Total Benefits Planning Agency v. Anthem Blue Cross and Blue Shi ( 2008 )


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  •                          RECOMMENDED FOR FULL-TEXT PUBLICATION
    Pursuant to Sixth Circuit Rule 206
    File Name: 08a0453p.06
    UNITED STATES COURT OF APPEALS
    FOR THE SIXTH CIRCUIT
    _________________
    X
    -
    TOTAL BENEFITS PLANNING AGENCY, INC.,
    Plaintiffs-Appellants, -
    et al.,
    -
    -
    No. 07-4115
    v.
    ,
    >
    -
    -
    ANTHEM BLUE CROSS AND BLUE SHIELD,
    Defendants-Appellees. -
    et al.,
    -
    -
    N
    Appeal from the United States District Court
    for the Southern District of Ohio at Cincinnati.
    No. 05-00519—Michael R. Barrett, District Judge.
    Argued: July 30, 2008
    Decided and Filed: December 22, 2008
    *
    Before: GILMAN and ROGERS, Circuit Judges; ZOUHARY, District Judge.
    _________________
    COUNSEL
    ARGUED: Richard B. Reiling, LAW OFFICE, Dayton, Ohio, for Appellants. James
    M. Burns, WILLIAMS MULLEN, Washington, D.C., Mark Edward Elsener, PORTER,
    WRIGHT, MORRIS & ARTHUR, Cincinnati, Ohio, for Appellees. ON BRIEF:
    Richard B. Reiling, LAW OFFICE, Dayton, Ohio, for Appellants. James M. Burns,
    WILLIAMS MULLEN, Washington, D.C., Mark Edward Elsener, PORTER, WRIGHT,
    MORRIS & ARTHUR, Cincinnati, Ohio, Kent A. Britt, Glenn V. Whitaker, VORYS,
    *
    The Honorable Jack Zouhary, United States District Judge for the Northern District of Ohio,
    sitting by designation.
    1
    No. 07-4115         Total Benefits Planning Agency, et al. v.                        Page 2
    Anthem Blue Cross and Blue Shield, et al.
    SATER, SEYMOUR & PEASE, Cincinnati, Ohio, B. Scott Jones, REMINGER CO.
    LPA, Cincinnati, Ohio, Thomas J. Gruber, McCASLIN, IMBUS & McCASLIN,
    Cincinnati, Ohio, Peter L. Cassady, Sarah Clay Leyshock, Brian R. Redden, BECKMAN
    WEIL SHEPARDSON, Cincinnati, Ohio, John R. Folkerth, Jr., WEPRIN, FOLKERTH
    & ROUTH, Dayton, Ohio, Christopher Freeman Johnson, FREUND, FREEZE &
    ARNOLD, Dayton, Ohio, Maria Del Monaco, ULMER & BERNE, Cleveland, Ohio,
    John M. Hands, ULMER & BERNE, Cincinnati, Ohio, Edward R. Goldman, RENDIGS,
    FRY, KIELY & DENNIS, Cincinnati, Ohio, for Appellees.
    _________________
    OPINION
    _________________
    JACK ZOUHARY, District Judge. Total Benefits Planning Agency and four of
    its insurance agents (collectively “Total Benefits”) appeal a dismissal of their amended
    complaint for failure to state a claim under 12(b)(6) of the Federal Rules of Civil
    Procedure. Total Benefits maintained contracts with Anthem Blue Cross and Blue
    Shield; Anthem Life Insurance Company, Inc.; Anthem Health Plans of Kentucky, Inc.;
    Anthem Insurance Company, Inc. (collectively “Anthem”); and Cornerstone Broker
    Insurance Services Agency (“Cornerstone”) for the sale of group life and health
    insurance policies in Ohio, Indiana, and Kentucky. Total Benefits allege Anthem
    conspired to boycott and blacklist Total Benefits in violation of Section 1 of the Sherman
    Act. In addition to appealing the dismissal, Total Benefits also appeal the district court’s
    failure to sua sponte permit them to file a second amended complaint before dismissing
    their case.
    The district court, after originally denying the motion to dismiss, dismissed the
    amended complaint after finding Plaintiffs failed to allege a violation of Section 1 of the
    Sherman Act under either the per se analysis or the rule-of-reason test. The court was
    persuaded in part by two Supreme Court decisions handed down after the district court’s
    original ruling: Leegin Creative Leather Prods., Inc. v. PSKS, Inc., 551 U.S. ___, 127
    No. 07-4115           Total Benefits Planning Agency, et al. v.                              Page 3
    Anthem Blue Cross and Blue Shield, et al.
    S. Ct. 2705 (2007); and Bell Atlantic Corp. v. Twombly, 
    550 U.S. 544
    , 
    127 S. Ct. 1955
    ,
    1974 (2007).
    For the reasons that follow, we AFFIRM the dismissal.
