Priority of coordinated no-fault & health insurance policies; MCL 500.3109a; Treatment of self-funded ERISA health plans; Auto Club Ins Ass’n v Frederick & Herrud, Inc (After Remand); Citizens Ins Co of Am v MidMich Health ConnectCare Network Plan (6th Cir); Coordination of benefits (COB) clause; Employee Retirement Income Security Act (ERISA)

Concluding that further discovery was needed in this case involving the priority of coordinated no-fault and health insurance benefits, the court vacated the order granting defendant-no-fault insurer (MEEMIC) summary disposition, and remanded. MEEMIC’s insured, nonparty-B, was injured in an auto accident. She “received a discounted rate by coordinating her no-fault benefits with her health insurance coverage.” The MEEMIC policy contained a COB clause. B was also covered at the time of the accident by “a self-funded health benefit plan through her employer—Marriott International. Early in the proceedings, MEEMIC identified Empire Blue Cross Blue Shield (BCBS) as administrator of the plan.” B received physical therapy services from plaintiff-healthcare provider after the accident and executed an assignment of rights for payment. The court noted that this “case should have been a straightforward application of contract language to the facts. However, neither [B], Marriott, nor BCBS were parties in this matter, leading to discovery issues. Further, discovery in [B’s] separate action involving MEEMIC and the Marriott ERISA plan administered by BCBS bled into this action at inopportune times. The result” was that neither the trial court nor the court “were provided the actual language of the Marriott ERISA plan or the Empire BCBS policy. Further, we cannot be certain which BCBS policy actually applied to [B]: Empire BCBS or BCBS Blue. BCBS’s position on coverage is unclear. And any errors made in this case might” impact B’s separate lawsuit. The court found that the trial court on remand must allow further discovery. “The parties should obtain the complete Marriott plan document and depose an appropriate plan representative to determine the name of the correct healthcare policy applicable at the time of [B’s] accident. If the applicable policy includes a COB provision that permits the insured to designate the ERISA plan as primary, the parties should inquire” as to the mechanics of that procedure. They should discover if B “contemporaneously notified BCBS in writing that she had elected coordinated coverage under her MEEMIC policy[.]” The court added the trial “court must also be cognizant that this case involves a health benefit plan self-funded by Marriott that includes a health insurance policy administered by BCBS.”