United States District Court, C.D. California
BEVERLY OAKS PHYSICIANS SURGICAL CENTER, LLC, A California Limited Liability Company Plaintiff,
BLUE CROSS BLUE SHIELD OF ILLINOIS; and Does 1 through 100; Defendants.
ORDER RE: DEFENDANT'S MOTION TO DISMISS
PLAINTIFF'S SAC 
HONORABLE RONALD S.W. LEW, SENIOR U.S. DISTRICT JUDGE.
before the Court is Defendant Blue Cross Blue Shield of
Illinois' (“Defendant”) Motion to Dismiss
Plaintiff's Second Amended Complaint 
(“Motion”). Having reviewed all papers submitted
pertaining to this Motion, the Court NOW FINDS AND
RULES AS FOLLOWS: the Court GRANTS
Defendant's Motion WITHOUT LEAVE TO
Beverly Oaks Physicians Surgical Center, LLC,
(“Plaintiff”) brings this Action against
Defendant for recovery of benefits under the Employee
Retirement Income Security Act of 1974 (“ERISA”).
Plaintiff is an ambulatory surgery center located in Sherman
Oaks, California. Second Am. Compl. (“SAC”)
¶ 3, ECF No. 30. Defendant is a managed care company
that, among other things, insures and/or administers employer
health plans typically governed by ERISA. Id. ¶
6. Defendant carries out its health insurance business
activities in each state where covered employees and their
dependents are located. Id. ¶ 8. Plaintiff
brings this Action as the purported assignee of patients
seeking recovery of ERISA benefits they allege Defendant owes
them. Id. ¶¶ 14-16.
provided surgery center facility services to eleven
patients enrolled in the Teamsters Western Region
& Local 177 Health Care Plan (“Teamsters
Plan”), a health plan governed by ERISA. Id.
¶¶ 10, 11. Plaintiff alleges that all of these
patients assigned their health plan benefits to Plaintiff and
that Plaintiff submitted seventeen claims for medical
services provided to these patients. Id.
¶¶ 21, 46; see id., Ex. A, ECF No. 30-1.
Plaintiff alleges that Defendant failed to pay
Plaintiff's full billed charges, and that as an assignee
of these benefits, it is entitled to recover additional
payments from Defendant. Id. ¶¶ 38, 39.
has provided the Teamster's Summary Plan Description
document (“Teamsters SPD”). Id. ¶
17. The Teamsters SPD contains the following clause in a
section titled “General Provisions”:
“Participants are generally responsible for notifying
the Fund of changes in family circumstances. Benefits are not
assignable, although the Fund will honor qualified medical
child support orders.” Id. The parties dispute
whether this clause is a valid anti-assignment provision
(“AAP”). The Teamsters SPD is not by itself the
Teamsters Plan document, but it expressly references Article
X of the Teamsters Plan Rules and Regulations. Id.
¶ 18. Article X of the Teamster Plan Rules and
Regulations, Section B provides:
Benefits payable hereunder shall not be subject in any manner
to anticipation, alienation, sale, transfer, assignment,
pledge, encumbrance, or charge by any person; however, any
Eligible The Court granted Defendant's Motion to Dismiss
Plaintiff's FAC without leave to amend as to these three
patients, and as such, these claims are no longer before the
Court. Employee may direct that benefits due him/her, except
benefits payable under Article III, be paid to an institution
in which he/she or his/her Dependent is hospitalized, or to
any provider of medical, dental or vision care services or
supplies in consideration for Hospital, medical, dental or
vision care services rendered or to be rendered.
Notwithstanding the foregoing, the Fund will honor any
“qualified medical child support order” as
defined by ERISA Section 609, received with respect to the
Fund, and will make any payment required by ERISA Section 609
to a State which has acquired rights under that Section.
Id. ¶ 20; see id., Ex. D at 59.
filed its Complaint  on May 9, 2018 for recovery of
benefits under ERISA. Defendant filed a Motion to Dismiss
 on August 6, 2018. This Court granted Defendant's
Motion to Dismiss with leave to amend  on November 8,
2018. On November 29, 2018, Plaintiff filed its
First Amended Complaint (“FAC”) . On December
13, 2018, Defendant filed a Motion to Dismiss Plaintiff's
FAC , which the Court granted on February 27, 2019 .
Specifically, the Court dismissed without leave to amend
Plaintiff's claims under the Woodward & Williams Lea
Plans, and Plaintiff's claim brought on behalf of Patient
E. The Court granted leave to amend solely as to
Plaintiff's claims under the Teamsters Plan.
March 20, 2019, Plaintiff filed its SAC . On April 3,
2019, Defendant filed the instant Motion to Dismiss
Plaintiff's SAC . Plaintiff timely opposed , and
Defendant timely replied .