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Semerena v. District Board of Trustees of Miami Dade College

Florida Court of Appeals, Third District

October 23, 2019

Wade K. SEMERENA, individually and on behalf of a class of all others similarly situated, Appellants,
v.
The DISTRICT BOARD OF TRUSTEES OF MIAMI DADE COLLEGE, et al., Appellees.

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[Copyrighted Material Omitted]

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          An Appeal from the Circuit Court for Miami-Dade County, Abby Cynamon, Judge. Lower Tribunal No. 17-24717

         Lyons & Farrar, P.A., and Douglas S. Lyons, Marsha L. Lyons, and Aaron Brock (Tallahassee); Barbara C. McCauley, for appellants.

         Rumberger, Kirk & Caldwell, P.A., and Joshua D. Lerner, for appellee District Board of Trustees of Miami Dade College.

         Before FERNANDEZ, HENDON, and MILLER, JJ.

         OPINION

         HENDON, J.

          Wade K. Semerena ("Semerena") seeks to reverse the trial court’s order dismissing his first amended complaint with prejudice as to Miami Dade College and the District Board of Trustees of Miami Dade College (collectively, "MDC"). We affirm.

         In 2003, when Semerena retired from MDC after thirty-four years of employment as a philosophy professor, he enrolled in Medicare Part B and elected to continue his health insurance coverage under MDC’s group plan, as a "supplemental"[1] insurance policy to Medicare. The monthly premiums for any insurance Semerena chose would be deducted from his Florida Retirement System ("FRS") pension. The record indicates that Semerena made several choices from the menu of retirement benefits, and he opted to continue group health insurance with United HealthCare, as a supplemental policy to Medicare.[2] Because the group insurance option was offered through MDC as a result of his many years of state employment, Semerena could take advantage of the $150 subsidy provided by the FRS that would be applied towards any monthly insurance premium and deducted from his monthly pension income. In 2008, Aetna took over as the insurance provider for the health care insurance Semerena chose.[3] Semerena’s coverage would continue unless he chose to opt out and lose the FRS subsidy. Semerena alleges that in 2014 he discovered that the Aetna policy was a more expensive secondary health insurance plan for which he had been paying higher premiums since 2008.

         Semerena filed a putative class action complaint against MDC and Aetna. The order on appeal here dismissed the complaint with prejudice as to MDC.[4] In this

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appeal, Semerena alleges: 1) MDC, as Semerena’s agent, negligently failed to enroll him and others similarly situated in a group health insurance plan appropriate for retirees enrolled in Medicare; 2) MDC breached its fiduciary duty to Semerena by failing to ensure that the money taken out of his pension to pay the insurance premium was not grossly expensive; 3) MDC was unjustly enriched by its actions by having Semerena pay full price for a secondary health insurance policy, thereby lowering MDC’s risk pool; 4) MDC behaved unconscionably by binding Semerena to a non-negotiable insurance policy and by charging him and other retired Medicare recipients excessive premiums; 5) MDC negligently misrepresented the insurance options available to Semerena and induced him to choose the more expensive group health insurance to his detriment.[5]

          We review a final order dismissing a complaint with prejudice under the de novo standard of review. In doing so, we assume all of the allegations in the complaint are true. We construe all reasonable inferences from the allegations in favor of Semerena. SeeUnited Auto. Ins. Co. v. Law Offices of Michael I. Libman,46 So.3d 1101, 1103-04 (Fla. 3d DCA 2010); Extraordinary Title Servs., LLC v. Fla. Power & Light Co.,1 So.3d 400, 402 (Fla. 3d DCA 2009) (quoting Susan Fixel, Inc. v. Rosenthal & Rosenthal ...


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