United States Court of Appeals
For the First Circuit
No. 02-1817
JAMES ALVES and HILLEL STAVIS, INDIVIDUALLY
AND ON BEHALF OF A CLASS OF PERSONS SIMILARLY SITUATED,
Plaintiffs, Appellants,
v.
HARVARD PILGRIM HEALTH CARE, INC., HARVARD PILGRIM
HEALTH CARE OF NEW ENGLAND, INC., A MASSACHUSETTS CORPORATION,
HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.,
A RHODE ISLAND CORPORATION, HARVARD VANGUARD MEDICAL
ASSOCIATES, INC., and PILGRIM HEALTH CARE, INC.,
Defendants, Appellees.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MASSACHUSETTS
[Hon. Patti B. Saris, U.S. District Judge]
Before
Boudin, Chief Judge,
Torruella and Lipez, Circuit Judges.
Edward D. Rapacki with whom Ellis & Rapacki LLP and Stuart T.
Rossman, National Consumer Law Center, were on brief for
appellants.
Michael Arthur Walsh with whom Jennifer J. Aresco, Sandy Se
Young Shen and Choate, Hall & Stewart were on brief for appellees.
January 21, 2003
Per Curiam. In this case, two plaintiffs brought an
action under ERISA, 29 U.S.C. § 1001 et seq. (2000), on behalf of
themselves and class members, against the sponsors of several
employee health benefit plans and, in one case, against a related
non-profit entity that provides prescription medication to
employees covered by one of the plans. The plans have fixed
"copayment" requirements (e.g., $5.00 per prescription), and, in
some instances, the required copayment exceeds the actual cost of
the medication to the plan (although in many others the drugs are
far more expensive than the copayment).
The gist of the plaintiffs' claim is that whenever the
copayment exceeds the actual cost of the prescribed medicine to the
plan, the excess represents money wrongly taken from the
beneficiary, comprising a violation of the terms of the plan, a
breach of fiduciary duty and/or affirmative misrepresentation. In
a thorough and well-reasoned opinion, Judge Saris found that the
plans clearly described what beneficiaries had to pay and that
there was neither a breach of fiduciary duty nor any affirmative
misrepresentation. Alves v. Harvard Pilgrim Health Care, Inc., 204
F. Supp. 2d 198 (D. Mass. 2002).
We agree with the district court's admirable discussion
of the merits and see no reason to add anything more than our
endorsement. Standing objections were raised by the defendants in
the district court and rejected by Judge Saris, but these
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objections have not been reasserted on appeal and raise no
jurisdictional bar, so we do not comment upon them. Like the
district court, we agree that there is no reason to address the
complicated question of what remedies might be appropriate for
various alleged violations because in this instance there was no
violation at all.
Affirmed.
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