Document: 481 U.S. 41 107 S.Ct. 1549 95 L.Ed.2d 39 PILOT LIFE INSURANCE COMPANY, Petitionerv.Everate W. DEDEAUX. No. 85-1043. Argued Jan. 21, 1987. Decided April 6, Syllabus The "pre-emption clause" (§ 514(a)) of the Employee Retirement Income Security Act 1974 (ERISA) provides that ERISA supersedes all state laws insofar as they "relate to any employee benefit plan," but ERISA's "saving 514(b)(2)(A)) excepts from pre-emption clause law "regulates insurance." "deemer 514(b)(2)(B)) no plan shall be deemed an insurance company for purposes "purporting regulate On basis a work-related injury occurring in Mississippi 1975, respondent began receiving permanent disability benefits under his employer's ERISA-regulated welfare plan, which claims were handled by petitioner, insurer. However, after two years petitioner terminated respondent's benefits, and during following three reinstated several times. Respondent ultimately instituted diversity action against Federal District Court, alleging tort breach contract common petitioner's failure pay policy. court granted summary judgment finding pre-empted ERISA. Court Appeals reversed. Held: pre-empts suit alleged improper processing claim plan. Pp. 44-57. (a) causes asserted complaint, each based on to" therefore fall clause. Cf. Metropolitan Life Ins. Co. v. Massachusetts, 471 724, 739, 105 2380, 2389, 85 728; Shaw Delta Air Lines, Inc., 463 85, 96-100, 103 2890, 2899-3001, 77 490 (1983). is not limited specifically designed affect plans. 47-48. (b) Under guidelines set forth Life, decisional particularly cause, presently asserted, bad faith—do saving clause, thus are excepted pre-emption. A common-sense understanding language excepting insurance" does support argument faith falls To "regulate" insurance, must just have impact industry, directed toward industry. Supreme decisions establish its applies contract, merely contract. Neither do factors interpreting phrase "business McCarran-Ferguson (which appropriate consideration here) assertion 48-51. (c) Moreover, interpretation informed legislative intent concerning civil enforcement provisions. structure those provisions conclusion intended provide exclusive remedies ERISA-plan participants beneficiaries asserting claims. detailed comprehensive scheme represents careful balancing need prompt fair settlement procedures public interest encouraging formation policy choices reflected inclusion certain exclusion others federal would completely undermined if free obtain Congress rejected also confirmed history provisions, demonstrating pre-emptive force was modeled powerful § 301 Labor Management Relations Act, 1947. 51-56. 770 F.2d 1311, O'CONNOR, J., delivered opinion unanimous Court. John E. Nolan, Jr., Washington, D.C., petitioner. William C. Walker, respondent. Justice O'CONNOR 1 This case presents question whether (ERISA), 88 Stat. 829, amended, 29 U.S.C. 1001 et seq., actions insured 2 * In March Gulfport, Mississippi, Everate Dedeaux injured back accident related employment Entex, Inc. (Entex). Entex had at this time long term established purchasing group Pilot Insurance (Pilot Life). collected matched employees' contributions forwarded funds Life; employer provided forms employees claims, completed Life. bore responsibility determining who receive benefits. Although sought 1975 accident, years. During Dedeaux's 3 1980, United States Southern Mississippi. complaint contained counts: "Tortious Breach Contract"; "Breach Fiduciary Duties"; "Fraud Inducement." App. 18-23. "[d]amages sum determined trial," "[g]eneral damages mental emotional distress other incidental $250,000.00," "[p]unitive exemplary $500,000.00." Id., 23-24. did assert available him ERISA, see infra, ----. 4 At close discovery, moved judgment, arguing pre-empted. Pet. Cert. 16a. 5 Fifth Circuit reversed, primarily Court's decision 728 (1985). See 1311 We certiorari, 478 1004, 106 3293, 92 708 (1986), now reverse. II out 6 "protect . plans their beneficiaries, requiring disclosure reporting financial information with respect thereto, establishing standards conduct, responsibility, obligation fiduciaries plans, providing remedies, sanctions, ready access courts." 2, 1001(b). 7 comprehensively regulates, among things, that, "through purchase or otherwise," medical, surgical, hospital care, event sickness, disability, death. 3(1), 1002(1). 8 capped off massive undertaking relating effect legislation: 9 "Except subsection section [the clause], subchapter III chapter supersede State may hereafter relate ." 