Harris Corporation v. Humana Health Insurance Company of Florida, Inc.

Margaret Shallenberger was covered both by her employer Harris's (plaintiff) health plan, which had no coordination-of-benefits (COB) provision, and by her husband's employer-sponsored Humana (defendant) plan, which did have a COB provision making it secondary to plans lacking one. After Shallenberger, who also qualified for Medicare, died, Harris paid over $780,000 in her benefits and sought reimbursement first from Medicare, which refused because she had Humana coverage, and then from Humana, which also refused. The trial court, applying the plans' own COB terms, found Harris's plan primary because it lacked a COB provision while Humana's had one, and granted Humana summary judgment; Harris appealed, arguing the Medicare Secondary Payer Act (MSPA) made Humana primary regardless of the plans' own terms.