Lead Opinion
OPINION OF THE COURT
I. FACTUAL AND PROCEDURAL HISTORY
A. Factual History
Appellant Ronald Goepel is a civilian employee of the United States Department of the Navy. He and his wife, appellant Marilyn Goepel, reside in Deptford, New Jersey, and have been enrolled in the Mail Handlers Benefit Plan, a fee-for-service health benefits plan, continuously since 1981. The Mail
OPM has contracted with the appellee, the National Postal Mail Handlers Union, a division of the Laborers International Union of North America, AFL-CIO, for the provision of the Mail Handlers Benefit Plan, and the Union has subcontracted with Continental Assurance Company to underwrite and administer the Plan. Each year OPM and the Union negotiate the terms of the Plan and document these terms in the Plan brochure, which is included as an appendix to the contract between OPM and the Union.
In January 1993, Marilyn Goepel learned that she had metastatic breast cancer. Thereafter, her consulting oncologist, Dr. David L. Topolsky of Hahnemann University, recommended that she undergo a treatment in which high doses of chemotherapy are followed by a peripheral stem cell infusion (HDC/APCR).
The Goepels contacted Congressman Robert E. Andrews, who then sent a letter dated August 6, 1993, to OPM on their behalf. Within a week, OPM responded to Congressman Andrews’ inquiry with a letter stating that page 19 of the 1993 Plan brochure “explicitly excludes benefits for HDCT/ABMT for breast cancer,” and that therefore OPM had “no contractual basis to ask the Plan to provide benefits for Mrs. Goepel.”
B. Procedural History
On August 19, 1993, the Goepels filed a complaint in the Superior Court of New Jersey, Law Division, alleging that: (1) the Plan violated the New Jersey Law Against Discrimination, N.J.StatAnn. § 10:5-1 et seq. (West 1993); (2) the Plan breached its contract by refusing to certify her coverage for HDC/APCR; (3) any exclusion of coverage for HDC/APCR in the Plan brochure was unconscionable; and (4) the Plan’s handling of Mrs. Goepel’s claim involved unfair claim settlement practices in violation of N.J.Stat. Ann. § 17B:30-13.1 (West 1985). See app. at 1-10. On these bases, the Goepels sought a declaratory judgment, injunctive relief, damages, and counsel fees. Id.
The Plan immediately removed the case to the United States District Court for the District of New Jersey. In its notice of removal,
II. DISCUSSION
In denying the Goepels’ motion to remand this case to New Jersey Superior Court, the district court held that the case was removable pursuant to 28 U.S.C. § 1441(b) because “the matter [wa]s one ‘arising under’ the laws of the United States.” See Goepel v. Mail Handlers Benefit Plan, No. 93-3711, at 2 (D.N.J. Sept. 10, 1993). Section 1441(b) provides in relevant part that
[a]ny civil action of which the district courts have original jurisdiction founded on a claim or right arising under the Constitution, treaties or laws of the United States shall be removable without regard to the citizenship or residence of the parties.
The Goepels argue that the Plan improperly removed the case because they base their claims exclusively on state law, and thus do not raise any “federal questions” over which the district court would have original jurisdiction pursuant to 28 U.S.C. § 1331 and removal jurisdiction pursuant to 28 U.S.C. § 1441(b). We confine our review of the district court’s subject matter jurisdiction to whether it had federal question removal jurisdiction over the Goepels’ claims, as the Plan removed the ease to district court on this basis alone, and it does not contend that it could have removed the case on the basis of diversity of citizenship. See 28 U.S.C. §§ 1332, 1441(a); Caterpillar, Inc. v. Williams,
“ ‘[F]ederal question’ cases ... [are] those eases ‘arising under the Constitution; laws, or treaties of the United States.’ ” Metropolitan Life Ins. Co. v. Taylor,
The Goepels’ complaint does not purport to rely on federal law. Two of their its claims, namely the claims alleging violations of New Jersey’s Law Against Discrimination, N.J.Stat.Ann. § 10:5-1 et seq., and New Jersey’s law against unfair claim settlement practices, N.J.Stat.Ann. § 17B:30-13.1, are based expressly on New Jersey statutes. See app. at 1-4, 8-10. Moreover, although the Goepels’ breach of contract and uncon-scionability claims do not rely expressly on either state or federal law, in the absence of any indication that the Goepels intended to invoke federal common law, we conclude that “on their face” these claims are grounded exclusively on New Jersey common law.
