Plaintiffs initially filed the complaint in this case in New York state court, seeking, among other things, to enjoin defendant insurers under N.Y. Gen. Oblig. Law § 5-335 from obtaining reimbursement of medical benefits from plaintiffs’ tort settlements. Defendants removed this action to the Eastern District of New York (Joseph F. Bianco, District Judge), where the district court granted defendants’ motion to dismiss under Rule 12(b)(6) for failure to state a claim on the basis that plaintiffs’ claims were subject to both “complete” and “express” preemption under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq.
We hold that plaintiffs’ claims do not satisfy the Supreme Court’s test for being subject to complete ERISA preemption, which would have conferred federal subject-matter jurisdiction.
See Aetna Health Inc. v. Davila,
BACKGROUND
The New York statute at issue in this appeal, N.Y. Gen. Oblig. Law § 5-335, 1 states that a personal injury settlement presumptively “does not include any compensation for the cost of health care services” or other losses that “are obligated to be paid or reimbursed by a benefit provider” (such as an insurer), and that benefit providers have no “right of subro-gation or reimbursement against any such settling party.” 2 When section 5-335 was enacted in 2009, it eliminated an asymmetry between jury verdicts and settlements that tended to discourage the settlement of personal injury lawsuits. 3
Defendants removed this action to the Eastern District of New York and then moved to dismiss under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim based on ERISA preemption. The district court granted defendants’ motion to dismiss, holding that plaintiffs’ claims “are superseded under two parallel and independent principles of preemption: (1) complete preemption under ERISA § 502(a), and (2) express preemption under ERISA § 514.”
Wurtz v. Rawlings Co., LLC,
DISCUSSION
“We review a district court’s ERISA preemption ruling and 12(b)(6) dismissal for failure to state a claim de novo.”
Arditi v. Lighthouse Int’l,
I. Federal Subject-Matter Jurisdiction
We begin by addressing our “special obligation to satisfy [ourselves] ... of [our] own jurisdiction.”
Arnold v. Lucks,
A. Preemption and Federal Jurisdiction
Express preemption is one of the “three familiar forms” of ordinary defensive preemption (along with conflict and field preemption).
Sullivan v. Am. Airlines, Inc.,
In contrast, under the “so-called ‘complete preemption doctrine,’ ” which is distinct from the three forms of defensive preemption, “a plaintiffs ‘state cause of action [may be recast] as a federal claim for relief, making [its] removal [by the defendant] proper on the basis of federal question jurisdiction.’ ”
Vaden v. Discover Bank,
Thus, in a case such as this, complete preemption may be “crucial to the existence of federal subject-matter jurisdiction.”
Sullivan,
B. Class Action Fairness Act
In this case, defendants have asserted an alternative basis to justify removal to federal court. Under CAFA, federal courts have jurisdiction over a class action filed under Fed.R.Civ.P. 23 or a “similar State statute or rule of judicial procedure authorizing an action to be brought by 1 or more representative persons as a class action” if “the matter in controversy exceeds the sum or value of $5,000,000, exclusive of interest and costs” and the parties are minimally diverse. 28 U.S.C. § 1332(d)(l)-(2). CAFA does not apply when “the number of members of all proposed plaintiff classes in the aggregate is less than 100.” Id. § 1332(d)(5)(B).
“We generally evaluate jurisdictional facts, such as the amount in controversy, on the basis of the pleadings, viewed at the time when defendant files the notice of removal. With this in mind, a court must assess the three prerequisites for CAFA jurisdiction: no fewer than 100 members of the plaintiff class, minimal diversity, and $5 million in controversy.”
Blockbuster, Inc. v. Galeno,
Defendants have satisfied this burden. Plaintiffs filed this action as a class action under Article 9 of the New York Civil Practice Law and Rules. With regard to the number of class members, the complaint states that “[plaintiffs reasonably believe[ ] that there are hundreds of members in the proposed Class.” With regard to minimal diversity, the complaint states that the named plaintiffs are residents of Arkansas and New York but makes no declaration as to citizenship. As defendants state in their notice of removal, however, “[e]ven if both were citizens of New York, minimal diversity exists since UnitedHealth is both incorporated and has its principal place of business in Minnesota.”
