Jennifer Perkins v. US Airways, Inc., et al.

Petitioner has been continuously employed as a flight attendant with Respondent US Airways, Inc. (US Air), a member of the flight attendants’ union, and a participant in the US Airways Health Benefit Plan (the Plan) since 1992. Lightning struck Petitioner on a jetway while she was working for US Air. Petitioner continued working for US Air without taking a leave of absence after she was struck. Petitioner’s condition worsened considerably, and she has been on approved medical leave of absence since October 2001. Petitioner began receiving long-term disability benefits from US Air in February 2002, and she began receiving Medicare disability benefits in September 2003. As a result of her current employment status with US Air and her membership in the union, Petitioner is entitled to continue receiving benefits, including retirement benefits, health benefits, and seniority through US Air. While on approved medical leave, Petitioner has experienced several issues with Respondents improperly determining its payer status as secondary to Medicare. During all relevant times, Petitioner has timely paid the full amount of her health insurance premium in order to maintain the high-quality coverage offered by the Plan. Petitioner successfully appealed those determinations through 2010; however, in 2011, Respondents refused to correct its erroneous payer status determination and denied Petitioners’ claims for health benefits. In connection with Respondents’ denials in 2010 and 2011, Petitioner requested copies of certain Plan documents in order to assist her in appealing the denials. Respondents repeatedly failed to timely provide