to convince this court that the Seventh Circuit’s holding Jass allows Holy Cross to sue plan

insurers Alta and Unicare.

Conclusion
For the foregoing reasons, the defendants’ motion to dismiss counts I and II of Holy

Cross’ amended complaint as to Alta and Unicare is GRANTED.

y

Enter:
aud.
David H. Coar
United States District Judge
Dated: August 6, 2002


Disability Plan for Salaried Employees, et al., No. 01 C 5863, slip. op. (N.D. Ill. Oct. 3, 2001);

see e.g., Anderson v. Illinois Bell Telephone Co., 961 F. Supp. 1208 (N.D. Ill. 1997) (dismissing

Section 1132(a)(1)(B) claim against employer holding that plaintiff/beneficiary is required to sue
the plan); Fortmann v. Avon Products, Inc., 1999 WL 160258, *4 (N.D. III.1999) (finding that
since the employer and the plan are not the same entity, plaintiff/beneficiary only may bring suit
against the plan under Section 1132(a)(1)(B) claim); Frank v. Ameritech Corp., 1999 WL

1011107, *3 (N.D. Ill. Oct. 12, 1999); Witowski v. Tetra Tech, Inc., 38 F.Supp.2d 640, 644

(N.D.II. 1998); Wyluda v. Fleet Financial Group, 2000 WL 1264617, *2 (E.D. Wis.).

In count I of its amended complaint, Holy Cross seeks to obtain benefits under Section
502 from plan insurers Alta and Unicare, not the plan itself and therefore count I must be
dismissed as to the defendants. Holy Cross argues that both the Seventh Circuit and the Supreme
Court have construed Section 502 to allow claims against insurers like Unicare and Alta for
benefits allegedly withheld under ERISA plans.

In support of its position, Holy Cross points this court to the Supreme Court’s decision in

Metrolitan Life Ins. Co. v. Taylor, 481 U.S. 58 (1987) as well as the Seventh Circuit’s holdings

in Brundage-Peterson v, Compcare Health Servs. Ins, Corp., 877 F.2d 509 (7" Cir. 1989), and

Kennedy v. Connecticut Gen. Life. Ins, Co., 924 F.2d 698 (7" Cir. 1991). These cases, however,

do not undermine the Seventh Circuit’s subsequent holding in Jass. None of these cases directly
examine the issue of whether an insurer (or any entity other than the plan) was a proper defendant
to a claim under Section 502(a) of ERISA. For example, the court in Kennedy addressed the
issue of who can sue for ERISA benefits, not the question of what entity is the proper defendant

in such an action. Consequently, the plaintiff has not provided sufficient argument or precedent


& — Minute Order Form (06/97)

United States District Court, Northern District of Illinois

Nan i i Sitting Judge if Other
verge Magistrate Judge David H. Coar han Assigned Judge
CASE NUMBER 01 C 1505 DATE 8/6/2002

CASE

TITLE Holy Cross Hospital v. Bankers Life and Casualty Company and HealthStar, Inc., et al

[In the following box (a) indicate the party filing the motion, e.g., plaintiff, defendant, 3rd party plaintiff, and (b) state briefly the nature
of the motion being presented. ]

MOTION:

DOCKET ENTRY:

(3) Oo Filed motion of [ use listing in “Motion” box above.]

(2) Qo Brief in support of motion due

(3) Oo Answer brief to motion due. . Reply to answer brief due.

(4) Oo Ruling/Hearingon___setfor___——_—at

(5) im) Status hearing[held/continued to] [set for/re-set for]on__——ssetfor_—sat_— tt.

