McDowell

Providence Health Plan v. McDowell

Good Law
361 F.3d 1243·2004 WL 574982
United States Court of Appeals for the Ninth CircuitMarch 24, 2004Nos. 02-35263, 02-35841California2,230 words

Opinion

Lead Opinion

Brunetti, J.

These appeals concern two actions by Providence Health Plan to recover benefits paid to its insureds, the McDowells. The first action, “McDowell was for breach of contract and was filed in state court. McDowell I was removed to federal court and dismissed as completely preempted under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq. The second action, “McDoivell II” was filed in federal court as an action for equitable relief under ERISA’s civil enforcement provision, 29 U.S.C. § 1132 (a). This action was also dismissed after the district court determined that Providence failed to state a claim under § 1132(a).

For the following reasons, we reverse the dismissal of McDowell I, but affirm as to McDowell II.

*1246 BACKGROUND

In February of 1990, Gary McDowell applied for health coverage through Select-Care Health Plans, the health care insurance plan selected by his employer. Rose-lea McDowell, Gary’s spouse, is covered under the same policy. The McDowells’ policy was renewed every year thereafter with SelectCare and then, after Select-Care’s 1997 merger with Providence, with both SelectCare and Providence. In January of 2000, the…

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