Fuller v. NortonFuller v. Norton
Appellant is the trustee of an Employee Retirement Income Security Act of 1974 (“ERISA”) plan offering benefits to the employees of its employer members through a multiple employer welfare arrangement (“MEWA”), as defined by section 3 of ERISA.
I. BACKGROUND
In 1992, a group of employers established a nonprofit organization, the International Association of Entrepreneurs of America (“IAEA”), to create an ERISA welfare benefit plan. The plan offered employees of its members health, disability, occupational illness or accident, and other benefits. To provide benefits, the IAEA established the International Association of Entrepreneurs of America Benefit Trust (“Benefit Trust”) as an unincorporated trust. Plaintiff Ross Fuller is the trustee of the Benefit Trust. Great Oaks Management is a member of the IAEA and was a plaintiff in this action, but is not a party to this appeal. The Benefit Trust created an employee welfare plan established for the purpose of providing welfare benefits to the employees of its employer members. For purposes of this appeal we look only to. allegations in the complaint, and assume the plan constitutes a MEWA as defined in
The Benefit Trust began soliciting members in Colorado and inquired of the Colorado Division of Insurance (“Division”) how to obtain a certificate of insurance allowing it to provide health benefits and workmen’s compensation benefits. Colorado prohibits entities from conducting insurance activities without a certificate from the Division, or providing workmen’s compensation benefits without complying with certain insurance requirements. The Commissioner of the Division notified the Benefit Trust that it was unlawfully providing workmen’s compensation and other insurance benefits in contravention of Colorado law. He ordered the Benefit Trust to cease and desist from these prohibited activities and to submit documents relating to any “unauthorized transaction of insurance.” Rather than complying with the order, the plaintiffs responded by filing this suit. Plaintiffs requested a declaratory judgment that application of Colorado insurance laws to MEWAs like the IAEA is preempted by federal ERISA regulation, and alleged that Colorado’s MEWA regulation violates the Commerce and Equal Protection clauses of the United States Constitution; they also asked the court to enter an injunction to prohibit the Division from interfering with the plan’s activities in Colorado.
Defendants filed a motion to dismiss for failure to state a claim,
II. DISCUSSION
We uphold a dismissal under
A. Are Colorado’s restrictions on the provision of workmen’s compensation benefits preempted by ERISA?
ERISA provides a complex and extensive preemption regime: “Except as provided in subsection (b) of this section, the provisions of this subchapter and subehapter III of this chapter shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in section 1003(a) of this title and not exempt under section 1003(b) of this title.”
Exempted from ERISA preemption are laws regulating some arrangements that constitute employee benefit plans, including plans “maintained solely for the purpose of complying with applicable workmen’s compensation laws or unemployment compensation laws or disability insurance laws.”
Plaintiff contends that these circuit cases misinterpret the exception to ERISA application found in § 1003(b)(3) and the limited holding of Shaw. According to plaintiff, Shaw stands for the proposition that § 1003(b)(3) allows state law application only to the portions of plans providing workmen’s compensation (or in Shaw, disability) benefits that are inferior to state-mandated benefits. He alleges that the Benefit Trust plan benefits meet the requirements of the Colorado scheme. Plaintiff misreads Shaw. There, the Supreme Court expressly allowed New York to impose requirements on disability benefits, whether or not the benefits were offered within multibenefit plans. 463 U.S. at 108, 103 S.Ct. at 2905-06. Laws insuring that benefits will be paid certainly must be considered “requirements” of state workmen’s compensation law with which plan benefits must comply. See id. Thus, consistent with our earlier ruling in Contract Services, we conclude that Colorado’s workmen’s compen
B. Preemption of Colorado’s MEWA Regulation
Plaintiff challenges Colorado’s authority to apply its insurance laws to the Benefit Trust plan by subjecting it to the jurisdiction of the Division. The relevant statute of which plaintiff complains,
Jurisdiction over providers of health care benefits. (1) Notwithstanding any other provision of law, and except as provided in this section, any person or other entity which provides coverage in this state for medical, surgical, chiropractic, ... dental; hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the division of insurance ....(2) ... Nothing in this section shall be construed to in any way limit the ability of the division of insurance to regulate insurance companies, multiple employer trusts, multiple employer welfare arrangements, association health plans, or preferred provider organizations.
An entity falling within § 10-3-903.5 is subject to examination by the Division, and to “all appropriate provisions [of Colorado insurance regulation] regarding the conduct of its business.”
