Ramirez v. Humana, Inc.

Decision Date27 October 2000
Docket NumberNo. 6:00CV1108-ORL-31B.,6:00CV1108-ORL-31B.
Citation119 F.Supp.2d 1307
PartiesChris RAMIREZ, Luis Ramirez, Joshua Ramirez, Plaintiffs, v. HUMANA, INC., Humana Medical Plan, Inc., Defendants.
CourtU.S. District Court — Middle District of Florida

Theodore J. Leopold, Scott C. Murray, Ricci, Hubbard, Leopold, Frankel & Farmer, P.A., West Palm Beach, FL, for Plaintiffs.

Edward Martin Waller, Jr., Russell S. Buhite, Elizzabeth Ann Boland, Fowler, White, Gillen, Boggs, Villareal & Banker, P.A., Tampa, FL, for Defendants.

ORDER GRANTING PLAINTIFF'S MOTION FOR REMAND

PRESNELL, District Judge.

This cause came on for consideration without oral argument on Plaintiffs' Motion For Remand (Doc. 12, filed September 21, 2000).

Background

On July 12, 2000, the Plaintiffs filed their complaint in the Circuit Court in and for Orange County, Florida, asserting various state-law claims stemming from the Defendants' allegedly wrongful denial of benefits to Plaintiff Joshua Ramirez. Joshua Ramirez was covered under a Humana health plan provided to Plaintiff Luis Hernandez by his employer, the United States Postal Service. The remaining Plaintiff, Chris Ramirez, is Joshua's mother.

The Defendants timely removed the case to this court (Doc. 1). As grounds for the removal, the Defendants asserted that this court "has original jurisdiction under 28 U.S.C. § 1331 and the Federal Employees Health Benefits Act ("FEHBA") as amended, 5 U.S.C. § [8]901, et seq., and in particular, 5 U.S.C. § 8902(m), because Plaintiffs' claims are completely preempted by FEHBA" (Doc. 1 at page 2).1 On September 21, 2000, the Plaintiffs moved to remand the case to state court (Doc. 12), arguing that, at best, FEHBA gives rise to ordinary preemption rather than complete preemption, and thus fails to provide a basis for federal question jurisdiction. It is undisputed that no grounds for diversity jurisdiction exist in this case.

LEGAL STANDARDS

It is axiomatic that federal courts are courts of limited jurisdiction. Kokkonen v. Guardian Life Ins. Co. of America, 511 U.S. 375, 377, 114 S.Ct. 1673, 1675, 128 L.Ed.2d 391 (1994). They possess only that power authorized by the Constitution and by statute. Id. (citing Willy v. Coastal Corp., 503 U.S. 131, 136-137,112 S.Ct. 1076, 1080, 117 L.Ed.2d 280 (1992), and Bender v. Williamsport Area School Dist., 475 U.S. 534, 541, 106 S.Ct. 1326, 1331, 89 L.Ed.2d 501 (1986)). These jurisdictional grants are not to be expanded by judicial decree. Id. at 377, 114 S.Ct. 1673, (citing American Fire & Casualty Co. v. Finn, 341 U.S. 6, 71 S.Ct. 534, 95 L.Ed. 702 (1951)). It is to be presumed that a cause lies outside this limited jurisdiction, id. at 377, 114 S.Ct. 1673 (citing Turner v. Bank of North America, 4 U.S. (4 Dall.) 8, 11, 1 L.Ed. 718 (1799)), and the burden of establishing the contrary rests upon the party asserting jurisdiction, id. (citing McNutt v. General Motors Acceptance Corp., 298 U.S. 178, 182-183, 56 S.Ct. 780, 782, 80 L.Ed. 1135 (1936)). Removal statutes are narrowly construed; when the defendant and the plaintiff clash about jurisdiction, any uncertainties must be construed in favor of remand. Burns v. Windsor Ins. Co., 31 F.3d 1092, 1095 (11th Cir.1994).

In considering whether they possess subject matter jurisdiction over a case or controversy, federal district courts are guided by the well-pleaded complaint rule, which provides that the plaintiff's properly pleaded complaint governs the jurisdictional determination. See Louisville & Nashville R.R. v. Mottley, 211 U.S. 149, 152, 29 S.Ct. 42, 43, 53 L.Ed. 126 (1908). Pursuant to that rule, a case may be removed based on federal question jurisdiction only when the plaintiff's statement of his own cause of action shows that it is based on federal law. Blab T.V. of Mobile, Inc. v. Comcast Cable Communications, Inc., 182 F.3d 851, 854 (11th Cir.1999) (citing Mottley). Stated differently, only state-court actions that originally could have been filed in federal court may be removed to federal court. Caterpillar, Inc. v. Williams, 482 U.S. 386, 392, 107 S.Ct. 2425, 2429, 96 L.Ed.2d 318. The presence of a federal defense does not make the case removable, even if the defense is preemption and even if the validity of the preemption defense is the only issue to be resolved in the case. Id. at 393, 107 S.Ct. 2425. The well-pleaded complaint rule generally makes the plaintiff the master of the claim; in the vast majority of cases, he or she may avoid federal jurisdiction by exclusive reliance on state law. Id. at 392, 107 S.Ct. 2425.

