McCaffrey v. Vill. of Hoffman Estates
| Docket Number | 1-20-0395 |
| Decision Date | 11 May 2021 |
| Citation | 2021 IL App (1st) 200395,197 N.E.3d 123,458 Ill.Dec. 710 |
| Parties | Paul MCCAFFREY, Margaret McCaffrey, and Christopher McCaffrey, Plaintiffs-Appellants, v. The VILLAGE OF HOFFMAN ESTATES, Defendant-Appellee. |
| Court | United States Appellate Court of Illinois |
Joseph P. Selbka, of Pluymert, MacDonald, Hargrove & Lee, Ltd., of Hoffman Estates, for appellants.
Hal R. Morris, Elizabeth A. Thompson, and Thomas A. Laser, of Saul Ewing Arnstein & Lehr LLP, of Chicago, for appellee.
¶ 1 Plaintiffs Paul McCaffrey, Margaret McCaffrey, and Christopher McCaffrey appeal from the trial court's dismissal with prejudice of their complaint, pursuant to sections 2-615 and 2-619 of the Code of Civil Procedure (Code) ( 735 ILCS 5/2-615, 2-619 (West 2018)). Plaintiffs argue that the trial court erred in concluding that defendant, Village of Hoffman Estates, was not obligated under section 10(a) of the Public Safety Employee Benefits Act (Benefits Act) ( 820 ILCS 320/10 (West 2014) ) to pay the insurance premiums for Margaret and Christopher after they became eligible for Medicare coverage. Plaintiffs also argue that the trial court erred in concluding that they could not seek recovery for the unpaid premiums under the Wage Payment and Collection Act (Wage Act) ( 820 ILCS 115/1 et seq. (West 2014)). For the reasons that follow, we affirm.
¶ 3 Plaintiffs instituted this action by the filing of their complaint in May 2019. In that complaint, they alleged the following. Paul was a full-time police officer for defendant's police department. On July 8, 2002, Paul was severely injured in the line of duty and was disabled as a result of his injury. Paul applied for and received a disability pension based on his injury. He also applied for health insurance benefits for him and his family—his wife, Margaret, and his dependent son, Christopher—under the Benefits Act, which defendant granted on February 9, 2006.
¶ 4 At some date unspecified in the complaint, Margaret and Christopher became eligible for Medicare based on disability. For the years 2015 through 2018, Margaret opted out of Medicare, Part B. On or about May 25, 2018, defendant notified plaintiffs that it would stop paying insurance benefits for Margaret and Christopher and seek recoupment from plaintiffs’ insurer, Blue Cross Blue Shield of Illinois (BCBS), for the insurance premiums paid from 2015 to 2018. At some point after June 1, 2018, defendant stopped providing insurance to Margaret and Christopher. Defendant asserted that Margaret's and Christopher's Medicare eligibility relieved it of paying any further insurance benefits for them under the Benefits Act. In addition, at some point after June 1, 2018, defendant informed BCBS that it had paid premiums in error for the years of 20171 through 2018 and requested reimbursement of all premiums paid for Margaret and Christopher during those years. In response, BCBS reimbursed defendant for the premiums at issue and requested and received reimbursement from Margaret's and Christopher's medical providers for medical expenses BCBS had paid on Margaret's and Christopher's behalf. In turn, Margaret's and Christopher's medical providers sought payment of the medical expenses directly from plaintiffs.
¶ 5 In count I of the complaint, plaintiffs alleged that Margaret's and Christopher's Medicare eligibility was not sufficient to relieve defendant of its obligation to pay their health insurance premiums under the Benefits Act and requested that the trial court enter a judgment of mandamus, mandating that defendant pay the health insurance premiums for Margaret and Christopher from 2015 forward. In count II, plaintiffs sought a declaratory judgment, declaring that defendant was obligated under the Benefits Act to pay the health insurance premiums of Margaret and Christopher from 20172 forward. Counts III and IV alleged that defendant violated the Wage Act by failing to pay Margaret's and Christopher's health insurance premiums and by seeking recoupment of health insurance premiums paid to BCBS.
¶ 6 Before proceeding further, we pause to clarify some of plaintiffs’ factual allegations, so as to avoid confusion in our discussion of defendant's motion to dismiss and the parties’ subsequent arguments on appeal. Although plaintiffs alleged in their complaint that defendant paid insurance premiums on behalf of Christopher from 2015 to 2018, in subsequent filings, plaintiffs clarified that defendant provided coverage for only Margaret during that time and not Christopher. Accordingly, the recoupment defendant sought from BCBS was for premiums paid on behalf of Margaret. It appears, however, that plaintiff contends that defendant did not provide coverage for Christopher during that time due to his Medicare eligibility, but that defendant should have.
