Michigan Court of Appeals; Docket No. 100716; Unpublished
Judges Maher, Murphy, and Burns; 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:
This is another Court of Appeals decision involving a situation where an injured person was covered under a no-fault coordinated policy and a self-insured employee health benefits plan that also had a coordination of benefits clause which purported to make it secondary to no-fault. The major question presented on appeal was whether the federal law of ERISA preempts the application of the Michigan no-fault law, particularly in light of the fact that the health insurance plan involved in this litigation was a self-insured ERISA plan. In holding that ERISA did not preempt the Michigan no-fault scheme, the Court rejected an earlier opinion of the Court of Appeals in State Farm v CA Muer Corp (Item No. 951). In refusing to follow the State Farm decision, the Court held, one panel of this court held that the deemer clause acts to preempt application of Michigan's no-fault laws when an uninsured ERISA plan is involved. State Farm v CA Muer Corp. However, the Sixth Circuit was later faced with the identical question of whether Michigan's coordination of benefits law was preempted by ERISA when applied to an insurance plan. In Northern Group Services, the Court held that "Michigan's coordination of benefits law was not preempted by ERISA." We are persuaded by the analysis from the Court in Northern Group Services, decided after State Farm, and agree that "Michigan coordination of benefits law is not preempted by ERISA when an uninsured ERISA plan is involved."
In addition, the Court held that the health plan's "other insurance provision allowing defendant to restrict its liability altogether after paying the $300 deductible was invalid as an escape clause" and thus unenforceable. In this regard, the Court relied in its earlier holding in Michigan Mutual v American Community (Item No. 1102).