THOMAS BARRY, BERNARD BRNE, MICHAEL CIARA, JAMES FITZGIBBON, JOHN HATZIS, WILLIAM KESTLER, EDWARD KICHURA, MICHAEL KING, JEROME KOCH, TERRENCE McSHANE, MICHAEL MICHON, LAWRENCE O’BOYLE, GEORGE RADKA, WILLIAM REDDY, MICHAEL ROCHE, ANDREW SOPKO, CHARLES SWAN, JOHN TUMPICH JR., LAWRENCE WALSH, and RANDALL WALZ v. THE CITY OF CHICAGO
No. 1-20-0829
APPELLATE COURT OF ILLINOIS FIRST DISTRICT
December 23, 2021
2021 IL App (1st) 200829
JUSTICE LAMPKIN delivered the judgment of the court, with opinion. Presiding Justice Reyes and Justice Rochford concurred in the judgment and opinion.
Fourth Division; Appeal from the Circuit Court of Cook County. No. 19 CH 5287; Honorable Raymond W. Mitchell, Judge, presiding.
OPINION
¶ 1 Plaintiffs, former Chicago Fire Department employees who suffered career-ending injuries, sued defendant, the City of Chicago (City), alleging that they are guaranteed by statute lifetime premium-free coverage under the City’s group health insurance plan for active-duty employees. The circuit court dismissed plaintiff’s claims, ruling that the City’s obligation to provide premium-free participation in its group plan ended when plaintiffs became eligible for Medicare because benefits payable under the statute are reduced by health insurance benefits payable from any other source. The circuit court also ruled that plaintiffs lacked standing to bring claims on behalf of their family members.
¶ 2 On appeal, plaintiffs argue that (1) they are entitled to premium-free health
¶ 3 For the reasons that follow, we affirm the judgment of the circuit court.1
I. BACKGROUND
¶ 5 The Public Safety Employee Benefits Act (Act) (
¶ 6 Plaintiffs were full-time Chicago Fire Department employees. Each suffered a career-ending injury while on duty and responding to an emergency and was awarded a duty disability benefit. In compliance with the Act, the City thereafter provided each plaintiff with premium-free health insurance through its group health insurance plan for active-duty employees.
¶ 7 At age 65, plaintiffs became Medicare participants, and the City terminated their premium-free coverage under its group plan. To supplement their Medicare coverage, the City allowed plaintiffs to participate in its Medicare supplement retiree health care plan until that plan was discontinued in December 2016. Plaintiffs could thereafter participate in a plan sponsored by the Chicago Firefighters Union Local 2 or purchase other Medicare supplemental plans. The City maintained that, if plaintiffs chose to use any of these supplemental plans, they were responsible for paying the plan premiums.
¶ 8 Nineteen plaintiffs filed a complaint in April 2019. They alleged that the Act required the City to provide them with premium-free coverage through its group plan for active-duty employeеs for the duration of their lifetimes regardless of their Medicare eligibility. Some plaintiffs also alleged that the City improperly terminated premium-free coverage for their spouses and children under age 26. Plaintiffs requested an injunction requiring the City to reinstate them in its group insurance plan for active-duty employees and sought damages in the amount of the premiums they paid for plans that supplemented their Medicare coverage.
¶ 9 Plaintiffs filed an amended complaint in May 2019, which added plaintiff Andrew Sopko. Sopko alleged that after he turned 65, the City provided him and his wife with premium-free coverage through its “Retiree Health Plans” rather than its plan for active-duty employees. The amended complaint repeated the allegations of the 19 other plaintiffs.
