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holding that a dependent beneficiary has no standing to bring a claim under the ADA because she is neither an employee nor attempting to secure employment with the defendant
Summary of this case from Collins v. OSF Healthcare SystemOpinion
No. 99 C 7391.
August 24, 2000
MEMORANDUM OPINION AND ORDER
Plaintiffs Charles Niemeier ("Mr. Niemeier") and Gina Niemeier ("Mrs. Niemeier"), husband and wife, filed a four-count complaint against Mr. Niemeier's former employer, Tri-State Fire Protection District ("Tri-State") and Tri-State's chief administrator of its insurance plan, James Eggert. Plaintiffs sue Tri-State for unlawful discrimination in violation of: (1) the Americans with Disabilities Act of 1990, 42 U.S.C. § 12112 et. seq. ("ADA") (Count 1); (2) Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (Count II); and (3) the Pregnancy Discrimination Act, 42 U.S.C. § 2000e(k), an amendment to Title VII ("PDA") (Count III). Theft final claim in Count IV is brought pursuant to 42 U.S.C. § 1983 ("section 1983") and alleges that Eggert violated plaintiffs' civil rights guaranteed under the Fifth and Fourteenth Amendments. Defendants filed a motion to dismiss plaintiffs' complaint pursuant to Federal Rule of Civil Procedure ("Rule") 12(b)(6). For the reasons stated herein, defendants' motion is granted.
Facts
Mr. and Mrs. Niemeier are husband and wife. (Compl. ¶ 4.) In 1997 and 1998, Mr. Niemeier was employed by Tri-State, which provided as sponsor and administrator a health/medical benefits plan ("Plan") to its employee Mr. Niemeier and his spouse and beneficiary, Mrs. Niemeier. (Id. ¶ 5; id., Ex, C.) Eggert was the chief administrator of the Plan. (Id.)
During 1997 and 1998, Mrs. Niemeier suffered from infertility and underwent medical treatment, including tests and procedures such as artificial insemination, in an effort to treat her infertility and conceive and bear a child. (Id. ¶¶ 9-10.) Plaintiffs sought to have Tri-State indemnify them for the expenses of the treatment. (Id. ¶ 11.) While Tri-State initially paid for the treatment, Tri-State later denied plaintiffs' request for indemnification and demanded and received back those payments. (Id. ¶ 12.) It denied their claim based on the Plan provision that excluded benefits for "artificial insemination, in vitro fertilization, or treatment of sexual dysfunctions not related to organic disease." Id.; id., Ex. C at 72.) Plaintiffs also sought reimbursement for medical expenses relating to a miscarriage suffered by Mrs. Niemeier, but that request was also denied by Tri-State under the same Plan exclusion. (Id. ¶ 13.)
Mr. Niemeier, on his own behalf and that of his wife, filed a timely charge of discrimination with the EEOC. (Id. ¶ 2.) The plaintiffs filed the instant lawsuit sometime after they received the EEOC's right to sue notice. Id.)
Discussion
On a motion to dismiss under Rule 12(b)(6), all well-pleaded allegations in the complaint must be taken as true, with all reasonable inferences drawn in the plaintiff's favor. See Sherwin Manor Nursing Ctr., Inc. v. McAuliffe, 37 F.3d 1216, 1219 (7th Cir. 1994). A complaint may be dismissed only if it is clear that no set of facts consistent with its allegations would entitle the plaintiff to relief. Hishon v. King Spalding, 467 U.S. 69, 73 (1984).
Count I: ADA
Plaintiffs' first count against Tri-State is brought under Title I of the ADA which prohibits disability discrimination in employment. Plaintiffs claim that Mrs. Niemeier is disabled because of her infertility, and that Tri-State discriminated against plaintiffs by denying coverage for infertility treatment while providing coverage for other medical conditions. (Compl. Count I ¶¶ 15, 18, 19.) Tri-State claims that plaintiffs' ADA claim against it must be dismissed because plaintiffs do not have standing under the ADA to bring suit.
Mrs. Niemeier
Title I of the ADA provides: "No covered entity shall discriminate against a qualified individual with a disability because of the disability of such individual in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment." 42 U.S.C. § 12112 (a). A "qualified individual with a disability" is defined as "an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires." 42 U.S.C. § 12111 (8).
