Sawyer v. Pacificare of California, 1999 U.S. App. LEXIS 30136 (9th Cir. November 17, 1999) (unpublished)

Sawyer v. Pacificare of California, 1999 U.S. App. LEXIS 30136 (9^th Cir. November 17, 1999) (unpublished)-This court affirmed the district court’s dismissal of Sawyers’ breach of contract and covenant of good faith and fair dealing claims against Sawyers’ HMO provider, PacifiCare, because ERISA preempted the Sawyers' state claims.

Sawyer’s employer offered a comprehensive benefits package to all eligible employees that included medical coverage under one of three available HMO plans. ERISA defines "employee welfare benefit plan" as "any plan, fund or program . . . established or maintained by an employer . . . for the purpose of providing for its participants . . . through the purchase of insurance or otherwise . . . medical, surgical, or hospital care or benefits." 29 U.S.C. § 1002(1). Thus, the plan qualified as an "employee welfare benefit plan" under ERISA.

Apparently unfamiliar with ERISA preemption, plaintiff’s attorney contended that PacifiCare breached the terms of the insurance plan as well as the covenant of good faith and fair dealing by delaying Mrs. Sawyer's Gamma Knife surgery. ERISA "supercede[s] any and all State laws insofar as they may now or hereafter relate to any employee benefit plan." 29 U.S.C. § 1144(a). A state claim "relate[s] to" an ERISA plan if it "has a connection with or reference to such plan." This court stated that “both claims clearly "relate to" an ERISA plan. ERISA preempted both claims.