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Frankenmuth Mutual Insurance Company v Meijer, Inc; (COA-PUB, 1/20/1989; RB #1212)

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Michigan Court of Appeals; Docket No.102284; Published  
Judges MacKenzie, McDonald, and Robinson; Unanimous; Per Curiam    
Official Michigan Reporter Citation:  176 Mich App 675; 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 unanimous per curiam Opinion, the Court of Appeals affirmed the trial court's decision holding that defendant Meijer's employee benefit plan was responsible for medical expense benefits in a case where the no-fault insurer and the Meijer benefit plan had conflicting coordination of benefits clauses.

Defendant Meijer claimed that the Supreme Court decision in Federal Kemper (Item No. 868) did not control this case, because § 3109a was preempted by the ERISA statute, 29 USC 1001, et seq. The Meijer employee benefit plan was funded by Meijer from its own monies, although to protect it from catastrophic loss Meijer purchased stop-loss coverage from Blue Cross/Blue Shield. The Court of Appeals rejected Meijer's contention that because the plan was uninsured it was not subject to state regulation. The Court of Appeals disagreed with the previous ruling in State Farm Mutual v CA Muer (Item No. 951), and adopted the reasoning of Northern Group Services v Auto Owners Insurance Company (Item No. 1090). In the Northern Group Services case, supra, the federal court held that where stop-loss coverage is purchased by an otherwise self-insured employee benefit plan, the plan itself is considered to be an "insured plan" and therefore is not protected by federal law from state regulation under §3109a.

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