See Blockbuster, 472,
F.3d at 59 (“[I]t seems plain to us that [defendant] is able to meet its burden of showing there is a reasonable probability that at least one of these class members is a citizen of New York and thus is ‘a citizen of a State different from ... defendant.’ ” (quoting 28 U.S.C. § 1332(d)(2)(A))). Finally, with regard to the requirement of $5 million in controversy, the complaint states that defendants have “collected] hundreds of millions of dollars in fully insured health insurance liens that they were not entitled to enforce or collect following the enactment of N.Y. GOL 5-335.” In their notice of removal, defendants confirm that “[d]efen-dant Rawlings has handled subrogation and reimbursement claims totaling more than $5 million with respect to New York
CAFA also contains express exceptions to jurisdiction. For example, federal jurisdiction would not exist here if (1) over two-thirds of the proposed plaintiffs were citizens of New York; (2) at least one defendant from whom “significant relief is sought” was a citizen of New York; (3) “principal injuries resulting from the alleged conduct ... were incurred in” New York; and (4) “during the 3-year period preceding the filing of that class action, no other class action has been filed asserting the same or similar factual allegations against any of the defendants on behalf of the same or other persons.” 28 U.S.C. § 1332(d)(4). The Second Circuit has declined to reach the issue of who bears the burden with regard to CAFA exceptions.
See Blockbuster,
Because CAFA supplies a basis for federal subject-matter jurisdiction, we reach defendants’ express preemption defense in addition to their complete preemption argument. We discuss both forms of preemption below.
II. Express Preemption
ERISA expressly preempts any state law that “relate[s] to any employee benefit plan,” but not if that law “regulates insurance.” ERISA § 514(a)-(b), 29 U.S.C. § 1144(a)-(b). It is undisputed that N.Y. Gen. Oblig. Law § 5-335 “relate[s] to” ERISA plans, but we conclude that it is “saved” from express preemption as a law that “regulates insurance.” A law “regulates insurance” under this savings clause if it (1) is “specifically directed toward entities engaged in insurance,” and (2) “substantially affect[s] the risk pooling arrangement between the insurer and the insured.”
Kentucky Ass’n of Health Plans, Inc. v. Miller,
The district court’s holding that N.Y. Gen. Oblig. Law § 5-335 does not fall within this savings clause is contrary to the Supreme Court’s decision in
FMC Corp. v. Holliday,
Here, the district court concluded that section 5-335 is not “specifically directed” at insurance because it regulates not only insurers but also all other “benefit provider[s],” “including self-funded employer plans.”
5
Wurtz,
The district court also concluded that section 5-335 does not “substantially affect the risk pooling arrangement between the insurer and the insured” because the law “only applies to a subset of benefit providers, specifically, those without a statutory right of reimbursement and who do not intervene in underlying third party actions in which the third party settles.”
Wurtz,
Because N.Y. Gen. Oblig. Law § 5-335 is specifically directed toward insurers and substantially affects risk pooling between insurers and insureds, we conclude that it is saved from express preemption under ERISA § 514 as a law that regulates insurance.
III. Complete Preemption
The district court held that plaintiffs’ claims are completely preempted under ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), which allows an ERISA participant to bring an action to receive or to clarify his plan benefits. In
Davila,
[under Davila ], claims are completely preempted by ERISA if they are brought (i) by “an individual [who] at some point in time, could have brought his claim under ERISA § 502(a)(1)(B),” and (ii) under circumstances in which “there is no other independent legal duty that is implicated by a defendant’s actions.”
Montefiore Med. Ctr. v. Teamsters Local 272,
A. Davila Part One
In
Montefiore,
we “expressly disaggregate[ed] the first prong of
Davila
“First, we consider whether the plaintiff is the
type
of party that can. bring a claim pursuant to § 502(a)(1)(B); and second, we consider whether the
actual claim
that the plaintiff asserts can be construed as a col-
ERISA § 502(a)(1)(B) allows a plaintiff “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.” The claims in plaintiffs’ complaint seek to do none of these things. Plaintiffs do not contend that they have a right to keep their tort settlements “under the terms of [their] plan[s]” — rather, they contend that they have a right to keep their tort settlements under N.Y. Gen. Oblig. Law § 5-335. They also do not seek to “enforce” or “clarify” their rights “under the terms of [their] plan[s]” because the state right they seek to enforce — to be free from subrogation — is not provided by their plans. Indeed, the terms of plaintiffs’ ERISA plans are irrelevant to their claims. Plaintiffs’ claims are thus unlike the claims for benefits that were held completely preempted in
Davi-la,
for which “the wording of the plans [was] certainly material to [the] state causes of action.”
The district court held that plaintiffs’ claims can be construed as claims for benefits under ERISA § 502(a)(1)(B) because they “effectively seek to cut off defendants’ reimbursement rights under the Plans.”
Wurtz,
This expansive interpretation of complete preemption ignores the fact that plaintiffs’ claims are based on a state law that regulates insurance and are not based on the terms of their plans. As a result, state law does not impermissibly expand the exclusive remedies provided by ERISA § 502(a). Under ERISA § 514(a)-(b), state laws that “relate to” ERISA plans are expressly preempted, but not if they “regulate[ ] insurance.” 29 U.S.C. § 1144(a)-(b). Based on this “insurance saving clause,” the Supreme Court has held that state statutes regulating insurance that nonetheless affect ERISA benefits are not expressly preempted, with no hint that claims under these statutes might still be completely preempted and thus unable to be adjudicated under those state laws when they do not expand the reme
B. Davila Part 2
Plaintiffs’ claims under N.Y. Gen. Oblig. Law § 5-335 also do not satisfy the second part of the
Davila
test — that there be “no other independent legal duty that is implicated by [the] defendants’] actions.”
