Case: Health Care & Benefits/Plan Benefits & Fiduciary Duties (D. Utah)

A federal district court in Utah granted Aetna Health of Utah Inc. and Banner Health judgment on the pleadings in this action by IHC Health Services Inc. for recovery of plan benefits and breach of fiduciary duties. IHC provided medical services to a patient who is participant and beneficiary of an employee health and welfare plan sponsored by Banner and administered by Aetna. The patient incurred $20,000 in charges, but Banner and Aetna only paid $375. The court said that the plan prohibits the assignment of benefits, so there is no valid assignment to IHC and it lacks standing, and ...