Court Opinion

ID: 9484588
Source: CourtListenerOpinion
Date Created: 2023-08-05 09:57:52.070905+00
Date Added: 2024-06-11T17:50:19.723681
License: Public Domain

EBEL, J.,
concurring.
I concur. But I would admonish the Office of Personnel Management (“OPM”) that the need to resolve difficult issues of interpretation of a Plan could be avoided if OPM would require health insurers to make their plan language clear. The way the clause at issue in this case was written is counterintuitive to how a Plan participant would understand his health insurance to work. OPM and the insurer are doing federal employees and other Plan beneficiaries a disservice, the insurer by drafting the terms of the Plan using such ambiguous language and OPM by permitting it. Nevertheless, in this case, I cannot fault OPM for choosing one of several reasonable interpretations of the language at issue here. Nor can I fault the panel for deferring to OPM’s interpretation. Thus, I concur.