Background
John Philip Meyer, a Montana resident, suffered a life-threatening ski accident in December 2015 and received treatment at out-of-network facilities. He later filed suit against his insurer, UnitedHealthcare, alleging violations of the Employee Retirement Income Security Act of 1974. After a prior appeal regarding preemption, Meyer filed a new putative class action in December 2021, alleging breaches of fiduciary duty and violations of the No Surprises Act. The district court dismissed the complaint with prejudice, finding the claims failed to state a cause of action and were time-barred.
The court’s reasoning
The Ninth Circuit reviewed the dismissal de novo, applying the standard that a complaint must contain sufficient factual matter to state a plausible claim for relief. The court affirmed the district court’s finding that Meyer failed to allege facts supporting a breach of fiduciary duty under ERISA. Crucially, the court noted that the No Surprises Act, which codified protections against surprise billing, did not apply to the conduct at issue because it occurred before the Act went into effect on January 1, 2022. Because the dismissal was based on the failure to state a claim, the court declined to address the statute of limitations or whether a fiduciary relationship existed.
What it means going forward
The decision reinforces that ERISA plaintiffs must plead specific facts to support fiduciary breach claims and confirms that the No Surprises Act does not retroactively cover conduct occurring prior to its January 2022 effective date.