they may now or hereafter relate to any employee benefit plan.” 29 U.S.C. § 1444 (a). The second component, ERISA section 502(a), outlines the scope of civil remedies available to enforce any part of ERISA’s provisions. Insys Therapeutics, 390 F. Supp. 3d at 1003 (citing Cleghorn v. Blue Shield of Cal., 408 F.3d 1222, 1225 (9th Cir. 2005)). If a state cause of action falls within this scope, the Court deems the cause of action preempted as conflicting with the intended exclusivity of ERISA’s civil remedies. Id. This is the case even if the state cause of action is not preempted by section 514(a), as discussed below. Id. a. Section 514(a) Section 514(a) requires that ERISA “supersede any and all State laws insofar as they may … relate to any employee benefit plan.” § 1144(a). The Court considers a law to “relate to” an employee benefit plan if it has “a connection with or reference to such a plan.” Insys Therapeutics, 390 F. Supp. 3d at 1003 (quoting Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96–97 (1983) (internal quotations omitted)). The Court considers a state law to “refer to” an ERISA plan when it “acts immediately and exclusively upon ERISA plans … or where the existence of ERISA plans is essential to the law’s operation.” Id. (quoting Cal. Div. of Labor Standards Enforcement v. Dillingham Const., N.A., Inc., 519 U.S. 316, 325 (1997) (internal quotations omitted)). Additionally, Ninth Circuit courts use a separate “relationship test” to determine whether a state law has a “connection with” an ERISA plan. Id. Specifically, when “a state law claim bears on an ERISA-regulated relationship, e.g., the relationship between plan and plan member, between plan and employer, between employer and employee,” then the claim is preempted. Id.at 1004 (internal quotations and citation omitted). b. Section 502(a) Next, the Court considers whether a state law cause of action is preempted under ERISA Section 502(a),

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

Wagoner v. First Fleet Incorporated, (D. Ariz. 2022).

Wagoner v. First Fleet Incorporated (Wagoner v. First Fleet Incorporated) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Carver v. Jackson
29 U.S. 1 (Supreme Court, 1830)
Shaw v. Delta Air Lines, Inc.
463 U.S. 85 (Supreme Court, 1983)
Pilot Life Insurance v. Dedeaux
481 U.S. 41 (Supreme Court, 1987)
FMC Corp. v. Holliday
498 U.S. 52 (Supreme Court, 1990)
Astoria Federal Savings & Loan Ass'n v. Solimino
501 U.S. 104 (Supreme Court, 1991)
Erickson v. Pardus
551 U.S. 89 (Supreme Court, 2007)
Bell Atlantic Corp. v. Twombly
550 U.S. 544 (Supreme Court, 2007)
Ashcroft v. Iqbal
556 U.S. 662 (Supreme Court, 2009)
Vaden v. Discover Bank
556 U.S. 49 (Supreme Court, 2009)
Johnson v. Riverside Healthcare System, LP
534 F.3d 1116 (Ninth Circuit, 2008)
Outdoor Media Group, Inc. v. City of Beaumont
506 F.3d 895 (Ninth Circuit, 2007)
Satterly v. LIFE CARE CENTERS OF AMERICA
61 P.3d 468 (Court of Appeals of Arizona, 2003)