OSF Healthcare System an Illinios not for profit corporation d/b/a Saint Francis Medical Center v. Star Transport, Inc. Health Care Plan Exact Name Unknown
1:15-cv-01436
C.D. Ill.Jun 26, 2017Background
- OSF Healthcare provided medical services to an insured under Star Transport’s employee health plan and sought reimbursement for unpaid bills.
- OSF sued the plan and Star Transport on October 23, 2015 under ERISA § 502(a)(1)(B) for $192,195.78 (assigned benefits), plus attorney’s fees and costs.
- Defendants were served on November 12, 2015, failed to answer, and the clerk entered default; a prior default-judgment motion was stayed due to bankruptcy and later renewed.
- OSF also alleged a claim under ERISA § 502(c)(1)(B) against Star for failure to produce plan documents, seeking statutory penalties for each day of noncompliance.
- The court treated OSF’s monetary requests as joint and several against the plan and Star for the reimbursement and fees/costs, and separately awarded a § 1132(c) penalty against Star as plan administrator.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Liability under ERISA § 502(a)(1)(B) for unpaid benefits | OSF: plan owes $192,195.78 as assigned beneficiary | Plan/Star: no response / default | Default taken as admission; judgment entered for $192,195.78 jointly and severally |
| Award of attorney's fees and costs under ERISA § 502(g) | OSF: seeks $4,295 fees and $492.50 costs incurred litigating claim | Defendants: no response / default | Fees $4,295 and costs $492.50 awarded jointly and severally |
| § 502(c)(1)(B) statutory penalty for failure to produce plan documents | OSF: requested daily statutory penalty for delayed response to document request beginning Sept 14, 2014 | Star: no response / default | Penalty awarded against Star; court calculated entitlement for 817 days but granted OSF's requested $67,400 |
| Whether judgment can be entered against corporate/plan defendants when plan identity/control unclear | OSF: may name entities that control the plan; seeks relief against plan and Star | Defendants: no response / default | Court construes claims as against plan and entities controlling it and enters joint and several judgment (citing authority allowing such practice) |
Key Cases Cited
- e360 Insight v. The Spamhaus Project, 500 F.3d 594 (7th Cir.) (personal jurisdiction requirement before default judgment)
- Dundee Cement Co. v. Howard Pipe & Concrete Prod., Inc., 722 F.2d 1319 (7th Cir.) (well-pleaded allegations taken as true upon default)
- Breuer Elec. Mfg. Co. v. Toronado Sys. of Am., Inc., 687 F.2d 182 (7th Cir.) (default judgment establishes liability on pleaded causes of action)
- Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (U.S.) (ERISA authorizes suits against fiduciaries and administrators to enforce plan compliance)
- Larson v. United Healthcare Ins. Co., 723 F.3d 905 (7th Cir.) (plaintiff may sue entities that control or are effectively the plan when plan identity is unclear)
- Leister v. Dovetail, Inc., 546 F.3d 875 (7th Cir.) (permitting suit against entities when the plan is not unambiguously identified)