    FACTUAL BACKGROUND
    Total Benefits developed “an innovative strategy for controlling health care costs
    . . . utiliz[ing] a 51-year old federal tax law to ‘refinance’ health-care costs by raising
    deductibles on existing group insurance policies and administering benefits through a
    medical expense reimbursement plan” (Am. Comp. ¶ 22). Total Benefits claim the
    system is able to “save businesses in Ohio, Indiana, and Kentucky, 20% or more on their
    health insurance costs, without cutting benefits” (Am. Comp. ¶ 23). In September 2004,
    Anthem advised Total Benefits that the strategy “was not in the best interest of Anthem
    or the more traditional insurance agencies,” and that Anthem would not permit Total
    Benefits, or any other Anthem agent, to engage in such practices and remain agents of
    Anthem. In June 2005, Anthem severed its agency relationship with Total Benefits
    because they continued to promote the strategy (Am. Comp. ¶ 24).
    Total Benefits allege Anthem and its various agents1 conspired to blacklist and
    organize an industry boycott against Total Benefits in violation of the Sherman Act, 15
    U.S.C. § 1, because Total Benefits refused to relinquish the strategy. Total Benefits also
    allege defamation, libel, tortious interference with contract, conspiracy, and breach of
    contract under state law.
    PROCEDURAL BACKGROUND
    On August 4, 2005, Total Benefits filed suit to prevent and restrain continuing
    violations of the Sherman Antitrust Act, 15 U.S.C. § 1. On September 8, 2005, Anthem
    filed a motion to dismiss, arguing dismissal was appropriate because Total Benefits
    1
    These other Defendants included Anthem Life Insurance Company, Inc.; Anthem Health Plans
    of Kentucky; Anthem Insurance Company, Inc.; Cornerstone Broker Insurance Services Agency, Inc.; John
    Does 1-100; Jane Does 1-100; CAI Insurance Agency; Horan Associates, Inc.; USI Midwest; McGohen-
    Brabender, Inc.; Brower Insurance Agency, LLC; Lange Financial Group; and Benefit Resources, Inc.
    No. 07-4115         Total Benefits Planning Agency, et al. v.                        Page 4
    Anthem Blue Cross and Blue Shield, et al.
    (1) failed to identify the subject, product and geographic markets that were at issue;
    (2) claimed harm only to themselves as opposed to harm to competition; (3) failed to
    adequately allege “a contract, combination or conspiracy” in sufficient detail; and (4)
    was barred from challenging the alleged conduct by the McCarren-Ferguson Act, 15
    U.S.C. § 1012, because Total Benefits could not demonstrate a boycott. Cornerstone
    moved to dismiss on grounds identical to those set forth by Anthem.
    On September 8, 2006, the district court denied the motions to dismiss of Anthem
    and Cornerstone, finding Anthem’s refusal to contract with Total Benefits to be a
    vertical boycott and that the complaint sufficiently alleged Anthem unlawfully coerced
    insurance agents who did business with Total Benefits. The district court concluded
    from these allegations that Total Benefits “sufficiently alleged a prima facie case of each
    element of the per se test” for their Sherman Act claim.
    Anthem immediately filed a motion to reconsider, advancing the following
    arguments: (1) the district court erred by using per se principles for a vertical boycott;
    and (2) Plaintiffs’ claims must be reviewed under the rule-of-reason test, and Plaintiffs
    failed to adequately plead “a rule of reason case.” Cornerstone again joined Anthem’s
    motion.
    On November 2, 2006, Total Benefits filed an amended complaint, further
    defining their claims against Anthem, Cornerstone, and the newly added other
    Defendants, claiming these Defendants had conspired with Anthem to boycott, coerce,
    and otherwise blacklist Total Benefits.
    Following the amended complaint, Anthem again moved to dismiss, asserting
    Total Benefits failed to allege: (1) sufficient detail in connection with the “participants,
