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IHC Health Services, Inc. v. JetBlue Airways Corp.

United States District Court, D. Utah

April 13, 2018

IHC HEALTH SERVICES, INC., dba INTERMOUNTAFN MEDICAL CENTER, Plaintiff,
v.
JETBLUE AIRWAYS CORPORATION, and ANTHEM BLUE CROSS AND BLUE SHIELD, Defendants.

          MEMORANDUM OPINION AND ORDER

          Bruce S. Jenkins United States Senior District Judge.

         INTRODUCTION

         Plaintiff IHC Health Services ("IHC") and Defendants JetBlue Airways Corporation ("JetBlue") and Anthem Blue Cross and Blue Shield ("Anthem") filed and fully briefed cross motions for summary judgment.[1] The motions came before the court for hearing on March 28, 2018. Joseph Amadon appeared on behalf of Plaintiff. Jessica Wilde appeared on behalf of Defendants.[2]

         As clarified at hearing, [3] IHC seeks the following: (i) $30, 291.87 for the remaining balance due on the medical services rendered, plus ten percent interest, and (ii) $25, 905.00 for JetBlue's failure to produce plan documents.

         Having considered the parties' briefs, the evidence presented, the arguments of counsel, and the relevant law, the court hereby GRANTS IN PART IHC's motion for summary judgment. The court awards IHC $30, 291.87 for amounts owed to IHC for the emergency medical services rendered, plus ten percent interest for an additional $11, 359.45, resulting in a total award of $41, 651.32.

         BACKGROUND

         The following briefly outlines the pertinent undisputed facts in this action, drawn from the parties' summary judgment briefing:

• R.S. was a JetBlue employee and was entitled to benefits under JetBlue's Medical Plan (the "Plan").
• R.S. signed a document entitled "Legal Assignment of Benefits and Release of Medical and Plan Documents" in favor of IHC.
• Anthem is a claims administrator of the Plan. JetBlue delegated to Anthem the authority and obligation to process claims, handle appeals, resolve disputes and interpret the language of the Plan.
• R.S. received emergency treatment from IHC related to acute chest pain on May 21, 2014 through May 30, 2014.
• The billed charges for the treatment totaled $ 148, 702.25.
• Under the Plan, emergency health services are paid at the rate of 80% of "Eligible Expenses" once the deductibles and out-of-pocket maximums are applied.
• "Eligible Expenses" is defined in pages 117-18 of the Plan. Under the Plan, Eligible Expenses for non-network providers, such as IHC, are based on either (1) negotiated rates between the provider and either the claims administrator (Anthem) or one of its affiliates; (2) competitive fees ...

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