the United Healthcare Choice Plus Plan for City of Austin Employees and the City of Austin v. Charles Lesniak ( 2015 )


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  •                                                                                        ACCEPTED
    03-15-00309-CV
    6070665
    THIRD COURT OF APPEALS
    AUSTIN, TEXAS
    7/15/2015 9:39:20 AM
    JEFFREY D. KYLE
    CLERK
    No. 03-15-00309-CV
    ________________________________________________________________
    FILED IN
    3rd COURT OF APPEALS
    IN THE THIRD COURT OF APPEALS                  AUSTIN, TEXAS
    IN AUSTIN, TEXAS                    7/15/2015 9:39:20 AM
    ____________________                   JEFFREY D. KYLE
    Clerk
    City of Austin and The United Healthcare Choice Plus Plan
    for City of Austin Employees
    Appellants,
    v.
    Charles Lesniak
    Appellee
    ____________________
    On Appeal From the 419th District Court,
    Travis County, Texas
    ____________________
    APPELLEE BRIEF
    ____________________
    James C. Plummer (16075700)
    Amar Raval (24046682)
    Plummer | Raval
    4203 Montrose Blvd., Suite 270
    Houston, TX 77006
    (713) 522-2887
    (713) 522-3605 Fax
    jplummer@plummerlawyers.com
    araval@plummerlawyers.com
    COUNSEL FOR APPELLEE CHARLES LESNIAK
    ORAL ARGUMENT REQUESTED
    IDENTITIES OF PARTIES AND COUNSEL
    City of Austin                               Appellant
    Andralee Cain Lloyd (24071577)
    Megan Mosby (24073392)
    City of Austin - Law Department
    P.O. Box 1546
    Austin, TX 78767-1546
    (512) 974-2918
    andralee.lloyd@austintexas.gov
    megan.mosby@austintexas.gov                  Counsel for Appellant
    The United Healthcare Choice Plus
    Plan for City of Austin Employees            Appellant
    Andrew G. Jubinsky (11043000)
    Lance V. Clack (24040694)
    Figari & Davenport, LLP
    901 Main St., Suite 3400
    Dallas, TX 75202
    (214) 939-2000
    andy.jubinsky@figdav.com
    lance.clack@figdav.com                       Counsel for Appellant
    Charles Lesniak                              Appellee
    James C. Plummer (16075700)
    Amar Raval (24046682)
    Plummer | Raval
    4203 Montrose Blvd., Suite 270
    Houston, TX 77006
    (713) 522-2887
    jplummer@plummerlawyers.com
    araval@plummerlawyers.com                    Counsel for Appellee
    i
    TABLE OF CONTENTS
    Page
    IDENTITIES OF PARTIES AND COUNSEL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
    INDEX OF AUTHORITIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
    STATEMENT OF THE CASE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
    STATEMENT REGARDING ORAL ARGUMENT. . . . . . . . . . . . . . . . . . . . . . . . v
    STATEMENT OF FACTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
    ARGUMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
    Standard of Review:.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
    Issue 1: Providing health insurance to city employees is a purely
    proprietary function for which governmental immunity does not exist. . . . . 3
    Issue 2: Governmental Immunity was Waived by
    T EXAS L OCAL G OVT C ODE §271.152. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
    PRAYER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
    CERTIFICATE OF SERVICE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
    CERTIFICATE OF COMPLIANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
    ii
    INDEX OF AUTHORITIES
    Pages
    Bailey v. City of Austin
    
    972 S.W.2d 180
    , 192-93 (Tex.App.-Austin 1998, pet. denied). . . . . . . . . . . . . . . 5,7
    Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. v. Texas Political Subdivisions
    Prop.
    
    212 S.W.3d 320
    (Tex. 2006). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,12
    City of El Paso v. Henrich
    
    284 S.W.3d 366
    , 371-72 (Tex. 2009). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,4
    City of Galveston v. Posnainsky
    
    62 Tex. 118
    (1884).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
    City of Georgetown v. Lower Colorado River Authority
    
    413 S.W.3d 803
    , 811 (Tex.App.-Austin 2013, pet. dism’d). . . . . . . . . . . 5,13,14,15
    City of Houston v. Williams
    
    353 S.W.3d 128
    , 134 (Tex. 2011). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,7
    City of Terrell v. McFarland
    
    766 S.W.2d 809
    , 813 (Tex.App.-Dallas 1988, writ denied). . . . . . . . . . . . . . . . . . . 4
    City of Mexia v. Tooke
    
    197 S.W.3d 328
    (Tex. 2006). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,5,6,12,13,14
    Dillard v. Austin Indep. Sch. Dist.
    
