United States District Court, D. New Jersey
Michael Vazquez, U.S.D.J.
matter comes before the Court on Defendant Anthem Blue Cross
Blue Shield's ("Anthem" or
"Defendant") unopposed motion to dismiss. D.E. 7.
The Court reviewed all submissions in support of the motion
and considered it without oral argument pursuant to Federal
Rule of Civil Procedure 78 and Local Civil Rule 78.1(b). For
the reasons that follow, the Court grants Defendant's
alleges that she is employed by "Cardinal Health"
and is an account holder with Anthem through a Cardinal
Health group plan. Compl., Count 1, ¶¶ 3-4. During
2015 and 2016, Plaintiff submitted medical claims to Anthem,
primarily related to a foot injury that ultimately required
surgery. Id. ¶ 5. Plaintiff alleges that her
claims were submitted timely and "in all other ways
complied with the contract of insurance." Id.
¶ 6. According to the Complaint, Anthem refused to make
"full and proper payment, " by either reducing
reimbursement or denying payment altogether. Id.
filed the Complaint in the Superior Court of New Jersey,
Essex County. Defendants removed the matter to this Court on
the basis of federal question and diversity jurisdiction.
D.E. 1. Plaintiffs two-count Complaint alleges breach of
contract and breach of the covenant of good faith and fair
dealing. Defendant moved to dismiss the Complaint. Plaintiff
did not file an opposition.
LAW AND ANALYSIS
Standard of Review
to Rule 12(b)(6) of the Federal Rules of Civil Procedure, a
court should dismiss a complaint when it fails "to state
a claim upon which relief can be granted." In analyzing
a motion to dismiss under Rule 12(b)(6) the court will
"accept all factual allegations as true, construe the
complaint in the light most favorable to the plaintiff, and
determine whether, under any reasonable reading of the
complaint, the plaintiff may be entitled to relief."
Phillips v. Cty. of Allegheny, 515 F.3d 224, 231 (3d
Cir. 2008) (quoting Pinker v. Roche Holdings Ltd.,
292 F.3d 361, 374 n.7 (3d Cir. 2002)). In addition to the
complaint, the Court may also consider any exhibits attached
thereto. See Pension Ben. Guar. Corp. v. White Consol.
Indus., Inc., 998 F.2d 1192, 1196 (3d Cir. 1993) (noting
that when deciding a motion to dismiss, courts generally
consider "the allegations contained in the complaint,
exhibits attached to the complaint and matters of public
survive dismissal, "a complaint must contain sufficient
factual matter, accepted as true, to 'state a claim to
relief that is plausible on its face.'" Ashcroft
v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell
Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)).
Determining whether a complaint is plausible is a
"context-specific task that requires the reviewing court
to draw on its judicial experience and common sense."
Id. at 679. While not a "probability
requirement, " plausibility means "more than a
sheer possibility that a defendant has acted
unlawfully." Id. at 678. "A claim has
facial plausibility when the plaintiff pleads factual content
that allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged."
Id. Even if plausibly pled, however, a complaint
will not withstand a motion to dismiss if the facts alleged
do not state "a legally cognizable cause of
action." Turner v. J.P. Morgan Chase & Co.,
No. 14-7148, 2015 WL 12826480, at *2 (D.N.J. Jan. 23, 2015).
Additionally, a court is "not compelled to accept
unwarranted inferences, unsupported conclusions or legal
conclusions disguised as factual allegations."
Baraka v. McGreevey, 481 F.3d 187, 211 (3d Cir.
argues that Plaintiffs claims are completely preempted under
Section 502(a) of the Employee Retirement Income Security Act
("ERISA"). The Court agrees.
applies to "any employee benefit plan if it is
established or maintained ... by any employer engaged in
commerce." 29 U.S.C. § 1003(a). ERISA defines
"employee welfare benefit plan" as
any plan, fund, or program which was heretofore or is
hereafter established or maintained by an employer or by an
employee organization, or by both, to the extent that such
plan, fund, or program was established or is maintained for
the purpose of providing for its participants or their
beneficiaries, through the purchase ...