Colorado has chosen to exempt certain qualifying MEWAs from direct regulation by the Division. “The provisions of this section and any other laws of this state that regulate insurance or insurance companies shall not apply to ... any multiple employer welfare arrangement which meets the requirements of paragraph (c).”
By directly regulating MEWAs,
Neither an employee benefit plan described in section 1003(a) of this title, which is not exempt under section 1003(b) of this title (other than a plan established primarily for the purpose of providing death benefits), nor any trust established under such a plan, shall be deemed to be an insurance company ... or to be engaged in the business of insurance ... for purposes of any law of any State purporting to regulate insurance companies, insurance contracts, banks, trust companies, or investment companies.
Finally, and most relevant to this discussion, ERISA allows state regulation of MEWAs in specific situations, such as the one before us, by removing federal restriction. The pertinent provision, applicable to MEWAs (which by definition provide welfare, not pension, benefits), states:
(i) in the case of an employee welfare benefit plan which is a multiple employer welfare arrangement and is fully insured (or which is a multiple employer welfare arrangement subject to an exemption under subparagraph (B)), any law of any State which regulates insurance may apply to such arrangement to the extent that such law provides—
(I) standards, requiring the maintenance of specified levels of reserves and specified levels of contributions, which any such plan, or any trust established under such a plan, must meet in order to be considered under such law able to pay benefits in full when due, and
(II) provisions to enforce such standards, and
(ii) in the case of any other employee welfare benefit plan which is a multiple employer welfare arrangement, in addition to this subehapter, any law of any State which regulates insurance may apply to the extent not inconsistent with the preceding sections of this subchapter.
Plaintiff raises three arguments why Colorado’s MEWA regulation is not protected from ERISA preemption by
1. Does Colorado Impermissibly “Deem” MEWAs to be Insurance?
While admitting that the MEWA clause allows states to apply insurance laws to MEWAs, plaintiff nevertheless contends that states may not effectuate this regulation by merely “deeming” MEWAs to be insurance arrangements. He argues that enactment of the MEWA clause does not affect the operation of the deemer clause. At the outset, we assume for purposes of this argument that by presumptively subjecting MEWAs to be subject to the jurisdiction of the Division,
In FMC Corp. v. Holliday, 498 U.S. 52, 111 S.Ct. 403, 112 L.Ed.2d 356 (1990), the Supreme Court held that the deemer clause exempts self funded ERISA plans from state regulation “insofar as that regulation ‘relates to’ the plans.” Id. at 61, 111 S.Ct. at 409. On the other hand, state insurance laws indirectly may regulate plans that are not self funded, because insured plans are bound by state regulation insofar as the regulations apply to their insurers. Id. The Court drew this distinction from Congress’s interest in creating national rules governing pension plans and in avoiding “‘endless litigation over the validity of State action.’” Id. at 64-65, 111 S.Ct. at 410-11 (quoting 120 Cong. Rec. 29942 (1974) (remarks of Sen. Javits)).3
The MEWA provision was added in a 1983 amendment to ERISA. Pub.L. No. 97—473 (97th Cong., 2nd Sess.) (1983). The impetus behind the amendment was an interest in curbing abuses by multiple employer trusts, which would claim ERISA preemption when states attempted to regulate them as quasi-
The Second Circuit has held that the MEWA clause “authorizes states to regulate MEWAs as insurance companies.” Atlantic Healthcare Benefits Trust v. Googins, 2 F.3d 1, 5 (2d Cir.1993), cert. denied, — U.S.-, 114 S.Ct. 689, 126 L.Ed.2d 656 (1994). Based on both the language and structure of § 1144 and on the legislative history of the MEWA amendment, we agree. The savings clause limits preemption of state insurance law to the extent it could be read to “exempt or relieve any person from [state insurance law].”
In this fashion Congress satisfied its goal of reserving to the states regulation of the business of insurance and protecting ERISA plans themselves from being subjected to state and local regulation. See FMC Corp., 498 U.S. at 61-65, 111 S.Ct. at 409-11. This interest in protecting plans from preemption is notably absent in the MEWA clause, which specifically authorizes state regulation of MEWAs as insurance providers, even if the MEWA is an employee benefit plan.
2. Does CoIo.Rev.Stat. § 10-3-903.5 Regulate Insurance?
For MEWAs that are not fully insured, as defined in ERISA, the state may apply any “law of any State which regulates insurance ... not inconsistent [with ERISA].”