    806 S.W.2d 589
    , 594-595 (Tex.App.-Austin 1991, writ denied). . . . . . . . . . . . . . . 4
    East Houston Estate Apartments, L.L.C. v. City of Houston
    
    294 S.W.3d 723
    , 731-32 (Tex.App.-Houston [1st Dist.] 2009, no pet.).. . . . . . . . . . 5
    Entergy Gulf States, Inc. v. Summers
    
    282 S.W.3d 433
    , 437 (Tex. 2009). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
    First Am. Title Ins. Co. v. Combs
    iii
    
    258 S.W.3d 627
    , 631-32 (Tex. 2008). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
    Foster v. Teacher Ret. Sys.
    
    273 S.W.3d 883
    , 886 (Tex.App.-Austin 2008, no pet.). . . . . . . . . . . . . . . . . . . . . . 11
    Gates v. City of Dallas
    
    704 S.W.2d 737
    , 738-39 (Tex. 1986). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
    Gay v. City of Wichita Falls
    
    2014 WL 393141
    (Tex.App.-El Paso Aug. 13, 2014, no pet.). . . . . . . . . . . . . 12,13
    Houston Mun. Empls. Pension Sys. v. Ferrell
    
    248 S.W.3d 151
    (Tex. 2007). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
    Richardson Hosp. Auth. v. Duru
    
    387 S.W.3d 109
    , 113 (Tex.App-Dallas 2012, no pet.). . . . . . . . . . . . . . . . . . . . . . 11
    Texas Dept. of Parks and Wildlife v. Miranda
    
    133 S.W.3d 217
    , 226 (Tex. 2004). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
    Tex. Natural Res. Conservation Comm’n v. IT-Davy
    
