Ray v. Caruthersville School District No. 18 et al
Filing
83
OPINION MEMORANDUM AND ORDER re: 31 MOTION to Dismiss Party UHC filed by Defendant United Healthcare Insurance Company motion is DENIED without prejudice. Signed by Honorable Henry E. Autrey on 3/29/12. (CSG)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
SOUTHEASTERN DIVISION
STAN RAY,
Plaintiff,
v.
CARUTHERSVILLE SCHOOL
DISTRICT NO. 18, et al.,
Defendants.
)
)
)
)
)
)
)
)
)
)
No. 1:10CV158 HEA
OPINION, MEMORANDUM AND ORDER
This matter is before the Court on defendant United Health Care Insurance
Company’s (“UHC”) Motion to Dismiss Plaintiff’s First Amended Complaint [ECF
No. 31].
Plaintiff, a former employee of Caruthersville School District No. 18, brings
this action pursuant to the Employee Retirement Income Security Act (“ERISA”),
29 U.S.C. §§ 1001, et seq., or in the alternative, under the Public Health Services
Act (“PHSA”), 42 U.S.C. §§ 300bb-1, et seq. Specifically, plaintiff asserts that
defendants violated his rights under the Consolidated Omnibus Budget
Reconciliation Act (“COBRA”), 29 U.S.C. §§ 1166(a), et seq., by failing to give
him proper notice and the opportunity to elect continuation health care coverage
after termination from his employment. Defendant UHC was the insurance carrier
for Caruthersville School District at the time of plaintiff’s termination.
Plaintiff alleges three causes of action against defendant UHC. Counts VII
and VIII of the first amended complaint assert an alleged breach of fiduciary duty
by UHC. Count IX is titled “equitable estoppel,” however, plaintiff has clarified in
his briefing materials that he is really seeking to bring an action against UHC under
the Missouri state law doctrine of promissory estoppel.
UHC moves for dismissal of plaintiff’s claims on several grounds. UHC first
argues that plaintiff’s claims brought pursuant to ERISA are subject to dismissal
because ERISA regulates private employee benefit plans, whereas the PHSA
applies to governmental employee benefit plans such as the one of which plaintiff
was a beneficiary during his employment at Caruthersville School District. UHC
additionally argues that it cannot be held liable for a breach of fiduciary duty under
the PHSA because the PHSA applies only to employers and plan administrators.
UHC argues that it was neither plaintiff’s employer nor the plan administrator.
Lastly, UHC argues that plaintiff’s “equitable estoppel” claim is an affirmative
defense and cannot be pleaded as a cause of action. Thus UHC asserts that plaintiff
fails to state a claim against it as a matter of law.
In defense of his claims against UHC, plaintiff argues that there remain
issues of fact as to whether ERISA or the PHSA applies to this action, which would
require the Court to delve into matters outside the pleadings. Plaintiff also suggests
-2-
that defendant UHC could be considered a “de facto” plan administrator based on
the actions of an alleged agent of UHC. Plaintiff additionally claims that the facts
will show that plaintiff detrimentally relied on a promise made by defendant’s
agents relating to plaintiff’s health care coverage. Review of these facts would also
require digging into matters outside the record.
The Court finds that because the motion to dismiss and response brief rely on
factual matters outside the pleadings, they are better analyzed under the summary
judgment standard. As this matter has been more fully briefed in defendant UHC’s
motion for summary judgment, currently pending before this Court [ECF No. 66],
the Court will deny UHC’s motion to dismiss, without prejudice, and utilize the
summary judgment standard to better discern UHC’s arguments for judgment as a
matter of law.
Accordingly,
IT IS HEREBY ORDERED that defendant UHC’s Motion to Dismiss [ECF
No. 31] is DENIED without prejudice.
Dated this 29th day of March, 2012.
HENRY EDWARD AUTREY
UNITED STATES DISTRICT JUDGE
-3-
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?