    time, place and effect of the alleged conspiracy”; (2) facts to support the “conclusionary
    assertions that [Total Benefits] are the victims of a price fixing conspiracy”; and (3) the
    applicable product and geographic markets, and the impact on competition. The other
    Defendants filed motions to dismiss asserting these same grounds.
    No. 07-4115         Total Benefits Planning Agency, et al. v.                          Page 5
    Anthem Blue Cross and Blue Shield, et al.
    On July 25, 2007, following the Leegin and Twombly decisions, the district court
    reversed its earlier position and dismissed the recently amended complaint. The district
    court held:
    •       Total Benefits failed to sufficiently allege there was a horizontal
    agreement between Defendants and therefore failed to state a
    claim for a per se violation under the Sherman Act.
    •       Total Benefits failed to set forth a prima facie case for a rule-of-
    reason violation because it failed to plead (a) a set price or price
    level in order to support a claim of price fixing; (b) plausible
    grounds to infer an agreement between the parties; (c) an adverse
    effect on the marketplace; and (d) the existence of market power.
    Total Benefits appeal this decision.
    JURISDICTION
    The district court had federal question jurisdiction pursuant to 28 U.S.C. § 1331
    and supplemental jurisdiction over state law claims pursuant to 28 U.S.C. § 1337. This
    Court has appellate jurisdiction pursuant to 28 U.S.C. § 1291.
    STANDARD OF REVIEW
    The standard of appellate review for a motion to dismiss pursuant to Rule
    12(b)(6) is de novo, and the Court will employ the same standard as the district court.
    First Am. Title Co. v. Devaugh, 
    480 F.3d 438
    , 443 (6th Cir. 2007); Nat’l Hockey League
    Players Ass’n v. Plymouth Whalers Hockey Club, 
    419 F.3d 462
    , 468 (6th Cir. 2005).
    An action may be dismissed if the complaint fails to state a claim upon which
    relief can be granted. Federal Civil Rule 12(b)(6). The moving party has the burden of
    proving that no claim exists. Although a complaint is to be liberally construed, it is still
    necessary that the complaint contain more than bare assertions or legal conclusions. In
    re DeLorean Motor Co., 
    991 F.2d 1236
    , 1240 (6th Cir. 1993) (citing Scheid v. Fanny
    Farmer Candy Shops, Inc., 
    859 F.2d 434
    , 436 (6th Cir. 1988)). All factual allegations
    in the complaint must be presumed to be true, and reasonable inferences must be made
    in favor of the non-moving party. Great Lakes Steel v. Deggendorf, 
    716 F.2d 1101
    ,
    No. 07-4115            Total Benefits Planning Agency, et al. v.                                    Page 6
    Anthem Blue Cross and Blue Shield, et al.
    1105 (6th Cir. 1983); 2 MOORE’S FEDERAL PRACTICE § 12.34[1][b] (Matthew Bender
    3d ed. 2003). The court need not, however, accept unwarranted factual inferences.
    Morgan v. Church’s Fried Chicken, 
    829 F.2d 10
    , 12 (6th Cir. 1987). To survive a
    motion to dismiss, the complaint must present “enough facts to state a claim to relief that
    is plausible on its face.” Bell Atlantic Corp. v. Twombly, 
    550 U.S. 544
    , 
    127 S. Ct. 1955
    ,
    1974 (2007).2
    A Sherman Act Section 1 complaint must contain “more than labels and
    conclusions, and a formulaic recitation of the elements of a cause of action”; rather, it
    must “raise a right to relief among the speculative level.” 
    Id. at 1964-65.
    A plaintiff
    must allege “enough factual matter . . . to suggest that an agreement was made,” and “an
    allegation of parallel conduct and a bare assertion of conspiracy will not suffice.” 
    Id. at 1965-66.
    DISMISSAL FOR FAILURE TO STATE A CLAIM
    Plaintiffs allege the district court erred in failing to find the complaint adequately
    pled a violation of Section 1 of the Sherman Act based on a per se violation or the rule-
