ROY B. DALTON, Jr., District Judge.
In the instant motion, Plaintiffs move for remand. (Doc. 18 ("
Plaintiffs brought this action seeking medical benefits under a group health insurance policy that Defendant United Healthcare Insurance Company ("
Constant LLC first applied for a group health insurance policy with UHIC on
Under the original Policy, Andre Raab was enrolled for family coverage with his wife, and two non-owner employees were also enrolled for coverage. (Doc. 26-1, ¶ 5.) Thereafter, in 2010, two additional non-owner employees enrolled for coverage under the Policy. (Id. ¶ 6.) Coverage for all of the individuals under the Policy, other than Andre Raab, terminated on
In 2015, Andre Raab submitted a claim under the Policy for Laura Raab's medical expenses during 2014. (Doc. 2, ¶¶ 5-6.) UHIC ultimately denied the claim. (Id. ¶ 14.) Based on this denial, Plaintiffs filed suit in the Circuit Court of the Eighteenth Judicial Circuit in and for Seminole County, Florida, on
"On a motion to remand, the removing party bears the burden of establishing jurisdiction." Diaz v. Sheppard, 85 F.3d 1502, 1505 (11th Cir. 1996). Any doubts about removal jurisdiction should be construed in favor of remand to state court. Id. Where a case is removed on the basis of federal question jurisdiction, the applicable federal claim must appear on the face of the plaintiff's well-pleaded complaint. Ervast v. Flexible Prod. Co., 346 F.3d 1007, 1012 (11th Cir. 2003). An exception to this rule, however, is the doctrine of complete preemption. Id. "If a federal statute completely preempts a state-law cause of action, a claim which comes within the scope of that cause of action, even if pleaded in terms of state law, is in reality based on federal law." May v. Lakeland Reg'l Med. Ctr., No. 8:09-cv-406-T-33AEP, 2010 U.S. Dist. LEXIS 5866, *6 (M.D. Fla. Jan. 5, 2010) (citing Aetna Health Inc. v. Davila, 542 U.S. 200, 207-08 (2004)). So "`when a federal statute wholly displaces the state-law cause of action through complete pre-emption, the state claim can be removed.'" Id. (citing Aetna Health Inc., 542 U.S. at 207). ERISA completely preempts state law claims involving rights to recover benefits under employee benefit plans. Ervast, 346 F.3d 1007, 1014 (11th Cir. 2003).
As a preliminary matter, the Court finds that it is proper to consider post-removal evidence relied on by UHIC in its Response—inclusive of information regarding the Policy as it stood when it was initially issued in 2009. In their reply, Plaintiffs argue that UHIC should be constrained to the allegations in its Notice of Removal. (Doc. 32, ¶¶ 7-10.) But the Eleventh Circuit has "adopt[ed] a more flexible approach, allowing the district court when necessary to consider post-removal evidence in assessing removal jurisdiction." Sierminski v. Transouth Fin. Corp., 216 F.3d 945, 949 (11th Cir. 2000). "While it is undoubtedly best to include all relevant evidence in the petition for removal and motion to remand, there is no good reason to keep a district court from eliciting or reviewing evidence outside the removal petition." Id. Still, "under any manner of proof, the jurisdictional facts that support removal must be judged at the time of the removal, and any post-petition affidavits are allowable only if relevant to that period of time." Id. (quoting Allen v. R&H Oil Co., 63 F.3d 1326, 1335 (5th Cir. 1995)). Moreover, UHIC's post-removal evidence "does not state completely new grounds or allegations for removal, but rather provides specific support for the grounds for removal that already were stated in its Notice of Removal." May, 2010 U.S. Dist. LEXIS 5866, *7-8 (finding it proper to consider post-removal evidence with respect to complete preemption under ERISA). Accordingly, the Court will consider UHIC's post-removal evidence relevant to assessing the existence of jurisdiction at the time of the removal.