    74 S.W.3d 849
    , 854 (Tex. 2002). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
    VanDevender v. Woods
    
    222 S.W.3d 430
    , 433 (Tex.2007).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
    STATUTES
    T EX. INS. C ODE §1575. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
    T EX. L OCAL G OVT. C ODE §51.075. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
    T EX. L OCAL G OVT. C ODE §271.152. . . . . . . . . . . . . . . . . . . 7,8,9,10,11,12,13,14,15
    T EX. L OCAL G OVT. C ODE §271.151. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,8,9
    T EX. L OCAL G OVT. C ODE §271.158. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
    iv
    STATEMENT OF THE CASE
    This is an interlocutory appeal of a denial of a plea to the jurisdiction. The suit involves
    the denial of medical treatment at an eating disorder facility for the dependent of a City
    of Austin employee. Appellants City of Austin and The United Healthcare Choice Plus
    Plan for City of Austin Employees contend that governmental immunity shields them
    both from suit and liability. Appellee contends that governmental immunity does not
    exist or has been waived by statute.
    STATEMENT REGARDING ORAL ARGUMENT
    Appellee believes that oral argument will be helpful to the Court because (a) this case
    involves a claim for benefits under the City of Austin’s health benefit plan, with
    technical terms that may require assistance from counsel, and (b) the Court will be able
    to question Appellants on their position that City of Austin employees should have no
    access to the judicial system if their health insurance claims are denied.
    v
    STATEMENT OF FACTS
    1.   This is a lawsuit for health benefits by a City of Austin employee against the City
    of Austin (“Austin”) and the United HealthCare Choice Plan for City of Austin
    Employees (“Plan”). Mr. Lesniak works for Austin as an environmental policy
    program manager. C.R. 186. He enrolled in the Plan in 2013 and 2014 to obtain
    health insurance for himself and his eligible dependents. 
    Id. 2. The
    Plan is self funded by Austin. C.R. 30. Austin designated United Healthcare
    Services, Inc. (“United”) as the Plan Administrator of the Plan. C.R. 30. United
    was responsible for processing claims and payments and conducting appeals of
    adverse benefit determinations on behalf of Austin. C.R187.
    3.   The Plan includes coverage for inpatient and outpatient mental health care
    services determined in accordance with prevailing medical standards and clinical
    guidelines. Mr. Lesniak’s coverage under the Plan extended to his dependent
    daughter, Alice. C.R. 187.
    4.   Alice suffered from symptoms of anorexia nervosa that led to weight loss,
    malnutrition, abnormal heart rhythm, and other signs of poor health. C.R. 187.
    Her parents and medical providers decided that she needed residential treatment
    in a facility with continuous monitoring and intensive therapy. 
    Id. Because no
    facilities near Austin would accept someone as young as Alice, she enrolled in
    1
    Avalon Hills Eating Disorder Treatment Center (“Avalon”) in Logan, Utah in
    August 2013. C.R. 188. United approved and periodically re-authorized
    residential treatment until October 29, 2013. 
    Id. 5. On
    October 30, 2013, United advised Avalon that it would not authorize further
    treatment because it claimed that Alice’s condition had improved to the extent
    that she could be adequately treated at a lower level of care known as “partial
    hospitalization”. C.R. 188.
    6.   Avalon filed an appeal, which United denied in November 2013. C.R. 188.
    Although Alice remained in treatment at Avalon, United only authorized payment
    for the reduced partial hospitalization level beginning November 21, 2013,
    leaving Mr. Lesniak responsible for the balance. 
    Id. Avalon submitted
    a second
    appeal, which United denied in February 2014. C.R. 189. With the denial of the
    second appeal, all required appeals under the Plan had been exhausted. C.R. 190.
    Alice remained in treatment at Avalon until February 18, 2014. 
    Id. 7. Mr.
    Lesniak filed suit against Austin and the Plan for breach of contract on
    January 6, 2015. C.R. 3. Austin and the Plan filed a plea to the jurisdiction. C.R.
    29. The plea was denied by the trial court on April 29, 2015. C.R. 206.
    Appellants filed their notice of appeal on May 18, 2015. C.R. 207-208.
    2
    ARGUMENT
    The issues presented by this appeal are based on the limits of governmental immunity.
    Austin cannot escape judicial review of its decision to deny health insurance coverage
    to city employees and their dependents. Governmental immunity does not exist for two
    reasons. First, Austin’s creation of a health insurance plan for city employees is a purely
    proprietary function not subject to immunity. Second, immunity does not exist because
    the Texas Legislature codified a waiver of governmental immunity that applies here.
    The trial court’s ruling should thus be upheld, and this case should be remanded to the
    trial court.
    Standard of Review:
    The standard of review for a trial court’s ruling on a plea to the jurisdiction is
    de novo. Houston Mun. Empls. Pension Sys. v. Ferrell, 
    248 S.W.3d 151
    , 156 (Tex.
    2007); Texas Dept. of Parks & Wildlife v. Miranda, 
    133 S.W.3d 217
    , 228 (Tex.
    2004).
    Issue 1:
    Providing health insurance to city employees is a purely proprietary function
    for which governmental immunity does not exist.
    Before a court considers whether governmental immunity has been waived, it
    must determine if immunity even exists. City of El Paso v. Henrich, 
    284 S.W.3d 366
    ,
    3
    371-72 (Tex. 2009). The limits of governmental immunity were first explored by the
    Texas Supreme Court 131 years ago. City of Galveston v. Posnainsky, 
    62 Tex. 118
    (1884). The Court noted that when a municipality exercises powers “exclusively public
    in character”, immunity should exist unless it has been waived. 
    Id. However, when
    a
    municipality assumes powers “intended for the private advantage and benefit of its
    locality and its inhabitants”, there is no policy reason for immunity. 
    Id. Posnainsky thus
    created a distinction between governmental and proprietary
    functions. A city performs governmental functions when it acts “as an agent of the state
    in furtherance of general law for the interest of the public at large”. City of Terrell v.
