Cartwright v. State ( 2013 )


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  •                          Nebraska Advance Sheets
    CARTWRIGHT v. STATE	431
    Cite as 
    286 Neb. 431
    Sandra Cartwright, appellant, v. State                     of
    Nebraska et al., appellees.
    ___ N.W.2d ___
    Filed August 9, 2013.    No. S-12-749.
    1.	 Summary Judgment: Appeal and Error. An appellate court will affirm a lower
    court’s grant of summary judgment if the pleadings and admitted evidence show
    that there is no genuine issue as to any material facts or as to the ultimate infer-
    ences that may be drawn from the facts and that the moving party is entitled to
    judgment as a matter of law.
    2.	 ____: ____. In reviewing a summary judgment, an appellate court views the
    evidence in the light most favorable to the party against whom the judgment was
    granted, and gives that party the benefit of all reasonable inferences deducible
    from the evidence.
    3.	 Summary Judgment: Proof. The party moving for summary judgment has the
    burden to show that no genuine issue of material fact exists and must produce
    sufficient evidence to demonstrate that the moving party is entitled to judgment
    as a matter of law.
    4.	 Summary Judgment: Evidence: Proof. After the movant for summary judg-
    ment makes a prima facie case by producing enough evidence to demonstrate
    that the movant is entitled to judgment if the evidence was uncontroverted at
    trial, the burden to produce evidence showing the existence of a material issue
    of fact that prevents judgment as a matter of law shifts to the party opposing
    the motion.
    5.	 Summary Judgment. Conclusions based upon guess, speculation, conjecture, or
    a choice of possibilities do not create material issues of fact for purposes of sum-
    mary judgment.
    6.	 ____. If a genuine issue of fact exists, summary judgment may not properly
    be entered.
    7.	 Civil Rights. Title VII of the Civil Rights Act of 1964, as amended, prohib-
    its employment discrimination on the basis of race, color, religion, sex, or
    national origin.
    8.	 ____. Title VII of the Civil Rights Act of 1964 prohibits both intentional dis-
    crimination, known as disparate treatment, as well as practices that, although
    they are not intentional discrimination, have a disproportionately adverse effect
    on minorities, which is known as disparate impact.
    9.	 Employer and Employee: Discrimination. Disparate impact occurs when an
    employer uses an employment practice that has a disproportionately adverse
    effect on protected groups.
    10.	 Employer and Employee: Discrimination: Proof. To prove a prima facie case
    of disparate impact, the plaintiff must show (1) the existence of a statistically
    significant disparity among members of different groups affected by employment
    decisions; (2) the existence of a specific, facially neutral employment practice;
    and (3) a causal nexus between the specific, facially neutral employment practice
    and the statistical disparity.
    Nebraska Advance Sheets
    432	286 NEBRASKA REPORTS
    11.	 Discrimination: Proof. To recover under the disparate impact theory, plaintiffs
    must do more than merely prove circumstances raising an inference of a discrimi-
    natory impact; they must prove the discriminatory impact at issue.
    12.	 ____: ____. To recover under the disparate impact theory, plaintiffs must point to
    a clearly identifiable practice and prove its impact.
    Appeal from the District Court for Lancaster County: Paul
    D. Merritt, Jr., Judge. Affirmed.
    Kathleen M. Neary, of Vincent M. Powers & Associates, for
    appellant.
    Jon Bruning, Attorney General, and Stephanie Caldwell for
    appellees.
    Heavican, C.J., Wright, Connolly, Stephan, McCormack,
    Miller-Lerman, and Cassel, JJ.
    McCormack, J.
    NATURE OF CASE
    Sandra Cartwright filed suit against the State of Nebraska
    and Dave Heineman, Gerry Oligmueller, and Randy Palmer,
    in their individual capacities, in the Lancaster County District
    Court, alleging racial discrimination and a denial of equal pro-
    tection under 
    42 U.S.C. §§ 1981
     and 1983 (2006) and title VII
    of the Civil Rights Act of 1964 (Title VII).1 The district court
    granted the motion for summary judgment on all counts in
    favor of all defendants. Cartwright now appeals.
