Indian Health Plans May or May Not Be Exempt From ERISA.

In Dobbs v. Anthem Blue Cross and Blue Shield, No 05-1319 (1-30-07), The Tenth Circuit Court of Appeals remanded the case to the District Court below to determine whether the plaintiffs’ Indian tribal health insurance plan was a “governmental plan” that is excluded from ERISA. The Dobbs brought a suit against Anthem in a Colorado district state court asserting five state law claims against Anthem.  Anthem responded by removing the state court case to a federal district court in Denver, asserting that ERISA preempted the state court claims.  The Dobbs argued that their plan, sponsored by the Southern Ute Indian tribe, was exempt from ERISA because it was a “governmental plan.”  Governmental plans for federal and state employees are exempt from ERISA.  There was no explicit inclusion of Indian tribal plans within the definition of governmental plans in the ERISA statute.

The federal judge in Denver concluded that Indian tribal plans were not included in the definition of “governmental plans.” He therefore dismissed the case. Two federal circuit courts of appeal also arrived at the same conclusion. See Lumber Industry Pension Fund v. Warm Spring Forrest Products Indus., 939 F 2d 683 (9^th Cir. 1991) and Smart v State Farm Ins. Co., 868 F 2d 929 (7^th Cir. 1989).

In August of 2006, after the Dobbs appeal was argued in the Tenth Circuit Court of Appeals, Congress passed the Pension Protection Act of 2006 (“PPA”), which undertook to clarify whether Indian tribal plans were “government plans.”   The PPA provided that tribal plans were government plans if established by an Indian tribal government, a subdivision of an Indian tribal government, an agency or instrumentality of either, and all of the participants are the employees of such entity and substantially all of the services of whom are in the performance of essential government functions, not commercial activities (whether or not an essential government function). It would appear that tribal plans governing casino operation employees would not qualify as government plans. The circuit court held that there was insufficient information in the pleadings to determine whether the Southern Ute plan was governmental or not.

The court, in passing, chastised the lawyers on both sides for failing to advise the court with a supplemental filing of the adoption of the statute last August.  This is a kind of “gotcha” to demonstrate that the court is on the ball and the lawyers are not.  Lawyers need to stay on top of the fast breaking pension protection enactments in Congress.

Comments

[Future Generali]

Thanks for posting this, any info on the subject, positive that is, will help people understand more about this subject.

[Heart Surgery India]

Thanks for sharing this informative material. Its really like a guide for other people to understand.