was in error largely in part because while it's simple taney asli argued that the benefit booklet was not part of the plan documents it then reli on selective portions of that benefit booklet to rule in favor of the plaintive it is our contention that that was incorrect it was incorrect in the context of the district court should have recognized the benefit booklet as part of the resupply and along with the s p d but wall of recognizing it and understanding there were benefits to be provided it must also give force to the entire agreement including the anti assignment provision that is found within that agreement and which it was not in that document ok so it's only in the benefit booklet that is correct your honor so it's within the play why wouldn't we read anyone else in the plan why would it be applicable here it would be applicable because it states that you cannot assign your right to receive payment to anyone else except as required by the qualified medical child support the anyone else means individuals other than the member it is not the provider here the anyone else  arise the plan to make payments directly to providers for covered services the you there is the member and so while the provision allows the the member to have the payment directed to the provider it does not indicate that assignment of rights can be assigned by the member to the provider that's that's a greater issue than the direction of payment and so when it says anyone else it is not related to the provider itself  that the sentence right before it says any payments made by the plan will destroy the plan obligation to pay for covered services so there is not an assumption that there would be and assignment by way of just allowing for the direction of payment within that language  your feet is a little choppy i think you what you've just asked me is if the district judge did not incorporate portions of the the benefit booklet whether or not the their plan would be in danger of not meeting essentially obligations under a risk and we owe it i think yes i mean if you were just looking at the s p d there is i don't think there's any dispute by any of the parties or for that matter the lower court that the s p d alone doesn't provide for benefits and of course under a risk a plan must have the provision for benefits which is why it is the case that the district court needed to go back to that benefit booklet in order to make it's willing but in doing so what it is doing is essentially recognizing that that benefit booklet is part and parcel of the plan itself i the documents it's for the purposes of ensuring that there's an operation and benefits to be provided so yes the district court in order to award any sort of damage to the plaintiffs here had to recognize some taking that portion of the document the entire document was to be considered not just selective portions moreover the end to assignment provision itself is in a section referred to as payment of benefits and in looking at the documents the s p d states that its certificates will talk about the terms and conditions with regard to the payment of benefits and as a consequence that provision is already and recognize it does not your honor in insignia you had a completely different situation you had actually a sponsor and an administrator being the same entity and they were trying to change language that's not what we have here we have a separate administrator that crafted the document which is completely normal and within the market the language is not u i would argue your honor that in fact cigna recognizes that an administrator can in fact draft the terms of the plan the s p d also incorporates and and assumes that that will be the case and that's not unusual by any means but what cigna had an issue with was with regard to that plan having been established and then attempts to unilaterally change it which is not what we have and in this case  assignment their benefits well but where the hospital went wrong your honor is assuming that those assignments were effective so that they didn't even involve the patients in trying to recover the amounts that had already been paid under the plan to the members with the hospital went wrong is that it didn't seek its payment from from the members which had better say from me which had been received from the insurer and the plan regard to the position on two assignments is really as a matter of control ensuring that the payment of the benefit of the plan is actually going to the member who is in contract with the plan as opposed to of different policy is to out of network in network providers anthem has a policy that out of network provider that assignments would not be recognized with regard to out of network providers in part because of the fact that they want to ensure that the benefits are going to the members who are the ones who contract it for the coverage let me ask you another question equitable principles your honor no could could the language be be better yes the language could be better but in fact the language that is present is sufficient to understand that the benefit booklet is part of the plan because the s p d itself defines certificate of coverage as including planned booklets and then you have the plan benefit booklet it is it is absolutely tenable and understandable clear that the s p d anticipated expected a booklet to be existing and in fact that is the case and we would contend your honor that given that it was inappropriate for the lower court to fashion its own contract that actually is counter to what is expected within analysis of a risk of plans that the court is not the fashion its own plan one of them over a moment versus the only difference there was it was an entire document rather than just abortion a document is that is not that's exactly right and in this case if essentially the court's ruling implicitly acknowledge that the benefit it please the court well the reason to uphold the judgment in favor of martin luther king jr i mean the hospital is very simple and ok provided over one million dollars worth of uncompensated emergency care it's going on five years now all of the patients involved except for one and that one was one where the court did not grant summary judgment in our favor at this time it's a benefits that they assign their benefits to the hospital but that and the reason that it can we look at this and the key sentence in the plan and everyone everyone agrees is a plan document where it says the certificates of coverage for your elected benefit options are planned booklets provided by the insurance company that provide contracted ministrations services for the plan how can that be construed as referring to anything other than these booklets it's uses the word booklet provided by the insurance company these are booklets provided by the insurance company why why isn't this this difficult of coverage that your honor we think that there are several ways to reach the result that the district court reached we think that he reached the right conclusion and the way he did it is he didn't think that anthem met its burden to show that these books were just if it gets of coverage i think that we wouldn't even if they are and even if  point document is that it on the st page that you're looking at at the bottom the very last paragraph says benefits described in this document are effective january st two thousand and fifteen it also says that to the extent there's a conflict between the terms of this does p d and the certificate of coverage that this happy show control except where it says that certificates will control the event if you accept the premise that the benefit book which is the plan booklet potters intent was very clear that this be a governing document and perhaps parts of the benefit booklet are incorporated but not the whole booklet your honor i want to jump ahead to the booklet itself so that the very technical issue but the call that issue the assignment clause is pretty clear it says very straightforwardly that you also write the plan to make payments directly to providers for coverage services and as we've discussed only a few sentences later it says you may not sign your right to receive payment to any one else so important thing to understand here there's two things  is to assuming that this is part of the plan to look at the actual language of the other simon clause and to say that this clearly prohibit assignment and if not then assignment should be allowed so that we look at that clause i mean the last sentence under your reading where anyone else means anyone other than the persons referred to in the prior i guess three sentences would not  the except clause in the final sentence because it repeats someone who's already mentioned in the prior sentences right the recipient of a two m c s o a child support order made by a patient to a provider so there are lots of problems with that clause but they clearly what the whatever it whatever does the one thing it doesn't do was prohibit the assignment to providers in fact it explicitly contemplates that court judge did is justifiable incorporating just the benefits the sec that the missing i do agree that that with the court that the requirement that there be a basis on which the payments to and from the plan must be set forth in the governing plan document that is supplied by the benefit booklet and that was proper to corporate just benefits that's consistent with the approach that the s p d takes because they didn't want the patients to get the checks d we also had no success in collecting and if the payments from the patients so really coming to the court in the way that we have is the primary  the interpretation of the time provision i will note that there are several decisions you know the dual the decision the gryphon decision and the ng step position all of against you i don't think so if if the court st told me that the neither m l k nor the lower court ever determined there was any sort of ambiguity if this court were to determine that that would become a question of fact quite frankly that should be certainly addressed at the trial court level but certainly not the result of a decision with regard to a motion for s says that the plan booklets quote describe the health care or other welfare benefits and the terms and conditions for receiving those benefits which are offered to employees of the company and their families by the plan and so the plan document perceives not only the benefits but also the manner in which and the terms and conditions for receiving those benefits which specifically then references the anti of mission under a section literally entitled payment for benefits it is therefore our position that in fact both the benefit booklet and the s