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Farmers Insurance Exchange v Central States, Southeast & Southwest Areas Health and Welfare Fund; (USD-UNP, 7/23/1990; RB #1510)

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United States District Court, Eastern District of Michigan; Docket No. 90-CV-73374-DT;  
Judge Bernard Friedman; Unpublished  
Official Michigan Reporter Citation:  Not Applicable; Link to Opinion alt  


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 1990 decision by Judge Friedman, the court held that where conflicting coordination of benefits provisions exist between a no-fault insurance policy and a "self-funded" health plan regulated under ERISA, the self-funded ERISA plan may not be regulated by state laws purporting to regulate insurance.

Judge Friedman noted that this decision was nearly identical to his recent decision in Automobile Club Insurance Association v Health and Welfare Plans (Item No. 1406), and the rule of law stated therein should be applied to this case. The relevant precedent for both decisions is the recent Supreme Court case of FMC Corp v Holliday, 111 S Ct 403 (1990). The court in FMC, supra, held that a self-funded ERISA plan may not be regulated by state laws purporting to regulate insurance because the "deemer" clause of the ERISA act states that an ERISA plan shall not be deemed an insurance company for purposes of state laws regulating insurance. Judge Friedman stated that, as in his earlier ruling in Auto Club v Health and Welfare Plans, the decision in FMC, supra, effectively overruled the Sixth Circuit's position as articulated in Northern Group Services (Item No. 1090), which had held that self-funded plans may, in some instances, be regulated by state laws for purposes of resolving the dispute between conflicting coordination of benefits clauses. Consequently, §3109a of the No-Fault Act does not apply to such "self-funded" ERISA plans providing health benefits arising from a motor vehicle accident where such plans contain a coordination of benefits clause.  

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