Brannigan v. Anthem Insurance Companies, Inc., 8:21-cv-02353

Background

KP (a South Carolina resident) suffered a heart attack on a cruise ship in the Dominican Republic and was air-evacuated by Jet ICU to Broward Health Medical Center in Fort Lauderdale.
Jet ICU billed Anthem $237,770 for the air ambulance; Anthem paid only ground transfer and denied the air-ambulance balance as not medically necessary, citing available Dominican hospitals.
KP executed a power of attorney in favor of Florida attorney Michael Brannigan, who is also Jet ICU’s counsel; Brannigan (as KP’s attorney-in-fact) and Jet ICU sued Anthem under ERISA for plan benefits.
Anthem moved to dismiss under Rules 12(b)(1), 12(b)(2), and 12(b)(6), arguing lack of statutory standing, lack of personal jurisdiction, and failure to identify Plan provisions.
The magistrate judge recommended granting the motion: found Brannigan has standing to sue as KP’s attorney-in-fact (on KP’s behalf), but Jet ICU lacks standing absent an assignment (and the Plan contains anti-assignment language); personal jurisdiction is proper under ERISA’s nationwide-service provision; and the complaint fails to identify a specific Plan term entitling KP to the claimed benefit.
The R&R recommends dismissal without prejudice and leave to amend to cure the standing and plan-term pleading defects within 14 days.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Brannigan has statutory standing to sue under ERISA as KP’s attorney-in-fact	Brannigan says the power of attorney gives him derivative standing to pursue KP’s ERISA benefits	Anthem argues only participants or beneficiaries (or assignees) may sue; providers and agents lack independent standing absent assignment	Court: Brannigan adequately alleged standing as KP’s attorney-in-fact at pleading stage; he may assert KP’s claim
Whether Jet ICU (provider) has standing to sue for benefits	Jet ICU asserts rights to payment for services; relies on Brannigan and KP’s POA	Anthem says providers are not beneficiaries/participants and the Plan forbids assignment absent written consent	Court: Jet ICU lacks standing because no assignment alleged and Plan contains anti-assignment provisions; claim dismissed but with leave to amend
Whether the court has personal jurisdiction over Anthem	Plaintiffs invoke ERISA’s nationwide-service provision to establish jurisdiction	Anthem challenges jurisdiction under Florida long-arm and due process norms	Court: Personal jurisdiction is proper under 29 U.S.C. § 1132(e)(2); Fifth Amendment minimum-contacts with the U.S. satisfied
Whether the complaint states an ERISA benefits claim by identifying a Plan term	Plaintiffs point to the Certificate and Fla. Stat. § 627.64194 and claim emergency-services coverage	Anthem contends Plaintiffs fail to specify the Plan provision that confers the claimed benefit	Court: Complaint fails to identify a specific Plan term entitling KP to the disputed payment; dismissal without prejudice and amendment allowed

Key Cases Cited

Bell Atl. Corp. v. Twombly, 550 U.S. 544 (U.S. 2007) (plausibility pleading standard)
Hobbs v. Blue Cross Blue Shield of Ala., 276 F.3d 1236 (11th Cir. 2001) (healthcare providers generally are not ERISA participants or beneficiaries)
Physicians Multispecialty Grp. v. Health Care Plan of Horton Homes, Inc., 371 F.3d 1291 (11th Cir. 2004) (ERISA-plan parties may contractually provide for assignment)
Day v. Taylor, 400 F.3d 1272 (11th Cir. 2005) (courts may consider documents central to the complaint even if not attached)
Republic of Panama v. BCCI Holdings (Luxembourg) S.A., 119 F.3d 935 (11th Cir. 1997) (when federal statute provides nationwide service, Fifth Amendment governs minimum-contacts analysis)
S.E.C. v. Carrillo, 115 F.3d 1540 (11th Cir. 1997) (nationwide service requires sufficient contacts with the United States)