    of-reason test. Each argument will be addressed separately.
    2
    This Court has cited the heightened pleading standard of Twombly in a wide variety of cases,
    not simply limiting its applicability to antitrust actions. See, e.g., Tucker v. Middleburg-Legacy Place, 
    539 F.3d 545
    (6th Cir. 2008) (Family & Medical Leave Act); Bassett v. Nat’l Collegiate Athletic Ass’n, 
    528 F.3d 426
    (6th Cir. 2008) (antitrust); McKnight v. Gates, 282 F. App’x 394 (6th Cir. 2008) (age
    discrimination); Gilles v. Garland, 281 F. App’x 501 (6th Cir. 2008) (violation of First and Fourteenth
    Amendment rights); B. & V. Distrib. Co., Inc. v. Dottore Cos., L.L.C., 278 F. App’x 480 (6th Cir. 2008)
    (breach of contract); Ferron v. Zoomego, Inc., 276 F. App’x 473 (6th Cir. 2008) (violation of Ohio
    Consumer Sales Act); Bishop v. Lucent Tech., Inc., 
    520 F.3d 516
    (6th Cir. 2008) (breach of fiduciary duty
    in ERISA context); Eidson v. Tenn. Dep’t of Children’s Servs., 
    510 F.3d 631
    (6th Cir. 2007) (42 U.S.C.
    § 1983); NicSand, Inc. v. 3M Co., 
    507 F.3d 442
    (6th Cir. 2007) (antitrust); League of United Latin Am.
    Citizens v. Bredesen, 
    500 F.3d 523
    (6th Cir. 2007) (equal protection). However, some cases have
    questioned the scope of Twombly. See, e.g., United States v. Ford Motor Co., 
    532 F.3d 496
    , 503 n.6 (6th
    Cir. 2008); Sensations, Inc. v. City of Grand Rapids, 
    526 F.3d 291
    (6th Cir. 2008); Midwest Media Prop.,
    L.L.C. v. Symmes Twp., 
    512 F.3d 338
    , 341 (6th Cir. 2007) (Martin, Moore, Cole, Clay, JJ., dissenting from
    denial of request for en banc hearing). For an exhaustive collection and analysis of over 3,000 district
    court decisions applying Twombly, see Note, Much Ado About Twombly, 83 NOTRE DAME L. REV. 1811
    (2008).
    No. 07-4115        Total Benefits Planning Agency, et al. v.                       Page 7
    Anthem Blue Cross and Blue Shield, et al.
    1.       Per se Violation
    The per se standard recognizes there are some methods of restraint that are so
    inherently and facially anti-competitive that an elaborate and burdensome inquiry into
    a demonstrable economic impact on competition in a relevant market is not required.
    See Nat’l Soc’y of Prof’l Eng’rs v. United States, 
    435 U.S. 679
    , 692 (1978). When this
    case was originally filed, there were two possible grounds for the application of a per se
    antitrust claim: (1) a “group boycott” alleging a horizontal agreement among
    competitors, and (2) a vertical price fixing conspiracy. See NYNEX Corp. v. Discon,
    Inc., 
    525 U.S. 128
    , 136 (1998); Ezzo’s Invs., Inc. v. Royal Beauty Supply, Inc., 
    243 F.3d 980
    , 986-87 (6th Cir. 2001). However, between the motion for reconsideration and the
    district court’s decision, the Supreme Court decided Leegin Creative Leather Prods.,
    Inc. v. PSKS, Inc., 551 U.S. ___, 
    127 S. Ct. 2705
    (2007), in which it overruled the
    vertical price fixing standard of Dr. Miles Med. Co. v. John D. Park & Sons Co., 
    202 U.S. 373
    (1911). Now, all vertical price restraints are to be judged under the rule-of-
    reason standard. Only a group boycott through horizontal agreement can constitute a per
    se violation.
    Total Benefits contend that the Anthem Defendants constitute “horizontal direct
    competitors” under a per se analysis. However, Plaintiffs fail to plead in their amended
    complaint the necessary factual allegations. Specifically, there neither is, nor can be, a
    horizontal relationship among the Anthem Defendants.
    The Supreme Court has held that a parent company and its wholly owned
    subsidiaries are incapable, as a matter of law, of conspiracy. Copperweld Corp. v.
    Independence Tube Corp., 
    467 U.S. 752
    , 769 (1984); Guzowski v. Hartman, 
    969 F.2d 211
    , 213-14 (6th Cir. 1992). This Court has expanded that position to include sister
    companies with the same parent. See Directory Sales Mgmt. Corp. v. Ohio Bell Tel. Co.,
    
