United States District Court, W.D. Wisconsin
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY, Plaintiff,
AETNA HEALTH & LIFE INSURANCE COMPANY and AETNA HEALTH INSURANCE COMPANY, Defendants
November 2, 2015
University of Wisconsin Hospitals and Clinics Authority,
Plaintiff: Mark S. Sweet, LEAD ATTORNEY, Neuberger, Wakeman,
Lorenz, Griggs & Sweet, Watertown, WI.
Aetna Health and Life Insurance Company, Defendant: Brett
Wortman Barnett, Jeffrey C. Clark, LEAD ATTORNEYS,
McGuireWoods LLP, Chicago, IL; Todd G. Smith, LEAD ATTORNEY,
Godfrey & Kahn, S.C., Madison, WI.
Aetna Health Insurance Company, Defendant: Brett Wortman
Barnett, Jeffrey C. Clark, LEAD ATTORNEYS, McGuireWoods LLP,
Chicago, IL; Todd G. Smith, Godfrey & Kahn, S.C., Madison,
OPINION & ORDER
M. CONLEY, District Judge.
civil action, plaintiff University of Wisconsin Hospitals and
Clinics Authority (" UWHCA" ) asserts breach of
contract and related claims against defendants Aetna Health &
Life Insurance Company and Aetna Health Insurance Company for
denying a claim to payment for medical services provided to
defendants' insured. Defendants properly removed this
action from state court on the basis of exclusive federal
question jurisdiction, 28 U.S.C. § 1331, asserting that
plaintiff's state law claims are completely preempted by
the Employee Retirement Income Security Act ("
ERISA" ), 29 U.S.C. § 1001 et seq. (Not.
of Removal (dkt. #1) ¶ ¶ 6, 11-14.) Before the
court is defendants' subsequent motion to dismiss on the
grounds that plaintiff's claims fail as a matter of law
because of an anti-assignment provision in the ERISA plan at
issue. (Dkt. #4.) The court agrees with defendants and,
therefore, will grant defendants' motion.
University of Wisconsin Hospitals and Clinics Authority is a
public entity created by the State of Wisconsin. UWHCA
operates a hospital in Dane County where Chandra Aschenbrener
received medical treatment.
Aetna Health & Life Insurance Company and Aetna Health
Insurance Company (collectively " Aetna" ) are
corporations that provide health insurance coverage and
engage in other insurance-related business.
B. The Policy
Aschenbrener is a policy holder of a contract for health
insurance with Aetna under an ERISA plan issued by Safelite
Group. This policy contains an anti-assignment clause in the
General Provisions section of the Benefit Plan documents,
which states in material part that: " coverage and your
rights under this Aetna medical benefits plan may not be
assigned. A direction to pay a provider is not an
assignment of any right under this plan or of any legal or
equitable right to institute any court proceeding" .
(Defs.' Reply, Ex. 1 (dkt. #9-1) p.70 (emphasis added).)
The plan also states that " Aetna has the right to pay
any health benefits to the service ...