Mrs. Niemeier's standing, as a dependent beneficiary, can be determined by looking to the statutory language. Based on the definition of "qualified individual," Mrs. Niemeier is not an employee or attempting to secure employment with Tri-State. While no federal court of appeals, including our own, has addressed whether a disabled beneficiary/dependent has standing to challenge an employee benefit plan under the ADA, case law from this circuit indicates that Mrs. Niemeier as a non-employee does not have standing. For example, in EEOC v. CNA Ins. Cos., 96 F.3d 1039, 1044-45 (7th Cir. 1996), our court of appeals held that a former employee had no claim under Title I of the ADA to challenge her former employer's long term disability plan because she no longer had an employment position with defendant and she was not a job applicant. Other district courts that have directly addressed this issue have held that plan beneficiaries like Mrs. Niemeier do not have standing under the ADA to sue the defendant employer. See Micek v. City of Chicago, No. 98C6757, 1999 WL 966970, at *5 (N.D. Ill. Oct. 4, 1999) (holding that plan beneficiary dependents' claims under Titles I and II of the ADA fell outside the ADA's zone of interest because they challenged a health plan offered to and elected by defendant's employee); Morgenthal v. American Tel. Tel. Co., Inc., 97C6443, 1999 WL 187055, at *1 (S.D.N.Y. Apr. 6, 1999) (collecting district court cases that held that dependents of an employee lacks standing to sue the employer under the ADA); Foote v. Folks, Inc., 864 F. Supp. 1327, 1328 (N.D. Ga. 1994) (holding that a former wife beneficiary lacked standing to bring suit under Title I of the ADA for disability benefits because she was not a job applicant or employee, and, therefore, her claim fell outside the ADA's zone of interest). Plaintiffs have presented no argument that Mrs. Niemeier's claim is contemplated by the ADA, and we agree with the other courts that have addressed this issue that Mrs. Niemeier lacks standing under the ADA to assert her claim against Tri-State. Accordingly, her claim under Count I is dismissed.
Mr. Niemeier
Mr. Niemeier argues that although he does not have a disability he has standing to assert the Count I discrimination claim under the associational discrimination provision of the ADA. 42 U.S.C. § 12112 (b)(4). This provision prohibits "excluding or otherwise denying equal jobs or benefits to a qualified individual because of the known disability of an individual with whom the qualified individual is known to have a relationship or association." 42 U.S.C. § 121 12(b)(4). Plaintiffs assert that Mr. Niemeier was denied equal benefits under the Plan because of his marriage to a disabled individual. (Pls.' Resp. at 5.) Defendants counter that Mr. Niemeier was offered the same benefit plan as all other Tri-State employees, and was not singled out based on his relationship with Mrs. Niemeier. (Defs.' Reply at 3.) Defendants also argue under standing principles that Mr. Niemeier has not alleged a separate and distinct injury to confer standing because any injury he suffered is intertwined with his wife's disability. (Id.) Mr. Niemeier states he has standing to assert an associational discrimination claim because he suffered the injury of the expense of the infertility treatments and injury to "his opportunity to reproduce and . . . raise a family. . . . with his wife." (Pls.' Resp. at 4.)
Again, much like the standing of beneficiary dependents, this circuit has not yet addressed "association" claims under the ADA. However, case law from other circuits and courts within this district provide some guidance. The First Circuit Court of Appeals recently interpreted the legislative history of the associational discrimination provision of the ADA. Oliveras-Sifre v. Puerto Rico Dept. of Health, 214 F.3d 23, 26 (1st Cir. 2000). It found that the history of section 12112(b)(4) "makes clear that the provision was intended to protect qualified individuals from adverse job actions based on `unfounded stereotypes and assumptions' arising from the employees' relationships with particular disabled persons." Id. (citation omitted). Further, as discussed in an analogous case from this district, other courts have required a plaintiff bringing an associational discrimination claim to suffer some "specific, separate, and direct injury as a result of his association with the disabled individual." Micek, 1999 WL 966970, at *3-4 (citing Innovative Health Sys., Inc., v. City of White Plains, 117 F.3d 37, 46-48 (2d Cir. 1997) (affirming finding of standing where drug and alcohol rehabilitation center claimed it was denied a permit because of its association with disabled people); Oak Ridge Care Ctr., Inc. v. Racine County, 896 F. Supp. 867, 872 (E.D. Wis. 1995) (finding standing where elder care facility claimed it was denied a permit because of its association with disabled people); Simenson v. Hoffman, No. 95C 1401, 1995 WL 631804, at *2 (N.D. Ill. Oct. 24, 1995) (dismissing parents' claim of associational discrimination where their disabled child was refused treatment and parents could not show that the denial of services and subsequent ejection from the facility constituted a separate and distinct denial of services to them); Tugg v. Towey, 864 F. Supp. 1201, 1208 (S.D. Fla. 1994) (finding that relatives of deaf children stated a claim under ADA where relatives, who were jointly receiving counseling with children, alleged that sessions were ineffective or less effective for all recipients where sessions were conducted by a counselor who was not hearing impaired)); but see Morganthal, 1999 WL 187055, at *2 (finding employee whose dependent son was denied benefits for treatment for autism had standing under ADA because employee alleged that employer denied employer insurance benefits to treat son's disability). The plaintiff-employee in Micek sought relief under Titles I and II of the ADA for denial of certain health benefits for his wife and son's hearing disability. The district court held, based on standing principals and the limited case law interpreting standing under the associational discrimination provisions of the ADA, that the plaintiff-employee lacked standing under the ADA because his economic loss and "inferior insurance benefits" were not a separate and direct injury to support standing. Id. *4, n. 7. Rather, the court found that although the employee suffered an "indirect injury" under the employer's policy, he was not singled out or provided fewer options than those provided to other employees. The court concluded that this indirect injury was insufficient under the prudential limitations on standing because it did not fall within the zone of interest protected by the ADA. Id. at *3 *4.