    833 F.2d 606
    , 611 (6th Cir. 1987). The district court properly examined the amended
    complaint and other public records, including Anthem’s 2005 Annual Report and
    Corporate Disclosure Statements, to determine that each of the Anthem Defendants is
    No. 07-4115           Total Benefits Planning Agency, et al. v.                                  Page 8
    Anthem Blue Cross and Blue Shield, et al.
    wholly owned and controlled by Anthem Insurance Company, Inc., which itself is owned
    by WellPoint, Inc. This “sister” relationship between each of the Anthem Defendants
    makes them incapable, as a matter of law, of conspiring to form a horizontal group
    boycott in violation of Section 1 of the Sherman Act.
    Total Benefits also argue the amended complaint alleges a “hub and spoke”
    conspiracy that qualifies for per se treatment pursuant to Toys ‘R’ Us, Inc. v. F.T.C., 
    221 F.3d 928
    (7th Cir. 2000).3 However, this analysis of Toys ‘R’ Us is incorrect. In Toys
    ‘R’ Us, several toy manufacturers conspired together, and also with Toys ‘R’ Us, to
    distribute certain toys to only Toys ‘R’ Us. In finding a per se violation, the Seventh
    Circuit held the hub and spoke conspiracy included horizontal agreements between
    competing toy manufacturers as well as vertical agreements with Toys ‘R’ Us. Thus, the
    per se standard was applied because the case met the NYNEX requirement of a horizontal
    agreement among direct competitors. There is no special exception for applying per se
    status just because there is a hub and spoke conspiracy; the complaint still must show
    some horizontal relationship.
    Here, Total Benefits have sufficiently identified the hub as Anthem, and the
    spokes as the independent insurance agents. However, the rim holding everything
    together is missing. No agreements are identified between competitors, as were the
    agreements between the toy manufacturers in Toys ‘R’ Us. Simple allegations in the
    amended complaint, such as a general date of when the conspiracy likely began and that
    parties are acting in a similar fashion, are insufficient to establish an agreement. See
    Elder-Beerman Stores Corp. v. Federated Dep’t Stores, 
    459 F.2d 138
    , 144 (6th Cir.
    1972). Total Benefits focus instead on agreements between Anthem and other insurance
    agents, but these are irrelevant because the critical issue for establishing a per se
    violation with the hub and spoke system is how the spokes are connected to each other.
    3
    A hub and spoke conspiracy involves a hub, generally the dominant purchaser or supplier in the
    relevant market, and the spokes, made up of the distributors involved in the conspiracy. The rim of the
    wheel is the connecting agreements among the horizontal competitors (distributors) that form the spokes.
    Each of the three parts is integral in establishing a per se violation under the hub and spoke theory.
    No. 07-4115        Total Benefits Planning Agency, et al. v.                        Page 9
    Anthem Blue Cross and Blue Shield, et al.
    The amended complaint falls short of presenting such a connection, offering only a
    rimless theory. Thus, the Section 1 claim fails as a matter of law.
    2.      Rule-of-Reason Test
    The rule-of-reason test requires the court to analyze the actual effect on