Davila,
In
Stevenson,
The district court also stated that section 5-335 could not be the basis of an independent legal duty because it does not apply “where there is a statutory right of reimbursement,” N.Y. Gen. Oblig. Law § 5-335(a), and plaintiffs’ plans contain a right of reimbursement that “is enforced by means of ERISA.”
Wurtz,
“The [Davila] test is conjunctive; a state-law cause of action is [completely] preempted only if both prongs of the test are satisfied.”
Montefiore,
C. Other Circuits
We recognize that this result is in some tension with holdings of the Third, Fourth, and Fifth Circuits in similar antisubrogation cases, albeit decided before
Davila. See Arana v. Ochsner Health Plan,
As we have explained, however, the logic of Arana, Singh, and Levine would expand complete preemption to encompass state laws that regulate insurance and that do not impermissibly expand the exclusive remedies provided by ERISA § 502(a).
We are more persuaded by the reasoning of the Ninth Circuit in
Marin General Hospital v. Modesto & Empire Traction Co.,
Other circuits have similarly declined to expand complete preemption doctrine to allow removal of state law claims into federal court simply because they implicate ERISA benefits.
See, e.g., Gardner v. Heartland Indus. Partners, LP,
In the same vein, in this case plaintiffs are not claiming that they have a right to enjoin defendants from seeking reimbursement because of the terms of their ERISA plans. Rather, they claim that they have this right under N.Y. Gen. Oblig. Law § 5-335, which imposes an independent legal duty on defendants not to seek reimbursement of medical expenses from plaintiffs’ tort settlements, regardless of what plaintiffs’ ERISA plans say about reimbursement.
Allowing plaintiffs’ state-law claims under section 5-335 to proceed will not disturb ERISA’s goal of providing national uniformity. ERISA has strong preemp
CONCLUSION
For the reasons stated above, we conclude that CAFA supplies a basis for federal subject-matter jurisdiction and that plaintiffs’ claims are neither expressly nor completely preempted by ERISA. We VACATE the district court’s judgment and REMAND for further proceedings on plaintiffs’ claims.
Notes
.For purposes of this appeal, we will refer to the version of section 5-335 that was in effect at the time of this action and relied upon by the District Court in reaching its decision as well as the parties in their briefing here. We note, however, that the statute has since been amended on November 13, 2013, primarily by replacing references to “a benefit provider” with "an insurer,” and the amendment applies retroactively to claims brought on or after November 12, 2009. See 2013 N.Y. Sess. Laws Ch. 516 (codified at N.Y. Gen. Oblig. Law § 5-335). The changes enacted by the New York legislature do not affect our analysis.
. "[S]ubrogation is the principle by which an insurer, having paid losses of its insured, is placed in the position of its insured so that it may recover from the third party legally responsible for the loss.”
Teichman ex rel. Teichman v. Cmty. Hosp. of
W.
Suffolk,
.
See
2009 N.Y. Sess. Laws 1265 (Ch. 494) (enacting section 5-335). In New York, jury
. The Rawlings Company collects subrogation claims on behalf of insurer Oxford Health (N.Y.), which is a wholly owned subsidiary of insurer UnitedHealth Group.
. Under N.Y. Gen. Oblig. Law § 5-101, " 'benefit provider' means any insurer, health maintenance organization, health benefit plan, preferred provider organization, employee benefit plan or other entity which provides for payment or reimbursement of health care expenses, health care services, disability payments, lost wage payments or any other benefits under a policy of insurance or contract with an individual or group.”
. The issue in
FMC
was the effect of the so-called “deemer clause” of ERISA § 514(b)(2)(B), which exempts self-funded plans from the savings clause. The Supreme Court held that the deemer clause did not cause preemption of the entire statute in all cases, but only as applied to self-funded plans.
. The
Davila
plaintiffs "complain[ed] only about denials of coverage promised under the terms of ERISA-regulated employee benefit plans,” arguing that they were entitled to additional benefits under a state law that imposed a duty to "exercise ordinary care when making health treatment decisions.”
. The
Singh
Court did, however, conclude that the antisubrogation statute was
not
expressly preempted, noting that "[i]n
FMC Corp. v. Holliday,
the Supreme Court dealt precisely with the question of whether a State antisubrogation law was saved from preemption under § 514(b)(2)(A), and held that it was.”