    BACKGROUND
    Cartwright, who is African-American, was employed by the
    Nebraska Department of Health and Human Services from 1990
    until her retirement in 2009. At all relevant times, Cartwright
    resided in Omaha, ZIP code 68111.
    The State is self-insuring as to state employee health care
    coverage. Contracts for the administration of health care cov-
    erage are awarded every 2 years to one or more successful
    bidders. In 2006, the State health care coverage plan contracts
    were open for bids for the 2007 and 2008 benefit years. In
    1
    See title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq.
    (2006 & Supp. V 2011).
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	433
    Cite as 
    286 Neb. 431
    May 2006, the State issued a “Request for Proposal Number
    1270Z1,” which sought proposals for the administration of the
    State’s group health insurance plans. After receiving and scor-
    ing proposals, contracts were awarded to Mutual of Omaha
    (later purchased by Coventry HealthCare of Nebraska) and
    Blue Cross Blue Shield of Nebraska.
    In 2007 and 2008, the State began using ZIP code coverage
    areas for the employee health care coverage plans to com-
    bat significant increases in health care costs. The State was
    informed by a contract actuary consultant that the presence of
    a viable health maintenance organization (HMO) network in
    the metropolitan ZIP codes, located primarily in the Omaha
    and Lincoln, Nebraska, metropolitan areas, could allow for a
    more cost-efficient plan in those areas. The ZIP code approach
    was a convenient way to define the geographical areas where
    the provider networks existed. By implementing the ZIP code
    approach, the State was able to minimize cost increases to both
    employees and the State.
    The two state employee health care coverage plans offered
    under the Mutual of Omaha contract to the employees who
    resided in areas with ZIP codes starting with 680, 681, and
    685 were an HMO plan and a point-of-service (POS) plan.
    According to Palmer, the employee benefits administrator for
    the State at the time, these plans were designed to be the
    equivalent of the HMO and POS plans offered under the Blue
    Cross Blue Shield of Nebraska contract to state employees who
    resided in all of the other ZIP codes of Nebraska. The differ-
    ence was that the Mutual of Omaha plans were true HMO and
    POS plans, whereas the Blue Cross Blue Shield plans were
    not considered to be true HMO and POS plans because they
    were not administered with a true HMO and POS network,
    but, rather, a preferred provider organization (PPO) network.
    This distinction, according to Palmer, allowed the State and its
    employees to save on premiums in their network.
    In the end, four health coverage plan designs were avail-
    able for each state employee regardless of the ZIP code of the
    employee’s residence. Two plans were administered by Mutual
    of Omaha in the metropolitan Omaha and Lincoln areas, with
    ZIP codes starting with 680, 681, and 685. In all other ZIP
    Nebraska Advance Sheets
    434	286 NEBRASKA REPORTS
    code areas, Blue Cross Blue Shield offered all four health care
    coverage plans. During the open enrollment process for ben-
    efit year 2007, all State employees residing in the ZIP codes
    starting with 680, 681, and 685, including Cartwright, had the
    option to select one of the following medical plans: Mutual of
    Omaha POS, Mutual of Omaha HMO, Blue Cross Blue Shield
    PPO, and Blue Cross Blue Shield “High Deductible” PPO.
    The PPO plans administered by Blue Cross Blue Shield were
    available to all employees regardless of where they resided.
    However, employees who resided in ZIP codes starting with
    680, 681, and 685 were excluded from Blue Cross Blue
    Shield “BlueSelect” HMO plan and the Blue Cross Blue Shield
    “BlueChoice” POS plan.
    During open enrollment for benefit year 2007, Cartwright
    selected the Blue Cross Blue Shield PPO health insurance plan.
