Robinson v. Aetna Life Ins. Co.

• Decision Date: 26 May 2021
• Docket Number: No. CV-20-01830-PHX-DWL,CV-20-01830-PHX-DWL
• Parties: Lowell Robinson, Jr., Plaintiff, v. Aetna Life Insurance Company, Defendant.
• Court: U.S. District Court — District of Arizona

Lowell Robinson, Jr., Plaintiff, v. Aetna Life Insurance Company, Defendant.

No. CV-20-01830-PHX-DWL

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA

May 26, 2021

ORDER

Plaintiff Lowell Robinson, Jr. ("Robinson") is a United States Marine Corps veteran bringing this action pro se against Defendant Aetna Life Insurance Company ("Aetna"). Pending before the Court is Aetna's motion to dismiss and motion to strike. (Doc. 12.) For the following reasons, the Court orders the parties to show cause why Robinson's claims against Aetna should not be dismissed without prejudice based on a lack of subject-matter jurisdiction.

BACKGROUND

The Federal Employee Dental and Vision Benefit Enhancement Act of 2004, Pub. L. No. 108-496, 118 Stat. 4001 ("FEDVIP Act"), directs the Office of Personnel Management ("OPM") to "establish and administer a program through which an eligible individual may obtain dental coverage to supplement coverage available through chapter 89." 5 U.S.C. § 8952(a). The dental benefits created by the FEDVIP Act supplement the health benefits afforded through the Federal Employee Health Benefit Act ("FEHBA"). Pursuant to the FEDVIP Act, OPM established the Federal Employee Dental and Vision Insurance Program ("FEDVIP") to provide supplemental dental and vision insurance to federal employees, annuitants, and their dependents. See Federal Employees Dental and Vision Insurance Program, 73 Fed. Reg. 50,183 (Aug. 26, 2008) (codified at 5 C.F.R. pt. 894).

In his complaint, Robinson alleges that Aetna failed to fulfill its contractual obligations as a dental carrier under FEDVIP when it denied his out-of-network claims for reimbursement for dental services obtained in Mexico. (Doc. 1.) He seeks $1,995.77 in repayment for his out-of-pocket expenses, $400 in costs, and $25,000 in punitive damages. (Id. at 4, 7.) In response, Aetna has filed a motion to dismiss under Rule 12(b)(6) of the Federal Rules of Civil Procedure (Doc. 12), which is now fully briefed (Docs. 14, 15).

DISCUSSION

Before addressing Aetna's dismissal arguments under Rule 12(b)(6), the Court must first confirm that it possesses subject-matter jurisdiction over the claims in this action. Sinochem Int'l Co. v. Malaysia Int'l Shipping Corp., 549 U.S. 422, 430-31 (2007) ("[A] federal court generally may not rule on the merits of a case without first determining that it has jurisdiction over the category of claim in suit (subject-matter jurisdiction) and the parties (personal jurisdiction)."). Indeed, the Court has "an independent obligation to determine whether subject-matter jurisdiction exists." Arbaugh v. Y&H Corp., 546 U.S. 500, 514 (2006). See also Fed. R. Civ. P. Rule 12(h)(3) ("If the court determines at any time that it lacks subject-matter jurisdiction, the court must dismiss the action.").

Robinson's pro se complaint asserts that the Court has federal question jurisdiction based upon: (1) U.S. Public Law 108-496; (2) "The Federal Employees Dental and Vision Benefits Enhancement Act of 2004";¹ and (3) OPM letter 06-602, dated October 6, 2006. (Doc. 1 at 3.) As explained below, the Court is not convinced this is correct.

The starting point for the analysis is the FEDVIP Act's jurisdictional provision, 5 U.S.C. § 8961, which is titled "Jurisdiction of courts." It provides as follows:

The district courts of the United States have original jurisdiction, concurrent with the United States Court of Federal Claims, of a civil action or claim against the United States under this chapter after such administrative remedies as required under section 8953(d) have been exhausted, but only to the extent judicial review is not precluded by any other dispute resolution or other remedy under this chapter.

The parties do not cite any case law interpreting this provision and the Court did not uncover any in its own research.

Congress can limit a federal court's subject-matter jurisdiction to claims against certain defendants. Arbaugh, 546 U.S. at 515-16 ("If the Legislature clearly states that a threshold limitation on a statute's scope shall count as jurisdictional, then courts and litigants will be duly instructed and will not be left to wrestle with the issue.") (footnote omitted); id. at 515 n.11 ("Certain statutes confer subject-matter jurisdiction only for actions brought by specific plaintiffs, or for claims against particular defendants . . . .") (citations omitted). "[C]ourts are to review a statute's language, context, and relevant historical treatment to determine whether Congress clearly intended a statutory restriction to be jurisdictional." Kwai Fun Wong v. Beebe, 732 F.3d 1030, 1036 (9th Cir. 2013).