514(a), 1144(a) (pre-emption clause). 10 subparagraph (B) deemer nothing construed exempt relieve person regulates banking, securities." 514(b)(2)(A), 1144(b)(2)(A) (saving 11 "Neither nor trust such insurer, bank, company, investment engaged business banking purporting companies, contracts, banks, companies." 514(b)(2)(B), 1144(b)(2)(B) (deemer 12 summarize pure mechanics quoted above: If "relate[s] plan[s]," it 514(a). "regulat[e] 514(b)(2)(A). makes clear "purport[s] cannot deem company. 514(b)(2)(B). 13 "[T]he one congressional intent. ' "The purpose ultimate touchstone." " Allis-Chalmers Corp. Lueck, 202, 208, 1904, 1909, 206 (1985), quoting Malone White Motor Corp., 435 497, 504, 98 1185, 1189, 55 443 (1978), Retail Clerks Schermerhorn, 375 96, 103, 84 219, 222, 179 (1963). observed past express preemption deliberately expansive, "establish pension regulation exclusively concern." Alessi Raybestos-Manhattan, 451 523, 101 1895, 1906, 68 402 (1981). As we explained 98, 2900, (1983): 14 bill became originally applicable only specific subjects covered Conference Committee favor present language, indicated section's scope broad language. H.R.Conf.Rep. 93-1280, p. 383 (1974); S.Conf.Rep. 93-1090, (1974)." 15 House Senate sponsors emphasized both breadth importance Representative Dent described "reservation authority [of] sole power field plans" "crowning achievement." 120 Cong.Rec. 29197 (1974). Senator Williams said: 16 "It should stressed narrow exceptions specified bill, substantive conference substitute preempt regulations, eliminating threat conflicting inconsistent local principle apply broadest sense governments, instrumentality thereof, law." 29933. 17 supra, 99-100, n. 20, S.Ct., 2901, 20 (describing remarks Sen. Javits). 18 noting clauses "perhaps model drafting," U.S., interpreted these relation Massachusetts statute required minimum health care residents general policies. appellants argued statute, applied policies purchased regulated 19 concluded, first, placing within sweep 2389. held because "regulate[d] insurance," prevented being guided 59 33, 1011 seq. Given "statutory complexity" 740, well wide variety statutory arguably affected surprising again called interpret 21 There dispute 2899-2901, noted expansive cases "[t]he 'relate to' given meaning, 'relate[s] 'in normal phrase, has connection reference plan.' 97, 2900. particular "state plans." raised undoubtedly meet criteria 22 Unless exception therefore, expressly pleaded action, before counts—called "tortious contract" "the faith" brief—as protected faith, argues, "which saved 514(b)(2)(A).1 23 considerations First, took what guidance "common-sense view" itself. Second, made use clause.2 Three been used determine practice Act: 24 "[F]irst, transferring spreading policyholder's risk; second, integral part relationship between insurer insured; third, entities industry." Union Pireno, 458 119, 129, 102 3002, 3009, 73 647 (1982) (emphasis original). 25 case, weighed argue 26 early 1915 recognized punitive when act omission constituting amounts commission tort." Hood Moffett, 109 Miss. 757, 767, 69 So. 664, 666 (1915) (involving physician's attend woman her approaching "accouchement"). American Railway Express Bailey, 142 622, 631, 761, 763 (1926), involving finance deliver plaintiff correct amount money cabled through company's offices, could "attended some intentional wrong, insult, abuse, gross negligence, independent Standard Veal, 354 So.2d 239 (1977), citing D.L. Fair Lumber Weems, 196 201, (1944) (breach accompanied breaking down destruction another's fence"), upheld award defendant credit life Since considered large number plaintiffs companies great many identical formulation, first stated "attend" order recoverable. See, e.g., Employers Mutual Casualty Tompkins, 897, 902 (1986); Farm Fire & Simpson, 477 242, 248 (1985); Consolidated Toche, 410 1303, 1304 (1982); Gulf Guaranty Kelley, 389 920, 922 (1980); Automobile Roberts, 379 321, 322 New Hampshire Smith, 357 121 (1978); Lincoln National Crews, 341 1321, 1322 (1977). Recently "[w]e come carrier refuses there reasonably arguable deny acting 'bad faith,' lawsuit upon arbitrary refusal faith' cause action." Blue Cross Shield Campbell, 466 833, 842 (1984). 