Court of Appeals of Missouri, Western District, Second Division
JANICE E. SPURGEON, Appellant,
MISSOURI CONSOLIDATED HEALTH CARE PLAN, BOARD OF TRUSTEES, ET AL., Respondents.
from the Circuit Court of Cole County, Missouri The Honorable
Jon Edward Beetem, Judge.
Before: James Edward Welsh, Presiding Judge, Alok Ahuja,
Judge, Anthony Rex Gabbert, Judge.
Anthony Rex Gabbert, Judge.
Spurgeon appeals the circuit court's Judgment concluding
that she is not entitled to enroll in the Missouri
Consolidated Health Care Plan (MCHCP) pursuant to Section
103.085 and 22 C.S.R. 10-2.020. Spurgeon contends
that the circuit court erred in interpreting Section 103.085
and in applying 22 C.S.R. 10-2.020.
and Procedural History
late husband, Gary,  was an employee of the Missouri Department
of Public Safety, Division of Alcohol and Tobacco Control,
from January 12, 1976, through November 30, 2009. He retired
on December 1, 2009. Gary was covered for health care
benefits under MCHCP at the time of his retirement. He
elected to continue coverage with MCHCP upon his retirement
and maintained coverage until his death on March 4, 2014.
did not elect to enroll Spurgeon in MCHCP coverage when he
retired. Spurgeon, therefore, was not covered by MCHCP at the
time of Gary's death. At the time of Gary's passing,
Spurgeon was an employee of Crawford Electric Cooperative
covered under her employer's health insurance plan. After
Gary's death, Spurgeon completed a Survivor Enrollment
Form which was received by MCHCP on April 3, 2014. MCHCP
denied Spurgeon's application on the grounds that
Spurgeon was ineligible to enroll for survivor coverage under
22 C.S.R. 10-2.020(2)(C)2. This provision only allows
survivors of retirees to continue enrollment in MCHCP if the
retiree elected at retirement to enroll the survivor; it does
not allow a survivor to initiate enrollment at the time of a
appealed MCHCP's decision to the MCHCP Board of Trustees
("the Board"). The Board denied Spurgeon's
appeal. On October 2, 2014, Spurgeon filed an amended
petitionin the circuit court against the Board and
Judith Muck, executive director of MCHCP
("Respondent's" collectively). The amended
petition alleged that Spurgeon met all of the requirements of
Section 103.085 to be allowed healthcare coverage under
MCHCP, and the Board's denial of her appeal was unlawful,
unreasonable, arbitrary, capricious, and deprived her of a
property right she is entitled to under the law. Spurgeon
also contended that she had relied upon an averment made in a
telephone call to MCHCP's customer service representative
that Spurgeon could wait until Gary's death to enroll for
coverage. Further, she argued that MCHCP had discretion to
approve coverage pursuant to 22 C.S.R. 10-2.075(6)(B). She
contended that 22 C.S.R. 10-2.020(2)(C)2 contradicts Section
103.098 which statutorily authorizes her enrollment.
October 22, 2014, Respondents moved to dismiss Spurgeon's
petition for failure to state a claim upon which relief could
be granted. The court heard argument on Respondent's
motion on November 7, 2014, and on July 15, 2015, entered a
Judgment dismissing Spurgeon's petition for failure to
state a claim. Spurgeon appealed the circuit court's
dismissal to this court. On March 9, 2016, we issued a
mandate reversing the circuit court's judgment.
Spurgeon v. Missouri Consolidated Health Care Plan,
481 S.W.3d 604 (Mo. App. 2016). We found that, in construing
Spurgeon's petition liberally and assuming the facts
alleged therein to be true, the petition stated a claim for
judicial review of MCHCP's decision. Id. at
607-608 (Mo. App. 2016). We determined that MCHCP's
motion to dismiss challenged the merits of Spurgeon's
claim rather than the adequacy of the petition, and noted
that MCHCP had not alternatively requested a judgment on the
pleadings. Id. at 608. We concluded that Spurgeon
was entitled to a decision on the merits and remanded the
matter to the circuit court. Id.
remand, the circuit court reviewed the merits of
Spurgeon's claims and concluded, as relevant to this
appeal, that Section 103.085 and 22 C.S.R. 10-2.020 required
MCHCP to deny Spurgeon's application for enrollment. This
appeal from the circuit court's review of a non-contested
administrative decision, we review the circuit court's
judgment, not the administrative agency's decision."
Spurgeon, 481 S.W.3d at 606 (citing Mo.
Nat'l Educ. Ass'n v. Mo. State Bd. of Educ., 34
S.W.3d 266, 274 (Mo. App. 2000). "Legal questions of
statutory interpretation are reviewed de novo."
Macon County Emergency Services Board v. Macon County
Commission, 485 S.W.3d 353, 355 (Mo. banc 2016).
'"The rules of a state administrative agency duly
promulgated pursuant to properly delegated authority have the
force and effect of law and are binding upon the agency
adopting them."' Farrow v. Saint Francis Medical
Center, 407 S.W.3d 579, 588 (Mo. banc 2013) (quoting
State ex rel. Martin-Erb v. Missouri Com'n on Human
Rights, 77 S.W.3d 600, 607 (Mo. banc 2002). However,
'"[a]s a creature of statute, an administrative
agency's authority is limited to that given it by the
legislature."' Farrow, 407 S.W.3d at 588
(quoting State ex rel. Missouri Public Defender Com'n
v. Waters, 370 S.W.3d 592, 598 (Mo. banc 2012)).
"While administrative regulations are entitled to a
presumption of validity and may not be overruled except for
weighty reasons, the rules or regulations of a state agency
are invalid if they are beyond the scope of authority
conferred upon the agency, or if they attempt to expand or
modify statutes." Union Elec. Co. v. Director of
Revenue, 425 S.W.3d 118, 124-125 (Mo. banc 2014)
(internal quotation marks and citations omitted).
asserts two points on appeal. In her first point she contends
that the circuit court erred in finding that MCHCP was
required to deny her application for survivor enrollment
because denial of her enrollment is contrary to the purpose
of the plan's establishment set forth in Section 103.005,
she met the statutorily mandated requirements for enrollment
under Section 103.085. In her second point she contends that
22 C.S.R. 10-2.020(2)(B) is in direct conflict with Section
103.085 and, therefore, the court erred in applying 22 C.S.R.
10-2.020. As both points involve interpretation of Section
103.085, we review them together.
Purpose - Section 103.005
103.005, titled "Missouri Consolidated Health Care Plan
established, purpose - powers to ...