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Esser v. Peoria

Court of Appeals of Illinois, Third District

November 20, 2019

TERRY ESSER, Plaintiff-Appellant,
v.
THE CITY OF PEORIA, Defendant-Appellee.

          Appeal from the Circuit Court of the 10th Judicial Circuit, Peoria County, Illinois. Appeal No. 3-18-0702 Circuit No. 16-MR-198 The Honorable Katherine Gorman Hubler, Judge, presiding.

          Attorneys for Appellant: Jennifer Bonesteel, of Stephen P. Kelly, Attorney at Law, LLC, of Peoria, for appellant.

          Attorneys for Appellee: Kenneth M. Snodgrass Jr. and Kevin O. Sheahan, of Hasselberg Grebe Snodgrass Urban & Wentworth, of Peoria, for appellee.

          JUSTICE CARTER delivered the judgment of the court, with opinion. Justices O'Brien and Wright concurred in the judgment and opinion.

          OPINION

          CARTER JUSTICE.

         ¶ 1 Plaintiff, Terry Esser, a disabled former Peoria police officer who was awarded health insurance benefits pursuant to the Public Safety Employee Benefits Act (Act) (820 ILCS 320/1 et seq. (West 2014)), filed an action in the trial court against defendant, the City of Peoria (City), seeking a declaratory judgment that the City was required by the Act to pay the entire premium amount for Esser to be covered by the City's low-deductible group health insurance plan. The City opposed the action and argued that, under the statute, it was only required to pay the premium amount for Esser to be covered by the City's high-deductible group health insurance plan, which was less expensive than the City's low-deductible plan. Following a hearing, the trial court ruled in favor of the City and dismissed Esser's declaratory judgment action. Esser appeals. We affirm the trial court's judgment.

         ¶ 2 BACKGROUND

         ¶ 3 Esser was employed by the City, a home-rule unit, as a police officer. In June and October 2013, Esser injured his back while at work. Esser eventually had surgery on his back but was unable to return to work as a police officer. In September 2014, Esser filed an application with the pension board for line-of-duty disability pension benefits, which was later granted. In August 2015, Esser filed an application for health insurance benefits from the City pursuant to section 10 of the Act (id. § 10). The City initially opposed the application but subsequently withdrew its objection. In November 2015, an agreed order was entered granting Esser health insurance benefits under the Act.

         ¶ 4 In February 2016, the City sent Esser a letter notifying him that he had two different group health insurance plans available to him as a recipient under the Act-a high-deductible plan and a low-deductible plan-the same two plans that the City offered to active City police officers. Esser had previously been enrolled in the low-deductible plan prior to leaving his employment with the police department (due to his disability). The City informed Esser that it would pay the full cost of the premium for the high-deductible plan but that if Esser chose the low-deductible plan, which was more expensive, he would have to pay the difference in the premiums between the two plans. Esser later elected to enroll in the low-deductible plan.

         ¶ 5 The directions that the City gave Esser regarding the premium that the City would pay were taken from a City policy adopted in January 2014. Prior to that time, for approximately seven years, the City had paid the entire premium amount for its recipients under the Act, regardless of whether those recipients had enrolled in the high-deductible or low-deductible plan. Only one exception to the City's policy had been made. The City had elected to pay the entire premium amount of the low-deductible plan for the wife and children of a police officer, Officer Faulkner, who had been killed in the line of duty.

         ¶ 6 In March 2016, Esser filed the instant declaratory judgment action against the City, asking the trial court to issue a ruling that the City was required by the Act to pay the entire cost of Esser's health insurance premium for the low-deductible plan. After a hearing, the trial court ruled in favor of the City and dismissed Esser's declaratory judgment action. Esser appealed.

         ¶ 7 ANALYSIS

         ¶ 8 On appeal, Esser argues that the trial court erred in finding that, under the Act, the City was not required to pay the entire cost of Esser's health insurance premium for the low-deductible group health insurance plan and in dismissing Esser's declaratory judgment action on that basis. Esser asserts that, as a matter of statutory interpretation, the Act requires the City to pay the entire premium amount of "basic" group health insurance coverage for its recipients under the Act, which Esser maintains in this case is the entire premium amount for the low-deductible plan. More specifically, Esser contends that both the high- and low-deductible plans are "basic" group health insurance plans as described in the statute and that the City is required by the Act to continue Esser in the low-deductible plan because that was the health insurance plan that Esser had at the time of his disability. As further support for his position on appeal, Esser points to the prior instance where the City paid the entire premium amount of the low-deductible plan for the family of Officer Faulkner after Faulkner was killed in the line of duty and asserts that the Act does not allow the City to distinguish between employees who are killed in the line of duty and those who are catastrophically injured in determining what amount to pay for benefits under the Act. Finally, Esser maintains that continuing his existing health insurance plan at the same level is not a "supplemental" benefit under the Act, despite the City's contention to the contrary, and is consistent with the purpose of the statute-to continue health insurance coverage for those workers (and their families) who are killed or catastrophically injured in the line of duty. For all of the reasons stated, Esser asks that we reverse the trial court's judgment.

         ¶ 9 The City argues that the trial court's ruling was proper and should be upheld. The City asserts that the plain language of the Act mandates only that the City pay the entire premium amount for the "basic" group health insurance plan, which the City contends is the high-deductible plan. Thus, the City maintains that it satisfied its statutory obligation under the Act when it agreed to pay the entire premium amount of the high-deductible plan for Esser. In support of its assertion, the City points out that the statute refers to "plan" in the singular form, rather than plural, and contends that the singular language is an indication that, contrary to Esser's claim on appeal, an employer can have only one "basic" group health insurance plan. The City asserts further that Esser's broad interpretation of the Act in favor of recipients is contrary to case law precedent, which holds that the Act must be construed in favor of employers. In addition, the City asserts that, under its home-rule authority, it has the ability to designate which of its group health insurance plans is the "basic" plan for the purpose of benefits under the Act, since the City has an obligation to be fiscally responsible along with providing those benefits. The City also contends that it is not prohibited under the Act from providing additional benefits to the family of a police officer who has been killed in the line of duty and that the City doing so for Officer Faulkner's family did not ...


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