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Rome v. HCC Life Insurance Co.

United States District Court, N.D. Texas, Dallas Division

June 20, 2018

AARON ROME, Plaintiff,


          David C. Godbey United States District Judge

         This Order addresses Defendant HCC Life Insurance Company's (“HCC”) motion to dismiss or, in the alternative, motion for summary judgment [38]. Because Rome's state law claims are preempted by ERISA, the Court grants HCC's motion to dismiss.

         I. Origins of the Dispute

         This is a dispute between a former professional hockey player and a life insurance company. HCC issued a disability policy (the “Policy”) to the National Hockey League (the “NHL”) for the benefit of active NHLplayers. The Policy was established pursuant to a collective bargaining agreement (“CBA”) between the NHL and the National Hockey League Players' Association (the “NHLPA”). Under the CBA, individual NHL club teams pay the cost of the benefits to a specific fund (the “Fund”). The Fund, administered by a board, then pays premiums to HCC.

         Plaintiff Aaron Rome, a former NHL player, suffered a career-ending injury while playing for the Dallas Stars. He sought benefits under the Policy, but HCC denied benefits. HCC later affirmed the denial of benefits pursuant to an administrative appeal process. Initially, Rome filed this action in Texas state court, bringing several state law claims against HCC related to improper processing of his claim. HCC, however, removed his claims before this Court. HCC argues that because the Policy is an employee welfare benefit plan under the Employee Retirement Income Security Act of 1974 (“ERISA”), federal law preempts those state law claims. Accordingly, HCC moves to dismiss Rome's state law claims or, in the alternative, seeks summary judgment on those claims. For the reasons set forth below, the Court grants HCC's motion to dismiss.

         II. The Rule 12(b)(6) Standard

          When considering a Rule 12(b)(6) motion to dismiss, a court must determine whether the plaintiff has asserted a legally sufficient claim for relief. Blackburn v. City of Marshall, 42 F.3d 925, 931 (5th Cir. 1995). A viable complaint must include “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). To meet this “facial plausibility” standard, a plaintiff must plead “factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). A court generally accepts well-pleaded facts as true and construes the complaint in the light most favorable to the plaintiff. Gines v. D.R. Horton, Inc., 699 F.3d 812, 816 (5th Cir. 2012). But a court does not accept as true “conclusory allegations, unwarranted factual inferences, or legal conclusions.” Ferrer v. Chevron Corp., 484 F.3d 776, 780 (5th Cir. 2007). A plaintiff must provide “more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do.” Twombly, 550 U.S. at 555 (internal citations omitted). “Factual allegations must be enough to raise a right to relief above the speculative level . . . on the assumption that all the allegations in the complaint are true (even if doubtful in fact).” Id. (internal citations omitted).

         In ruling on a Rule 12(b)(6) motion, a court generally limits its review to the face of the pleadings. See Spivey v. Robertson, 197 F.3d 772, 774 (5th Cir. 1999). However, a court may also consider documents outside of the pleadings if they fall within certain limited categories. First, “[a] court is permitted . . . to rely on ‘documents incorporated into the complaint by reference, and matters of which a court may take judicial notice.'” Dorsey v. Portfolio Equities, Inc., 540 F.3d 333, 338 (5th Cir. 2008) (quoting Tellabs, Inc. v. Makor Issues & Rights, Ltd., 551 U.S. 308, 322 (2007)). Second, a “written document that is attached to a complaint as an exhibit is considered part of the complaint and may be considered in a 12(b)(6) dismissal proceeding.” Ferrer, 484 F.3d at 780. Third, a “court may consider documents attached to a motion to dismiss that ‘are referred to in the plaintiff's complaint and are central to the plaintiff's claim.'” Sullivan v. Leor Energy, LLC, 600 F.3d 542, 546 (5th Cir. 2010) (quoting Scanlan v. Tex. A & M Univ., 343 F.3d 533, 536 (5th Cir. 2003)). Finally, in deciding a Rule 12(b)(6) motion to dismiss, “a court may permissibly refer to matters of public record.” Cinel v. Connick, 15 F.3d 1338, 1343 n.6 (5th Cir. 1994) (citation omitted); see also, e.g., Funk v. Stryker Corp., 631 F.3d 777, 783 (5th Cir. 2011) (stating, in upholding district court's dismissal pursuant to Rule 12(b)(6), that “the district court took appropriate judicial notice of publicly-available documents and transcripts produced by the [Food and Drug Administration], which were matters of public record directly relevant to the issue at hand”).

         III. The Court Grants HCC's Motion to Dismiss

          A. The Policy is an Employee Welfare Benefit Plan under ERISA

          ERISA defines an employee welfare benefit plan (an “ERISA Plan”) as

any plan, fund, or program . . . established or maintained by an employer or by an employee organization, or by both, to the extent that such plan, fund, or program was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, (A) medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training programs, or day care centers, scholarship funds, or prepaid legal services . . . .

29 U.S.C. § 1002(1). A given policy qualifies as an ERISA Plan if a plan: (1) exists; (2) does not fall within ERISA's safe harbor provision; and (3) is established or maintained by an employer or employee organization for the benefit of employees. Meredith v. Time Ins. Co., 980 F.2d 352, 355 (5th Cir. 1993). Here, the Policy is an ERISA Plan because it meets the above three requirements.

         1. A Plan Exists. - An ERISA Plan exists if a “‘reasonable person could ascertain the intended benefits, a class of beneficiaries, the source of financing, and procedures for receiving benefits.'” Mem'l Hosp. Sys. v. Northbrook Life Ins. Co., 904 F.2d 236, 240-41 (5th Cir. 1990) (quoting Donovan v. Dillingham, 688 F.2d 1367, 1373 (11th Cir. 1982)). While an employer's purchase of an insurance plan alone does not establish that an ERISA Plan exists, the purchase of ...

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