Michigan Court of Appeals; Docket No. 114212; Unpublished
Judges Danhof, Maher, and Hood; Unanimous; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
Coordination with ERISA Plans [§3109a]
TOPICAL INDEXING:
Employee Retirement Income Security Act (ERISA – 29 USC Section 1001, et seq.)
CASE SUMMARY:
In this unanimous per curiam Opinion, the Court of Appeals upheld the trial court decision that §3109a was not preempted by ERISA and that the defendant's self-funded health care plan (an employee benefit plan under ERISA) was primarily liable for the medical expenses of plaintiff s insured.
Ronald DeVos was injured in a motor vehicle accident and claimed no-fault benefits from Farm Bureau. Farm Bureau filed this action seeking a declaration that Ronald DeVos' employee benefit plan under ERISA was primarily liable for his medical expenses. The plan contained a coordination of benefits clause excepting liability for medical expenses arising from an automobile accident when there is a no-fault policy in effect.
Relying upon the decision in Federal Kemper Insurance v Health Insurance Administration, 424 Mich S37 (1986), the court held that a health insurer will be primarily liable when there are conflicting coordination of benefits clauses. The Court of Appeals rejected defendant's argument that Federal Kemper was not controlling because §3109a is preempted by the provisions of ERISA, 29 USC 1144(a). This position has been considered and rejected in several recent decisions of this Court.