Geissal v. Moore Medical Corporation

PETITIONER: Geissal
RESPONDENT: Moore Medical Corporation
LOCATION: National Endowment for the Arts

DOCKET NO.: 97-689
DECIDED BY: Rehnquist Court (1986-2005)
LOWER COURT: United States Court of Appeals for the Eighth Circuit

CITATION: 524 US 74 (1998)
ARGUED: Apr 29, 1998
DECIDED: Jun 08, 1998

ADVOCATES:
Bradley J. Washington - Argued the cause for the respondents
Bradley J. Washburn - on behalf of the Respondents
James A. Feldman - Argued the cause for the United States, as amicus curiae, by special leave of court, supporting the petitioner
Sheldon Weinhaus - Argued the cause for the petitioner
S. Sheldon Weinhaus - on behalf of the Petitioner

Facts of the case

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended the Employee Retirement Income Security Act of 1974 to permit a beneficiary of an employer's group health plan to elect continuing coverage when he might otherwise lose that benefit because of a "qualifying event," such as the termination of employment. In 1993, when Moore Medical Corporation fired James Geissal, it told him that COBRA gave him the right to elect continuing coverage under Moore's health plan. Later, Moore informed Geissal that he was not entitled to COBRA benefits because he was already covered by a group plan through his wife's employer. Geissal then filed suit against Moore, alleging that Moore was violating CORBA by renouncing an obligation to provide continuing coverage. Ultimately, a Magistrate Judge concluded that an employee with coverage under another group health plan on the date he elects COBRA coverage is ineligible for COBRA coverage under 29 USC section 1162(2)(D)(i), which allows an employer to cancel such coverage as of "the date on which the qualified beneficiary first becomes, after the date of the election... covered under any other group health plan." The Court of Appeals affirmed.

Question

Does 29 USC section 1162(2)(D)(i) allow an employer to deny Consolidated Omnibus Budget Reconciliation Act of 1985 continuation health coverage to a qualified beneficiary who is covered under another group health plan at the time he makes his COBRA election?

Media for Geissal v. Moore Medical Corporation

Audio Transcription for Oral Argument - April 29, 1998 in Geissal v. Moore Medical Corporation

William H. Rehnquist:

We'll hear argument next in Number 97-689, Bonnie Geissal v. the Moore Medical Corporation.

Very well, Mr. Weinhaus.

S. Sheldon Weinhaus:

Mr. Chief Justice, and may it please the Court:

In this case, Mr. Geissal, who is now dead, was terminated from his employment by Moore Medical Corporation at a time when he had cancer and was dying of cancer.

He was offered immediately COBRA continuation and at the same time his wife had always carried health insurance coverage with her own employer which covered dependents, including Mr. Geissal.

He was allowed to continue to make COBRA payments for 6 months, when all of a sudden Moore Medical announced that it was not responsible for his health insurance coverage, they wrongly accepted COBRA payments, they would pay him back, and they would not pay any of his bills.

This case was brought, using the wording of the statute, and the wording is simple, and that's where we start with, that coverage must be offered to the individual of the same quality as given to employees, and that would be true... if employees got dual coverage, he would be entitled to dual coverage, required to offer the same policy, and it must extend for at least the period beginning on the date of the qualifying event and ending not earlier than the earliest of the following, and one of them is, when... the date on which he becomes... first becomes qualified after the date of election for further insurance.

Now, in this instance, Moore Medical Corporation took the position that he first became, after the date of election, covered by the wife's policy and therefore was not entitled to the coverage.

At that point, litigation ensued.

Sandra Day O'Connor:

Mr. Weinhaus, would you explain to me what your client stands to recover now?

Were Mr. Geissal's medical expenses actually paid by the other policy?

S. Sheldon Weinhaus:

We know some of them were paid.

We do not know whether all of them were paid.

My understanding, some were not paid, but unfortunately in this case what the magistrate judge did is, after denying our motion for summary judgment, turned around and, sua sponte, without development of anything in the record, declared summary judgment for Moore Medical Corporation, so there is no record and, while Moore Medical does continuously argue, in the absence of a record, that we lost nothing, we don't think that's true.

Sandra Day O'Connor:

Well, presumably your client ought to know whether something was lost or not.

Is there no claim?

S. Sheldon Weinhaus:

Well--

Sandra Day O'Connor:

What is the claimed injury now?

S. Sheldon Weinhaus:

--Well, the claimed injury are, amongst other things, we have at least the deductible that we have to pay for, and we have to face health care providers who may hereafter bill us.

In these cases, in the health insurance field, the health providers do not send the bill to the patient, usually, they send them to the health institution which is paying the bills.

Sandra Day O'Connor:

How long ago did this death occur?

S. Sheldon Weinhaus:

Well, it now occurred a couple of years ago, but--

Sandra Day O'Connor:

But you don't have any bills and we don't know if there's any injury.

S. Sheldon Weinhaus:

--We have not been told of any bills.

The only bills I know of in which there's likely injury is what I call the Greek trip in which he received medication in the Greek Islands, for which--

Sandra Day O'Connor:

It's just hard to picture what remains of the claim, if anything.

S. Sheldon Weinhaus:

--Well, what also remains of the claim is this.

There may be, in fact, double coverage.

I don't know here.

We have not gotten that far.