Wollenberg v. Blue Cross and Blue Shield of Kansas, Inc.

CourtDistrict Court, D. Kansas
DecidedApril 5, 2024
Docket5:23-cv-04029
StatusUnknown

This text of Wollenberg v. Blue Cross and Blue Shield of Kansas, Inc. (Wollenberg v. Blue Cross and Blue Shield of Kansas, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wollenberg v. Blue Cross and Blue Shield of Kansas, Inc., (D. Kan. 2024).

Opinion

In the United States District Court for the District of Kansas _____________

Case No. 23-cv-04029-TC-TJJ _____________

JANAE WOLLENBERG, ET AL.,

Plaintiffs

v.

BLUE CROSS AND BLUE SHIELD OF KANSAS, INC.,

Defendant _____________

MEMORANDUM AND ORDER

Plaintiffs filed this putative class action in Kansas state court, seek- ing relief from Blue Cross and Blue Shield of Kansas, Inc. Doc. 1-1. Blue Cross removed to federal court. Doc. 1. Plaintiffs seek remand to state court, Doc. 10, and Blue Cross asks that their complaint be dis- missed, Doc. 13. For the following reasons, Plaintiffs’ motion is de- nied. Blue Cross’s motion is granted in part and denied in part. I A 1. Federal courts have limited jurisdiction. Kokkonen v. Guardian Life Ins. Co. of Am., 511 U.S. 375, 377 (1994); see U.S. Const. art. III, § 2. For federal district courts, that means they may not exercise judicial power absent statutory authority to do so. Home Depot U.S.A., Inc. v. Jackson, 139 S. Ct. 1743, 1746 (2019) (quoting Exxon Mobil Corp. v. Al- lapattah Services, Inc., 545 U.S. 546, 552 (2005)). Consequently, there is an ongoing and independent obligation to ensure that subject-matter jurisdiction exists in every case, Henderson ex rel. Henderson v. Shinseki, 562 U.S. 428, 438 (2011), requiring prompt dismissal or remand in any “proceeding[ ] in which it becomes apparent that jurisdiction is lack- ing.” Penteco Corp. v. Union Gas Sys., Inc., 929 F.2d 1519, 1521 (10th Cir. 1991) (quoting Basso v. Utah Power & Light Co., 495 F.2d 906, 909 (10th Cir. 1974)). The party invoking the federal court’s jurisdiction bears the burden of establishing by a preponderance of the evidence that jurisdiction is proper. Dart Cherokee Basin Operating Co. v. Owens, 574 U.S. 81, 89 (2014); Dutcher v. Matheson, 733 F.3d 980, 985 (10th Cir. 2013). Con- gress has given federal courts jurisdiction to hear two general types of cases: those that “arise under” federal law, 28 U.S.C. § 1331, and those between completely diverse parties where the amount in controversy exceeds $75,000, 28 U.S.C. § 1332(a). See also Home Depot, 139 S. Ct. at 1746; Allapattah Servs., 545 U.S. at 552. For suits initially filed in state court, Congress permits removal to federal court only in certain situations. See generally Lincoln Prop. Co. v. Roche, 546 U.S. 71, 83 (2005). Specifically, a defendant may remove “any civil action brought in a State court of which the district courts of the United States have original jurisdiction ... to the district court of the United States for the district and division embracing the place where such action is pending.” 28 U.S.C. § 1441(a). The party seeking removal must provide “actual proof of jurisdictional facts.” McPhail v. Deere & Co., 529 F.3d 947, 953 (10th Cir. 2008). Normally, any doubts concerning remand should be “resolved against federal jurisdiction.” Bd. of Cnty. Comm’nrs of Boulder Cnty. v. Suncor Energy, 25 F.4th 1238, 1250 (10th Cir. 2022) (quoting United States ex rel. King v. Hillcrest Health Ctr., Inc., 264 F.3d 1271, 1280 (10th Cir. 2001)). But “no antiremoval pre- sumption attends cases invoking CAFA,” the Class Action Fairness Act. Dart Cherokee, 574 U.S. at 89. 2. To survive a motion to dismiss for failure to state a claim, the complaint need only contain “a short and plain statement … showing that the pleader is entitled to relief” from each named defendant. Fed. R. Civ. P. 8(a)(2); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). Two “working principles” underlie this standard. Kan. Penn Gaming, LLC v. Collins, 656 F.3d 1210, 1214 (10th Cir. 2011); see also Ashcroft v. Iqbal, 556 U.S. 662, 678–79 (2009). First, a court ignores legal conclu- sions, labels, and any formulaic recitation of the elements. Penn Gaming, 656 F.3d at 1214. Second, a court accepts as true all remaining allega- tions and logical inferences and asks whether the claimant has alleged facts that make his or her claim plausible. Id. A claim need not be probable to be considered plausible. Iqbal, 556 U.S. at 678. But the facts, viewed in the light most favorable to the claimant, must move the claim from conceivable to plausible. Id. at 678–80. The “mere metaphysical possibility that some plaintiff could prove some set of facts in support of the pleaded claims is insufficient; the complaint must give the court reason to believe that this plaintiff has a reasonable likelihood of mustering factual support for these claims.” Ridge at Red Hawk, L.L.C. v. Schneider, 493 F.3d 1174, 1177 (10th Cir. 2007). Plausibility is context specific. The requisite showing depends on the claims alleged, and the inquiry usually starts with determining what the plaintiff must prove at trial. See Comcast Corp. v. Nat’l Assoc. of African Am.-Owned Media, 140 S. Ct. 1009, 1014 (2020). In other words, the nature and complexity of the claim(s) define what plaintiffs must plead. Cf. Robbins v. Oklahoma, 519 F.3d 1242, 1248–49 (10th Cir. 2008) (com- paring the factual allegations required to show a plausible personal in- jury claim versus a plausible constitutional violation). Ordinarily, a motion to dismiss is decided on the pleadings alone. But “the district court may consider documents referred to in the com- plaint if the documents are central to the plaintiff’s claim and the par- ties do not dispute the documents’ authenticity.” Alvarado v. KOB-TV, L.L.C., 493 F.3d 1210, 1215 (10th Cir. 2007) (citation and internal quo- tation marks omitted). B Plaintiffs are teachers with Blue Cross Blue Shield of Kansas health insurance policies. Doc. 1-1 at ¶ 6–8.1 Those policies cover preventive health services. Id. at ¶ 12. And they refer outward to preventive service policy guidance from the United States Preventive Services Task Force and federal agencies. Id. (referencing the Centers for Disease Control and the Health Resources and Services Administration). This policy guidance is periodically updated. Doc. 1-1 at ¶ 13. Thus, Plaintiffs’ pol- icies evolve as external guidance evolves. That evolutionary process takes time, though. Blue Cross “has im- plemented a policy that when guidance is updated [it] does not imme- diately begin covering preventive services.” Doc. 1-1 at ¶ 17. Instead, it incorporates new opinions “within one year of the date they are

1 All document citations are to the document and page number assigned in the CM/ECF system. published, to be effective by the beginning of the benefit period fol- lowing that year from the date of release.” Id. Plaintiffs say that this delay breaches a portion of their insurance contracts. Doc. 1-1 at ¶ 17.

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Wollenberg v. Blue Cross and Blue Shield of Kansas, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/wollenberg-v-blue-cross-and-blue-shield-of-kansas-inc-ksd-2024.