Compliance July 1, 2005

Appeals Court Tosses Health Benefit Tobacco Exclusion Case

July 1, 2005 (PLANSPONSOR.com) - A federal appeals court has upheld a lower court ruling that a Cottage Grove, Minnesota specialty plastics manufacturer improperly denied health coverage to an employee suffering from cardiovascular disease.
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As did US District Judge Richard Kyle of the US District Court for the District of Minnesota, the US 8 th Circuit Court of Appeals decided that Up North Plastics wrongly denied coverage claims by plaintiff Richard Christianson for the treatment of his deep venous thrombosis (DVT).

Even though the company’s plan document contained an exclusion for “[c]harges related in any way, shape or form to, or complicated by, the use of tobacco products,” Circuit JudgeDavid Hansen , writing for the appeals court, ruled that the employer had not presented enough evidence to prove a direct link between Christianson’s smoking habits and the DVT. The company had argued that Christianson’s smoking brought the DVT claim under the tobacco-related illness exclusion.

>The opinion in Christianson v. Poly-America, Inc. Medical Benefit Plan is    here .

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