Michigan Court of Appeals; Docket No. 91957; Published
Judges Sullivan, McDonald, and Graves, Jr.; Per Curiam; 2-1 (with Judge McDonald Dissenting)
Official Michigan Reporter Citation: 174 Mich App 171; Link to Opinion
In this 2-1 per curiam Opinion, the Court of Appeals held that an employee benefit trust plan which provided certain, medical benefits to employees of Georgie Boy Manufacturing, Inc. was not engaged in the insurance business, and therefore, not governed by the provisions of the Michigan Insurance Code. Consequently, in a dispute between no-fault insurance company and the employee benefit trust regarding which was responsible for payment of plaintiff s medical expenses arising out of an automobile accident, the Court held that Congress intended ERISA to supersede all state laws that relate to employee benefit plans, and therefore, the no-fault insurance policy was obligated to provide the coverage.
In a dissent, Judge McDonald noted that the employee benefit plan had "stop loss" insurance, and therefore, came within the holding of State Farm v Muer (Item No. 951) in which the Court of Appeals held that insured ERISA plans were subject to Michigan insurance laws. Judge McDonald also cites the Northern Group Services v Auto-Owners decision from the Sixth Circuit Court of Appeals, which held that both insured and non-insured plans were subject to the Supreme Court decision in Federal Kemper v Health Insurance Administration (Item No. 868).