TIARA YACHTS, INC. v. BLUE CROSS BLUE SHIELD OF MICHIGAN - Articles

All Content

TIARA YACHTS, INC. v. BLUE CROSS BLUE SHIELD OF MICHIGAN

Posted by: Azya Thornton on May 21, 2025

Court: 6th Circuit Court (Published Opinions)

Attorneys 1: ARGUED: Aaron M. Phelps, VARNUM LLP, Grand Rapids, Michigan, for Appellant. Tacy F. Flint, SIDLEY AUSTIN LLP, Chicago, Illinois, for Appellee.

Attorneys 2: ON BRIEF: Aaron M. Phelps, Perrin Rynders, Herman D. Hofman, Neil E. Youngdahl, VARNUM LLP, Grand Rapids, Michigan, for Appellant.

Attorneys 3: ON BRIEF: Tacy F. Flint, H. Javier Kordi, SIDLEY AUSTIN LLP, Chicago, Illinois, for Appellee.

Judge(s): MURPHY, DAVIS, and BLOOMEKATZ, Circuit Judges

Court Appealed: United States District Court for the Western District of Michigan at Grand Rapids

BLOOMEKATZ, Circuit Judge. Tiara Yachts, Inc., hired Blue Cross Blue Shield of Michigan (“BCBSM”) to administer its self-funded healthcare benefits plan. It alleges that BCBSM knowingly squandered plan assets by systematically overpaying some categories of claims. BCBSM then allegedly profited from its mismanagement by implementing a program through which it caught overpayments, clawed them back, and kept a portion of those “savings” for itself. Tiara Yachts sued BCBSM under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001, et seq., and BCBSM moved to dismiss. The district court granted that motion, holding that Tiara Yachts hadn’t plausibly alleged that BCBSM acted as an ERISA fiduciary. It also held that ERISA’s remedial provisions couldn’t provide the relief Tiara Yachts sought. Because the district court erred on both fronts, we reverse.

Attachments: