T. E., individually and on behalf of C. E. a minor v. ANTHEM BLUE CROSS AND BLUE SHIELD; STOLL KEENON OGDEN PLLC; STOLL KEENON OGDEN PLLC BENEFIT PLAN - Articles

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T. E., individually and on behalf of C. E. a minor v. ANTHEM BLUE CROSS AND BLUE SHIELD; STOLL KEENON OGDEN PLLC; STOLL KEENON OGDEN PLLC BENEFIT PLAN

Posted by: Julia Wilburn on Jan 28, 2026

Court: 6th Circuit Court (Published Opinions)

Attorneys 1: ARGUED: Brian S. King, BRIAN S. KING P.C., Salt Lake City, Utah, for Appellant.

Attorneys 2: ARGUED: Miles R. Harrison, FROST BROWN TODD LLP, Louisville, Kentucky, for Appellee Anthem Blue Cross and Blue Shield.

Attorneys 3: ARGUED: Donald P. Sullivan, JACKSON LEWIS, P.C., San Francisco, California, for Stoll Keenon Ogden Appellees.

Attorneys 4: ON BRIEF: Brian S. King, BRIAN S. KING P.C., Salt Lake City, Utah, for Appellant.

Attorneys 5: ON BRIEF: Miles R. Harrison, Jason P. Renzelmann, Miranda M. Ronnow, FROST BROWN TODD LLP, Louisville, Kentucky, for Appellee Anthem Blue Cross and Blue Shield.

Judge(s): GRIFFIN, THAPAR, and HERMANDORFER, Circuit Judges

Court Appealed: United States District Court for the Western District of Kentucky at Louisville

T.E. enrolled his son, C.E., in a long-term, residential-treatment center to address C.E.’s mental-health issues. That enrollment followed years of failed attempts to address C.E.’s conditions through other means. T.E. asked his insurer Anthem to help cover the costs of the treatment. Anthem agreed and paid for the first 21 days of C.E.’s treatment without issue. But it then reversed course and refused to pay any further, reasoning that C.E.’s treatment was no longer medically necessary. After a series of failed internal appeals with Anthem, T.E. sued. He alleged that Anthem’s coverage denial was arbitrary and capricious under the Employee Retirement Income Security Act (ERISA) and violated the Mental Health Parity and Addiction Equity Act (Parity Act). The district court granted summary judgment to Anthem on both claims. We agree with T.E. that Anthem’s coverage decision was arbitrary and capricious. But T.E. has failed to identify record evidence demonstrating that Anthem’s decision violated the Parity Act. We therefore affirm in part, vacate in part, and remand the case to the district court with instructions to remand to Anthem for further assessment of T.E.’s coverage request.

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