In the instant case, because the Plaintiffs asserted only state-law claims in their complaint, the well-pleaded complaint rule would normally require a remand by this Court due to a lack of subject matter jurisdiction. There exists, however, an independent corollary to the well-pleaded complaint rule, known as the "complete preemption" doctrine. Complete preemption occurs when the pre-emptive force of a statute is so "extraordinary" that it converts an ordinary state common-law complaint into one stating a federal claim for purposes of the well-pleaded complaint rule. BLAB T.V. of Mobile, Inc., 182 F.3d at 854 (citing Caterpillar, 482 U.S. at 393, 107 S.Ct. 2425). Because they are recast as federal claims, state law claims that are held to be completely preempted give rise to federal question jurisdiction. Id. (citing McClelland v. Gronwaldt, 155 F.3d 507, 512 (5th Cir.1998)).

Although they share similar titles, the doctrines of ordinary preemption and complete preemption present distinctly different issues — a difference not merely of scope but of quality. Ordinary preemption is simply a defense to the application of state law. See 14B Charles A. Wright & Arthur R. Miller, Federal Practice and Procedure § 3722.1 (3d ed.). Ordinary preemption operates to dismiss state claims on the merits and may be invoked in either federal or state court. BLAB T.V. of Mobile, Inc., 182 F.3d at 855. In contrast, complete preemption provides a basis for federal jurisdiction rather than simply a defense: "In complete preemption, a federal court finds that Congress desired to control the adjudication of the federal cause of action to such an extent that it did not just provide a federal defense to the application of state law; rather, it replaced the state law with federal law and made it clear that the defendant has the ability to seek adjudication of the federal claim in a federal forum." 14B Charles A. Wright & Arthur R. Miller, Federal Practice and Procedure § 3722.1 (3d ed.).

The Supreme Court has addressed complete preemption only rarely, and has found it to exist only in two areas2: certain claims under the Labor Management Relations Act ("LMRA"), 29 U.S.C. § 185, and certain claims under the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a). See Avco Corp. v. Aero Lodge No. 735, 390 U.S. 557, 560, 88 S.Ct. 1235, 20 L.Ed.2d 126 (1968) (LMRA) and Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 63-64, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987) (ERISA). Outside of the context of the LMRA or ERISA, the Eleventh Circuit has addressed the topic directly only in Blab T.V. of Mobile, Inc., which involved the Cable Communications Policy Act of 1984, 47 U.S.C. § 532. See Blab T.V. of Mobile, Inc., 182 F.3d at 856. Neither the Supreme Court nor the Eleventh Circuit has adopted a specific test for use in determining whether claims outside the context of the LMRA or ERISA have been completely preempted by federal laws. See Blab T.V. of Mobile, Inc. 182 F.3d at 857 (solely considering congressional intent and declining to adopt a test for making future complete preemption determinations).

Prior to 1998, the majority of the case law addressing the issue held that the FEHBA did not completely preempt state law. See, e.g., Goepel v. National Postal Mail Handlers Union, 36 F.3d 306 (3d Cir.1994); Lambert v. Mail Handlers Benefit Plan, 886 F.Supp. 830, 836 (M.D.Ala. 1995). But see Hanson v. Blue Cross Blue Shield of Iowa, 953 F.Supp. 270 (N.D.Iowa 1996). However, in 1998, Congress amended the FEHBA's preemption section, as more fully detailed below. Since that amendment took effect, three federal district courts have found that the FEHBA completely preempts state law claims: Carter v. Blue Cross and Blue Shield of Fla., Inc., 61 F.Supp.2d 1237 (N.D.Fla. 1999); Kight v. Kaiser Foundation Health Plan, 34 F.Supp.2d 334 (E.D.Va.1999); and Rievley v. Blue Cross & Blue Shield of Tennessee, 69 F.Supp.2d 1028 (E.D.Tenn. 1999). Since 1998, the single district court that has reached the opposite conclusion did so without considering the effect of the 1998 amendment. See Weathington v. United Behavioral Health, 41 F.Supp.2d 1315 (M.D.Ala.1999).

Neither party has asserted that the pre-1998 language applies in this case, and this Court will decide the subject matter jurisdiction issue on the basis of the post-1998 language. See Landgraf v. USI Film Prods., 511 U.S. 244, 274-275, 114 S.Ct. 1483, 128 L.Ed.2d 229 (1994) (stating that law in effect at the time of decision normally governs jurisdictional disputes because such laws speak to the power of the court rather than to the rights or obligations of the parties).

ANALYSIS

As noted above, neither the Supreme Court nor the Eleventh Circuit Court of Appeals has adopted a specific test for determining whether a particular federal statute completely preempts state law. However, it is clear from both the Supreme Court's decision in Metropolitan Life Insurance and the Eleventh Circuit's decision in BLAB T.V. of Mobile, Inc., that Congressional intent is the ultimate consideration in such inquiries. See Metropolitan Life Insurance, 481 U.S. at 67, 107 S.Ct. 1542 (stating that the lawsuit in that case was "necessarily federal in character by virtue of the clearly manifested intent of Congress"); and BLAB T.V. of Mobile, Inc., 182 F.3d at 857 (stating that complete preemption analysis focuses primarily upon "ev...

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