Lana Robertson v. Blue Cross Blueshield of Texas

MEMORANDUM

Lana V. Robertson appeals from the district court’s grant of summary judgment in favor of Blue Cross and Blue Shield of Texas (Blue Cross) and Stallion Oilfield Holdings, Inc. (Stallion). We have jurisdiction pursuant to 28 U.S.C. § 1291 , and we affirm.

The district court did not err in reviewing Blue Cross’s decision to deny benefits for an abuse of discretion because Robertson’s employer-sponsored health benefits plan (the Plan) unambiguously provides discretion to Blue Cross. See Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 963 (9th Cir.2006) (en banc). The Plan states that “the Claims Fiduciary [Blue' Cross] ... will ... have final discretionary authority to (i) administer, enforce, construe, and construct the Plan ... (ii) make decisions relating to all questions of eligibility to participate and (iii) make a determination of benefits.... ” The Plan further provides that such interpretations and determinations “will be final and conclusive on all persons and entities subject only to the claims appeal provisions of the Plan.” Because these provisions establish that Blue Cross has authority to construe the terms of the Plan and to determine eligibility for…