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Raab v. United Healthcare Insurance Co.

United States District Court, M.D. Florida, Orlando Division

August 25, 2017

LAURA RAAB; and ANDRE RAAB, Plaintiffs,


          ROY B. DALTON JR., JUDGE

         In the instant motion, Plaintiffs move for remand. (Doc. 18 (“Motion”).) Defendant responded on August 3, 2017. (Doc. 26 (“Response”).) The Court then permitted: (1) Plaintiffs to file a reply (Doc. 32); and Defendant to file a sur-reply (Doc. 34). For the reasons set forth below, the Motion is due to be denied.

         I. Background

         Plaintiffs brought this action seeking medical benefits under a group health insurance policy that Defendant United Healthcare Insurance Company (“UHIC”) issued to Constant Innovation, LLC (“Constant LLC”). Importantly, Plaintiff Andre Raab and his wife, Nancy Raab, are the co-owners of Constant LLC. (Doc. 18-1, ¶ 2.)

         Constant LLC first applied for a group health insurance policy with UHIC on October 6, 2008. (See Doc. 26-3.) On the application form, it specified that three full-time employees would be participating in the plan. (Doc. 26-3, p. 2.) Based on this application, UHIC issued a group health insurance policy-Group No. GA759799BW (“the Policy”)- to Constant LLC with an effective date of January 1, 2009. (Doc. 26-2.)

         Under the original Policy, Andre Raab was enrolled for family coverage with his wife, and two non-owner employees were also enrolled for coverage. (Doc. 26-1, ¶ 5.) Thereafter, in 2010, two additional non-owner employees enrolled for coverage under the Policy. (Id. ¶ 6.) Coverage for all of the individuals under the Policy, other than Andre Raab, terminated on January 1, 2011. (Id. ¶ 7; Doc. 32, ¶ 18.) At that point, the Policy was updated to cover only Andre Raab, Nancy Raab, and their children. (Doc. 26-1, ¶ 7; Doc. 32, ¶ 18.) Indeed, in 2014, the sole participants in the Policy were Andre Raab and Nancy Raab. (Doc. 18-1, ¶ 4.) Their daughter, Plaintiff Laura Raab, was a beneficiary of the Policy. (Id.) The Policy was terminated on January 1, 2015. (Doc. 26-1, ¶ 8.)

         In 2015, Andre Raab submitted a claim under the Policy for Laura Raab's medical expenses during 2014. (Doc. 2, ¶¶ 5-6.) UHIC ultimately denied the claim. (Id. ¶ 14.) Based on this denial, Plaintiffs filed suit in the Circuit Court of the Eighteenth Judicial Circuit in and for Seminole County, Florida, on April 12, 2017, alleging claims for breach of contract and statutory bad faith. (Id. ¶¶ 20-27.) UHIC removed the case to this Court on June 8, 2017, on the ground that Plaintiffs claims were preempted by the Employee Retirement Income Security Act of 1974 (“ERISA”). (Doc. 1, ¶ 7.) Plaintiffs now seek to remand the case, arguing that ERISA is inapplicable to the Policy. (Doc. 18, at p. 6.)

         II. Legal Standards

         “On a motion to remand, the removing party bears the burden of establishing jurisdiction.” Diaz v. Sheppard, 85 F.3d 1502, 1505 (11th Cir. 1996). Any doubts about removal jurisdiction should be construed in favor of remand to state court. Id. Where a case is removed on the basis of federal question jurisdiction, the applicable federal claim must appear on the face of the plaintiff's well-pleaded complaint. Ervast v. Flexible Prod. Co., 346 F.3d 1007, 1012 (11th Cir. 2003). An exception to this rule, however, is the doctrine of complete preemption. Id. “If a federal statute completely preempts a state-law cause of action, a claim which comes within the scope of that cause of action, even if pleaded in terms of state law, is in reality based on federal law.” May v. Lakeland Reg'l Med. Ctr., No. 8:09-cv-406-T-33AEP, 2010 U.S. Dist. LEXIS 5866, *6 (M.D. Fla. Jan. 5, 2010) (citing Aetna Health Inc. v. Davila, 542 U.S. 200, 207-08 (2004)). So “‘when a federal statute wholly displaces the state-law cause of action through complete pre-emption, the state claim can be removed.'” Id. (citing Aetna Health Inc., 542 U.S. at 207). ERISA completely preempts state law claims involving rights to recover benefits under employee benefit plans. Ervast, 346 F.3d 1007, 1014 (11th Cir. 2003).

         III. Analysis

         A. Post-Removal Evidence

         As a preliminary matter, the Court finds that it is proper to consider post-removal evidence relied on by UHIC in its Response-inclusive of information regarding the Policy as it stood when it was initially issued in 2009. In their reply, Plaintiffs argue that UHIC should be constrained to the allegations in its Notice of Removal. (Doc. 32, ¶¶ 7- 10.) But the Eleventh Circuit has “adopt[ed] a more flexible approach, allowing the district court when necessary to consider post-removal evidence in assessing removal jurisdiction.” Sierminski v. Transouth Fin. Corp., 216 F.3d 945, 949 (11th Cir. 2000). “While it is undoubtedly best to include all relevant evidence in the petition for removal and motion to remand, there is no good reason to keep a district court from eliciting or reviewing evidence outside the removal petition.” Id. Still, “under any manner of proof, the jurisdictional facts that support removal must be judged at the time of the removal, and any post-petition affidavits are allowable only if relevant to that period of time.” Id. (quoting Allen v. R&H Oil Co., 63 F.3d 1326, 1335 (5th Cir. 1995)). Moreover, UHIC's post-removal evidence “does not state completely new grounds or allegations for removal, but rather provides specific support for the grounds for removal that already were stated in its Notice of Removal.” May, 2010 U.S. Dist. LEXIS 5866, *7-8 (finding it proper to consider post-removal evidence with respect to complete preemption under ERISA). Accordingly, the Court will consider UHIC's post-removal evidence relevant to assessing the existence of jurisdiction at the time of the removal.

         B. Safe Harbor Provision

         In determining whether an employee benefit plan is governed by ERISA, the court must examine whether it falls within the regulatory “safe harbor” provision. Miller v. Colonial Life & Acc. Ins. Co., No. 6:13-CV-825-ORL-36KRS, 2013 WL 4855056, at *4 (M.D. Fla. Sept. 11, 2013). Pursuant to 29 C.F.R. ยง ...

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