27 Certainly view word "regulates" lead Even though identified roots firmly planted principles law. Any liability 28 Unlike mandated-benefits issue policyholder risk. said concern insured." insurer-insured attenuated best, however. contrast define terms declares whatever agreed circumstances allow damages. more "integral" than State's State. Finally, noted, Mississippi's even associated developed case. Hart Orion Co., 453 1358 (CA10 1971) (general arbitration statutes Act); Hamilton Republic 408 606 (CA2 1969) (same). Accordingly, most meets identify moreover, obliged consider role whole. numerous occasions '[i]n expounding single sentence member sentence, look whole law, object policy.' Kelly Robinson, 479 36, 43, 353, 358, 93 216 Offshore Logistics, Tallentire, 207, 221, 2485, 2493, 91 174 (1986) (quoting Mastro Plastics NLRB, 350 270, 285, 76 349, 359, 100 L.Ed. 309 (1956) (in turn Heirs Boisdore, How. 113, 122, 1009 (1849))). Because seeks our 502(a), 1132(a). 30 Solicitor General, amicus curiae, argues clearly expressed 502(a) vehicle varying pose obstacle objectives Congress. Brief Amicus Curiae 18-19. agree. supported, declared remedy 1947 (LMRA), 61 156, 185. 31 essential tools accomplishing ERISA.3 sandwiched relevant Section 501, 1131, authorizes criminal penalties violations 503, 1133, requires every comply Department regulations giving notice participant beneficiary whose denied, affording reasonable opportunity review denying claim. sue recover due enforce participant's rights clarify future Relief take form accrued due, declaratory entitlement injunction administrator's bring fiduciary duty, seek removal fiduciary. §§ 502(a)(2), 409. discretion attorney's fees either party. 502(g). Russell, 473 134, 147, 3085, 3092-3093, 87 96 concluded duty provision, 409(a), 1109(a), beneficiary. declined find implied section, '[t]he presumption omitted strongest enacted including integrated system enforcement.' 3093, Northwest Airlines, Transport Workers, 77, 1571, 1583, 67 750 Our examination us "reluctant tamper crafted evident ERISA." 3093. 32 sum, six carefully found finally strong evidence intend authorize simply forgot incorporate expressly." 146, 3092 33 deliberate drafted embodied choice strongly exclusive. fully provision. demonstrates LMRA. 34 Report describing says: 35 "Under agreement, brought relief responsibility. [W]ith suits involve application title I district courts competent jurisdiction. All regarded arising similar fashion Labor-Management 1947." 327 (1974), U.S.Code Cong. Admin.News 1974, pp. 4639, 5107 added). 36 aware LMRA displaced violation contracts labor organization, purported unavailable "state-law [whose resolution] substantially dependent analysis agreement parties contract." 220, 1916. Allis-Chalmers, analyzed Teamsters Lucas Flour 369 95, 82 571, 593 (1962). dimensions require paramount area statute." 576. "[I]n enacting doctrines uniformly prevail over rules." 104, 577. Indeed, jurisdiction, singled having "pre-emptive so displace entirely 'for organization.' purely creature Franchise Tax Board Cal. Construction Laborers Vacation Trust Cal., 1, 23, 2841, 2853, 420 (1983), referring Avco Machinists, 390 557, 1235, 126 (1968). 37 Congress' describe intention treated questions governed 502(a). H.R.Rep. 93-533, (1973), reprinted Public Welfare, Legislative History 94th Cong., 2d Sess., 2359 (Comm. Print 1976) ("The uniformity foster will help administrators, predict legality proposed without necessity laws"); 29933 (1974) (remarks Williams) (suits "will States, Act"); id., 29942 Javits) ("[i]t body deal issues obligations private plans"). expectations develop, indeed, entire comparison LMRA, make little supplemented supplanted laws. 38 746, 2393, 1144(b)(2)(A), "only unrelated ERISA," "[n]othing structure, Act" supported reading however, conflicted provision Therefore observation—that clause—was focused conflict particular, occasion case: might express, action. resolution different earlier observations Considering defining and, importantly, expression exclusive, conclude 514(a).4 40 Reversed. Decisional covers "any State." For 514, 'State law' includes laws, decisions, rules, 1144(c)(1) (2). provides, part: therein, subject taxation business." 1012(a). 1132(a), provides: "A brought— "(1) beneficiary— "(A) [concerning requests administrator information], "(B) plan; "(2) Secretary, participant, 1109 [breach duty]; "(3) beneficiary, (A) enjoin violates equitable (i) redress (ii) "(4) 1025(c) [information furnished participants]; "(5) except otherwise subsection, Secretary subchapter, subchapter; "(6) collect penalty section." rescued reach place plan's trustees direct

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