Morris v. Humana Health Plan, Inc.
829 F. Supp. 2d 848
W.D. Mo.2011Background
- Plaintiff filed in Missouri state court alleging unjust enrichment, conversion, and injunctive relief against Humana Health Plan, Inc. for subrogation/reimbursement of FEHBA benefits from third-party tortfeasor payments; Humana removed to federal court claiming federal question and federal officer removal jurisdiction; court analyzes FEHBA preemption and officer-removal doctrines; court holds remand is proper and dismissal moot; discussion cites Grable and Empire HealthChoice for substantial federal-interest standards.
- Court notes FEHBA contracts govern federal employee health plans and may implicate federal questions where a substantial federal issue exists; no sufficient federal-question facially pleaded in the plaintiff’s state-law claims.
- Court distinguishes between federal defenses and the well-pleaded complaint rule, emphasizing that removal cannot be based on defenses absent a facial federal question.
- Court considers and rejects the theory that FEHBA preemption or the government-contractor defense creates removal jurisdiction in this case.
- Court concludes remand to state court is required; removal defenses do not create jurisdiction, and the 12(b)(1)/(6) dismissal is moot.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether FEHBA creates federal-question jurisdiction to support removal | Humana argues a substantial federal question exists under FEHBA | Federal question and Grable-style substantial federal issue justify removal | No substantial federal question on face of complaint |
| Whether removal under 28 U.S.C. §1442(a)(1) is proper for acting under a federal officer | State-law claims lack acting-under relationship; remand proper | Humana acted under federal direction via OPM contract | Not established; no acting-under relationship sufficient for §1442(a)(1) |
| Whether complete preemption under FEHBA warrants removal | Complete preemption would convert state claims to federal | FEHBA preemption not broad enough to create removal jurisdiction | Empire HealthChoice and related authority show no complete preemption here |
| Whether federal-officer defenses (immunity, government-contractor, express preemption) support removal | Humana’s defenses could immunize removal | Defense theories do not create removal jurisdiction absent federal-question | No removal jurisdiction based on these defenses |
| Whether remand is proper and dismissal moot | Remand appropriate to preserve state-court proceedings | Removal would complicate proceedings | Remand GRANTED; dismissal moot |
Key Cases Cited
- Empire HealthChoice Assur., Inc. v. McVeigh, 547 U.S. 677 (U.S. 2006) (limitations on FEHBA preemption; not all contract-derived claims rise to federal jurisdiction)
- Grable & Sons Metal Prods., Inc. v. Darue Eng’g & Mfg., 545 U.S. 308 (U.S. 2005) (substantial federal issue necessary for federal-question jurisdiction)
- Watson v. Philip Morris Cos., Inc., 551 U.S. 142 (U.S. 2007) (broad reading of acting-under-federal-officer; limits exist)
- Houston Community Hosp. v. Blue Cross & Blue Shield of Tex., Inc., 481 F.3d 265 (5th Cir. 2007) (FEHBA framework; government-regulator relationship does not imply control)
- Orthopedic Specialists of New Jersey P.A. v. Horizon Blue Cross/Blue Shield of New Jersey, 518 F.Supp.2d 128 (D.N.J. 2007) (contract terms alone do not show government control for removal)