Kentucky Assn. of Health Plans, Inc. v. Miller

In Kentucky Assn. of Health Plans, Inc. v. Miller (2003) 538 U.S. 329, the Supreme Court established a two-part test to determine whether a state law regulates insurance within the purview of ERISA section 514(b): "First, the state law must be specifically directed toward entities engaged in insurance. Second ... the state law must substantially affect the risk pooling arrangement between the insurer and the insured." (Miller, supra, 538 U.S. at p. 342.) Under the first prong of the Miller test, a state law "must be 'specifically directed toward' the insurance industry in order to fall under ERISA's saving clause." (Miller, supra, 538 U.S. at p. 334.) In Miller, the court considered Kentucky's "Any Willing Provider" statute, which prohibited health insurers from discriminating against providers that were willing to meet the terms and conditions for participation established by the health insurers. (Id. at p. 332.) The insurers argued the statute was not "specifically directed" at the insurance industry because it did not regulate the relationship between insurers and insureds. The court rejected this argument, reasoning that the statute regulated insurance because it "imposed conditions on the right to engage in the business of insurance" within Kentucky. (Id. at p. 338.)