    competition in a relevant market to determine whether the conduct unreasonably
    restrains trade. Nat’l Soc’y of Prof’l 
    Eng’rs, 435 U.S. at 692
    . To state a claim under this
    test, a plaintiff must include in the complaint allegations demonstrating: (1) the
    defendants “contracted, combined or conspired among each other”; (2) “the combination
    or conspiracy produced adverse, anticompetitive effects within relevant product and
    geographic markets”; (3) “the objects of and conduct pursuant to that contract or
    conspiracy were illegal”; and (4) “the plaintiff was injured as a proximate result of that
    conspiracy.” Crane & Shovel Sales Corp. v. Bucyrus-Erie Co., 
    854 F.2d 802
    , 805 (6th
    Cir. 1988).
    The first element requires a plaintiff to allege the existence of the conspiracy in
    more than “vague and conclusory” terms. 
    Id. The Supreme
    Court in Twombly
    reaffirmed that “conclusory allegations of agreement at some unidentified point do not
    supply facts adequate to show 
    illegality.” 127 S. Ct. at 1966
    . An antitrust plaintiff must
    provide factual allegations plausibly suggesting, not merely consistent with, such a
    claim. See NicSand, Inc. v. 3M Co., 
    507 F.3d 442
    , 451 (6th Cir. 2007).
    The allegations in the amended complaint fall significantly short of the required
    pleading threshold. Plaintiffs complain of “a continuing agreement, understanding and
    concert of actions among Defendants . . . . [S]ince September, 2004, the Defendants and
    co-conspirators have . . . defamed and libeled the Total Benefits Strategy to third
    parties,” “coerced and threatened certain insurance agents by threatening to blacklist
    them and cancel their contracts,” and “organized a boycott of Plaintiffs” (Am. Comp.
    ¶ 26). However, nowhere did Plaintiffs allege when Defendants joined the Anthem
    conspiracy, where or how this was accomplished, and by whom or for what purpose.
    There is no factual description of the substance of the statements or who made the
    No. 07-4115        Total Benefits Planning Agency, et al. v.                      Page 10
    Anthem Blue Cross and Blue Shield, et al.
    statements that “defamed and libeled,” “coerced and threatened,” and “blacklisted”
    Plaintiffs. The time period for the conspiracy is generally stated as “since September
    2004,” but Plaintiffs give no explanation of where or when during this multiple-year
    time frame any unlawful agreements or understandings might have occurred. Generic
    pleading, alleging misconduct against defendants without specifics as to the role each
    played in the alleged conspiracy, was specifically rejected by Twombly:
    Apart from identifying a seven-year span in which the § 1 violations
    were supposed to have occurred (i.e., “[b]eginning as early as February
    6, 1996, and continuing to the present,” . . .) the pleadings mentioned no
    specific time, place or person involved in the alleged conspiracies. . . .
    The complaint here furnishes no clue as to which of the four [defendants]
    (much less which of their employees) supposedly agreed, or when and
    where the illicit agreement took place. . . . [A] defendant seeking to
    respond to Plaintiffs’ conclusory allegations in the § 1 context would
    have little idea where to begin.
    
