Dakotas and Western Minnesota Electrical Industry Health & Welfare Fund v. First Agency, Inc., No. 16-1846 (8th Cir. 2017)
Annotate this CaseJacob Plassmeyer incurred medical expenses during a collegiate baseball practice, and his college provided its student athletes insurance with FA. Jacob's father was also insured by the Dakotas, an employee welfare benefit plan, and Jacob was covered under this Employee Retirement Income Security Act (ERISA) plan as a dependent of his father. In this case, the trustees of Dakotas brought this declaratory judgment action against FA under section 502(a)(3) of ERISA, 29 U.S.C. 1132(a)(3), seeking an order enforcing the coordination of benefits (COB) provisions in the Dakotas plan by declaring that FA's policy provided primary coverage of Jacob's claim for medical expenses already incurred. The district court denied FA's motion to dismiss and granted Dakotas' motion for summary judgment. The Eighth Circuit held that a declaratory judgment action to enforce the Dakotas plan as it applied to the claim for benefits was both consistent with the plain language of section 502(a)(3), as construed in light of historical equitable remedies available to trustees; the court agreed with the district court that FA's coverage was primary; but the district court abused its discretion in awarding attorney fees. Accordingly, the court affirmed in part, reversed in part, and remanded.
Court Description: Loken, Author, with Colloton and Kelly, Circuit Judges] Civil case - Insurance. Where the injured party was covered by both his father's ERISA plan medical insurance and by a blanket policy covering accidental injuries issued to his college by defendant First Agency, the ERISA plan could bring an action under Section 502(a)(3) of ERISA seeking an order enforcing the Coordination of Benefits in its ERISA plan and determining that First Agency's policy provides primary coverage for the medical expenses the injury party had already incurred; the ERISA plan's declaratory judgment action is an equitable claim seeking remedies typically available in equity and therefore available under Section 502(a)(3) of ERISA; the district court did not err in determining First Agency's coverage was primary; the district court erred in awarding the ERISA plan attorney fees as First Agency's position that ERISA should not govern this dispute was not obviously wrong and its argument that the ERISA plan was not entitled to declaratory judgment was virtually untested. Judge Colloton, concurring the judgment.
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