    For the 2008 benefit year, Cartwright selected the Blue Cross
    Blue Shield “High Deductible” PPO health insurance plan. For
    the benefit year 2009 and beyond, the ZIP code method was
    discontinued.
    Cartwright filed the instant lawsuit because she was denied
    the opportunity to enroll with the health insurance carrier that
    had insured her prior to 2007 due to the ZIP code exclusion
    plan. Cartwright alleges that she was discriminated against on
    the basis of her race because most African-American employ-
    ees resided in the three excluded ZIP codes and they were
    offered substandard health insurance based upon the ZIP codes
    associated with their residential addresses.
    In her complaint, Cartwright alleged that approximately 450
    African-American citizens are employed by the State and that
    96 percent of the 450 African-American employees resided
    in the ZIP codes starting with 680, 681, and 685. She further
    alleged that the “health insurance coverage offered through the
    Mutual of Omaha Insurance was less satisfactory, less compre-
    hensive, provided fewer services, fewer providers, less cover-
    age and less treatment options than the health insurance plan
    offered in all other zip codes.” In her deposition, Cartwright
    stated that as a result of this discriminatory practice, she suf-
    fered an increase in blood pressure, had to increase her insulin
    and blood pressure medication, suffered headaches, and had to
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	435
    Cite as 
    286 Neb. 431
    take time off work due to health-related matters. Cartwright
    also had to make additional visits to her physician, purchase
    more prescription medications and diabetes test equipment, and
    suffered from back spasms as a result of the stress related to
    the discriminatory practice.
    The State and the individual defendants filed a motion for
    summary judgment on the three causes of action found in the
    final amended complaint. The first cause of action was based
    upon 
    42 U.S.C. § 1981
     and alleged that the ZIP code-based
    health insurance coverage plan discriminated on the basis of
    race. The second cause of action was under 
    42 U.S.C. § 1983
    and alleged that Cartwright was denied equal protection of the
    law. The third claim was brought under Title VII, and it alleged
    that there was a disparate impact upon her as an African-
    American employee of the State.
    The district court granted the motion for summary judg-
    ment on all causes of action. Regarding the Title VII dispar­
    ate impact claim, the district court found that the State and
    the individual defendants had presented prima facie evidence
    that neither Cartwright nor any other State employee was
    truly harmed or adversely impacted by the ZIP code-based
    health insurance coverage because the evidence is that all of
    those health insurance coverage plans were designed to be
    equivalent. The district court further noted that other than
    Cartwright’s own deposition testimony, she provided virtually
    no evidence that any State employee was harmed or adversely
    impacted. The district court rejected her testimony and stated
    that “‘[c]onclusions based on guess, speculation, conjecture,
    or a choice of possibilities do not create material issues of fact
    for purposes of summary judgment.’”2 Therefore, the district
    court concluded that Cartwright did not adduce any credible
    evidence of adverse impact.
    ASSIGNMENT OF ERROR
    Cartwright argues that the district court erred in granting the
    motion for summary judgment on her claim of disparate impact
    arising under Title VII, because there were genuine issues of
    2
    See Recio v. Evers, 
    278 Neb. 405
    , 
    771 N.W.2d 121
     (2009).
    Nebraska Advance Sheets
    436	286 NEBRASKA REPORTS
    material fact and the State and individual defendants were not
    entitled to judgment as a matter of law. Cartwright does not
    appeal the district court’s granting of summary judgment on
    the 
    42 U.S.C. §§ 1981
     and 1983 claims.