    McFarland, 
    766 S.W.2d 809
    , 813 (Tex.App.-Dallas 1988, writ denied). A city
    performs proprietary functions when it acts for the benefit of those within its municipal
    limits. 
    Id. The city
    is not traditionally entitled to governmental immunity when
    performing proprietary functions. Id.; Dillard v. Austin Indep. Sch. Dist., 
    806 S.W.2d 589
    , 594-595 (Tex.App.-Austin 1991, writ denied).
    Courts expanded Posnainsky’s governmental-proprietary distinction to the
    contract context. In 2006, the Texas Supreme Court seemed to cast doubt on the
    governmental-proprietary distinction for contracts. City of Mexia v. Tooke, 
    197 S.W.3d 328
    (Tex. 2006). Tooke focused on the viability of governmental immunity under
    T EXAS L OCAL G OVT. C ODE §51.075. In dicta, it noted that it had never held that the
    4
    governmental-proprietary distinction should apply in the contract context. However, the
    Court wisely sidestepped the issue, as it noted that “we need not determine that issue
    here”. 
    Id. at 333.
    As a result, many courts continue to apply the governmental-
    proprietary test to contract claims. City of Georgetown v. Lower Colorado River
    Authority, 
    413 S.W.3d 803
    , 811 (Tex.App.-Austin 2013, pet. dism’d); East Houston
    Estate Apartments, L.L.C. v. City of Houston, 
    294 S.W.3d 723
    , 731-32 (Tex.App.-
    Houston [1 st Dist.] 2009, no pet.).
    The issue in this case is whether providing health insurance to city employees is
    considered a governmental function or a proprietary function. Courts have routinely
    labeled it a proprietary function, including a previous health benefit plan offered by
    Austin. See Bailey v. City of Austin, 
    972 S.W.2d 180
    , 192-93 (Tex.App.-Austin 1998,
    pet. denied) (city’s provision of health insurance to its employees is a proprietary
    function; no governmental immunity); Gates v. City of Dallas, 
    704 S.W.2d 737
    , 738-
    39 (Tex. 1986) (city providing self funded health insurance to its employees is a
    proprietary function).
    Austin chose to provide its employees with medical and prescription drug
    benefits. It created a self funded plan and contracted with United to administer the Plan
    and process payment or reimbursement for covered medical expenses. Both the 2013
    and 2014 Plans are contracts (“The Plan and its application of the Covered Persons, if
    5
    any, constitute the entire contract of Coverage under the Plan between the City, the Plan
    Administrator, and the Covered Persons”). C.R. 46. By entering into contract for the
    benefit of its employees, Austin engaged in a proprietary function for which
    governmental immunity does not exist.
    Understanding their disadvantage, Appellants are limited to arguing the scope of
    the Tooke case. They contend that Tooke definitively eliminated the applicability of the
    governmental-proprietary distinction in the contract context. However, the words of the
    Court betray their position: “we need not determine that issue here” (emphasis
    added). City of Mexia v. Tooke, 
    197 S.W.3d 328
    , 333 (Tex. 2006). This is in line with
    the well settled principle of judicial restraint when deciding cases. VanDevender v.
    Woods, 
    222 S.W.3d 430
    , 433 (Tex. 2007) (“The cardinal principle of judicial
    restraint-if it is not necessary to decide more, it is necessary not to decide
    more-counsels us to go no further.”). The governmental-proprietary distinction in the
    contract context remains viable. Standing alone, it is sufficient to deny Appellants’ plea
    to the jurisdiction.
    Issue 2:
    Governmental Immunity was Waived by Texas Local Govt Code §271.152.
    Municipalities have governmental immunity from suit unless the Legislature
    expressly waives it by statute. City of Houston v. Williams, 
    353 S.W.3d 128
    , 134 (Tex.
    6
    2011). The Legislature is better suited to weigh conflicting public policies associated
    with waiving immunity and subjecting the government to increased liability. Tex.
    Natural Res. Conservation Comm’n v. IT-Davy, 
    74 S.W.3d 849
    , 854 (Tex. 2002). In
    2005, the Texas Legislature enacted T EX. L OCAL G OVT. C ODE §271.152, which waives
    immunity for certain contractual claims against governmental entities. This waiver
    applies if the party against whom waiver is asserted is (1) a local governmental entity,
    (2) authorized to enter into contracts, and (3) entered into a “contract subject to this
    subchapter”. T EX. L OCAL G OVT. C ODE §271.152.
    Here, there is no dispute that the City of Austin is a qualifying local
    governmental entity under the statute. Second, there is no dispute that Austin was
    authorized to enter into this contract to provide health benefits for its employees. Austin
    has traditionally offered life, health, and dental insurance to its employees, their
    spouses, and dependent children. Bailey v. City of Austin, 
    972 S.W.2d 180
    , 183
    (Tex.App.-Austin 1998, pet. denied).
    The third element is that the governmental enter into a “contract subject to this
    subchapter”. A “contract subject to this subchapter” is (1) in writing, (2) states the
    essential terms of the agreement, (3) provides for goods or services, (4) to the local
    governmental entity, and (5) is executed on behalf of the local governmental entity.
    7
    T EX. L OCAL G OVT. C ODE §271.151; City of Houston v. Williams, 
    353 S.W.3d 128
    , 135
    (Tex. 2011).
    Here, Appellants have provided all of the evidence required to prove that the
    Plans are contracts “subject to this subchapter”. The 2013 and 2014 Plans are in
    writing. They state the essential terms of the agreement. (“The Plan and its application
    of the Covered Persons, if any, constitute the entire contract of Coverage under the Plan
    between the City, the Plan Administrator, and the Covered Persons”). C.R. 46. The
    Plans provide medical and prescription drug benefits to Austin employees, their
    spouses, and dependent children. The Plan also provides services to Austin, as it details
    the role United plays as Plan Administrator to interpret the Plan terms, make factual
    determinations, and determine eligibility for benefits. C.R. 93-94. Finally, the Plans are
    executed on behalf of Austin.
    Conceding the other elements, Appellants limit their argument to element 4: the
    contract must provide goods or services to the local governmental entity. T EX. L OCAL
