where he designated his daughters shall be this is something that people do every day of the week you know they have self plus one or they have self plus family she defined as a plan participant she gets benefits under the plan and i'm having trouble with the notion that even though she gets all the benefits of the plan she's somehow not bound by any of the other let's say more detrimental criteria whether it's giving notice of a claim or whether it's a subrogation obligation or whether it's you know an age limit or or whatever else it may be i can think of all sorts of fairly common limitations and so whether you do this by saying she is a defined participant in the plan and if she's going to take the money she needs to abide by the rest of it or if you just use rd party beneficiary language i think this is a pretty good fit read she's too young you know could be a two year old for that matter and so what i'm curious to know is whether you have found any case in the context of welfare benefit plans i'm not talking about pension plans right now welfare benefit plans that has held as you would like us to hold here that somebody is entitled to receive coverage for the welfare benefit here medical benefits but who does not need to comply with limitations on that coverage is there any such will your distinction between penciling welfare providers and central states paid the three hundred we'll just call three hundred and twelve thousand dollars so it seems to me you know that's a significant benefit for if i had a bill for three hundred and twelve thousand to be saying i don't mean to be too you know unfair about this but you seem to be saying that there isn't enough paperwork already in the administration of health care plan and that's a shocking proposition to anybody who's had to work their way through any kind of medical care hospitalization or comparable outpatient care when somebody is listed as a dependent on their relatives could be a spouse could be a parent plan then people rely on that it was a big deal in the affordable care act that parents could keep children until the age of twenty six dollars and there wasn't this extra paperwork burden your information you are at the three minute mark foley and agreement between the parties and the athletes request that this decision be affirmed all of the parties agree that the controlling model is a series of supreme court cases regarding subrogation or reimbursement rights family therapy os mccutcheon and monster niall and each of these upon her arguing that no equitable levi agreement exists in this case because no appellant evergrey to the terms of the plan now this argument is made despite the fact that as the court pointed out so we took the benefits the pain when she did the most accounts make much of the fact that shelby's conduct was passive in this case and all she did was become ill but i want to start by highlighting a few of the undisputed facts that support all these agreement to the plan as the court pointed out be accepted over three hundred thousand dollars with a benefit and her father didn't roll her in the plan i also want to point out that at the time she went to the hospitals she represented to the providers the doctors that she was covered by the plan she either did this by giving them the funds contact information or more likely she probably showed them a copy of her insurance card and you know otherwise the doctors would have had no no other way no way to know who the bill so she made the affirmative representation at that time that she was covered by the plan after she she receive treatments she received the o b s showing how much the funded paid and she never called the fund in question her coverage under the plan and then after after she hired her or her counsel for her underlying medical malpractise case documents to include a requirement that an agreement be signed i think that these implications are significant in there especially the failure of the suggestion is highlighted by the current health crisis that our country is in today obviously in order to enforce compliance with this requirement the fund would have to suspend coverage until it's signed agreement is received and this is significant it would lead to a delay treatment for many many people particularly in times of emergency or when it prescriptions are needed a media basis oftentimes participants aren't too concerned with complying with the plan until until they need something from the plan so this would cause a rush to get agreement signed and coverage turned back on   a couple who i think i want to touch on the appellants have cited to a series of cases litigated by the fund in support of their position regarding the coordination of benefits with other important other insurers however these cases entities that insurance benefit sherry's now in these cases the courts through a clear distinction between these other insurers and the funds own beneficiaries who have been put on notice of their reimbursement obligations under the plan the courts also noted that the other insurers had no mutual promise with a find now obviously there were mutual promises in this case the the fund you know shelby expected her medical benefits to be paid out that's why she provided her insurance card or you know the funds information to her provider she anything about comments on reimbursement and was only later copied that was was clear about that and so they're pressing as a backup argument as i understand it that the one million five hundred thousand in the tort settlement you regard as a common fund and they they are entitled to some you know they contributed to that so that needs to be into account can go look at it and actually anyone can go look at it there they're not there you know it's not it's not hidden and anyway and i also would like to point out that the participants can request a hard copy of any plan documents and by statute the fund is required to provide those within a certain time period or the subject to daily fines so there are many ways that these documents are all available to view and were both of those of the you know with the s p d states in this case the plan specifically states that the fund subrogation rights are not in any way subordinate to you or effected by any common fund principle or factor so the plan clearly addresses the issue of the common bond doctrine and it leaves no space for the comm power guardian eventually she gets a version of the plan and says that i think her problem is that there is a version that she's given of the summary plan description that isn't as clear as what you just stated sure sure ye sure sorry i apologize for the the summary plan descriptions at issue in this case anyone that you would look at states that the fund has subrogation right to one hundred percent reimbursement you know that alone warrants that there should be no the idea that somebody is supposed to scour through an entire summary plan description to make sure you didn't put a sentence in the worker's compensation section belong to some other section seems to me it's on you to put it in the right section now maybe it's enough to say one hundred percent reimbursement and understand that that excludes all sorts of things including perhaps the common fund doctrine but i'm not really taken with the idea that you know if you put it under some completely unrelated part of the document people are supposed to realize that that was the wrong place sure we understand that that was an that was an error that that occurred in putting it i can together we did we don't expect people to scour the entire document but i do believe that as our position that the language that says the fund of subrogation rights to one hundred percent reimbursement is enough of this court and merge vs marry at recognize that a plan and a summ plan description one can clarify the other and i think that's exactly what happened in this case the the summary plan description is supposed to contain less legally so it doesn't necessarily have to contain the phrase common fund doctrine but as a district court pointed out the plan and the summary plan description are in accord they say the same thing i mean the same thing on i'm just telling you why you're not just talking sugar corporation against a moron stopping you understand that case to hold that if there's a conflict between the summary plan description and the plan the plan wins and it's all that simple yes i agree iow i absolutely agree and and that case also states that the summ description provides communication about the plan but it doesn't constitute the terms of a plan and that's because the plan is at the center of a recess so i think that i think the analysis does and there i think that we look at the plan that clearly just of out of the common   the other thing i want to point out is that this summer atlanta scription warned that information provided in the summary cited scripture and it's subject to the terms of the plan directing and directing the reader to go look at another document that you know obviously clearly disavows the comments on doctrine and this court is recognize that if stoppel is not available when participants receive such a warning so how is this awful argument must fail and the clear language of the plan to following the common fund action should control in this case because it didn't send the bill it didn't just send one to every entity in the united states so if you really do we don't know from this record whether or you know a family member or someone showed an insurance card or whether information was orally given boy it's pretty standard procedure for medical providers to find out who's going to pay for they do too much  i think we're going to have to leave it there mr yaxley that you have certainly made that point and you're doing your brief so we thank you for your argument we also thank mcmahon and we will take the case under advisement