United States District Court, D. Delaware
ALEXANDRA B. KELLY, Plaintiff,
MARKETPLACE/BLUE CROSS HIGHMARK DELAWARE, Defendant.
Alexandra B. Kelly, Wilmington, Delaware. Pro Se Plaintiff.
Geoffrey Graham Grivner, Buchanan Ingersoll & Rooney
P.C., Wilmington, Delaware. Counsel for Defendant.
NOREIKA, U.S. DISTRICT JUDGE
Alexandra B. Kelly (“Plaintiff) appears pro se
and has paid the filing fee. She commenced this action on
July 22, 2019, against Defendant Market/Blue Cross Highmark
Delaware (“Defendant”) and asserts jurisdiction
by reason of a federal question pursuant to 28 U.S.C. §
1331. (D.I. 2). Before the Court is Defendant's motion to
dismiss or for a more definite statement and Plaintiffs
request for counsel. (D. I. 9, 11). Briefing is complete.
alleges that “her insurance - purchased through the
Marketplace - is too high because it is taking into account
her husband even though he is not on it . . . .”
(Id. at 3). Plaintiff further alleges that she
applied for Obamacare through Marketplace and Highmark. When
she did her taxes she found out she owes $26, 000 dollars in
taxes. Her husband had insurance and was denied coverage
through Highmark but they are using his income even though I
wasn't on the policy. A person representing [H]ighmark
led her to believe that they were not going to use his
income. When she signed up her husband just had knee
replacement surgery and was laid-off In the second half of
the year he retired and got social security disability. This
income was $5, 300 dollars a month and was applied by the
IRS. I am Victic por Domestic Balen.
(Id. at 4-5).
alleges that she filed the Complaint because she was not
informed the premiums would cost $2, 500 per month more than
the premium payments. (Id. at 9). She alleges that
the person who sold her the policy did not disclose
information about extra payments. (Id.). The Civil
Cover Sheet describes the action as “[f]raud charges
for $30, 000 for IRS for taxes because of Highmark.”
has filed numerous exhibits. (See D.I. 2, Exs. 4, 5;
D.I. 3, Exs. 1, 2, 3, 6, 7; D.I. 7; D.I. 16). One exhibit
advises Plaintiff by correspondence from Highmark Delaware
dated February 8, 2019, that her health insurance coverage
was terminated effective January 1, 2019 due to nonpayment of
the required premium. (D.I. 2-1 at 4). Another exhibit
indicates that Plaintiff was notified by Highmark Delaware by
a February 11, 2019 account activity summary of the
“member premium responsibility” in the sum of $1,
505.26 (adjusted to $1, 410.26 due to a previous balance) for
the billing period March 1, 2019 to March 31, 2019. (D.I. 3).
A third exhibitprovided information on premium tax credits
and advised that the amount of premium tax credits is based
on “the number of people in your household” which
includes your spouse and any dependents claimed on your tax
return and the household income for the year in which
coverage is desired. (D.I. 3-1 at 1). The exhibit indicates
that “the marketplace will send any advance of the
premium tax credit directly to your insurance company, not to
you.” (Id.). The exhibit also provides
information regarding reporting tax credits on federal tax
returns. (Id. at 2).
relief, Plaintiff “wants the IRS to just use her income
to base her Obamacare Insurance.” (Id. at 7).
In a separate filing, Plaintiff asks for $25, 000, as well as
a refund, and interest. (D.I. 18).
plaintiff proceeds pro se, her pleading is liberally
construed and her complaint, “however inartfully
pleaded, must be held to less stringent standards than formal
pleadings drafted by lawyers.” Erickson v.
Pardus, 551 U.S. 89, 94 (2007) (citations omitted). When
presented with a motion to dismiss for failure to state a
claim pursuant to Rule 12(b)(6), district courts conduct a
two-part analysis. Fowler v. UPMC Shadyside, 578
F.3d 203, 210 (3d Cir. 2009). First, the court separates the
factual and legal elements of a claim, accepting “all
of the complaint's well-pleaded facts as true, but
[disregarding] any legal conclusions.” Id. at
210-11. Second, the court determines ...