    G OVT. C ODE §271.151. Appellants contend that no services were provided to Austin
    directly, so governmental immunity should shield them from suit and liability. This
    argument is defeated by the Texas Supreme Court’s review of T EX. L OCAL G OVT. C ODE
    §271.152's legislative history.
    8
    Other governmental entities have unsuccessfully tried to argue that the fourth
    element of T EX. L OCAL G OVT. C ODE §271.151 limited the waiver of governmental
    immunity. In Ben Bolt, the Fund argued that it was immune from suit because nothing
    was provided to it directly; it simply provided insurance to its members in exchange for
    payment. Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. v. Texas Political
    Subdivisions Prop., 
    212 S.W.3d 320
    (Tex. 2006). Here, Appellants argue that they are
    immune because nothing is provided to them directly1 . In rejecting this argument, the
    Court reviewed the legislative history of T EX. L OCAL G OVT. C ODE §271.152 and how
    it was intended to loosen the shackles of immunity:
    all local governmental entities that have been given or are given the
    statutory authority to enter into contracts shall not be immune from
    suits arising from those contracts.
    House Comm. On Civil Practices, Bill Analysis, Tex. H.B. 2039,
    79th Leg., R.S. (2005); Id at 327.
    While the mere act of self insuring was not a waiver of immunity, entering into a
    written contract stating the essential terms of an agreement for providing goods and
    services to a local governmental entity “clearly does”. 
    Id. In Appellants’
    crabbed interpretation, governmental immunity applies if no
    services were directly provided to Austin. This begs the question: what services are
    1
    Appellants continue to cite Ben Bolt to argue that they are immune from suit
    when providing benefits to employees. The analysis of the opinion does not support this
    position.
    9
    provided to Austin? Mr. Lesniak provides his services to Austin as a city employee.
    Like many other employers who seek the best and brightest talent, Austin provides
    health insurance benefits as part of an employee benefit plan. The health insurance
    benefits provided by the Plan are part of a bargained-for benefit of employment with
    Austin.
    Another way to look at what services are being provided to Austin is by looking
    at what the Plan provides it. The Plans provide medical and prescription drug benefits
    to Austin employees, their spouses, and dependent children. The Plan also provides
    services to Austin, as it details the role United plays as Plan Administrator to interpret
    the Plan terms, make factual determinations, and determine eligibility for benefits. C.R.
    93-94.
    This expansive approach to providing goods or services to the local governmental
    entity complies with judicial deference to legislative intent. When construing a statute,
    the court’s primary goal is to give effect to the legislature’s intent. First Am. Title Ins.
    Co. v. Combs, 
    258 S.W.3d 627
    , 631-32 (Tex. 2008). When statutory text is clear, it is
    determinative of legislative intent, unless enforcing the plain meaning of the statute’s
    words would produce an absurd result. Entergy Gulf States, Inc. v. Summers, 
    282 S.W.3d 433
    , 437 (Tex. 2009). This approach to waiver is also supported by the statute
    itself. Nothing in T EX. L OCAL G OVT. C ODE §271.152 “shall constitute a grant of
    10
    immunity to a local governmental entity”. T EX. L OCAL G OVT. C ODE §271.158. Thus,
    to the extent that any governmental immunity exists, it has been waived by statute.
    Appellants cited Richardson Hosp. Auth. v. Duru to argue that a municipality
    offering insurance to employees did not fall within the waiver of T EX. L OCAL G OVT.
    C ODE §271.152. Richardson Hosp. Auth. v. Duru, 
    387 S.W.3d 109
    , 113 (Tex.App-
    Dallas 2012, no pet.). In Richardson, the plaintiff sued for breach of contract for legal
    services he claimed he never received. The court found no waiver of immunity under
    §271.152 because there was no evidence of a written contract between the parties. That
    is distinguishable from this case, where Appellants have produced the 2013 and 2014
    Plans that provide health insurance benefits to Mr. Lesniak and his dependent.
    Appellants also cite Foster v. Teacher Ret. Sys. to argue that a state agency did
    not waive immunity by providing benefits via a self funded plan. Foster v. Teacher Ret.
    Sys., 
    273 S.W.3d 883
    , 886 (Tex.App.-Austin 2008, no pet.). The plaintiff in Foster
    sought a waiver of governmental immunity through T EX. INS. C ODE §1575, which
    regulates the Texas Teachers Retirement System (“TRS”). The Plan here is not part of
    TRS. Moreover, Mr. Lesniak does not contend that the mere act of self insuring is a
    waiver of immunity. It is when the parties entered into a written contract stating the
    essential terms of an agreement for providing goods and services to a local
    governmental entity that T EX. L OCAL G OVT. C ODE §271.152 applied.
    11
    Appellants rely most heavily on Gay v. City of Wichita Falls to support their
    position that T EX. L OCAL G OVT. C ODE §271.152 does not apply to them. Gay v. City
    of Wichita Falls, 
    2014 WL 393141
    (Tex.App.-El Paso Aug. 13, 2014, no pet.) In Gay,
    police officers filed for disability benefits from a trust established by Wichita Falls. The
    court determined that Tooke eliminated the governmental-proprietary distinction in
    contractual claims. It also concluded that the officers’ promissory estoppel claim fell
    outside T EX. L OCAL G OVT. C ODE §271.152 because the waiver only applies to a written
    contract. 
    Id. Gay is
    full of poor reasoning, not controlling law, and should not be followed.
    In it, the court noted that the city was not a party to the contract because the contract
    was between the trust and the insurance company. This is a distinction without a
    difference. In Ben Holt, the risk pool fund formed to provide insurance considered itself
    a separate entity entitled to governmental immunity. Implicit in this position was the
    argument that the city was not a party to the contract. The Fund argued that its insurance
    contract was immune because nothing was provided to it directly. The Court rejected
    the argument, noting the expansive nature of T EX. L OCAL G OVT. C ODE §271.152. Ben
    Bolt-Palito Blanco Consol. Indep. Sch. Dist. v. Texas Political Subdivisions Prop.,
    
