Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_17-cv-01076/USCOURTS-cand-4_17-cv-01076-3/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1132 E.R.I.S.A.: Employee Benefits

---

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

JACQUELINE ADAN,

Plaintiff,

v.

KAISER FOUNDATION HEALTH PLAN, 

INC.,

Defendant.

Case No.17-cv-01076-HSG 

ORDER DENYING PLAINTIFF’S 

MOTION FOR LEAVE TO FILE A 

MOTION FOR RECONSIDERATION

Re: Dkt. No. 40

On March 29, 2018, Plaintiff Jacqueline Adan requested leave to file a motion for 

reconsideration of the Court’s order granting in part and denying in part a motion to dismiss by 

Defendant Kaiser Foundation Health Plan, Inc. Dkt. No. 40. In the March 6, 2018 order, as 

relevant here, the Court dismissed without prejudice Plaintiff’s claims under ERISA, 29 U.S.C. § 

1132(a)(1)(B), because she failed to exhaust her administrative remedies. See Dkt. No. 37 at 15. 

Plaintiff now seeks leave to file a motion for reconsideration because “the Court manifest[ly] 

fail[ed] . . . to consider material facts or dispositive legal arguments which were presented to the 

Court before it entered the order on Kaiser’s motion to dismiss.” See Dkt. No. 40 at 3 (quoting 

Civil L.R. 7-9(b)(3)) (internal quotation marks omitted) (original brackets and ellipses). The 

Court denies Plaintiff’s motion.

A party seeking reconsideration of an interlocutory order must “show reasonable diligence 

in bringing the motion” and—as relevant here—“a manifest failure by the Court to consider 

material facts or dispositive legal arguments which were presented to the Court before” issuance 

of the challenged order. Civil L.R. 7-9(b)(3). “No motion for leave to file a motion for 

reconsideration may repeat any oral or written argument made by the applying party . . . in 

opposition to the interlocutory order which the party now seeks to have reconsidered.” Civil L.R. 
2

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

7-9(c).

Plaintiff’s motion amounts to no more than a repetition and reframing of the arguments she 

made in opposition to Defendant’s motion to dismiss. The Court’s finding that Plaintiff failed to 

exhaust was premised in part on its conclusion that she “never submitted a claim within the 

meaning of the [relevant ERISA] regulation, [29 C.F.R. § 2560.503-1(e)].” See Dkt. No. 37 at 12-

13. Plaintiff now contends that under the terms of Defendant’s health plan, she initiated the claim 

process when she requested treatment from individual doctors—and that because Defendant failed 

to provide written notice when those requests were denied by the doctors, she was not required to 

exhaust Defendant’s administrative process before bringing this ERISA action. See Dkt. No. 40 at 

4-5. But this argument is inapposite. While it may be true that Defendant requires its members to 

first request services from their personal physician, see Dkt. No. 40 at 4, Plaintiff fails to show 

how such a request is a “claim” for purposes of exhaustion within the meaning of Defendant’s 

Evidence of Coverage (“EOC”) or the relevant implementing regulation, 29 C.F.R. § 2560.503-1. 

In other words, even if Plaintiff showed that she began the claims process, she has still failed to 

show that she completed it (or even attempted to complete it) for exhaustion purposes. See Dkt. 

No. 37 at 10-11, 13-15.

Plaintiff’s argument that the Court should have granted leave to amend suffers a similar 

defect. It is premised on the notion that Defendant’s “practice of using physicians to make 

frontline coverage decisions . . . [does] not comply with ERISA’s claims handling procedures 

because Kaiser does not provide written or electronic notice of [the decisions].” See Dkt. No. 40 

at 6. But as stated above, the Court is not persuaded that such “frontline coverage decisions” 

constitute a claim, either under the EOC or the relevant ERISA regulations.

//

//

//

//

//

//
3

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

In short, rather than demonstrate a “manifest failure” on the Court’s part to “consider 

material facts or dispositive legal arguments,” Plaintiff simply takes issue with the Court’s 

characterization of her argument—a characterization which was based on allegations she made. A 

motion for reconsideration is not an appropriate vehicle by which to relitigate arguments made on 

a motion to dismiss.

Accordingly, for the foregoing reasons, Plaintiff’s motion is DENIED.

IT IS SO ORDERED.

Dated:

HAYWOOD S. GILLIAM, JR.

United States District Judge

4/5/2018