Barry v. City of Chi.
| Docket Number | 1-20-0829 |
| Decision Date | 23 December 2021 |
| Citation | 2021 IL App (1st) 200829,196 N.E.3d 631,458 Ill.Dec. 327 |
| Parties | 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, Plaintiffs-Appellants, v. The CITY OF CHICAGO, Defendant-Appellee. |
| Court | United States Appellate Court of Illinois |
Stephen B. Horwitz, of Hogan Marren Babbo & Rose, Ltd., of Chicago, for appellants.
Celia Meza, Acting Corporation Counsel, of Chicago (Benna Ruth Solomon, Myriam Zreczny Kasper, and Ellen W. McLaughlin, Assistant Corporation Counsel, of counsel), for appellee.
¶ 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 insurance on a lifetime basis, so that benefit does not end upon their eligibility for Medicare coverage at age 65, (2) the circuit court relied on precedent that misconstrued the relevant statute, and (3) they had standing to bring claims on behalf of their eligible dependents.
¶ 3 For the reasons that follow, we affirm the judgment of the circuit court.1
¶ 5 The Public Safety Employee Benefits Act (Act) ( 820 ILCS 320/1 et seq. (West 2018)) guarantees health and educational benefits for firefighters who are injured in the line of duty, as well as their spouses and children. Specifically, the Act requires public employers to "pay the entire premium of the employer's health insurance plan" for employees catastrophically injured in the line of duty, their spouse, and their dependent children. Id. § 10(a).
¶ 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 employees 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) ( 735 ILCS 5/2-619.1 (West 2018) ). The City argued that the claims plaintiffs asserted on behalf of their spouses and children should be dismissed under section 2-619(a) of the Code (id. § 2-619(a)) for lack of standing. The City argued that the Act guaranteed plaintiffs’ spouses and dependent children the right to insurance coverage, that right belonged to them personally, and nothing indicated that they lacked the capacity to assert their own claims.
¶ 11 Regarding plaintiffs’ own benefits claims, the City argued those claims should be dismissed under section 2-615 of the Code (id. § 2-615) because the Act does not require public employers to pay premiums for insurance plans that supplement Medicare. The City argued section 10(a)(1) of the Act expressly limits employers’ obligation to pay premiums for health coverage when other benefits are available, stating that "[h]ealth insurance benefits payable from any other source shall reduce benefits payable under this Section." 820 ILCS 320/10(a)(1) (West 2018). The Act also states that "[t]he term ‘health insurance plan’ does not include supplemental benefits that are not part of the basic group health insurance plan." Id. § 10(a). The City contended that because plaintiffs had Medicare, they wanted to use the City's plan for active-duty employees to supplement that coverage, but the Act does not require the City to pay premiums for supplemental coverage. The City also argued that the Illinois Appellate Court rejected plaintiffs’ precise arguments in Pyle v. City of Granite City , 2012 IL App (5th) 110472, 365 Ill.Dec. 583, 978 N.E.2d 1086, which also involved an injured firefighter eligible for Medicare.
¶ 12 In their 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) ( 820 ILCS 320/10(a)(1) (West 2018)), was not a limit on the employer's obligation to pay plan premiums, but rather was a coordination of benefits clause, which allows the employer to reduce its payments for health care costs that are also covered by Medicare.
¶ 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 that 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.
¶ 15 Plaintiffs moved for reconsideration, raising two new arguments. They contended that the circuit court should not have relied on Pyle because that decision improperly referenced section 367f of the Illinois Insurance Code (Insurance Code) ( 215 ILCS 5/367f (West 2018) ) in its analysis, and incorrectly treated the City's group plan as a Medicare supplemental or "Medigap" policy. The circuit court denied the motion to reconsider on May 14, 2020. Plaintiffs timely filed their notice of appeal.
¶ 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 motion to dismiss based upon certain defects or defenses. 735 ILCS 5/2-619.1 (West 2018). It is proper for a court when ruling on a motion to dismiss under either section 2-615 or section 2-619 to accept all well-pleaded facts in the complaint as true and to draw all reasonable inferences from those facts in favor of the nonmoving party. Lykowski v. Bergman , 299 Ill. App. 3d 157, 162, 233 Ill.Dec. 356, 700 N.E.2d 1064 (1998). Our review is de novo for motions to dismiss brought under both sections 2-615 and 2-619. Id. Under de novo review, the reviewing court performs the same analysis the trial court would perform. Thomas v....
To continue reading
Request your trial