Health Plan’s Lawsuit Proceeds Against Stop Loss Insurer in Ohio Federal Court

DAYTON, Ohio — An Ohio federal judge has refused to dismiss a breach of contract brought by a self-insured employee welfare benefit plan against Excess Reinsurance Underwriters Agency Inc. in a dispute over reimbursement for medical services provided to a plan member’s child.

In a Jan. 3 order, Judge Thomas Rose of the U.S. District Court for the Southern District of Ohio found “it is plausible that an enforceable contract exists” between XSRE and The Raymath Company Health Plan.

Nationwide Children’s Hospital alleges it provided medical services to a minor known as John Doe from April to June 2021. Doe …