¶ 10 The City moved to dismiss the amended complaint pursuant to section 2-619.1 of the Code of Civil Procedure (Code) (
¶ 11 Regarding plaintiffs’ own benefits claims, the City argued those claims should be dismissed under section 2-615 of the Code (
¶ 12 In thеir response, plaintiffs argued that they should be able to assert their family members’ claims because they had a “real interest” in their spouses’ benefits and their spouses were entitled to benefits since plaintiffs were injured on the job. Plaintiffs also argued that (1) the Act required the City to continue providing premium-free and lifetime coverage under the City’s plan for active-duty employees; (2) Pyle misinterpreted the Act; and (3) section 10(a)(1) of the Act, which states that “benefits payable from any other source shall reduce benefits payable” under section 10(a) (
¶ 13 In reply, the City argued regarding the standing issue that the claims of plaintiffs’ spouses and dependents were based on the alleged denial of those individuals’ own benefits and not the denial of plaintiffs’ benefits. The City also argued that plaintiffs identified no legal authority that would allow them to assert the rights of their spouses or dependents. Regarding the merits of plaintiffs’ own claims, the City argued that Pyle was controlling and correctly read the plain language of section 10(a) to limit the employer’s obligation to pay plan premiums when benefits were payable from another source, like Medicare. The City contended that plaintiffs’ argument that section 10(a)(1) was a coordination of benefits clause was unsupported by the Act’s text or legislative history.
¶ 14 On November 22, 2019, the circuit court dismissed the claims plaintiffs brought on behalf of their family members for lack of standing and dismissed with prejudice plaintiffs’ own claims against the City. Specifically, the court held thаt plaintiffs could not litigate the alleged denial of benefits claim on behalf of their family members because that claim asserted an injury that belonged, not to plaintiffs, but rather to their spouses and dependents. Regarding plaintiffs’ claimed entitlement to lifetime premium-free coverage under the City’s group insurance plan, that claim was rejected by Pyle, which was controlling as the only appellate court case at that time to address the effect of Medicare eligibility on the Act’s premium-free insurance requirement.
II. ANALYSIS
¶ 17 Section 2-619.1 of the Code permits a party to combine a section 2-615 motion to dismiss based upon a plaintiff’s substantially insufficient pleadings with a section 2-619 mоtion to dismiss based upon certain defects or defenses.
¶ 18 A motion to dismiss under section 2-615 challenges the legal sufficiency of a complaint based upon defects apparent оn its face. Beacham v. Walker, 231 Ill. 2d 51, 57 (2008). The critical inquiry is whether the well-pleaded facts of the complaint, taken as true and construed in a light most favorable to the plaintiff, are sufficient to state a cause of action upon which relief may be granted. Loman v. Freeman, 229 Ill. 2d 104, 109 (2008). The complaint need only set forth the ultimate facts to be proved—not the evidentiary facts tending to prove such ultimate facts. City of Chicago v. Beretta U.S.A. Corp., 213 Ill. 2d 351, 369 (2004).
¶ 19 A motion to dismiss under section 2-619 admits the legal sufficiency of the complaint but raises defects, defenses, or some other affirmative matter that defeats the plaintiff’s claim. Ball v. County of Cook, 385 Ill. App. 3d 103, 107 (2008). The phrase “affirmative matter” encompasses any defense other than a negation of the essential allegations of the plaintiff’s cause of action. Piser v. State Farm Mutual Automobile Insurance Co., 405 Ill. App. 3d 341, 344 (2010).
A. Premium-Free Insurance Coverage
¶ 21 Plaintiffs argue that the City violated the Act by terminating their premium-free health care coverage once they became eligible for Medicare at age 65 because their Medicare eligibility was not a valid basis under the Act to terminate their right to premium-free health insurance coverage for life. They argue that the trial court’s dismissal of their complaint resulted from the court’s misconstruction of section 10(a) of the Act, which, according to plaintiffs, (1) provides that only a fraud conviction constitutes a valid event to terminate the premium-free health insurance coverage, (2) includes merely a coordination of benefits clause rather than a basis to reduce benefits when health insurance benefits are payable from any
¶ 22 In response, defendants argue the trial court properly dismissed plaintiff’s claims because the Act does not require the City to pay premiums for supplemental coverage and the City’s health insurance plan at issue here became supplemental coverage once plaintiffs were eligible for Medicare benefits.