In Franchise Tax Bd. v. Construction Laborers Vacation Trust,
A state claim which is “really one of federal law” may be removed to federal court because “it is an independent corollary of the well-pleaded complaint rule that a plaintiff may not defeat removal by omitting to plead necessary federal questions in a complaint.” Franchise Tax Bd.,
As we stated in Railway Labor Executives Ass’n v. Pittsburgh & Lake Erie R. Co.,
[t]he complete preemption doctrine holds that ‘Congress may so completely preempt a particular area, that any civil complaint raising this select group of claims is necessarily federal in character.’ Metropolitan Life Ins. Co. v. Taylor,481 U.S. 58 ,107 S.Ct. 1542 , 1546,95 L.Ed.2d 55 (1987). In such cases, ‘any complaint that comes within the scope of the federal cause of action [created by the federal statute] necessarily “arises under” federal law,’ Franchise Tax Bd. v. Construction Laborers Vacation Trust,463 U.S. 1 , 24,103 S.Ct. 2841 , 2854,77 L.Ed.2d 420 (1983), for purposes of removal based on federal question jurisdiction.
The Supreme Court has held that both the Labor Management Relations Act (LMRA), and the Employee Retirement Income Security Act (ERISA) “completely preempt” certain state causes of action. The Supreme Court first applied the complete preemption doctrine in Avco Corp. v. Aero Lodge No. 735,
The Court in Franchise Tax Bd. based its determination that ERISA did not preempt a state law action by state tax authorities seeking to enforce a tax levy against an ERISA plan in part on the fact that ERISA “d[id] not provide an alternative cause of action in favor of the State to enforce its rights.” Id. at 26,
Thus, based on our construction of Franchise Tax Bd., “[t]he doctrine of complete preemption applies only when [these] two circumstances are present.” Allstate Ins. Co. v. The 65 Security Plan,
Without applying the two-part test for complete preemption, which we have recognized as the only basis for recharacterizing a state law claim as a federal claim removable to a district court, the district court concluded that the removal was proper because the Goepels’ complaint was “ ‘necessarily federal in character by virtue of the clearly manifested intent of Congress.’ ” Goepel v. Mail Handlers Benefit Plan, No. 93-3711, at 10 (D.N. J. Sept. 10, 1993) (quoting Metropolitan,
With respect to preemption, FEHBA states that
[t]he provisions of any contract under this chapter which relate to the nature or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans to the extent that such law or regulation is inconsistent with such contractual provisions.
5 U.S.C. § 8902(m)(l). In some respects this provision does resemble ERISA’s preemption provision, which states that “[e]xcept as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III of this chapter shall supersede any and all State laws insofar as they may now or hereafter relate to an employee benefit plan.” 29 U.S.C. § 1144(a).
However, ERISA contains a civil enforcement provision expressly authorizing ERISA beneficiaries to bring actions to recover benefits under an ERISA plan. See 29 U.S.C. § 1132(a). In contrast, FEHBA does not create a cause of action vindicating a beneficiary’s interest in recovering his or her benefits under a plan. FEHBA only provides that “[t]he district courts of the United States have original jurisdiction, concurrent with the United States Claims Court, of a civil action or claim against the United States founded on this chapter.” 5 U.S.C. § 8912. But the United States is not a party to this action. Moreover, the regulations promulgated by OPM pursuant to FEHBA expressly provide that “[a]n action to recover on a claim for health benefits should be brought against the carrier of the health benefits plan.” See 5 C.F.R. § 890.107.