Mr. Niemeier argues that, unlike the employee in Micek, he suffered more than an indirect economic injury from Tri-State's denial of coverage for his wife's treatments. He asserts that he suffered injury to "his opportunity to reproduce and . . . raise a family. . . . with his wife." (Pls.' Resp. at 4.) While this may be true, this injury results from his wife's disability and is not a separate and distinct injury caused by Tri-State's actions. Further, Mr. Niemeier has not alleged that he was given a different plan or fewer benefits because he was known to have a wife with a disability. Rather, he had the same coverage as other Tri-State employees and their dependents. Accordingly, Mr. Niemeier does not have standing under the ADA, and Count I is dismissed.
Our holding applies equally to any claim brought by plaintiffs under Title II of the ADA.
Count II: Sex Descrimination under Title VII
In Count II, plaintiffs assert that Tri-State's denial of benefits to Mrs. Niemeier discriminates against her on account of her sex in violation of Title VII. (Compl. Count II ¶ 17.) Defendants argue that this claim must be dismissed because Mrs. Niemeier lacks standing to sue for discrimination. We agree.
In plaintiffs' response to defendants' motion to dismiss, plaintiffs indirectly assert that both Mr. and Mrs. Niemeier have a claim under Title VII. (Pls.' Resp. at 8.) However, their complaint only alleges discrimination against Mrs. Niemeier. (Compl. Count II ¶ 17.) Thus, we have only construed their complaint to allege a cause of action for Mrs. Niemeier under Count II. However, even if Mr. Niemeier were to allege sex discrimination under Title VII, as we discuss under the PDA, the pleadings and Plan language indicate he is not entitled to relief under Title VII.
Title VII's purpose is to protect employees from discrimination. 42 U.S.C. § 2000e-2 (a);see Newport News Shipbuilding Dry Dock Co. v. EEOC, 462 U.S. 669, 681-82 (1983). Section 703(a)(1) of Title VII provides in relevant part: "(a) It shall be an unlawful employment practice for an employer — (1) to fail or refuse to hire or discharge any individual, or otherwise to discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment, because of such individual's race, color, religion, sex, or national origin;. . . ." 42 U.S.C. § 2000e-2 (a).
Title VII does not contemplate third-party standing. See Nicol v. Imagematrix, Inc., 773 F. Supp. 802, 806 (E.D. Va. 1991) ("[T]hird party standing is not adequate for a prima facie Title VII claim."); Hillesland v. Paccar, Inc., 80 Or. App. 286, 293-94, 722 P.2d 1239, 1243-44 (Or.App. Ct. 1986) (finding male spouses have no remedy independent of the female employee's remedy for an inequitable benefit package; anything else would be inconsistent with Title VII, which only addresses discrimination against employees). Plaintiffs have presented no statutory provision to support Mrs. Niemeier's standing under Title VII. She vaguely refers to the U.S. Supreme Court's decision in Newport News as support for her standing. (Pls.' Resp. at 8.) However, this case, which decided whether a benefit plan discriminated against male employees because of their sex, provides no such support. Newport News, 462 U.S. at 675-76. Rather, the case reinforces the Court's understanding of Title VII, which makes clear that Mrs. Niemeier, as dependent spouse beneficiary, lacks standing to sue her husband's former employer for discrimination against her based on her sex. Thus, Count II is dismissed.
Count III: Discrimination under the PDA
As a preliminary matter, while defendants do not raise it, Mrs. Niemeier also lacks standing under the PDA to assert discrimination based on pregnancy. As discussed below, the PDA is an amendment to Title VII, under which, as we just discussed, Mrs. Niemeier has no standing. However, unlike the Title VII claim, Mr. Niemeier has alleged he was discriminated against under this count. Accordingly, we shall address defendants' motion against him.
