MANHATTAN (CN) – Empire Blue Cross Blue Shield and St. Joseph’s Medical Center unfairly deny health benefits to spouses of legally married same-sex couples, two women claim in a federal class action.
“Despite the fact that New York State recognizes same-sex marriage, St. Joseph’s and BCBS [Blue Cross Blue Shield] maintained a provision of the plan excluding same-sex spouses from eligible dependents of plan participants,” Jane Doe and Jane Roe says in their complaint.
Roe is employed by St. Vincent’s Westchester, a division of St. Joseph’s. Doe is her spouse. Both live in Westchester County.
Roe claims that after passage of New York’s Marriage Equality Act in late 2011, she applied for spousal benefits but was told “that her spouse would be denied coverage because the plan expressly excluded ‘same-sex’ couples as eligible dependents of the plan’s participants.”
The women claim that “the defendants, at all relevant dates, have condoned and maintained that provision despite its clearly discriminatory purpose and effect.”
“As fiduciaries of the plan, defendants had the responsibility and duty of providing benefits to plan participants and beneficiaries prudently and for the sole purpose of caring for the interests of those individuals pursuant to 29 U.S.C. 1104. As defendants failed to abide by their fiduciary duties by creating and maintaining a discriminatory provision which interfered with and denied the attainment of rights accorded to plaintiffs, they violated ERISA.”
The complaint cites several recent court rulings, including “a recent First Circuit opinion [in which] the Court of Appeals found that Section 1 of DOMA, which defines marriage narrowly as between two individuals of the opposite sex, was unconstitutional on the basis that the extreme economic burden placed on gay citizens seeking medical benefits, tax benefits and spousal death benefits outweighed the Congressional purposes of DOMA which violated the Equal Protection Clause. …
“Similarly, on June 6, 2012, DOMA was found unconstitutional by Judge Barbara Jones of the Southern District of New York, who, like the First Circuit, determined that the governmental goals set forth by DOMA were illegitimate.”
The plaintiffs seek declaratory judgment that they are entitled to benefits under ERISA, and want Blue Cross and St. Joseph’s enjoined from withholding benefits.
They are represented by Jeffrey Norton, with Newman Ferrara.