¶ 23 A case involving statutory construction, like this one, presents a question of law, which this court reviews de novo. Board of Education of the City of Chicago v. Moore, 2021 IL 125785, ¶ 18. The fundamental rule of statutory construction “is to ascertain and give effect to the legislaturе’s intent” (Michigan Avenue National Bank v. County of Cook, 191 Ill. 2d 493, 503-04 (2000)), and “[t]he plain language of the statute is the best indicator of legislative intent” (United States v. Glispie, 2020 IL 125483, ¶ 9). The court should give “words appearing in legislative enactments their common dictionary meaning or commonly accepted use unless otherwise defined by the legislature.” Bowes v. City of Chicago, 3 Ill. 2d 175, 201 (1954); see also People v. McChriston, 2014 IL 115310, ¶ 15 (“it is entirely appropriate to employ a dictionary to ascertain the plain and ordinary meaning of [undefined] terms [contained in a statute]” (internal quotation marks omitted)). When a statute’s language is clear and unambiguous, the court should not resort to further aids of construction. Hall v. Henn, 208 Ill. 2d 325, 330 (2003). “However, if the statutory language is ambiguous or unclear, this court may look beyond the act’s language to ascertain its meaning. [Citation.] A statute is ambiguous if it is capable of more than one reasonable interpretation.” Nowak v. City of Country Club Hills, 2011 IL 111838, ¶ 11.
¶ 24 Section 10 of the Act provides, in pertinent part:
“§ 10. Required health coverage benefits.
(a) An employer who employs a full-time *** firefighter, who *** suffers a catastrophic injury or is killed in the line of duty shall pay the entire premium of the employer’s health insurance plan for the injured employee, the injured employee’s spouse, and for each dependent child of the injured employee until the child reaches the age of majority or until the end of the calendar yeаr in which the child reaches the age of 25 if the child continues to be dependent for support or the child is a full-time or part-time student and is dependent for support. The term ‘health insurance plan’ does not include supplemental benefits that are not part of the basic group health insurance plan. If the injured employee subsequently dies, the employer shall continue to pay the entire health insurance premium for the surviving spouse until remarried and for the dependent children under the conditions established in this Section. However:
(1) Health insurance benefits payаble from any other source shall reduce benefits payable under this Section.
(2) It is unlawful for a person to willfully and knowingly make, or cause to be made *** any false, fraudulent, or misleading oral or written statement to obtain health insurance coverage
as provided under this Section. A violation of this item is a Class A misdemeanor.
(3) Upon conviction for a violation described in item (2), a *** beneficiary who receives or seeks to receive health insurance benefits under this Section shall forfeit the right to receive health insurance benefits ***. ***
(b) In order for the *** firefighter, spouse, or dependent children to be eligible for insurance coverage under this Act, the injury or death must have occurred as the result of the *** firefighter’s response to what is reasonably believed to be an emergency ***. Nothing in this Section shall be construed to limit health insurance coverage or pension benefits for which the officer, firefighter, spouse, or dependent children may otherwise be eligible.”
820 ILCS 320/10 (West 2018).
¶ 25 Section 10 of the Act provides for health coverage benefits, which is defined as a public employer’s payment of “the entire premium of the employer’s health insuranсe plan for the injured employee, the injured employee’s spouse, and for each dependent child of the injured employee.”
¶ 26 According to the plain language of section 10(a), the Act provides that the “[h]ealth insuranсe benefits” that section 10(a) guarantees are the payment of premiums for “the employer’s health insurance plan” (
¶ 27 Medicare is the federal health insurance program (see What’s Medicare, Medicare, https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-mеdicare (last visited Dec. 9, 2021) [https://perma.cc/ZLN3-VQ7E]) and therefore constitutes health insurance benefits payable from a source other than the City’s group insurance plan. Under the Act’s plain language, the City’s obligation to provide the benefit the Act requires—the payment of premiums for the City’s group health insurance plan—is reduced when Medicare benefits are available.
