The U.S. Court of Appeals for the Sixth Circuit ruled in favor of Anthem Blue Cross Blue Shield in an employee benefits dispute that involved coverage for a minor child. The court issued its decision Jan. 22 in T.E. v. Anthem Blue Cross Blue Shield, with the opinion recommended for publication under Sixth Circuit rules.
The case involved T.E., who sued both individually and on behalf of C.E., a minor, against Anthem Blue Cross and Blue Shield along with the law firm Stoll Keenon Ogden PLLC and its benefit plan. The lawsuit originated in the U.S. District Court for the Western District of Kentucky at Louisville, where Chief District Judge David Jason Hale presided over the initial proceedings.
The appellate panel consisted of Circuit Judges Griffin, Thapar, and Hermandorfer, with Judge Hermandorfer writing the opinion. The case was argued before the court Dec. 10, 2025, and decided approximately six weeks later.
While the specific details of the underlying dispute remain limited in the available court documents, the case structure suggests it involved employee benefit plan coverage issues. The inclusion of both an individual plaintiff and a minor child indicates the dispute likely centered on health insurance coverage or benefit denials affecting a family.
The defendants included not only Anthem Blue Cross and Blue Shield, the major health insurance provider, but also Stoll Keenon Ogden PLLC, a law firm, and its associated benefit plan. This suggests the case may have involved employment-related benefits provided through the law firm's employee benefit plan, with Anthem serving as the insurance carrier.
Employee Retirement Income Security Act (ERISA) cases often involve complex disputes over benefit plan coverage, particularly when insurance companies deny claims for medical treatment or coverage. These cases typically require courts to interpret plan documents and determine whether benefit denials were proper under the terms of the relevant plans.
The legal representation in the case included Brian S. King of Brian S. King P.C. in Salt Lake City representing the appellant T.E. Anthem Blue Cross and Blue Shield was represented by attorneys from Frost Brown Todd LLP in Louisville, including Miles R. Harrison, Jason P. Renzelmann, and Miranda M. Ronnow. The Stoll Keenon Ogden defendants were represented by Donald P. Sullivan of Jackson Lewis, P.C. in San Francisco.
The fact that the Sixth Circuit recommended the decision for publication under Internal Operating Procedure 32.1(b) suggests the court views the opinion as having precedential value for future cases. Published decisions carry more weight than unpublished opinions and can be cited as binding precedent within the circuit.
The Sixth Circuit covers federal appeals from district courts in Kentucky, Michigan, Ohio, and Tennessee. Employee benefits litigation is common in this circuit, which includes several major metropolitan areas where large employers maintain significant employee benefit plans.
For benefit plan participants, the decision may provide important guidance on how courts will interpret similar disputes involving coverage denials or benefit plan administration. The involvement of both an insurance company and a law firm's benefit plan suggests the case may address complex issues around plan administration and coverage determinations.
The timing of the case, with arguments in December 2025 and a decision in January 2026, reflects the typical appellate timeline for employment benefits cases. These cases often involve detailed review of administrative records and plan documents, requiring careful consideration by the appellate panel.
While the specific outcome favored the defendants, including Anthem Blue Cross and Blue Shield, the published nature of the decision means it will serve as precedent for future employee benefits litigation in the Sixth Circuit. This could impact how similar cases are resolved and how benefit plan administrators handle coverage determinations.
The case represents the ongoing complexity of employee benefits law, particularly in cases involving family coverage and benefit plan administration. As healthcare costs continue to rise and benefit plans become increasingly complex, disputes over coverage and plan interpretation remain common in federal courts.
For employers and benefit plan administrators, the decision may provide guidance on how courts will review benefit determinations and the standards applied to such decisions. The involvement of multiple defendants suggests the case addressed coordination between insurance carriers and plan administrators in making coverage determinations.