    212 S.W.3d 320
    , 327 (Tex. 2006).
    12
    Second, Gay improperly analyzed the governmental-proprietary common law and
    its connection to §271.152. In doing so, it misread the plain language of Tooke and
    bluntly ignored the logic and analysis provided in City of Georgetown. Gay contended
    that the Texas Supreme Court had “never held the proprietary/governmental dichotomy
    to be determinative of immunity from suit in contractual claims”. However, it ignored
    the very next sentence, in which the Texas Supreme Court continued, “we need not
    determine that issue here”. City of Mexia v. Tooke, 
    197 S.W.3d 328
    , 333 (Tex. 2006).
    The Court specifically chose not to rule on the governmental-proprietary distinction.
    The Gay court misread Tooke and mistook clearly labeled dicta for controlling law.
    To the extent Gay has any persuasive authority, it is easily distinguished. In Gay,
    the officers relied on a promissory estoppel claim, not a written contract. Here, Mr.
    Lesniak relies on a written Plan created by Austin, which is clearly provided for in T EX.
    L OCAL G OVT. C ODE §271.152. The Plan meets the test of the statute and falls under the
    waiver of immunity established by the Legislature.
    Most disturbing of all, the Gay court ignored the policy reasons provided in City
    of Georgetown for continuing to follow the governmental-proprietary distinction for
    analyzing governmental immunity in contract claims. Just two years ago, this Court
    directly addressed the applicability and scope of T EX. L OCAL G OVT. C ODE §271.152.
    13
    City of Georgetown v. Lower Colorado River Authority 
    413 S.W.3d 803
    (Tex.App.-
    Austin 2013, pet. dism’d).
    In City of Georgetown, the city’s contract to purchase electricity from the Lower
    Colorado River Authority was at issue. City of Georgetown at 803. The city filed a plea
    to the jurisdiction, alleging that there was no valid waiver of governmental immunity.
    