    STANDARD OF REVIEW
    [1,2] An appellate court will affirm a lower court’s grant
    of summary judgment if the pleadings and admitted evidence
    show that there is no genuine issue as to any material facts
    or as to the ultimate inferences that may be drawn from the
    facts and that the moving party is entitled to judgment as a
    matter of law.3 In reviewing a summary judgment, an appel-
    late court views the evidence in the light most favorable to the
    party against whom the judgment was granted, and gives that
    party the benefit of all reasonable inferences deducible from
    the evidence.4
    ANALYSIS
    [3-6] The party moving for summary judgment has the
    burden to show that no genuine issue of material fact exists
    and must produce sufficient evidence to demonstrate that the
    moving party is entitled to judgment as a matter of law.5 After
    the movant for summary judgment makes a prima facie case
    by producing enough evidence to demonstrate that the movant
    is entitled to judgment if the evidence was uncontroverted at
    trial, the burden to produce evidence showing the existence of
    a material issue of fact that prevents judgment as a matter of
    law shifts to the party opposing the motion.6 Conclusions based
    upon guess, speculation, conjecture, or a choice of possibilities
    do not create material issues of fact for purposes of summary
    judgment.7 If a genuine issue of fact exists, summary judgment
    may not properly be entered.8
    3
    Jeremiah J. v. Dakota D., 
    285 Neb. 211
    , 
    826 N.W.2d 242
     (2013).
    4
    
    Id.
    5
    
    Id.
    6
    
    Id.
    7
    Darrah v. Bryan Memorial Hosp., 
    253 Neb. 710
    , 
    571 N.W.2d 783
     (1998).
    8
    Jeremiah J. v. Dakota D., 
    supra note 3
    .
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	437
    Cite as 
    286 Neb. 431
    [7,8] Cartwright’s only remaining cause of action is brought
    under Title VII, which, as amended, prohibits employment
    discrimination on the basis of race, color, religion, sex, or
    national origin.9 Title VII prohibits both intentional discrimina-
    tion, known as disparate treatment, as well as practices that,
    although they are not intentional discrimination, have a dispro-
    portionately adverse effect on minorities, which is known as
    disparate impact.10
    [9,10] Disparate impact occurs when an employer uses an
    employment practice that has a disproportionately adverse
    effect on protected groups.11 Thus, to prove a prima facie case
    of disparate impact, the plaintiff must show (1) the existence
    of a statistically significant disparity among members of differ-
    ent groups affected by employment decisions; (2) the existence
    of a specific, facially neutral employment practice; and (3) a
    causal nexus between the specific, facially neutral employment
    practice and the statistical disparity.12
    [11,12] We have held that in order to recover under the
    disparate impact theory, plaintiffs must do more than merely
    prove circumstances raising an inference of a discriminatory
    impact; they must prove the discriminatory impact at issue.13
    That is, they must point to a clearly identifiable practice and
    prove its impact.14
    In Allen v. AT&T Technologies,15 we affirmed the district
    court’s dismissal of a disparate impact case under Title VII
    because the plaintiffs failed to prove how they were negatively
    9
    See Ricci v. DeStefano, 
    557 U.S. 557
    , 
    129 S. Ct. 2658
    , 
    174 L. Ed. 2d 490
    (2009).
    10
    
    Id.
    11
    
    Id.
    12
    Wards Cove Packing Co. v. Atonio, 
    490 U.S. 642
    , 
    109 S. Ct. 2115
    , 
    104 L. Ed. 2d 733
     (1989); Bennett v. Nucor Corp., 
    656 F.3d 802
     (8th Cir. 2011),
    cert. denied ___ U.S. ___, 
    132 S. Ct. 1807
    , 
    182 L. Ed. 2d 619
     (2012), and
    ___ U.S. ___, 
    132 S. Ct. 1861
    , 
    182 L. Ed. 2d 644
     (2012); E.E.O.C. v. Joe’s
    Stone Crab, Inc., 
    220 F.3d 1263
     (11th Cir. 2000).
    13
    See Allen v. AT&T Technologies, 
    228 Neb. 503
    , 
    423 N.W.2d 424
     (1988).
    14
    See 
    id.
    15
    
    Id.