¶ 28 Section 10(a) of the Act further states that “[t]he term ‘health insurance plan’ does not include supplemental benefits that are not part of the basic group health insurance plan.”
¶ 29 Accordingly, this court construes the plain language of the Act to conclude that it relieves the City of thе requirement of paying health insurance premiums for Medicare-eligible individuals.
¶ 31 The court also explained that this result was consistent with section 10(a)’s statement that “[t]he term ‘health insurance plan’ does not include supplemental benefits.” (Internal quotation marks omitted.) Id. ¶ 28. Once the plaintiff’s primary plan became Medicare, the city’s payment of premiums would have been for a “plan that supplemented Medicare,” and “the plain language of the statute” did not require it “to pay premiums for these supplemental benefits.” Id. ¶ 29; see also McCaffrey v. Village of Hoffman Estates, 2021 IL App (1st) 200395, ¶ 42 (following the Pyle analysis to conclude that a spouse’s Medicare eligibility alone was sufficient to relieve the defendant municipal employer of its obligation to pay the spouse’s health insurance benefits under the Act, even though the spouse chose not to take advantage of that Medicare coverage).
¶ 32 After construing the Act’s plain language, the court stated that its construction was also consistent with section 367f of the Insurance Code (
¶ 33 Since Pyle was decided in 2012, the General Assembly has not amended section 10(a) despite amending other provisions of the Act. “[W]hen the legislature chooses not to amend a statute after judicial construction,” the court presumes “it has acquiesced” in that construction. Glispie, 2020 IL 125483, ¶ 10; see also In re Marriage of Mathis, 2012 IL 113496, ¶ 25 (“We assume not only that the General Assembly acts with full knowledge of previous judicial decisions, but also that its silence on this issue in the face of decisions consistent with those previous decisions indicates its acquiescence to them.”).
¶ 34 We reject plaintiffs’ argument that the Act guarantees lifetime premium-free
¶ 35 Plaintiffs also argue that section 10(a)(1) is merely a coordination of benefits clause and its purpose is to determine which of two or more health insurance plans is the primary payer and which is the secondary payer. This argument is not persuasive. The term benefits as used in section 10(a)(1) does not refer to insurance payments for covered medical services. Rather, the Act defines benefits in section 10(a) to mean payment of “the entire premium of the employer’s health insurance plan.” (Emphasis added.)
¶ 36 Plaintiffs also argue that they are not attempting to acquire supplemental benefits, which they contend is a term-of-art in the health insurance lexicon that refers to benefits like dental and vision care. Moreover, plaintiffs contend the City’s group insurance plan does not satisfy the requirements to constitute a Medicare supplement insurance plan or Medigap policy. However, the General Assembly did not define supplemental benefits as a Medicare supplement policy or limit them to dental and vision care. When the legislature does not define a word, the court should apply the common meaning (Bowes, 3 Ill. 2d at 201), and the common meaning of “supplement” is “something that completes or makes an addition” (Merriam-Webster Online Dictionary, https://www.merriam-webster.com/dictionary/supplement (last visited Deс. 9, 2021) [https://perma.cc/2U24-FRNV]). The Act guarantees injured firefighters basic insurance coverage. When Medicare provides that coverage, the Act does not require the City to supplement it.
¶ 37 Finally, plaintiffs argue that when the court in Pyle referenced section 367f of the Insurance Code, the court improperly applied the tool of statutory construction known as in pari materia because
¶ 38 The Act guarantees firefighters injured in the line of duty health and educational benefits and also confers rights to those benefits directly on the firefighters’ spouses and children. But the Act limits a public employer’s obligation to pay those benefits when they are payable from any other source, and those other sources include Mеdicare. Because the Act does not guarantee plaintiffs lifetime premium-free insurance under the City’s plan, the trial court properly dismissed their claim.
