First Circuit Finds Wrongful Death Claim Related to Health Insurance Benefit Denial Is Preempted by ERISA

In Cannon v. Blue Cross & Blue Shield of Massachusetts, Inc., No. 24-1862, __F.4th__, 2025 WL 855194 (1st Cir. Mar. 19, 2025) (Before: Aframe, Lynch, and Howard, Circuit Judges), the First Circuit Court of Appeals addressed preemption of state law claims by the Employee Retirement Income Security Act of 1974 (ERISA). The court’s analysis focused on whether Scott Cannon’s wrongful death and punitive damages claims, arising from the denial of insurance coverage for an inhaler, were preempted by ERISA’s provisions.

The court’s preemption analysis centered on two aspects of ERISA: statutory preemption under 29 U.S.C. § 1144(a) and conflict preemption under 29 U.S.C. § 1132(a). Statutory preemption, often referred to as “express preemption,” applies to any state law that “relates to” an employee benefit plan. The court reiterated the standard that a state law “relates to” an ERISA plan if it has a connection with or reference to such a plan, as established in prior cases such as Shaw v. Delta Air Lines, Inc. and reaffirmed by the Supreme Court in Rutledge v. Pharmaceutical Care Management Association.

In this case, the court found that Cannon’s wrongful death claim was preempted because it required reference to and interpretation of the ERISA-governed health insurance policy. The court emphasized that resolving the claim would involve evaluating whether the denial of benefits was improper under the terms of the plan, thus establishing an impermissible connection with an ERISA plan. This reasoning aligns with precedent in Turner v. Fallon Community Health Plan, Inc., where the First Circuit held that wrongful death claims based on a denial of benefits under an ERISA plan are preempted because they essentially seek remedies for plan-related obligations.

Furthermore, the court addressed conflict preemption under 29 U.S.C. § 1132(a), which provides a comprehensive remedial scheme for ERISA plan participants. The court highlighted that state-law causes of action that duplicate or supplement the ERISA civil enforcement mechanism are preempted. Cannon’s claim was found to be preempted because it sought damages for the denial of benefits, falling squarely within the scope of ERISA’s enforcement provisions.

The court rejected Cannon’s arguments against preemption, including reliance on the Supreme Court’s decision in Rutledge. The court clarified that Rutledge addressed cost regulation of pharmacy benefit managers, which did not entail a direct challenge to benefit denials under an ERISA plan. The court noted that Rutledge did not alter the established preemption analysis for claims directly tied to the administration of ERISA plans.

Ultimately, the court affirmed the district court’s grant of summary judgment in favor of Blue Cross and Blue Shield of Massachusetts, concluding that both statutory and conflict preemption under ERISA barred Cannon’s wrongful death and punitive damages claims.