United States District Court, D. Utah
IHC HEALTH SERVICES, INC., dba INTERMOUNTAFN MEDICAL CENTER, Plaintiff,
JETBLUE AIRWAYS CORPORATION, and ANTHEM BLUE CROSS AND BLUE SHIELD, Defendants.
MEMORANDUM OPINION AND ORDER
S. Jenkins United States Senior District Judge.
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. 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.
clarified at hearing,  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.
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.
following briefly outlines the pertinent undisputed facts in
this action, drawn from the parties' summary judgment
• R.S. was a JetBlue employee and was entitled to
benefits under JetBlue's Medical Plan (the
• 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,
• 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 ...