B. Standing
¶ 40 Plaintiffs argue that they sufficiently asserted standing to bring claims for the City’s alleged violations of the Act pertaining to their spouses’ and dependents’ health coverage because that health coverage was a result of plaintiffs’ eligibility under the Act.
¶ 41 We review de novo the trial court’s dismissal of these claims for lack of standing. Lyons v. Ryan, 201 Ill. 2d 529, 534 (2002). “A court will consider the validity of a statutory provision only at the instance of one who is directly affected by it ***.” Illinois Municipal League v. Illinois State Labor Relations Board, 140 Ill. App. 3d 592, 599 (1986). To have standing, a plaintiff must possess a “personal claim, status, or right.” Greer v. Illinois Housing Development Authority, 122 Ill. 2d 462, 493 (1988).
¶ 42 The Act grants the spouses and children of injured firefighters the right to premium-free health insurance.
¶ 43 Plaintiffs argue, without citing relevant authority, that they should be able to assert claims on behalf of other people who are in the same family unit. But a close family relationship does not entitle someone to assert another person’s claims. Husbands are not entitled to litigate their wives’ claims simply because they are married. See In re Marriage of Keller, 2020 IL App (2d) 180960, ¶ 27 (husband lacked standing to advance an argument based on his wife’s legal interests). “A party must assert its own legal rights and interests, rather than assert a claim for relief based upon the rights of third parties.” Powell v. Dean Foods Co., 2012 IL 111714, ¶ 36. Plaintiffs thus lack standing to assert claims basеd on the personal rights of their wives and adult children.
¶ 44 Plaintiffs also argue that they can assert the rights of absent third parties based on the rule of third party or jus tertii standing. The appellate court has
“ ‘[T]he [Supreme] Court has looked primarily to two factual elements to determine whether the rule should apply in a particular case. The first is the relationship of the litigant to the person whose right he seeks to assert. If the enjoyment of the right is inextricably bound up with the activity the litigant wishes to pursue, the court at least can be sure that its construсtion of the right is not unnecessary in the sense that the right’s enjoyment will be unaffected by the outcome of the suit. Furthermore, the relationship between the litigant
and the third party may be such that the former is fully, or very nearly, as effective a proponent of the right as the latter. ***
The other factual element to which the Court has looked is the ability of the third party to assert his own right. Even where the relationship is close, the reasons for requiring persons to assert their own rights will generally still apply. If there is some genuine obstacle to such assertion, however, the third party’s absence from court loses its tendency to suggest that his right is not truly at stake, or truly important to him, and the party who is in court becomes by default the right’s best available proponent.’ ” Illinois Municipal League, 140 Ill. App. 3d at 603-04 (quoting Singleton v. Wulff, 428 U.S. 106, 114-16 (1976)).
According to the Supreme Court, jus tertii standing “should not be applied where its underlying justifications are absent.” Singleton, 428 U.S. at 114.
¶ 45 The justifications for jus tertii standing do not exist here. Plaintiffs do not even attempt to explain why their wives and adult children are unable to assert their own rights. And the record does not suggest that they lack the capacity to do so. Therefore, we affirm the dismissal based on lack of standing of the claims plaintiffs asserted on behalf of their spouses and children.
III. CONCLUSION
¶ 47 For the foregoing reasons, we affirm the judgment of the circuit court.
¶ 48 Affirmed.
Cite as: Barry v. City of Chicago, 2021 IL App (1st) 200829
Decision Under Review: Appeal from the Circuit Court of Cook County, No. 19-CH-5287; the Hon. Raymond W. Mitchell, Judge, presiding.
Attorneys for Appellant: Stephen B. Horwitz, of Hogan Marren Babbo & Rose, Ltd., of Chicago, for appellants.
Attorneys for Appellee: Celia Meza, Acting Corporation Counsel, of Chicago (Benna Ruth Solomon, Myriam Zreczny Kasper, and Ellen W. McLaughlin, Assistant Corporation Counsel, of counsel), for appellee.