    Twombly, 127 S. Ct. at 1970
    n.10 (internal citations omitted).
    Plaintiffs only offer bare allegations without any reference to the “who, what,
    where, when, how or why.” Similarly, the vague allegations in the instant case “do not
    supply facts adequate to show illegality” as required by Twombly.
    Total Benefits also fail to identify a relevant product market. The Supreme Court
    requires plaintiffs to identify the relevant product and geographic markets so the district
    court can assess “what the area of competition is, and whether the alleged unlawful acts
    have anticompetitive effects in that market.” Brown Shoe Co. v. United States, 
    370 U.S. 294
    , 324 (1962). The district court correctly noted that the amended complaint limits
    the geographic area to Indiana, Ohio, and Kentucky, but the court also observed that the
    amended complaint “fails to mention other insurance companies or agents within this
    market.”    There is no explanation of other companies with whom Plaintiffs or
    Defendants compete. Additionally, Total Benefits fail to indicate whether the relevant
    market consisted of products or services. Within the insurance industry there are a
    multitude of different policy types (for example, life insurance, health insurance, and
    group policies), and each is part of its own individual market. Without an explanation
    No. 07-4115          Total Benefits Planning Agency, et al. v.                   Page 11
    Anthem Blue Cross and Blue Shield, et al.
    of the other insurance companies involved, and their products and services, the court
    cannot determine the boundaries of the relevant product market and must dismiss the
    case for failure to state a claim. See Worldwide Basketball & Sport Tours, Inc. v.
    N.C.A.A., 
    388 F.3d 955
    , 961 (6th Cir. 2004).
    The amended complaint falls short of the specificity required for the rule-of-
    reason test. The district court’s dismissal for failing to adequately plead a Section 1
    claim was correct.
    NO ABUSE OF DISCRETION FOR FAILING TO INVITE ANOTHER
    AMENDED COMPLAINT
    The standard of review of a district court’s denial of a motion for leave to amend
    a complaint is abuse of discretion, unless the motion was denied because the amended
    pleading would not withstand a motion to dismiss, in which case the standard of review
    is de novo. See Evans v. Pearson Enters., Inc., 
    434 F.3d 839
    , 853 (6th Cir. 2006). Here,
    Plaintiffs did not seek leave to amend their complaint or proffer an amended pleading.
    Therefore, the standard of review is abuse of discretion. See 
    id. at 853-854;
    Sinay v.
    Lamson & Sessions, Co., 
    948 F.2d 1037
    , 1042 (6th Cir. 1991).
    Total Benefits argue the district court should have initiated an opportunity for
    Total Benefits to amend a second time before dismissing the case. Anthem maintains
    no opportunity to amend was necessary because Total Benefits had not requested leave
    and any additional amendment would have been futile.
    After the district court denied the motions to dismiss filed by Anthem and
    Cornerstone, and after both filed a motion for reconsideration, Total Benefits filed an
    amended complaint. Total Benefits claim they “had no reason to suspect that the
    District Court would conclude [they] failed to provide adequate factual averments”
    (App. Br. p. 28 (emphasis in original)). This statement misses the mark. With a motion
    to dismiss pending, Total Benefits had every reason to make sure their amended
    complaint met the standard of adequate notice pleading and “plausibility.” Indeed, it
    was after Defendants’ motions for reconsideration that Total Benefits filed their
    No. 07-4115        Total Benefits Planning Agency, et al. v.                      Page 12
    Anthem Blue Cross and Blue Shield, et al.
    amended complaint. Any doubt as to the sufficiency of the allegations in the complaint
    should have been addressed at that point. It is not the district court’s responsibility to
    rescue Total Benefits by giving them another opportunity to get it right.
    Furthermore, the district court was acting on a motion to reconsider and a
    renewed motion to dismiss. Total Benefits had an opportunity to brief the motions.
    Total Benefits knew the sufficiency of their complaint was at issue. There simply was
    no prejudice.
    Plaintiffs suggest that when a district court plans to grant a motion to dismiss, it
    must first allow the parties an opportunity to amend. Such a rule is not only wholly
    without support, it would render a motion to dismiss useless in disposing of unfit claims.
    Importantly, Plaintiffs never requested leave for additional amendments, and it is not the
    district court’s role to initiate amendments. “Furthermore, a district court does not abuse
    its discretion in failing to grant a party leave to amend where such leave is not sought.”
    