To determine whether § 8961 gives the Court subject-matter jurisdiction over this action, the Court begins, as it must, with the plain language of the statute. United States v. Hanousek, 176 F.3d 1116, 1120 (9th Cir. 1999) ("Statutory interpretation begins with the plain language of the statute."); United States ex rel. Hartpence v. Kinetic Concepts, Inc., 792 F.3d 1121, 1128 (9th Cir. 2015) ("The preeminent canon of statutory interpretation requires us to presume that the legislature says in a statute what it means and means in a statute what it says there. Thus, our inquiry begins with the statutory text, and ends there as well if the [statute's] text is unambiguous.") (alteration in original) (citation and internal quotation marks omitted). The plain text here, providing for "original jurisdiction . . . of a civil action or claim against the United States," along with § 8961's title—"Jurisdiction of courts"—together suggest that subject-matter jurisdiction is limited to actions against the United States. By necessary implication, then, subject-matter jurisdiction would not extend to actions against private insurance companies like Aetna.

Courts interpreting similar provisions have concluded that such language limits jurisdiction to actions against the United States. See, e.g., Miller v. Bruenger, 949 F.3d 986, 991 (6th Cir. 2020) (affirming dismissal for lack for subject-matter jurisdiction under a cause of action created by the Federal Employees' Group Life Insurance Act ("FEGLIA") because, inter alia, FEGLIA's language that "district courts of the United States have original jurisdiction, concurrent with the United States Claims Court [United States Court of Federal Claims], of a civil action or claim against the United States founded on this chapter" "[a]t most . . . allows for hypothetical suits against the United States to be brought in federal court" but does not authorize a suit against a private party) (first alteration in original); Ritchey v. Metro. Life Ins. Co., Inc., 476 F. Supp. 3d 738, 743 (N.D. Ill. 2020) ("Because Plaintiff is no longer asserting claims against the United States, FEGLIA does not create the causes of action in this case.") (citation omitted); Meriwether v. Metro. Life Ins. Co., 2017 WL 6442141, *2 (M.D. Tenn. 2017) ("The United States is not a party to this action; thus [FEGLIA] does not establish federal jurisdiction in this case.").² See also New Rock Asset Partners, L.P. v. Preferred Entity Advancements, Inc., 101 F.3d 1492, 1497-1504 (3d Cir. 1996) (holding that federal statute provided federal court jurisdiction only so long as the government agency named in the statute's jurisdiction-granting provision was a party to the action).

Another clue that jurisdiction may be limited to actions against the United States is the phrase "concurrent with the United States Court of Federal Claims." The Court of Federal Claims' jurisdiction is limited to actions against the United States. Edelmann v. United States, 76 Fed. Cl. 376, 380 (2007) ("The Court of Federal Claims does not havejurisdiction over suits against private parties; it only has jurisdiction over suits against the United States."). It would be anomalous for Congress to grant original jurisdiction in the Court of Federal Claims over FEDVIP-related claims against private parties when all other types of claims against private parties are verboten in that court. Although § 8961 theoretically could be read as granting broader jurisdiction to the district courts than the Court of Federal Claims, and thus as providing that district courts may hear claims against private parties while continuing to limit the Court of Federal Claims' jurisdiction, nothing in the statute indicates any difference between the concurrent original jurisdiction granted to district courts and the Court of Federal Claims. Accordingly, the plain language of § 8961 suggests this Court only has jurisdiction over claims against the United States.

Cases interpreting near-identical language in FEHBA's jurisdiction-granting provision provide further support for this conclusion. FEHBA and the FEDVIP Act are closely related: FEDVIP is designed to supplement the health benefits afforded through FEHBA. 5 U.S.C. § 8952(a); S. Rep. No. 108-393, at 1-4 (2004). FEHBA's jurisdictional provision, like that of the FEDVIP Act, provides that "[t]he district courts of the United States have original jurisdiction, concurrent with the United States Court of Federal Claims, of a civil action or claim against the United States founded on this chapter." 5 U.S.C. § 8912. Unlike the FEDVIP Act's jurisdictional provision, FEHBA's provision does not expressly require administrative exhaustion or preclude certain actions from judicial review. Id. §§ 8912, 8961. However, the phrase "of a civil action or claim against the United States" appears in both FEHBA and the FEDVIP Act. Id.

Courts interpreting FEHBA's jurisdiction-granting provision have concluded that the United States, not a private insurance carrier, is the proper defendant in a FEHBA action. Empire Healthchoice Assurance, Inc. v. McVeigh, 547 U.S. 677, 683 (2006) ("FEHBA itself provides for federal-court jurisdiction only in actions against the United States."); Botsford v. Blue Cross Blue Shield of Montana, Inc., 314 F.3d 390, 397 (9th Cir. 2002) ("We...