In determining whether an employee benefit plan is governed by ERISA, the court must examine whether it falls within the regulatory "safe harbor" provision. Miller v. Colonial Life & Acc. Ins. Co., No. 6:13-CV-825-ORL-36KRS, 2013 WL 4855056, at *4 (M.D. Fla. Sept. 11, 2013). Pursuant to 29 C.F.R. § 2510.3-1, an employee benefit plan is exempted from ERISA under the safe harbor provision if:
(2) Participation [in] the program is completely voluntary for employees . . .; (3) The sole functions of the employer . . . are, without endorsing the program, to permit the insurer to publicize the program to employees or members, to collect premiums through payroll deductions . . . and to remit them to the insurer; and (4) The employer . . . receives no consideration . . . for administrative services actually rendered in connection with payroll deductions . . . .
Id. A removing defendant bears the burden of proving that the policy fails to meet one of the safe harbor provision's criteria. Letner v. Unum Life Ins. Co. of Am., 203 F.Supp.2d 1291, 1300 (N.D. Fla. 2001).
Plaintiffs argue that UHIC's Notice of Removal and Response are insufficient to establish that the safe harbor provision does not apply to the Policy. (Doc. 32, ¶ 13.) Plaintiffs are correct that the Policy application (Doc. 26-3) attached to UHIC's Response indicates that employees were to pay 100% of the policy premium. (Id. at p. 2.) However, the group coverage documents (Doc. 26-2) also attached to UHIC's Response explain that the employer was required to pay at least 50% of the premium for each Eligible Person.
UHIC claims that the Policy under which Plaintiffs seek relief is governed by ERISA. Plaintiffs assert that the Policy at issue is a non-ERISA plan and, accordingly, is neither governed by nor preempted by ERISA. (Doc. 18, ¶¶ 8-10.) "Whether an insurance policy falls within the ambit of ERISA depends on whether the insurance policy qualifies as an `employee welfare benefit plan.'" May, 2010 U.S. Dist. LEXIS 5866, *11-13. The Eleventh Circuit has held that an employee welfare benefit plan exits where there is:
Donovan v. Dillingham, 688 F.2d 1367, 1371 (11th Cir. 1982) (emphasis added). An ERISA plan "is established if[,] from the surrounding circumstances[,] a reasonable person could ascertain the intended benefits, a class of beneficiaries, the source of financing, and the procedures for receiving benefits." Id. at 1373. It is clear to the Court that an ERISA plan was established by Constant LLC in 2009. The intended benefits were the medical benefits provided under the Policy; the class of beneficiaries was composed of Eligible Persons including employees; the source of financing was the Policy premiums; and the procedures for receiving benefits are set forth in the Policy. (See Doc. 26-2.) The remaining factors in the Donovan test are otherwise plainly satisfied.
In addition, an ERISA plan "must provide benefits to at least one employee, not including an employee who is also the owner of the business in question." Slamen v. Paul Revere Life Ins. Co., 166 F.3d 1102, 1104 (11th Cir. 1999). Relying upon Slamen, Plaintiffs argue that because the Policy did not cover any non-owner employees in 2014—the year in which Andre Raab's claim was denied—the Policy does not fall within the realm of ERISA. (Doc. 18, ¶ 10.) However, courts have rejected this argument, instead holding that regardless of the characteristics of the plan on the date that a plaintiff files a claim, ERISA will govern the plan if it originally covered a non-owner employee. Nix v. United Health Care of Ala., Inc., 179 F.Supp.2d 1363, 1368-70 (M.D. Ala. 2001) (explaining that the ERISA requirement that a plan be "`established or maintained' by an employer covers the situation where . . . an employer sets up an insurance plan for both owners and employees, but later all employees cease to work for the employer, leaving only the owners covered under the plan"). Accordingly, because the Plan initially covered non-owner employees, it falls within ERISA.
Still, Plaintiffs argue that even if the Plan was initially governed by ERISA, it converted to a non-ERISA plan when it ceased to cover non-owner employee participants effective
The facts here do not align with Mizrahi or Loudermilch. Constant LLC was not sold, nor did it dissolve. The updated Policy remained a group health insurance policy issued to Constant LLC and contemplated coverage for any future employees of the company. (Doc. 1-2, p. 2.) Moreover, employer contribution terms remained in the plan, namely— that Constant LLC was to contribute 50% of the premium for each Eligible Person. (Id. at 14.) Based on these facts, the Court finds that the updated Policy continued to be integrally linked with the original Policy much like in Glass. So the Policy continued to be governed by ERISA throughout its existence.
Accordingly, it is