    Id. at 806.
    The court began with an overview of the governmental-proprietary test. The
    city, just as Austin does here, argued that the test did not apply to contractual claims due
    to the Texas Supreme Court’s ruling in Tooke.
    The court cited Tooke and its clarification that it “need not determine that issue”.
    Going forward, the court concluded:
    until the supreme court answers this question, we rely on this Court’s
    precedent, as well as the nearly unanimous opinions of our sisters courts,
    to conclude that the proprietary-governmental dichotomy applies to
    contract claims under the common law.
    City of Georgetown at 810-811.
    However, it did not stop there. The court searched for “any principled reason”
    supporting applying the governmental-proprietary test to tort claims but not contract
    claims. 
    Id. Finding none,
    the court was reluctant to overturn its own precedent or
    “disagree with persuasive authority from the majority of our sister courts” on the issue.
    
    Id. Appellants have
    failed to provide any principled justification for abandoning this
    precedent.
    14
    Next, the City of Georgetown court reviewed the legislative intent of T EX. L OCAL
    G OVT. C ODE §271.152. Just as Austin does here, the city argued that because §271.152
    had no text regarding the governmental-proprietary test, it no longed applied to contract
    claims. City of Georgetown at 812. The court pointed out that the legislative history
    of §271.152 evidenced its intent to expand, not limit, plaintiffs’ ability to sue
    municipalities for contract damages. 
    Id. 813. It
    thus ruled that governmental immunity
    did not exist and denied the city’s plea to the jurisdiction.
    The City of Georgetown case is this Court’s previous ruling on the precise issues
    at stake here. It remains good law, and its review of the policy reasons behind the
    governmental-proprietary test in contract claims, as well as its review of the legislative
    intent of T EX. L OCAL G OVT. C ODE §271.152, represent the road map for deciding this
    matter.
    Prayer
    For these reasons, Appellee Charles Lesniak requests that this Court (1) uphold
    the Trial Court’s order denying Appellants’ Plea to the Jurisdiction, (2) remand this
    matter back to the Trial Court, and (3) grant Appellee any further relief, whether legal
    or equitable, to which he may be entitled.
    15
    Respectfully submitted,
    By ___/s/ Amar Raval________________
    James C. Plummer, TBA #16075700
    Amar Raval, TBA # 24046682
    PLUMMER | RAVAL
    4203 Montrose Boulevard, Ste 270
    Houston, Texas 77006
    (713) 522-2887
    (713) 522-3605 (Fax)
    Jplummer@plummerlawyers.com
    Araval@plummerlawyers.com
    ATTORNEYS FOR APPELLEE
    CERTIFICATE OF SERVICE
    I hereby certify that a true and correct copy of the above and foregoing Amended
    Appellee Brief was served pursuant to Tex. R. App. Proc. 9.5 on July 15, 2015, to:
    Andralee Cain Lloyd
    Megan Mosby
    City of Austin Law Department
    P.O. Box 1546
    Austin, TX 78767
    Andrew Jubinski
    Figari & Davenport, LLP
    901 Main St., Suite 3400
    Dallas, TX 75202
    ___/s/ Amar Raval________________
    16
    CERTIFICATE OF COMPLIANCE
    Pursuant to Tex. R. App. Proc. 9.4(e)(i)(3), I hereby certify that this brief
    complies with the word count limitations and type-volume limitations.
    1.    Exclusive of the exempted portions listed in Tex. R. App. Proc. 9.4(i)(1),
    the brief contains 3,328 words.
    2.    This brief has been prepared in standard 10 character per inch monospaced
    typeface using WordPerfect in Times New Roman 14.
    ___/s/ Amar Raval________________
    17