Based on the language of FEHBA and the regulations promulgated pursuant to it, it is clear that FEHBA does not create a statutory cause of action vindicating the same interest that the Goepels’ state causes of action seek to vindicate, namely the recovery of benefits from the Plan.
We recognize that our decision is at odds with the decision by the Court of Appeals for the Fourth Circuit in Caudill v. Blue Cross and Blue Shield of North Carolina,
Boyle was a tort action brought by the father of a United States marine killed in a helicopter crash during a training exercise. Boyle,
The Supreme Court affirmed the court of appeals’ determination that in the circumstances in Boyle, federal law displaced the “state law which holds Government contractors liable for design defects in military equipment.” Id. at 512,
The Court concluded that “the civil liabilities arising out of the performance of federal procurement contracts” involve a “uniquely
The Boyle Court limited the scope of the displacement of state laws holding government contractors liable for design defects to the following circumstances: “(1) the United States approved reasonably precise specifications; (2) the equipment conformed to those specifications; and (3) the supplier warned the United States about the dangers in the use of the equipment that were known to the supplier but not to the United States.” Id. at 512,
Based on the two-part test applied in Boyle, the court in Caudill held that federal common law displaces state claims to recover benefits from a FEHBA plan. Like Boyle, Caudill was not an action brought by or against the United States. Nonetheless, the Caudill court made the following determination:
[t]he interest in this case is uniquely federal because it involves health benefits for federal employees ... [and because the] imposition of state law liability here would seriously damage not only the government’s ability to enter into contracts with health insurers, but also would affect the price paid for such contracts. Most importantly, the federal government is a party to this contract. Thus, a significant federal interest exists here that is even stronger than in Boyle.
Caudill,
[a]s an employer, the federal government has an overwhelming interest in ensuring that all of its employees subject to a particular health insurance policy are treated equally regardless of the state in which they five, and the application of state law interferes with this interest_ [Moreover,] the very application of state contract law would undermine the uniformity envisioned by Congress when it delegated the authority to interpret health benefit contracts to OPM.
Id. at 79. Thus, based on the Supreme Court’s decision in Boyle, the Caudill court concluded that removal of the case was proper because “[i]n the area of federal employee health benefits, federal common law entirely replaces state contract law.” Id.
Our decisions in Railway and Allstate require us to reject the Caudill court’s holding that Boyle authorizes the removal of a state law contract claim to recover benefits from a FEHBA plan. First, Boyle is distinguishable from this case because it did not involve the removal of “what purports to be a state law claim” from state court to federal court on the basis of federal question jurisdiction. Railway,
Second, in Railway and Allstate, we held that: (1) in a case removed from state court, a federal court may not recharacterize “what purports to be a state law claim as a claim arising under a federal statute” unless the state claim is completely preempted by federal law, Railway,
Our outcome is consistent with that reached in Howard v. Group Hosp. Serv.,
Instead, the Howard court based its decision on its conclusion that the federal government had no “articulable interest in the outcome,” Howard,
We need not reach the question of whether the Goepels’ state law claims are preempted by FEHBA, and thus are governed by federal common law. The courts are divided on the extent to which FEHBA preempts state law. As we noted, the court in Howard held that FEHBA does not preempt state law claims to recover benefits under a FEHBA plan. Nevertheless, “ ‘[t]he weight of authority ... supports the position that state law claims are preempted,’” Burkey v. Government Employees Hosp. Ass’n,
The Plan is free to raise preemption as a defense in state court, and our holding that FEHBA does not completely preempt the Goepels’ state law claims so as to permit removal of this action does not prejudge the merits of such a claim. “State courts are competent to determine whether state law has been preempted by federal law,” Railway,
STAPLETON, Circuit Judge, concurring: I agree with all that is said in the opinion of the court. I write separately only to emphasize the importance, in my view, of the distinction noted by the court in footnote 7. Unlike the preemption provision of ERISA, the FEHBA preempts state law only “to the extent such law ... is inconsistent with [a] contractual provision” of a FEHBA policy. 5 U.S.C. § 8902(m)(l). I believe the fact that Congress chose to so limit the preemptive effect of the FEHBA is inconsistent with the notion that Congress intended to “completely” preempt state law.