In Pilot Life, the Supreme Court developed a test, derived from Metropolitan Life Insurance Co. v. Massachusetts, 471 U.S. 724, 105 S.Ct. 2380, 85 L.Ed.2d 728 (1985), to
Colorado enacted
3. Are Colorado’s MEWA regulations “inconsistent” with ERISA requirements because they require MEWA plans to comply with laws designed for insurance companies?
The MEWA clause does not allow all state insurance regulations to apply to MEWAs that are not fully insured. It permits only regulation that is “not inconsistent with [ERISA provisions].” Plaintiff argues that Colorado laws intended for regulation of insurance companies are inconsistent with ERISA. He contends that by forcing MEWAs to adopt the structure of insurance entities, the Colorado regulations do not allow MEWAs to provide benefits as MEWAs, as expressly permitted by ERISA. More specifically, by being forced to become an insurance-type entity, the IAEA would be forced to engage in a prohibited transaction as defined by § 406(a) of ERISA,
Where state regulation is not entirely excluded by a federal framework, state regulation is not “inconsistent” unless there is an actual conflict between federal and state requirements. See Fidelity Federal Sav. v. de la Cuesta, 458 U.S. 141, 153, 102 S.Ct. 3014, 3022, 73 L.Ed.2d 664 (1982) (applying “inconsistency” test to different federal preemption issue). An “actual conflict” is said to arise only when “compliance with both federal and state regulations is a physical impossibility” or when state law “stands as an obstacle to the accomplishment and execu
Plaintiff appears to argue that through merely subjecting MEWAs to regulation by the Division, § 10-3-903.5 is inconsistent with ERISA because Colorado might require it to engage in practices prohibited by ERISA or, conversely, prohibit practices specifically allowed by ERISA.6 He does not present facts, however, that suggest the Benefit Trust will be required to become an insurance entity in contravention of ERISA, that it is being subjected to laws with which it cannot comply, or that it will be unable to get a certificate of compliance from the Division.7 Under
Plaintiff’s suggestion that by requiring MEWAs to form or buy a wholly-owned insurance company, Colorado may force the plan to engage in a transaction prohibited by ERISA, see
C. Does Colo.Rev.Stat. § 10-3-903.5 Create an Irrational Classification?
Plaintiff argues that Colorado’s MEWA regulatory regime creates an irrational classification, thus violating the Equal Protection Clause. See Nordlinger v. Hahn, 505 U.S. 1, 10, 112 S.Ct. 2326, 2331-32, 120 L.Ed.2d 1 (1992) (under rational basis review, “the Equal Protection Clause requires only that the classification rationally further a legitimate state interest”). Specifically, he complains that MEWAs established after 1982 are prohibited from providing benefits as MEWAs, but must become insurance-type entities. See
We do not reach the substance of plaintiff’s equal protection challenge because he lacks Article III standing to raise it. The “constitutional minimum of standing,” in addition to requiring the plaintiff to allege an actual or imminent invasion of a legally protectable interest “fairly traceable” to the challenged action, requires a showing that it is “‘likely,’ as opposed to merely ‘speculative,’ that the injury will be ‘redressed by a favorable decision.’” Lujan v. Defenders of Wildlife, 504 U.S. 555, 560-61, 112 S.Ct. 2130, 2136-37, 119 L.Ed.2d 351 (1992)(quoting Simon v. Eastern Ky. Welfare Rights Org., 426 U.S. 26, 38, 41-43, 96 S.Ct. 1917, 1924, 1925-27, 48 L.Ed.2d 450 (1976)). Based on the complaint, it is clear that any claimed equal protection injury to the Benefit Trust plan cannot be “redressed by a favorable decision.”
Subsection (7)(c)(V)(C)of the Colorado statute requires MEWAs exempt from direct insurance regulation, in addition to having been in existence since 1982, to “be sponsored and maintained by an association which ....[h]as been in existence for a period of at least ten years.”
D. Does Colorado’s law requiring MEWAs to comply with the state’s insurance regulations violate the Commerce Clause?
Plaintiff asserts that Colorado’s workmen’s compensation laws and insurance laws, as applied to prohibit MEWAs from doing business in Colorado, violate the dormant Commerce Clause because they act to keep multistate MEWAs out of Colorado. The Commerce Clause provides that “Congress shall have Power ... to regulate Commerce ... among the several States.”
CONCLUSION
When Congress amended ERISA to include provisions allowing for state MEWA regulation, it envisioned that states would regulate these arrangements as insurance. Plaintiff complains because Colorado has done just that. The district court properly dismissed the complaint, and its judgment is AFFIRMED.