No. 22-1213

Roslyn Gonzalez v. Blue Cross Blue Shield Association, et al.

Lower Court: Fifth Circuit
Docketed: 2023-06-15
Status: Denied
Type: Paid
Response Waived
Tags: administrative-remedies administrative-review benefits benefits-denial coverage-denials federal-employee-health-benefits-act fehba opm-review plan-participant
Key Terms:
AdministrativeLaw ERISA JusticiabilityDoctri
Latest Conference: 2023-09-26
Question Presented (AI Summary)

Does the denial of 'benefits' under FEHBA include denial of the plan participant's access to services, or access to the OPM administrative review of coverage denials?

Question Presented (OCR Extract)

QUESTIONS PRESENTED 1. Does the denial of “benefits’ under FEHBA include denial of the plan participant’s access to services, or access to the OPM administrative review of coverage denials? 2. Has a FEHBA plan participant exhausted her administrative remedies when the plan administrator notified the participant that she had exhausted her appeal rights and had no right to OPM review?

Docket Entries

2023-10-02
Petition DENIED.
2023-07-14
Waiver of right of respondent Blue Cross Blue Shield Association to respond filed.
2023-07-12
DISTRIBUTED for Conference of 9/26/2023.
2023-06-29
Waiver of right of respondents Blue Cross Blue Shield Association; Health Care Services Corporation, Doing Business As Blue Cross Blue Shield of Texas to respond filed.
2023-06-29
Waiver of right of respondent Office of Personnel Managment to respond filed.
2023-06-12
Petition for a writ of certiorari filed. (Response due July 17, 2023)

Attorneys

Blue Cross Blue Shield Association
Adam Peter FeinbergMiller & Chevalier Chartered, Respondent
Blue Cross Blue Shield Association; Health Care Services Corporation, Doing Business As Blue Cross Blue Shield of Texas
Kwaku Affawua AkowuahSidley Austin LLP, Respondent
Office of Personnel Managment
Elizabeth B. PrelogarSolicitor General, Respondent
Roslyn Gonzalez
Michael Edmund Burke IVArnall Golden Gregory LLP, Petitioner