(6) a Pretrial conference[held/continued to] [set for/re-set for]on____setfor, = at_

(Cp) Bb Trial[set for/re-set for]on_____at

(8) Oo {Bench/Jury trial] [Hearing] held/continued to__—_at

(9) oO This case is dismissed [with/without] prejudice and without costs[by/agreement/pursuant to]
OOFRCP4(m) OGeneralRule 21 CIFRCP41(a)(1) OOFRCP41(a)(2).

et) _| (Other docket entry] For the reasons stated in the attached Memorandum Opinion and Order,

defendants’, Unicare Life and Health Life Insurance Company and Alta Health and Life Insurance Company,
motions to dismiss plaintiff’s, Holy Cross Hospital, amended comp granted. [Doc. #s 76, 78].

(11) [For further detail see order attached to the original minute order.]

Document
Number

No notices required, advised in open court.

4 No notices required.
Notices mailed by judge’s staff.

Notified counsel by telephone.

Docketing to mail notices.

Mail AO 450 form.

LUNA LoD tsi a7)

Copy to judge/magistrate judge.

courtroom
vg(le) deputy’s
initials



IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION
Holy Cross Hospital, )
)
Plaintiff, y
) No. 01 C 1505
v. )
) HONORABLE DAVID H. COAR
Bankers Life and Casualty Company and )
HealthStar, Inc., et al )
) )
Defendants. ) 4

AUG 9-7 5
MEMORANDUM OPINION AND ORDER UG 0% 2n02

Before this court is defendants’, Unicare Life and Health Life Insurance Company
(“Unicare”) and Alta Health and Life Insurance Company (“Alta”) (collectively “defendants”),
motions to dismiss plaintiff's, Holy Cross Hospital (“Holy Cross”), amended complaint against
them.' For the following reasons, the defendants’ motion is granted.

Background

Holy Cross filed its three-count amended complaint on December 28, 2001, only counts I
and II state claims against defendants. Count I of Holy Cross’ amended complaint alleges claims
under the civil enforcement provisions of the Employee Retirement Income Security Act of 1974,
as amended (“ERISA”), 29 U.S.C. § 1132 against Unicare, Alta for taking improper discounts on
bills rendered to their insureds in purported reliance upon a contract between Holy Cross and

defendant HealthStar, Inc. (“HealthStar”). Count II of Holy Cross’ Amended Complaint alleges a

' Unicare and Alta, represented by the same firm, have filed two separate but essentially
similar motions and briefs. Consequently, this court will address both motions in this
Memorandum Opinion and Order.

)20


state law claim against defendants for discounts taken on bills rendered to insureds who did not
obtain their health coverage through ERISA plans.

In both Counts, Holy Cross alleges that it is the assignee of its patents’ health insurance
benefits.

Unicare and Alta have moved to dismiss Holy Cross’ claims.

Discussion

The defendants argue that they are not proper in an action to obtain benefits under Section
502 of ERISA. They also argue that no supplemental jurisdiction exists for Holy Cross’ state law
claims if they are not proper defendants to an ERISA claim. This court agrees.

Under Section 1132(a)(1)(B) a participant in an employee welfare benefit plan covered by
ERISA may bring a civil action “to recover benefits due to him under the terms of his plan, to
enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the
terms of the plan.” In this circuit, it is well-established that actions to recover ERISA plan
benefits may only be brought against the employee welfare benefit plan itself. See Garrat v.

Knowles, 245 F.3d 941, 949 (7" Cir. 2001); Jass v. Prudential Healthcare Plan, Inc., 88 F.3d

1482, 1490 (7" Cir. 1996) (rejecting a denial of benefits claim brought against individual
defendant and ruling “the appropriate defendant for denial of benefits claim would be the plan.”);

see also Riordan v. Commonwealth Edison Co., 128 F.3d 549, 551 (7" Cir. 1997). Further,

several courts in the Northern District, including this court, have followed the Seventh Circuit’s
decision in Jass to hold that the only proper defendant to a plan beneficiary’s claim for ERISA

plan benefits is the plan itself. See Mathisen v. Sundance Homes, Inc. and Great West Life &

Annuity Ins. Co., No. 97 C 1305, slip. op. (N.D. Ill. Sept. 27, 2000); Carguti v. The Long Term