    Sinay, 948 F.2d at 1042
    .
    The argument that the district court should have rescued Plaintiffs by sua sponte
    offering leave to amend the complaint is simply misplaced. As the court in DM
    Research, Inc. v. Coll. of Am. Pathologists, 
    170 F.3d 53
    , 56 (1st Cir. 1999) stated:
    Once [plaintiff] knew of the thrust of defendants’ arguments for
    dismissal, it was perfectly free to respond to the motion to dismiss by
    providing the district court with additional facts to make its complaint
    concrete and plausible. . . . Yet nothing in [plaintiff’s] opposition, or
    even its brief on appeal, has anything factual to underpin its complaint.
    The same holds true here.
    CONCLUSION
    For the reasons set forth above, the judgment of the district court is affirmed.
    

Document Info

Docket Number: 07-4115

Filed Date: 12/22/2008

Precedential Status: Precedential

Modified Date: 9/22/2015

Authorities (28)

DM Research, Inc. v. College of American Pathologists , 170 F.3d 53 ( 1999 )

Bassett v. National Collegiate Athletic Ass'n , 528 F.3d 426 ( 2008 )

United States v. Ford Motor Company , 532 F.3d 496 ( 2008 )

Eidson v. Tennessee Department of Children's Services , 510 F.3d 631 ( 2007 )

32-fair-emplpraccas-1788-32-empl-prac-dec-p-33805-4-employee , 716 F.2d 1101 ( 1983 )

National Hockey League Players Association v. Plymouth ... , 419 F.3d 462 ( 2005 )

In Re Delorean Motor Company, Debtor. David W. Allard, Jr. ... , 991 F.2d 1236 ( 1993 )

Worldwide Basketball and Sport Tours, Inc. v. National ... , 388 F.3d 955 ( 2004 )

The Elder-Beerman Stores Corp. v. Federated Department ... , 459 F.2d 138 ( 1972 )

Carolyn Morgan v. Church's Fried Chicken , 829 F.2d 10 ( 1987 )

crane-shovel-sales-corporation-v-bucyrus-erie-co-bucyrus-construction , 854 F.2d 802 ( 1988 )

Tucker v. Middleburg-Legacy Place, LLC , 539 F.3d 545 ( 2008 )

Directory Sales Management Corporation v. Ohio Bell ... , 833 F.2d 606 ( 1987 )

frank-guzowski-lorraine-guzowski-raymond-guzowski-and-donald-guzowski-v , 969 F.2d 211 ( 1992 )

Sensations, Inc. v. City of Grand Rapids , 526 F.3d 291 ( 2008 )

League of United Latin American Citizens v. Bredesen , 500 F.3d 523 ( 2007 )

Vivian J. Scheid v. Fanny Farmer Candy Shops, Inc. , 859 F.2d 434 ( 1988 )

Bishop v. Lucent Technologies, Inc. , 520 F.3d 516 ( 2008 )

NicSand, Inc. v. 3M Co. , 507 F.3d 442 ( 2007 )

Lynn Sinay, David Rosenberg (90-4075) and Aline Halye (91-... , 948 F.2d 1037 ( 1991 )

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