¶ 7 In July 2019, defendant filed a motion to dismiss plaintiffs’ complaint under section 2-619.1 of the Code ( 735 ILCS 5/2-619.1 (West 2018) ). In that motion, defendant argued that plaintiffs’ claims should be dismissed under section 2-619 of the Code ( 735 ILCS 5/2-619 (West 2018) ) because, under the Benefits Act, defendant was not required to pay the health insurance premiums for Margaret and Christopher after they became eligible for Medicare coverage. In addition, defendant argued that plaintiffs’ Wage Act claims should be dismissed under section 2-615 of the Code ( 735 ILCS 5/2-615 (West 2018) ) because plaintiffs had failed to plead or attach an employment contract or agreement to their complaint and because plaintiffs had failed to plead that Paul was not paid "final compensation" under the Wage Act.
¶ 8 In response, plaintiffs argued that Margaret's and Christopher's Medicare eligibility alone did not relieve defendant of its obligation to pay their health insurance premiums because mere access to other coverage (without taking advantage of it) was not sufficient to reduce plaintiffs’ health insurance benefits under the Benefits Act. In addition, plaintiffs argued that Medicare was only a secondary payer for Margaret and Christopher, because Paul retained "current employment status" with defendant while on disability and, accordingly, their Medicare eligibility could not be taken into consideration in coordinating benefits. Plaintiffs also contended that defendant was obligated to provide at least the basic insurance agreed to in the collective bargaining agreement with the police union. With respect to their Wage Act claims, plaintiffs argued that they did not need to plead or attach an employment contract or agreement, and even if they did, an employment agreement was created by law when defendant employed Paul as a police officer. Finally, plaintiffs argued that they did not need to plead that the insurance premiums were final compensation, because they qualified under the Wage Act as wage supplements.
¶ 9 The parties continued to debate their respective positions in defendant's reply and plaintiffs’ surresponse.
¶ 10 On January 27, 2020, the trial court issued its memorandum and order. In that order, the trial court concluded that plaintiffs’ complaint warranted dismissal with prejudice under section 2-619 of the Code because defendant was not obligated to pay insurance premiums for Margaret and Christopher under the Benefits Act where they were eligible for Medicare. The trial court rejected plaintiffs’ claim that Medicare was a secondary payer. The trial court observed that the determination of whether Medicare was a secondary payer turned on the question of whether Paul had "current employment status" with defendant. The trial court concluded that he did not have "current employment status" with defendant, because he was not actively working for defendant and was not associated with defendant in a business relationship. In so concluding, the trial court noted that Paul's employment relationship with defendant terminated upon the award of his line-of-duty disability pension and that the fact that he was subject to recall for emergency duty under the Illinois Pension Code ( 40 ILCS 5/3-116 (West 2018) ) did not confer employment status on him, because that condition stemmed simply from the Pension Board's jurisdiction over pensions.
¶ 11 Although the trial court concluded that the entire complaint was subject to dismissal under section 2-619 of the Code for these reasons, it also concluded that counts III and IV were also subject to dismissal under section 2-615 of the Code on the basis that plaintiffs failed to allege the existence of an employment contract or agreement under the Wage Act. Additionally, the trial court concluded that counts III and IV failed because health insurance benefits under the Benefits Act do not constitute wages or wage supplements under the Wage Act, in that they are postemployment benefits that are granted only after an employee has been terminated.
¶ 12 Plaintiffs then instituted this timely appeal.
¶ 14 On appeal, plaintiffs argue that the trial court erred in dismissing their complaint because (1) Margaret's and Christopher's Medicare eligibility alone did not relieve defendant of its obligations to pay their health insurance premiums under the Benefits Act and (2) the unpaid premiums constituted wage supplements under the Wage Act and did not require proof of an employment contract or agreement. We address each of these contentions in turn.
¶ 15 Defendant filed its motion to dismiss pursuant to section 2-619.1 of the Code. Section 2-619.1 of the Code permits a litigant to combine motions to dismiss pursuant to sections 2-615 and 2-619 of the Code in a single filing. 735 ILCS 5/2-619.1 (West 2018). The section 2-619 portion of defendant's motion to dismiss was brought pursuant to section 2-619(a)(9) of the Code ( 735 ILCS 5/2-619(a)(9) (West 2018)), which provides for the dismissal of a complaint on the basis that "the claim...
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