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

Paid petition · United States Court of Appeals for the Fifth Circuit, No. 22-10062 · judgment March 13, 2023

Certiorari denied · October 2, 2023
Pre-decision estimate: 7% cert probability (95% interval 5%–10%)

Before the decision, about 1.7× the 4.1% base rate. The model weighted this up for a Fifth Circuit decision below, a circuit split argued in the petition, and a petition filed soon after the judgment below.

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?

Counsel of record

For petitioner
Michael Edmund Burke IV
Arnall Golden Gregory LLP

For respondent
Kwaku Affawua Akowuah
Sidley Austin LLP

Case

Conference history
Distributed for 1 conference

Proceedings

  1. Oct 02 2023
    Petition DENIED.
  2. Jul 14 2023
    Waiver of right of respondent Blue Cross Blue Shield Association to respond filed.
    Main Document
  3. Jul 12 2023
    DISTRIBUTED for Conference of 9/26/2023.
  4. Jun 29 2023
    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.
    Main Document
  5. Jun 29 2023
    Waiver of right of respondent Office of Personnel Managment to respond filed.
    Main Document
  6. Jun 12 2023
    Petition for a writ of certiorari filed. (Response due July 17, 2023)
    PetitionAppendixCertificate of Word CountProof of Service