Plaintiffs allege in Count III that Tri-State violated the PDA by "refusing to pay for medical testing and treatment received by Gina [Mrs. Niemeier] despite providing coverage and payment for other medical conditions and/or for `normal' pregnancies." (Compl. Count III ¶ 17.) Defendants argue that the Plan's exclusions do not discriminate on the basis of pregnancy because it applies equally to all employees and is not sex-linked.
The PDA was a 1978 amendment to Title VII. In this instance, it applies to Title VII's prohibition against discrimination against an employee "with respect to his compensation, terms, conditions, or privileges of employment, because of such individual's . . . sex. . . ." 42 U.S.C. § 2000e-2 (a). The PDA, in relevant part, amends Title VII's definition of discrimination "because of" or "on the basis" of "sex":
The terms "because of sex" or "on the basis of sex" include, but are not limited to, because of or on the basis of pregnancy, childbirth, or related medical conditions; and women affected by pregnancy, childbirth, or related medical conditions shall be treated the same for all employment-related purposes, including receipt of benefits under fringe benefit programs, as other persons not so affected but similar in their ability or inability to work, and nothing in section 2000e-2(h) of this title shall be interpreted to permit otherwise. . . .42 U.S.C. § 2000e(k).
In Newport News, the Supreme Court held that the employer had discriminated under the PDA against its male employees with respect to their benefits because the employer's health plan afforded less comprehensive benefits to married male employees than to female employees. 462 U.S. at 684-85. Specifically, the employer's health insurance plan provided its female employees with hospitalization benefits for pregnancy-related conditions to the same extent as for other medical conditions, while it provided less extensive pregnancy benefits for spouses of male employees. Id. Thus, the male employees were discriminated against based on sex since "the sex of the spouse is always the opposite of the sex of the employee, it follows inexorably that discrimination against female spouses in the provision of fringe benefits is also discrimination against male employees." Id. at 684. The Court noted that the PDA makes clear that "discrimination based on a woman's pregnancy is, on its face, discrimination because of her sex." Id.
Plaintiffs argue that the PDA term "pregnancy related medical conditions" includes infertility, relying on two district court opinions from this district that held that the PDA applies to discrimination based upon intended or potential pregnancy and that infertility is a pregnancy-related condition for purposes of the PDA. See Erickson v. Board of Governors of State Colleges Universities for Northeastern Ill. Univ., 911 F. Supp. 316, 318-20 (N.D. Ill. 1995); Pacourek v. Inland Steel Co., 858 F. Supp. 1393, 1400-04 (ND. Ill. 1994). In these cases, the plaintiffs were women who were terminated by their employer due to their time away from work to undergo infertility treatments. In these cases, the courts found that the female plaintiffs were discriminated against because the employers' actions were prompted by their employees' "intended or potential pregnanc[ies]." Erickson, 911 F. Supp. at 320;Pacourek, 858 F. Supp. at 1401-02 ("It makes sense to conclude that the PDA was intended to cover a woman's intention or potential to become pregnant, because all that conclusion means is that discrimination against persons who intend to or can potentially become pregnant is discrimination against women, which is the kind of truism the PDA wrote into law."). On the other hand, in the only factually analogous case reported by the parties and located by this Court, the Eighth Circuit Court of Appeals inKrauel v. Iowa Methodist Med. Ctr., 95 F.3d 674, 679-80 (8th Cir. 1996), held that the district court properly concluded that infertility is outside the PDA's protection because it is not pregnancy, childbirth, or a related medical condition. The plaintiff-employee in Krauel sued her employer under the PDA because her health plan did not cover and pay for her infertility treatments. Id. The Eighth Circuit construed the statutory language and legislative history of the PDA, rejected thePacourek court's reading of the PDA and legislative history, and held that infertility, which "prevents conception," is "strikingly different from "pregnancy and childbirth, which occur after conception." Id. at 679. While we are faced with such inconsistent interpretations of the PDA, and currently remain unconvinced that the PDA contemplated infertility treatments as a "pregnancy related medical condition," we find that even if the PDA's "related medical conditions" include infertility, Mr. Niemeier has still failed to allege discrimination under the PDA and Title VII.
