Document: 524 U.S. 74118 S.Ct. 1869141 L.Ed.2d 64 Bonnie L. GEISSAL, beneficiary and representative of the estate James W. Geissal, deceased, Petitioner,v.MOORE MEDICAL CORPORATION et al. No. 97-689. Supreme Court United States Argued April 29, 1998. Decided June 8, Syllabus * The Consolidated Omnibus Budget Reconciliation Act 1985 (COBRA) amended Employee Retirement Income Security 1974 (ERISA) to permit a an employer's group health plan elect continuing coverage when he might otherwise lose that benefit because "qualifying event,'' such as termination employment. When respondent Moore Medical Corporation fired it told him COBRA gave right under Moore's plan. He so elected, but six months later, was not entitled benefits on his date election already covered by through wife's employer, Trans World Airlines (TWA). Geissal filed suit against respondents (collectively, Moore), claiming, inter alia, violating renouncing obligation provide coverage. died while this pending, wife replaced plaintiff. Magistrate granted partial summary judgment Moore, concluding employee with another elects is ineligible for 29 U.S.C. §1162(2)(D)(i), which allows employer cancel " [t]he qualified first becomes, after . any other plan.'' Eighth Circuit affirmed. Held: An may deny continuation its eligible at time Pp. ____-____. (a) Section 1162(2)(D)(i) speaks in terms "becom[ing] covered,'' event significant only if "first'' occurs "after election.'' Because TWA before elected coverage, did "first become'' election, could cut off §1162(2)(D)(i)'s plain meaning. contrary reading-that, pre-existing plan, moment day following being election-ignores condition must becom[e]'' robbing modifier consequence, thereby equating becomes covered'' "remains covered.'' (b) argues reading should be rejected would claim even has obtained entirely new between qualifying election. statute, however, cast expressly preserving status quo beneficiary's care event. In addition, there no reason assume receives windfall result ability Since pay whatever obtains, think will make does need. Even whenever "significant gap'' offered This approach §1162(2)(D)(i) plagued difficulties, beginning sheer absence statutory support it. Furthermore, requires courts policy judgments about adequacy provided sort inquiry far unsuitable expect clear mandate inferring Congress meant foist judiciary. 114 F.3d 1458, vacated remanded. SOUTER, J., delivered opinion unanimous Court. S. Sheldon Weinhaus, St. Louis, MO, petitioner. A. Feldman, amicus curiae special leave Bradley J. Washington, respondents. Justice SOUTER 1 (ERISA), (COBRA), authorizes obtain continued certain reasons, issue case whether who makes We hold not. 2 On July 16, 1993, suffering from cancer. While employed, well (TWA), Aetna Life Insurance Company. 3 According soon lost job, had continue made necessary premium payments months. January 27, 1994, informed been mistaken: actually employer. 4 then brought Group Benefit Plan Group, Herbert Walker (an administrator plan), Sedgwick Lowndes (another administrator) Moore).1 charged (Count I); further claimed estopped misled II), misrepresentation amounted waiver assert provisions deprive III), and, finally, violated failing documents IV). 5 After limited discovery, moved Counts I II complaint. argued reliance upon authority misplaced. Although subsection provides (as or otherwise),'' after. event, maintained, benefits, detrimentally relied assurances them. motion cancer, petitioner personal estate, 6 Judge hearing case2 arguments lacked standing party Federal Rule Civil Procedure 19(a). concluded correct compensatory damages paid all medical bills, seek §1132(a)(1).3 held suit, since complete relief without joining Aetna, verdict Geissal's favor subject risk inconsistent double obligations, Aetna's joinder determine primacy two plans. 7 denied instead sua sponte presented insufficient evidence detrimental representation COBRA. also found difference Moore's; they differed amount their respective deductibles, excluded condition. 8 unopposed 54(b) entry final II, enabled immediate review Magistrate's decision. Appeals affirmed, 1458 (1997), we certiorari, 522 ----, 118 877, 139 865 (1998), resolve conflict among Circuits COBRA.4 9 1985, Pub.L. 99-272, 100 Stat. 82, 222-237, Act, statutes. amendments ERISA require employer5 sponsors give plan's "qualified beneficiaries'' opportunity "continuation coverage'' beneficiaries occurrence events,'' including death employee, employee's employment (except cases gross misconduct), divorce legal separation employee. §1163. Thus, beneficiary'' "covered employee,'' (someone own employment), spouse dependent child prior event.'' §1167(3). 10 demands identical what have suffered §1162(1). statute plans advise rights both commencement within 14 days learning event,6 §1166(a), 60 §1165(1). If dates reduced hours, maximum period generally 18 months; cases, 36. §1162(2)(A). gets, up 102 percent "applicable premium'' 150 thereafter. §1162(3). usually cost providing regardless pays insurance benefit. §1164. Benefits cease fails premiums, §1162(2)(C), terminate discontinuance entirely, §1162(2)(B). 