Opinion · Supreme Court of the United States

FMC Corp. v. Holliday

498 U.S. 52

Type
Opinion
Court
Supreme Court of the United States
Jurisdiction
Federal
Date
1990-11-27
Topic
general

How later courts describe this case

  • holding that a state anti-subrogation statute “directly controls the terms of insurance contracts by invalidating any subrogation provisions that they contain”
  • holding that self-funded ERISA plans “are exempt from state regulation insofar as that regulation ‘relate[s] to’ the plans”
  • holding that state regulation of self-insured ERISA plans preempted while insured plans subject to indirect regulation because underlying insurance contracts regulable
  • holding that, for ERISA qualified plans, ERISA preempted application of the anti-subrogation provision of the MVFRL
  • holding that self-funded employee benefit plans governed by ERISA are not subject to direct state regulation
  • holding that state laws may not abridge an employer’s right to enforce an ERISA-governed plan’s subrogation provision
  • holding that state subrogation law related to employee benefit plans because it prohibited plans from being structured in a manner requiring reimbursement in the event of recovery from a third party
  • holding that ERISA preempted application of the Pennsylvania Motor Vehicle Financial Responsibility Law to an ERISA governed health care plan

Citator

FMC Corp. v. Holliday is good law as far as the corpus records: followed by 1 later decision, and nothing recorded condemns it.

Authority status
positive
Cited by
968 opinions
Followed
1 times

Headnotes

  1. Employee Benefits & Exec Comp — Preemption — Express Preemption In determining whether federal law preempts a state statute, a court looks to congressional intent; preemption may be either express or implied and is compelled whether Congress's command is explicitly stated in the statute's language or implicitly contained in its structure and purpose, and the court begins with the language employed by Congress, assuming that its ordinary meaning accurately expresses the legislative purpose. 498 U.S. at 56-57
  2. Employee Benefits & Exec Comp — Preemption Clause — Scope ERISA's preemption clause is conspicuous for its breadth and establishes as an area of exclusive federal concern the subject of every state law that "relates to" an employee benefit plan governed by ERISA; the saving clause returns to the States the power to enforce state laws that regulate insurance, except as provided in the deemer clause, under which a covered plan shall not be deemed an insurance company, an insurer, or engaged in the business of insurance for purposes of state laws purporting to regulate insurance companies or insurance contracts. 498 U.S. at 58
  3. Employee Benefits & Exec Comp — Preemption — "Relate To" A state law "relates to" an employee benefit plan within the meaning of ERISA's preemption clause if it has either a connection with or a reference to such a plan; Congress used the words "relate to" in their broad sense and did not mean to preempt only state laws specifically designed to affect employee benefit plans. 498 U.S. at 58 (citing Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96-97 (1983))
  4. Employee Benefits & Exec Comp — Preemption — Conflicting State Regulation ERISA's preemption clause applies to state laws that risk subjecting plan administrators to conflicting state regulations; requiring plan providers to design their programs in an environment of differing state regulations would complicate the administration of nationwide plans and produce inefficiencies that employers might offset with decreased benefits, so where a patchwork scheme of regulation would introduce considerable inefficiencies in benefit program operation, the preemption clause applies to ensure that benefit plans are governed by only a single set of regulations. 498 U.S. at 59-60
  5. Employee Benefits & Exec Comp — Subrogation A state antisubrogation law that prohibits plans from being structured to require reimbursement upon recovery from a third party relates to an employee benefit plan, because it requires plan providers to calculate benefit levels based on expected liability conditions differing from those in other States and thereby frustrates plan administrators' continuing obligation to calculate uniform benefit levels nationwide. 498 U.S. at 60
  6. Employee Benefits & Exec Comp — Saving Clause — Regulation of Insurance A state law falls within ERISA's insurance saving clause where it directly controls the terms of insurance contracts — for example, by invalidating any subrogation provisions they contain — and is aimed at the insurance industry rather than merely having an impact on it. 498 U.S. at 61 (citing Metropolitan Life Ins. Co. v. Massachusetts, 471 U.S. 724, 740-741 (1985); Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 50 (1987))
  7. Employee Benefits & Exec Comp — Deemer Clause — Self-Funded Plans The deemer clause exempts self-funded ERISA plans from state laws that regulate insurance within the meaning of the saving clause: by forbidding States to deem employee benefit plans to be an insurance company or other insurer or to be engaged in the business of insurance, the deemer clause relieves such plans from state laws purporting to regulate insurance, so that state laws directed toward the plans are preempted because they relate to an employee benefit plan but are not saved because they do not regulate insurance. 498 U.S. at 61
  8. Employee Benefits & Exec Comp — Deemer Clause — Insured Plans Employee benefit plans that are insured remain subject to indirect state insurance regulation, because an insurance company that insures a plan remains an insurer for purposes of state laws purporting to regulate insurance after application of the deemer clause, and the ERISA plan is consequently bound by state insurance regulations insofar as they apply to the plan's insurer. 498 U.S. at 61-62
  9. Employee Benefits & Exec Comp — Deemer Clause — Insured Versus Uninsured Plans ERISA's deemer clause produces a distinction between insured and uninsured plans, leaving the former open to indirect state regulation through regulation of their insurers while self-funded plans are not subject to such regulation; this distinction was created by Congress in the deemer clause and Congress has chosen not to alter it. 498 U.S. at 62 (citing Metropolitan Life Ins. Co. v. Massachusetts, 471 U.S. 724, 747 (1985))
  10. Employee Benefits & Exec Comp — Deemer Clause — Presumption Against Preemption Construing the deemer clause to exempt self-funded ERISA plans from direct state insurance regulation is consistent with the presumption that Congress does not intend to preempt areas of traditional state regulation, including regulation of the business of insurance reserved to the States by the McCarran-Ferguson Act, which encompasses not only direct regulation of the insurer but also regulation of the substantive terms of insurance contracts. 498 U.S. at 62-63 (citing Jones v. Rath Packing Co., 430 U.S. 519, 525 (1977); Metropolitan Life Ins. Co. v. Massachusetts, 471 U.S. 724, 742-744 (1985))
  11. Employee Benefits & Exec Comp — Deemer Clause — Rejected Narrow Readings The deemer clause is not limited to state insurance regulations that are pretexts for impinging on core ERISA concerns, nor is it directed solely at laws governing the business of insurance such as licensing and capitalization requirements; the phrase "purporting to regulate" refers to laws having the appearance of or intending to regulate insurance companies or contracts and does not confine the clause to deceit that Congress feared state legislatures would practice, and the deemer clause's language is either coextensive with or broader than that of the saving clause. 498 U.S. at 63-64
  12. Employee Benefits & Exec Comp — Deemer Clause — Administrative Difficulties A construction of the deemer clause that exempts employee benefit plans from only those state regulations encroaching upon core ERISA concerns or applying to insurance as a business would be fraught with administrative difficulties, necessitating definition of core ERISA concerns and of what constitutes business activity, and would undermine Congress's desire to avoid endless litigation over the validity of state action and instead lead to employee benefit plans' expenditure of funds in such litigation. 498 U.S. at 64-65
  13. Employee Benefits & Exec Comp — Preemption — Self-Funded Plans and State Antisubrogation Laws Given Congress's clear intent to exempt ERISA employee benefit plans from direct state insurance regulation, ERISA preempts the application of a state law precluding reimbursement from a claimant's tort recovery for benefit payments by a program, group contract, or other arrangement to a self-funded ERISA health care plan. 498 U.S. at 65