    Nebraska Advance Sheets
    438	286 NEBRASKA REPORTS
    impacted.16 The plaintiffs asserted that the emphasis AT&T
    Technologies places on education had a disparate impact upon
    them, because persons 40 years of age and older are less
    likely to possess post-high-school educations than are younger
    persons.17 In the opinion, we noted that the plaintiffs must be
    able to isolate clearly identifiable employment requirements
    or criteria which results in a less favorable impact on the pro-
    tected group.18 Although education was clearly an identifiable
    employment requirement, the plaintiffs failed to present evi-
    dence from which any fact finder could conclude that but for
    the lack of a higher education, any plaintiff would have been
    promoted.19 We held that such a failure to show a causal con-
    nection between the factor at issue and the lack of promotion
    defeats recovery under the disparate impact theory.20
    Here, Cartwright properly pleaded that the ZIP code exclu-
    sion had an unfavorable impact on those excluded. She alleged
    that nonexcluded ZIP code employees were “offered a prefer­
    able and significantly better health insurance plan.” She alleged
    that the Mutual of Omaha health insurance she was offered was
    “less satisfactory, less comprehensive, provided fewer services,
    fewer providers, less coverage and less treatment options than
    the health insurance plan offered in all other zip codes.” She
    further alleged that the offered insurance
    failed to provide an in-plan rate coverage to employees’
    children who attended college out-of-state, failed to pro-
    vide a nationwide provider network, failed to provide
    in-plan rates for specific health issues that required exper-
    tise not readily available in Nebraska and other adverse
    components and/of [sic] coverage and/or costs that are not
    specifically set forth herein.
    She alleged such differences resulted in negative consequences
    to her health and finances.
    16
    
    Id.
    17
    
    Id.
    18
    
    Id.
    19
    
    Id.
    20
    
    Id.
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	439
    Cite as 
    286 Neb. 431
    However, in response, the State and the individual defend­
    ants filed a motion for summary judgment. In support of their
    motion, they offered substantial evidence that the Mutual of
    Omaha plans and the Blue Cross Blue Shield plans were equiv-
    alent in terms of coverage and benefits.
    The State and the individual defendants offered the affidavit
    of Palmer. Palmer averred that the contract requirements for
    Mutual of Omaha and Blue Cross Blue Shield mandated equiv-
    alency of coverage in an effort to maintain equality of benefits
    and to avoid any negative coverage impact for State employees
    based on their residential ZIP codes. Subsequent to the award-
    ing of the contracts to Mutual of Omaha and Blue Cross Blue
    Shield, Palmer convened meetings with representatives of each
    contractor and members of his staff. At these meetings, the
    HMO and POS coverage plans offered by each contractor were
    reviewed, point by point, to ensure to the greatest extent pos-
    sible that these plans would be equivalent, regardless of which
    contractor administered the respective health coverage plans
    and regardless of the residential ZIP codes of the employees.
    Palmer avers in his affidavit that no potential discriminatory
    impact for any particular group of State employees was ever
    identified as a part of the contract award process or in the
    design of the health plans.
    Additionally, the State and the individual defendants offered
    the affidavit of Paula Fankhauser, the employee benefits admin-
    istrator for the State. According to Fankhauser, the Mutual of
    Omaha HMO and the Blue Cross Blue Shield “BlueSelect”
    HMO plans had identical benefit designs. Likewise, the Mutual
    of Omaha POS and the Blue Cross Blue Shield “BlueChoice”
    POS plans had identical benefits. In support of her testimony,
    Fankhauser prepared a spread sheet comparing State employee
    health plan options for 2007 and 2008.
