M. S. v. Premera Blue Cross

17 Citing cases

  1. Doe v. Intermountain Healthcare, Inc.

    2:18-cv-807-RJS-JCB (D. Utah Aug. 21, 2023)   Cited 5 times

    .M.S. v. Premera, 553 F.Supp.3d 1000, 1023 (D. Utah 2021). 29 C.F.R. § 2560.503-1(j)(4)(i).

  2. H.R. v. United Healthcare Ins. Co.

    2:21-cv-00386-RJS-DBP (D. Utah Jun. 24, 2024)

    Id.M.S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1033 (D. Utah 2021) (citing 29 U.S.C. § 1132(c)(1)(B)). If the administrator fails to provide requested documents covered by the disclosure provision within 30 days of the request, the plan administrator “may in the court's discretion be personally liable to such participant or beneficiary in the amount of up to [$110] a day from the date of such failure or refusal, and the court may in its discretion order such other relief as it deems proper.”

  3. L.D. v. UnitedHealthcare Ins.

    684 F. Supp. 3d 1177 (D. Utah 2023)   Cited 9 times
    Upholding denial of benefits because medical necessity letters offered by Plaintiffs recounted events leading to admission to Elevations, not treatment at Elevations

    M.S. v. Premera Blue Cross, 553 F. Supp. 3d 1000, 1028 (D. Utah 2021) (quotation simplified). "While the Tenth Circuit has not spoken on what is required to state a claim under the Parity Act, courts in this district typically apply either a three- or four-part test to analyze claims."

  4. K.K. v. Premera Blue Cross

    No. C21-1611-JCC (W.D. Wash. Jun. 12, 2023)   Cited 1 times

    See Long v. Flying Tiger Line, Inc. Fixed Pension Plan for Pilots, 994 F.2d 692, 694 (9th Cir. 1993) (interpretation of a federal statute “is a question of law subject to de novo review”); see also M. S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1027 (D. Utah 2021) (“Unlike the denial of benefits claim, the court affords Defendants no deference in interpreting the Parity Act because the interpretation of a statute is a legal question”); Howard W., 2023 WL 356585, slip op. at 13 (applying de novo standard of review to Parity Act claim).

  5. S.L. v. Premera Blue Cross

    675 F. Supp. 3d 1138 (W.D. Wash. 2023)   Cited 2 times

    The Court is not convinced. Indeed, the one case cited by plaintiffs in support of this argument, M. S. v. Premera Blue Cross, 553 F. Supp. 3d 1000 (D. Utah 2021), demonstrates the weakness of their argument. In M. S., the plaintiff brought both a denial of benefits claim and Parity Act claims against defendants after Premera denied coverage for the minor member's stay at a residential treatment center, finding that the stay was not medically necessary.

  6. Allison M. v. The Mueller Indus.

    2:23-cv-00421 (D. Utah Mar. 4, 2025)

    . M.S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1019 (D. Utah 2021). Van Steen v. Life Ins. Co. of N. Am., 878 F.3d 994, 997 (10th Cir. 2018).

  7. Kirsten W. v. Cal. Physicians' Serv.

    2:19-cv-00710-DBB-JCB (D. Utah Feb. 10, 2025)

    . M.S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1019 (D. Utah 2021). Van Steen v. Life Ins. Co. of N. Am., 878 F.3d 994, 997 (10th Cir. 2018).

  8. C.J. v. United Healthcare Ins. Co.

    2:22-cv-00092 (D. Utah Sep. 24, 2024)

    . M.S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1019 (D. Utah 2021). Van Steen v. Life Ins. Co. of N. Am., 878 F.3d 994, 997 (10th Cir. 2018).

  9. W.H. v. Allegiance Benefit Plan Mgmt.

    CV 22-166-M-DWM (D. Mont. Jun. 4, 2024)

    Since then, courts appear to disagree whether to apply Shaver's narrow definition of “instruments” or the Parity Act Regulations' definition. Compare Zavislakv. Netflix, Inc., 2024 WL 382448, at *23 (N.D. Cal. Jan. 31, 2024) (relying on Shaver), with M.S. v. Premera Blue Cross, 553 F.Supp.3d 1000, 1034-35 (D. Utah 2021) (relying on 2013 regulations). While the Ninth Circuit has yet to address this issue, the Tenth Circuit and its district courts apply the Parity Act Regulations' definition of instruments.

  10. J.W. v. United Healthcare Ins. Co.

    2:23-CV-193-DAK-DBP (D. Utah Feb. 28, 2024)

    United also claims that the documents Plaintiff seeks are not documents that need to be turned over to participants. But in M.S. v. Premara Blue Cross, 553 F.Supp.3d 1000, 1034-37 (D. Utah 2021), the court recognized that documents such as the ones Plaintiff requested in this case are within the scope of the statutory penalty provision.