J.H., A.H. v. Anthem Blue Cross Life and Health Insurance Company

Salt Lake City, Utah employment law lawyers represented the parties in an employment welfare-benefit plan dispute.



J.H. participated through her employer in an employee welfare-benefit plan (the Plan) fully insured by Anthem Blue Cross Life and Health Insurance Company.



Her son, A.H., was a beneficiary.1 After Plaintiffs sought benefits for A.H.'s yearlong stay at a mental-health treatment center, Anthem denied coverage. Plaintiffs' appeal to Anthem was unsuccessful. Well over a year after their final appeal through Anthem was decided, Plaintiffs filed this lawsuit, asserting a claim for recovery of benefits under § 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1132(a)(1)(B). A provision of the Plan stated: "If you bring a civil action under Section 502(a) of ERISA, you must bring it within one year of the grievance or appeal decision.” Aplt. App. at 174. The United States District Court for the District of Utah dismissed the action, concluding it was time-barred under the provision. On appeal Plaintiffs point to another sentence in the Plan setting a three-year limitations period, contending that the two deadlines are contradictory and create an

ambiguity that must be interpreted in their favor.



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Affirmed