    The spread sheet compares the “BlueChoice” plan not
    offered in ZIP codes starting with 680, 681, and 685 with
    the Mutual of Omaha POS, which was available in those ZIP
    codes. For the in-network plans, both offer identical cover-
    age and benefits. Neither plan requires a deductible, and both
    set an out-of-pocket maximum at $1,500 for individuals and
    $3,000 for the family. Both plans have identical copay and
    Nebraska Advance Sheets
    440	286 NEBRASKA REPORTS
    coinsurance benefits for every medical service provided. This
    includes: office visits; annual examinations; annual eye exami-
    nations; surgery, radiology, laboratory, and chemotherapy;
    inpatient hospitalization; outpatient surgery; outpatient surgical
    center; “Well baby” examinations; mammograms; Pap smears;
    maternity services; allergy testing and shots; child immuniza-
    tions (through age 6); ambulance; urgent care center; hospi-
    tal emergency room; skilled nursing facility; durable medical
    equipment; rehabilitation services (physical therapy, chiroprac-
    tic services, occupational therapy, and speech therapy); home
    health care and hospice; inpatient mental illness and substance
    abuse treatment; outpatient mental illness and substance abuse
    treatment; serious inpatient mental illness; and serious outpa-
    tient mental illness.
    The same holds true when comparing the “BlueChoice” out-
    of-network plan and the Mutual of Omaha POS out-of-network
    plan. Each of the above categories is identical for the out-of-
    network plans. Likewise, the “BlueSelect” plan, not available
    in ZIP codes starting with 680, 681, and 685, is identical to
    the Mutual of Omaha HMO. The only difference on the spread
    sheet is the premiums paid. However, across the board, the pre-
    miums paid in ZIP codes starting with 680, 681, and 685 were
    cheaper than the Blue Cross Blue Shield counterparts.
    Presented with this evidence, the district court concluded
    that the burden shifted to Cartwright to show the existence
    of a material issue of fact. We agree. The evidence presented
    by the State and the individual defendants established that
    the plans offered in the excluded ZIP codes were equivalent
    to the plans offered statewide. This entitled the State and
    the individual defendants to judgment as a matter of law.
    However, before the district court could enter judgment,
    the burden shifted to Cartwright to produce evidence show-
    ing the existence of a material issue of fact that would pre-
    vent judgment.21
    In response, Cartwright produced as evidence her deposi-
    tion testimony and relied on deposition statements made by
    21
    See Professional Mgmt. Midwest v. Lund Co., 
    284 Neb. 777
    , 
    826 N.W.2d 225
     (2012).
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	441
    Cite as 
    286 Neb. 431
    Palmer and Mike McCrory, who was the director of person-
    nel for the State. Cartwright alleges in her deposition that the
    plans offered to her were less comprehensive, provided smaller
    networks, did not cover medical care for dependents received
    out-of-network, offered fewer and inferior specialists, and cov-
    ered less of her medical expenses. Cartwright attempts to use
    the deposition testimony of Palmer and McCrory to support
    her conclusion.
    We first note, as an overview, that Cartwright offered very
    little evidence demonstrating the inferiority of the plans avail-
    able to her. Her own deposition testimony is largely conclu-
    sory, based on her own opinions and speculation.
    Second, in her deposition and brief, Cartwright repeatedly
    makes the mistake of comparing the wrong insurance plans.
    For instance, Cartwright states in her brief that “[t]he Mutual
    of Omaha and Coventry plans offered to . . . Cartwright in
    2007 and 2008 did not have the comprehensive in and out of
    network providers and paid fewer benefits than the plan previ-
    ously held by Cartwright.”22 Such a comparison is irrelevant.
    Only the plans offered in 2007 and 2008 are relevant to the
    determination of whether the excluded ZIP codes received
    inferior plans. Further, she often compares the wrong Blue
    Cross Blue Shield plan with the wrong Mutual of Omaha plan.
    Doing so creates an incorrect impression that the plans she
    was offered were inferior. For purposes of this summary judg-
    ment, the appropriate comparison is to contrast “BlueChoice”
    with Mutual of Omaha POS and “BlueSelect” with Mutual of
    Omaha HMO.
    With this in mind, we will now address Cartwright’s evi-
    dence that the plans she was offered were inferior. In her
    deposition, Cartwright repeatedly testified that the insurance
    coverage offered by Mutual of Omaha was inferior to the
    plans offered statewide. Her testimony was that the plans
    offered were less comprehensive and had inferior access to
    specialists. But, in her deposition and in her brief, Cartwright
    failed to give evidence establishing such allegations as true.
