UnitedHealthcare Insurance Company, a Connecticut Corporation, et al. v. Fremont Emergency Services (Mandavia), Ltd., a Nevada Professional Corporation, et al.

Section 514(a) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1144(a), expressly preempts state laws that “relate to” employee benefit plans. Petitioners provide administrative services to employee health benefit plans. Their duties include paying “out-of-network” medical providers—on the plans’ behalf—the amounts allowed by the plans for medical services provided to plan members. In this case, petitioners paid the full amounts authorized by plan terms, but they were sued by providers asserting an unjust enrichment claim alleging that Nevada law required petitioners to pay the providers more than the plan terms allowed. Three federal appellate decisions have held that materially identical claims were preempted by ERISA § 514 because they depend on the administrator’s duties under the plan to pay for out-of-network care and thus necessarily “relate to” the plan. In direct conflict with those decisions, the Nevada Supreme Court affirmed petitioners’ unjust enrichment liability, relying on a line of this Court’s precedents holding that § 514 does not apply to generally applicable laws that only incidentally increase plan costs. The question presented is: Whether ERISA § 514 preempts a claim asserting that the administrator of an ERISA-governed health plan was required by state law to reimburse out-ofnetwork providers at a rate higher than allowed by the plan’s terms for out-of-network services.