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O'Neil v. Wal-Mart Corp.

August 22, 2007

JOHN P. O'NEIL, COMMISSIONER OF SOCIAL SERVICES, ASSIGNEE, ON BEHALF OF BETSY LORD, ASSIGNOR, PLAINTIFF,
v.
WAL-MART CORPORATION, AS EMPLOYER OF AIMEE A. VRADENBURG, CHILD SUPPORT OBLIGOR,*FN1 DEFENDANT.



MEMORANDUM-DECISION AND ORDER*fn2

I. Background

Plaintiff Commissioner of Essex County Department of Social Services (hereinafter "Plaintiff" or "Commissioner") brought this case to require Defendant Wal-Mart Stores, Inc. Associates' Health and Welfare Plan (the "Plan") to extend health insurance benefits to WPL, the stepson of Wal-Mart Employee Amie Vradenburg ("Vradenburg"), pursuant to a Qualified Medical Child Support Order ("QMCSO" or the "Order"). Plntf's Mem. of Law (Dkt. No. 19) at 2; Deft's Mem. of Law (Dkt. No. 16) at 2. Defendant refuses to enroll WPL, arguing that WPL does not meet the plan's eligibility guidelines and the Order cannot override those guidelines. Currently before the Court is Defendant's Motion for Summary Judgment (Dkt. No. 16) and Plaintiff Commissioner's Cross-Motion for Summary Judgment (Dkt. No. 19).

II. Standard for Summary Judgment

Summary judgment should be granted when "the pleadings, depositions, answers to interrogatories, admissions, and affidavits show that there is no genuine issue as to any material fact, and that the moving party is entitled to summary judgment." FED. R. CIV. P. 56. The moving party must demonstrate the absence of any genuine issue of material fact. Id.; Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Once that burden is met, the non-moving party can defeat summary judgment by setting forth specific facts that form the basis of a genuine issue of fact for trial. FED. R. CIV. P. 56; Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250 (1986). In this case, there is no factual dispute. The issue is legal, rather than factual, and both parties have moved for summary judgment.

III. Discussion

The United States Code outlines if and how group health plans under the Employee Retirement Income Security Program are subject to medical child support orders. 29 U.S.C. § 1169. Under this system, a QMCSO compels a group health plan to provide benefits for an alternate recipient with some relationship to the participant. Id. at (a)(1), (a)(2)(c). However, a QMCSO cannot compel a group health plan to provide any type or form of benefit not otherwise provided under the plan. Id. at (a)(4). The exception to this rule is that a QMCSO can compel a plan to provide a new type or form of benefit if "necessary to meet the requirements of a law relating to medical child support described in section 1908 of the Social Security Act [42 U.S.C.A. § 1396g-1]." Id.

A. Is the Order a QMCSO?

Section 1169 of Title 29 of the United States Code defines QMCSO to mean a medical child support order:

(i) which creates or recognizes the existence of an alternate recipient's right to, or assigns to an alternate recipient the right to, receive benefits for which a participant or beneficiary is eligible under a group health plan, and

(ii) with respect to which the requirements of paragraphs (3) and (4) are met*fn3 .

29 U.S.C. § 1169(a)(2)(A).

1. Are Stepchildren Valid Alternate Recipients?

Defendant argues that the Order is not a valid QMCSO because WPL is not a valid "alternate recipient." Deft's Response and Reply (Dkt. No. 22) at 3-4. An alternate recipient is defined by ERISA as "[a]ny child of a participant who is recognized under a medical support order as having a right to enrollment under a group health plan with respect to such participant." 29 U.S.C. § 1169(a)(2)(C). See also Department of Labor, Employee Benefits Security Administration, Compliance Guide for Qualified Medical Child Support Orders (hereinafter, "DOL Compliance Guide"), at Q1-5, found at http://www.dol.gov/ebsa/publications/qmcso.html (accessed on 8/10/07).

The participant in this case, Amie Vradenburg, is WPL's stepmother. Decl. of Amie Vradenburg (Dkt. No. 16, Ex. B) at ¶3; 29 U.S.C. § 1002(7) (defining "participant" to refer to the employee or former employee who is enrolled in the group health plan). Defendant argues that WPL cannot be a valid recipient because he is not Vradenburg's child. Defendant has submitted a declaration by Vradenburg that she has never lived with WPL; is not his legal guardian; and has never claimed him as a dependant for tax purposes. Decl. of Amie Vradenburg (Dkt. No. 16, Ex. B) at ¶ 5-8. However, Defendant has not provided any legal support for the argument that a stepchild is distinct from a "child" as defined by ERISA or that cohabitation, legal guardianship, or tax status are relevant to the definition of "child" in this context. Instead, Defendant admits that "neither ERISA nor the Social Security Act ...


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