11 election- 12 (i) otherwise), contain exclusion limitation respect preexisting beneficiary, 13 (ii) title XVIII Social Act.'' §1162(2)(D).7 B like magistrate, believes defeats receive As reads relevant obtains coverage; instead, submits, matters whether, claims, became primary. 15 reading, square text. Subsection excused "is'' "remains'' Nothing says anything hierarchy suggests matter So concerned, crucial speak "coverage'' exist continue; occurs, It undisputed continuously TWA's thus meaning §1162(2)(D)(i). 16 argues, contrary, reasonable sense election,'' can said persist date: See National Cos. Health v. Joseph's Hosp., Inc., 929 F.2d 1558, 1570 (C.A.11 1991) (" [I]t immaterial acquires question when, date, take effect. than date''). But ignores transforms novelty becoming into continuity remaining over time. 17 further, our more faithful language, something preserve event.8 points out phrase after'' apply predating quite free election; case, circumstances That confine strictly guardianship is, course, perfectly true, though much less fact count (even assuming obvious vulnerable objection, see Ardestani INS, 502 129, 135, 112 515, 519-520, 116 496 (1991)). neither quo, nor except reference Nor decision advantage previously effect carry indicia presumably disapproved. need, place one 19 Still, true during interim gets say, (having condition), COBRA, whereas job come date. Do classify anomaly merely consequence need draw line somewhere? For sake argument call anomaly, balance position, defies normal language usage expectations common sense: retroactive ineffective bring roughly (or 36) month nonetheless surprising weeks, days, One wonders why wanted create strange scheme. produces Moore's. 20 all, anomalous consequences position are exhausted look interpretative morass led practice. To thesis individuals situated statement House Reports original bill, Committee [on Ways Means] concerned reports growing number Americans decreasing willingness Nation's hospitals those cannot afford pay.'' H.R.Rep. 99-241, pt. 1, p. 44 (1985); U.S.Code Cong. & Admin.News 1986, pp.42, 622. F.3d, 1463 (quoting Report). Of concern (expressed committee report) were thought legitimate limit enacted, "any insurance'' "any'' court rejecting gone far. Instead, draconian alternative averted nontextual compromise. 21 compromise apparently alludes proviso applies authorize "does beneficiary.'' urges us hold, some Courts done, although intended still eligibility plan.9 1464-1465; accord, F.2d, 1571; Brock Primedica, 904 295, 297 (C.A.5 1990). gap, explained, truly "covered'' 1463; supra, 1571. 22 mention do person's inadequate inferior; later-acquired limits excludes beneficiary. "gap'' coverages policies, specific different non-COBRA gap legislating about. 23 leaving textual inadequacy aside, trouble approach. Needless written) arguably apply, applicability easy determine. Once identified, later peculiar either found, left undisturbed; obtaining automatic. Applying rule, hand, very kind determination, essentially social policy. policy, essence regimes "significant'' enough. powerful point interpretation reasons. First, required judiciary.10 What strange, inject arena, evaluating happened same intending judicial intrusion, unmediated become effective just credibly attribute oddity congressional intent. 24 sum, justification disparaging clarity vacated, remanded proceedings consistent opinion. 25 ordered. syllabus constitutes part prepared Reporter Decisions convenience reader. Detroit Timber Lumber Co., 200 321, 337, 26 282, 287, 50 L.Ed. 499. November District plaintiff's dismiss prejudice. Pursuant 28 §636(c), parties agreed magistrate judge conduct case. §1132(c), comply request information 30 personally liable $100 failure. Before us, lacks maintain suit. They apparent policies $350 exceeded premiums owe successful. Despite assertions nothing record indicates way fully reimbursed bills. counsel represented oral minimum unpaid bills incurred trip Greek Islands. Quite apart this, tell recover sometime costs paid. Compare Lutheran Inc. Business Men's Assurance 51 1308 (C.A.7 1995) former Oakley City Longmont, 890 1128 (C.A.10 1989) (same), cert. denied, 494 1082, 110 1814, 108 944 (1990), 1558 suspend 295 1990) (same). Employers fewer employees exempt COBRA's requirements. §1161(b). Under §1166(a)(2), duty report most events, employment, originally plan,'' separate provision, §1162(E), individual "the remarries 228. struck §1162(E) otherwise).'' Tax Reform 99-514, 2938-2939. again 1989, added qualification, "which 101-239, 103 2297, 2432. Portability Accountability 1996, 104-191, Stat.2087-2088, yet inserting ", or'': (other satisfied by) chapter Internal Revenue Code subtitle 1974, XXVII Act).'' 1996 amendment arose. render COBRA-eligible typically high-risk. result, contends, covering them tends increase overall cause employers offering entirely. true. substantiated, considered construing scope vague provision; vague. lower disagreed actual expenses incurs cancellation, comparing policies' light available 1464-1465 (comparing approaches). unlikelihood, indeed, appears overwhelming considers comparison Medicare, treated present purposes, §1162(2)(D)(ii).

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