Source: http://nc.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180326_0000101.MNC.htm/qx
Timestamp: 2019-04-25 13:54:43+00:00

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FindACase | Lawrence v. Randolph Hospital, Inc.
Lawrence v. Randolph Hospital, Inc.
Presently before this Court is Defendant Randolph Hospital, Inc.'s (“Randolph”) Motion to Dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6). [Doc. #8.] This Court has considered Randolph's Motion and supporting brief [Doc. #9], Plaintiff Stacie Lawrence's Responses [Docs. #10, 11], and Randolph's Reply [Doc. #12], and concludes that Ms. Lawrence's Complaint asserts only state law claims which are preempted by the Employee Retirement Security Act of 1974 (“ERISA”). Accordingly, and for the reasons stated fully below, Randolph's Motion will be granted in part in that Ms. Lawrence's claims are preempted and denied in part in that she will be granted leave to amend her Complaint to assert her claims under ERISA.
A threshold question before analyzing preemption is whether or not the plans in question are governed by ERISA. Randolph argues that the Insurance Plans are governed by ERISA (Def.'s Br. in Supp. of Mot. to Dismiss [Doc. #9] at 2), and Ms. Lawrence does not contest this contention. ERISA governs any “employee welfare benefit plan” established or maintained by an employer or employee organization that is “engaged in commerce or in [an] industry or activity affecting commerce.” 29 U.S.C. § 1003(a). An employee welfare benefit plan is one that “‘through the purchase of insurance or otherwise, ' provide[s] medical, surgical, or hospital care, or benefits in the event of sickness, accident, disability, or death.” Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 44 (1987) (quoting 29 U.S.C. § 1002(1)). Thus, as Randolph is an employer engaged in commerce or an activity affecting commerce and the Plans are welfare benefit plans, the Plans are governed by ERISA.
Congress enacted ERISA to provide a uniform federal regulatory regime over employee benefit plans. Aetna Health Inc. v. Davila, 542 U.S. 200, 208 (2004). To ensure such uniformity, “ERISA includes expansive pre-emption provisions, which are intended to ensure that employee benefit plan regulation would be exclusively a federal concern.” Id. Courts recognize two types of ERISA preemption: complete preemption under § 502(a), 29 U.S.C. § 1132(a), and conflict preemption under § 514, 29 U.S.C. § 1144(a). See, e.g., Sonoco Prod. Co. v. Physicians Health Plan, Inc., 338 F.3d 366, 370-371 (4th Cir. 2003); Darcangelo v. Verizon Commc'n, Inc., 292 F.3d 181, 186-87 (4th Cir. 2002).
Complete preemption is a jurisdictional doctrine that transforms a claim into one arising under federal law “even if pleaded in terms of state law.” Aetna, 542 U.S. at 208; Metro Life Ins. Co. v. Taylor, 481 U.S. 58, 63-64, 65, 67 (1987). To determine whether a claim has such preemptive force, courts analyze whether or not the claim falls within the scope of ERISA's civil enforcement scheme, § 502(a), which provides the exclusive remedies for plans governed by ERISA. Aetna, 542 U.S. at 208-09. “ERISA's civil enforcement section, § 502, gives plan participants and beneficiaries the right to sue to force disclosure of certain information, to recover benefits due under the plan, to clarify the right to future benefits, or to enforce rights under ERISA or the plan.” Darcangelo, 292 F.3d at 192. In interpreting § 502(a), the Fourth Circuit Court of Appeals has outlined a three-prong test for complete preemption: “(1) the plaintiff must have standing under § 502(a) to pursue its claim; (2) the claim must come within the scope of an ERISA provision that can be enforced via § 502(a); and (3) the claim must not be capable of resolution without an interpretation of the contract governed by federal law, i.e., an ERISA-governed employee benefit plan.” Prince v. Sears Holdings Corp., 848 F.3d 173, 177 (4th Cir. 2017) (quoting Sonoco, 338 F.3d at 372).
The United States Supreme Court and the Fourth Circuit have consistently held that common law claims stemming from employee benefit claims are preempted by ERISA. See, e.g., Pilot Life Ins. Co., 481 U.S. 41 (finding state common law breach of contract, fraud, and bad faith claims preempted by ERISA); Powell v. Chesapeake & Potomac Tel. Co., 780 F.2d 419, 422 (4th Cir. 1985) (finding state law claims based on the maladministration of employee benefits preempted by ERISA).
The Fourth Circuit has made clear that when a state law claim is completely preempted under § 502(a) and has been removed to federal court, dismissal of the claim is inappropriate. See Darcangelo, 292 F.3d at 195 (“[W]hen a claim under state law is completely preempted and is removed to federal court because it falls within the scope of § 502, the federal court should not dismiss the claim as preempted, but should treat it as a federal claim under § 502.”). Rather, the court “may choose to grant plaintiff leave to amend her complaint in order to clarify the exact scope of relief requested under § 502(a).” Singh v. Prudential Health Care Plan, Inc., 335 F.3d 278, 292 (4th Cir. 2003).

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