Magellan Health Services, Inc. v. Highmark Life Insurance Co.

APPEL, Justice.

In this case, we are called upon to determine the legal ramifications of conflicting coordination of benefits provisions in a self-funded welfare benefit plan governed by the Employee Retirement Income Security Act of 1975 (ERISA) and an individual health insurance policy issued pursuant to Iowa Code chapter 513C.

I. Factual Background and Prior Proceedings.

John Doe was diagnosed with leukemia in the 1990s. His medical bills were initially paid through group health insurance coverage provided by his mother Jane Doe’s employer, Principal Financial Group. At the same time, John…