. In a certification dated August 17, 1993, Dr. Topolsky explained the treatment as foEows: it “works on the principal [sic] that the high doses of chemotherapy required to substantially kill or eradicate a patient's tumor will, as a side-effect, fatally destroy the patient's bone marrow. Therefore, a sample of either bone marrow or bone marrow cells which have been induced to enter the peripheral blood, are removed and stored in a freezer prior to the high-dose chemotherapy process. Following administration of the chemotherapy to the patient, the previously stored marrow cells are given back to the patient to protect them from an otherwise fatal toxic-side-effect of the treatment.” See app. at 94.
. In its letter the OPM referred to the coverage sought as “high dosage chemotherapy/autologous bone marrow transplant (HDCT/ABMT).” In view of our result we need not discuss the significance, if any, of the distinction between HDC/ APCR and HDCT/ABMT.
. We do not reach the question of whether the Goepels could have stated a cause of action under federal common law.
. See Mulcahey v. Columbia Organic Chems. Co.,
. "This same principle has been referred to elsewhere as the 'artful pleading' doctrine, under which a court will not allow a plaintiff to deny a .defendant a federal forum when the plaintiff's complaint contains a federal claim ‘artfully pled’ as a state law claim.” United Jersey Banks v. Parell,
. “[I]t is now settled law that a case may not be removed to federal court on the basis of a federal defense, including the defense of pre-emption, even if the defense is anticipated in the plaintiff's complaint, and even if both parties concede that the federal defense is the only question truly at issue.” Caterpillar, Inc. v. Williams, 482 U.S. at
. There is, of course, a distinction between the preemption provisions of ERISA and FEHBA. The former preempts "any and all state laws" having anything to do with employee benefit plans; the latter preempts state law relating to FEHBA health insurance or plans only "to the extent that such law ... is inconsistent with [a] contractual provision[]" of an FEHBA policy. ERISA thus preempts all state law in a particular area. Under the FEHBA, however, there is no preemption, even in the area of FEHBA health insurance and plans, unless there is a conflict between the particular state law being relied upon in the litigation and a specific contractual provision in am FEHBA policy.
. Congress authorized OPM to "prescribe regulations necessary to carry out" the provisions of FEHBA. 5 U.S.C. § 8913(a).
. "Under a well settled principle of deference, 'considerable weight should be accorded to an executive department's construction of a statutory scheme it is entrusted to administer.' " Katsis v. INS,
. “There is currently a split of authority with respect to the exhaustion requirements for plans governed by FEHBA." Kennedy v. Empire Blue Cross and Blue Shield,
.The Caudill court concluded that in light of its holding, it “need not answer the question whether the FEHBA completely preempts state law claims under federal health insurance contracts.” Caudill,
. Our holding that a state claim is not preempted completely by federal law unless the enforcement provisions of a federal statute create a federal cause of action vindicating the same interest that the plaintiff’s state cause of action seeks to vindicate is at odds with the holding in Deford v. Soo Line R. Co.,
. With the exception of Caudill, none of these federal cases holding that FEHBA preempts state law claims for benefits deals expressly with the question of whether in the absence of diversity jurisdiction, FEHBA authorizes the removal of claims grounded exclusively on state law. It seems that Nesseim, Harris, Burkey, and Tackitt involved actions initiated in federal district court. The action in Hayes was initiated in state court and then removed to federal district court, Hayes,
Lead Opinion
SUR PETITION FOR REHEARING
Oct. 25, 1994
The petition for rehearing filed by the appellee, Mail Handlers Benefit Plan, in the above captioned matter having been submitted to the judges who participated in the decision of this court and to all the other available circuit judges of the court in regular active service, and no judge who concurred in the decision having asked for rehearing, and a majority of the circuit judges of the circuit in regular active service not having voted for rehearing by the court in banc, the petition for rehearing is denied.
