Background
Kirsten W. filed suit on behalf of herself and her minor son after their health benefits plan denied claims for medical expenses related to behavioral health treatment. The district court granted summary judgment on some claims but remanded the determination of benefits to the plan administrator. The district court also granted summary judgment to one defendant, Trinet Group, Inc., while finding the other defendant, California Physicians Service, liable on the ERISA claim subject to the remand.
The court’s reasoning
The court determined that the district court’s order was not a final decision under twenty-eight U.S.C. section twelve ninety-one because it remanded the case for the administrator to determine the correct amount of damages. The order did not specify a sum certain and explicitly contemplated further proceedings regarding the liability of Trinet. The court declined to apply the doctrine of practical finality, noting that the appellant identified no issue that would be effectively unreviewable by waiting for a final award.
A decision is final when it ends the litigation on the merits and leaves nothing for the court to do but execute the judgment.
S.E.C. v. Merrill Scott & Associates, Ltd., 600 F.3d 1262, 1270 (10th Cir. 2010)
What it means going forward
The plaintiff must wait for the plan administrator to complete the remand and for the district court to issue a final judgment on any subsequent motions before appealing to the Tenth Circuit again.
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