Plaintiffs claim that Tri-State violated the PDA by denying plaintiff's benefits for Mrs. Niemeier's infertility treatment while providing coverage for "normal pregnancy" and "other" medical conditions. However, unlike the male spouses in Newport News, Mr. Niemeier has not alleged that female employees receive greater benefits than males. He has simply alleged that one facet of the Plan's pregnancy coverage, infertility treatment, is excluded from the Plan. However, the PDA does not state that an employer must cover every expense associated with pregnancy. It only states that it must treat pregnancy, childbirth, or related medical conditions in a "neutral way." Pacourek, 858 F. Supp. at 1801. In fact, the EEOC's guidelines on the PDA further confirm that Mr. Niemeier's complaint fails to support discrimination under the PDA:
While plaintiffs assert in their Title VII claim that the Plan does not exclude infertility testing and treatment for males (Compl. Count II ¶ 16), the plain language of the Plan indicates otherwise. (Compl. Ex. C at 72.) The same provision excluding charges for artificial insemination also excludes charges for "sexual dysfunctions not related to organic disease." (Id.) Thus, without evidence to the contrary, the exclusion for treatment for infertility applies equally to males and females under the Plan.
22. Q. Must an employer provide the same level of health insurance coverage for the pregnancy-related medical conditions of the spouses of male employees as it provides for its female employees?
A. No. . . . However, where the employer provides coverage for the medical conditions of the spouses of its employees, then the level of coverage for pregnancy related medical conditions of the spouses of male employees must be the same as the level of coverage for all other medical conditions of the spouses of female employees. . . .
EEOC Guidelines on Discrimination Because of Sex-Questions and Answers on the Pregnancy Discrimination Act, 29 C.F.R. § 1604, App. ("[A]ny health insurance provided must cover expenses for pregnancy-related conditions on the same basis as expenses for other medical conditions."). Mr. Niemeier has failed to allege that female employees and/or their spouses receive coverage for infertility treatment. Thus, he fails to state a claim under the PDA and his Count III is dismissed.
Count IV: Section 1983 Equal Protection Claim
In Count IV, plaintiffs claim that under section 1983 defendant Eggert "denied . . . [them] equal protection of the law by administering the Plan in a manner that deprived plaintiffs of the same benefits as they would receive had the Plan provided benefits under a policy of group insurance." (Compl. Count IV ¶ 18.) They claim that under Illinois law, group policies providing health insurance must contain coverage for "`diagnosis and treatment of infertility including, . . . in vitro fertilization, . . . artificial insemination. . . .'" (Compl. Count IV ¶ 15.) Despite this Illinois statutory provision, as admitted in paragraph 18, the Plan was not a group health insurance plan covered by the Illinois law, but rather a self-insurance plan outside the statute. Plaintiffs assert that their equal protection claim rests on Eggert's denial of the same protections that would be afforded to other citizens in Illinois who have insurance under group insurance contracts. (Pls.' Resp. at 13.) Defendant Eggert argues that plaintiffs' equal protection claim fails because he is entitled to qualified immunity. We agree.
Plaintiffs also assert in their Response brief that their equal protection count includes a claim that they were denied equal protection based their membership in a protected class under the ADA and Title VII. (Pls.' Resp. at 13-14.) However, nowhere in their complaint do plaintiffs allege a disability or sex-based equal protection claim under section 1983. Even if they had, such an allegation would fail to state a claim for denial of equal protection under section 1983 for several reasons. Namely, plaintiffs have failed to state a claim under the ADA or Title VII and, even if they had, the relief under these statutes preempts section 1983 remedies. See Lakoski v. James, 66 F.3d 751, 755 (5th Cir. 1995).
Qualified immunity shields government officials performing discretionary functions from suit unless their conduct violates clearly established federal law that a reasonable person would have known about.Stevens v. Umsted, 131 F.3d 697, 706 (7th Cir. 1997); Landstrom v. Illinois DCFS, 892 F.2d 670, 674-75 (7th Cir. 1990). Plaintiffs allege that Eggert, in his discretion, administered the Plan in a way that deprived them of the same benefits as group insurance beneficiaries. (Compl. Count IV ¶ 18.) However, plaintiffs fail to allege that there was any law, either state or federal, that clearly established their right to coverage for infertility treatments. Rather, they concede that the Illinois law they cite does not apply to them or give rise to any clearly established right. Thus, Eggert is immune from suit under section 1983. According, plaintiffs' Count IV is dismissed.
Conclusion
In sum, plaintiffs' complaint and the Plan language demonstrate that plaintiffs would not be entitled to relief under any of the claims alleged. Accordingly, defendants' Rule 12(b)(6) motion to dismiss the plaintiffs' complaint is granted. Furthermore, based on plaintiffs' pleadings, the Court is unable to discern any conceivable way that plaintiffs could amend their complaint to entitle them to relief. Thus, plaintiffs' complaint is dismissed with prejudice. This is a final and appealable order.