    There was no reference to the insurance plans or use of expert
    22
    Brief for appellant at 15 (emphasis supplied).
    Nebraska Advance Sheets
    442	286 NEBRASKA REPORTS
    testimony. The only probative evidence presented on this issue,
    which includes the testimony of Palmer and Fankhauser, estab-
    lished that the benefits were designed to be, and were in fact,
    equivalent. Cartwright never directly challenged this evidence.
    Therefore, in light of the State’s evidence, Cartwright’s tes-
    timony amounts to nothing more than speculation, which is
    insufficient to create a genuine issue of material fact.
    In addition, Cartwright attempted to use the deposition tes-
    timony of Palmer and McCrory to establish that the Mutual
    of Omaha plans did not cover medical care for dependents
    received out of network. In her brief, Cartwright stated that
    “McCrory admitted that the Mutual HMO lacked provider
    networks in greater Nebraska.”23 Cartwright also stated that
    Palmer “admitted that the HMOs offered in Zip Codes 680,
    681 and 685 in 2007-2008 did not provide out of service or
    out of network benefits to their insureds.”24 Although these
    statements in a vacuum are true, Cartwright fails to take into
    account that the equivalent “BlueSelect” plan offered by Blue
    Cross Blue Shield was also limited to “In-Network” only and
    that both plans did not have out-of-network coverage. In her
    brief, she also states that the Mutual of Omaha POS plan
    does not provide out-of-network benefits. This is wrong; the
    Mutual of Omaha POS plan specifically provided for out-of-
    network coverage. This out-of-network coverage was identical,
    according to Palmer and Fankhauser, as the coverage provided
    by “BlueChoice.”
    Cartwright failed to provide evidence, other than conclu-
    sions from her own testimony, on why “BlueSelect’s” in-
    network plan was superior to Mutual of Omaha’s in-network
    HMO plan or on why “BlueChoice’s” out-of-network coverage
    was preferable to Mutual of Omaha’s POS coverage. In fact,
    the only evidence in the record is from Palmer and Fankhauser,
    which established that the benefits and coverage are the same.
    Cartwright has failed to meet her burden, after it had shifted
    to her, of establishing a material issue of fact on whether the
    plans she was offered were inferior.
    23
    Id. at 12.
    24
    Id.
    Nebraska Advance Sheets
    CARTWRIGHT v. STATE	443
    Cite as 
    286 Neb. 431
    Cartwright has also failed to establish that the alleged
    inferiorities of the plans she was offered resulted in any
    adverse impact to her. Cartwright alleged that her post-2006
    health insurance did not cover her mammogram or Pap smear,
    did not allow access to some specialists, did not cover her
    insulin prescriptions, and classified the doctor treating her
    back condition as an “out-of-network provider.” Cartwright’s
    allegations fail because she never provided evidence that
    the plans she was excluded from would have provided these
    services. Rather, she repeatedly referenced that these were
    covered under her previous Blue Cross Blue Shield policy,
    which is irrelevant. Her failure to provide evidence that the
    plans she was excluded from would have covered the above-
    mentioned medical services is fatal to her claim. Cartwright
    failed to establish, with evidence, any adverse impact to
    being excluded.
    In sum, we find that the State and the individual defendants
    presented sufficient evidence to shift the burden to Cartwright.
    After it shifted, Cartwright failed to meet her burden to
    show the existence of a material issue of fact on the issues
    of whether the plans offered in ZIP codes starting with 680,
    681, and 685 were inferior and whether the alleged inferi-
    orities resulted in an adverse impact. The evidence provided
    in the record, even when viewed in the light most favorable
    to Cartwright, established that the State and the individual
    defend­ nts were entitled to judgment as a matter of law under
    a
    a Title VII disparate impact claim.
    CONCLUSION
    For the foregoing reasons, we affirm the judgment of the
    district court.
    Affirmed.