In THC–Orange County LLC v. Regence BlueShield of Idaho Inc., the U.S. District Court for the District of Idaho addressed a motion by plaintiff THC–Orange County LLC, doing business as Kindred Hospital Ontario, to conduct limited discovery from the defendants, including whether defendant WinCo Holdings Employee Benefit Plan “has reinsurance and, if so, who the reinsurer is and whether the reinsurer has any input into benefit decisions.”
The underlying lawsuit involves claims by plaintiff Kindred Hospital under ERISA for the payment of benefits for the care of a patient. The plaintiff’s complaint named several defendants, including the plan, Regence BlueShield of Idaho as contract administrator, and Cambia Health Solution, the parent company of Regence. The plaintiff moved to conduct limited discovery addressing the following topics: Regence’s relationship with the plan and its authority under the plan; whether the plan has reinsurance and, if so, the identity of the reinsurer and whether it has any input into benefit decisions; the identity and qualifications of medical reviewers; and appeal panel minutes.
Rejecting the defendants’ opposition, the court granted the plaintiff’s motion and compelled discovery regarding each topic. The court found that a “structural conflict may exist” regarding the relevant underlying plan documents and other documents and ordered limited discovery. The court also ordered limited discovery regarding the existence of reinsurance for the plan and the identity and authority of any such reinsurer. The court based this ruling on its observation of a “potential structural conflict of interest,” which the court noted “is sufficient to warrant limited discovery about a potential financial conflict of interest.” Finally, the court found that the plaintiff was entitled to discovery on the identities and qualifications of medical reviewers, the “Blue Card” program, and the appeal panel’s minutes and notes from meetings occurring during the relevant time period. The court also granted the plaintiff’s motion to take judicial notice of certain plan documents relied upon in filing its motion.
THC-Orange County, LLC v. Regence BlueShield of Idaho, Inc., No. 1:24-cv-00154 (D. Idaho June 2, 2025).
