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IN THE CIRCUIT COURT OF COUNTY, MISSISSIPPI AND PLAINTIFFSVS. NO. DEFENDANT ANSWER (" ") defendant in the above -entitled action, files the following Answer to Plaintiffs' Complaint. FIRST DEFENSE The allegations of the Complaint fail to state a clam upon which this Court can grant relief. SECOND DEFENSE The allegations of the Complaint are time barred in whole or in part by the statute of limitations and/or by laches. THIRD DEFENSE The allegations of the Complaint are time barred in whole or part by the provisions contained within the policies issued by . FOURTH DEFENSE The contracts and policies at issue in this lawsuit were approved by the Mississippi Department of Insurance, and therefore has no liability to Plaintiffs. FIFTH DEFENSE 's policies, practices and procedures are in compliance with both federal, state law, and/or pertinent regulations and/or other legal requirements, and therefore has no liability to Plaintiffs. SIXTH DEFENSE The policies, practices and procedures about which Plaintiffs complain have been implemented and are used by others in the health insurance industry. The policies, practices and procedures are designed to meet the important national goals and objectives of controlling and stabilizing health care costs, and therefore has no liability to Plaintiffs. SEVENTH DEFENSE Plaintiffs received benefits from the arrangements negotiated by with providers of medical and related services, and therefore, has no liability to Plaintiffs. EIGHTH DEFENSE The individual medical benefits policies at issue, and/or the policies which formed part of the employee benefit plans at issue, Contain no language that could legitimately be interpreted as a promise by to policyholders or participants that it would either obtain or pass along alleged discounts and/or savings from providers of medical and related services to such policyholders or participants, and therefore, has no liability to Plaintiffs. NINTH DEFENSE As a matter of law, is not chargeable with or liable for the acts, omissions, or representations of third parties including providers of medical and related services in connection with any alleged failure to inform Plaintiffs of the alleged discounts or savings. TENTH DEFENSE pleads the specific terms, conditions, limitations and exclusions of all of the health benefits policies which are placed at issue by Plaintiffs' allegations. ELEVENTH DEFENSE pleads the specific terms, conditions, limitations of all agreements, contracts, arrangements between and providers of medical and related services. TWELFTH DEFENSE Plaintiffs' allegations are barred because they have failed to exhaust their administrative remedies. THIRTEENTH DEFENSE has fulfilled its obligations to Plaintiffs under the terms of the policies, agreements and/or plans. FOURTEENTH DEFENSE Plaintiffs' claims should be dismissed because at all times acted in good faith. FIFTEENTH DEFENSE Plaintiffs' claims should be dismissed because they have failed to join an indispensable party. SIXTEENTH DEFENSE Plaintiffs' claims should be dismissed based on the equitable doctrines of waiver and estoppel. SEVENTEENTH DEFENSE Plaintiffs’ claims should be dismissed because they have failed to plead fraud and other claims with the required particularity. EIGHTEENTH DEFENSE Some or all of Plaintiffs' allegations, requested remedies, and rights are related to qualified employee health benefit plans, and such claims are preempted and exclusively governed by federal law -- specifically, the provisions of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. Section 1144(a). NINETEENTH DEFENSE Some or all of Plaintiffs' demands for compensatory damages against are preempted by ERISA. In accordance with ERISA, extra-contractual damages are unavailable to Plaintiffs and therefore, has no liability to Plaintiffs. TWENTIETH DEFENSE Plaintiffs are not entitled to a jury trial under the provisions of ERISA. Therefore, any demand for a jury trial by Plaintiffs should be struck, and hereby requests a bench trial in accordance with the provisions of ERISA. TWENTY-FIRST DEFENSE Some or all of Plaintiffs' claims are barred because the policies upon which Plaintiffs seek relief are void due to Plaintiffs making substantial misrepresentations to during the health benefit application process. TWENTY-SECOND DEFENSE Plaintiffs' claims are barred because this Court lacks subject matter jurisdiction over the causes of action alleged in the Complaint. Furthermore, this Court should dismiss Plaintiffs' proposed class action because its lacks jurisdiction to decide such actions, or in the alternative, transfer this action to County Chancery Court. TWENTY-THIRD DEFENSE And now specifically answering the allegations of the Complaint, respectfully states as follows: I. admits that , and are subscribers to health policies provided by the State of Mississippi. denies the remaining allegations of Paragraph I. II. admits that is a subscriber of a health policy. denies the remaining allegations of Paragraph II. Upon information and belief, admits that Plaintiffs are adult resident citizens of County, Mississippi. admits that Plaintiffs are subscribers of health benefit policies and that they have filed medical claims for payment of benefits under their respective policies. denies the remaining allegations of Paragraph II [sic]. III. admits that Plaintiffs are subscribers of health benefit policies. denies the remaining allegations of Paragraph III. IV. admits that it is a corporation doing business in Mississippi and its registered agent for service of process is . denies the remaining allegations of Paragraph IV. V. denies the allegations of Paragraph V. VI. denies the allegations of Paragraph VI. VII. denies the allegations of Paragraph VII. VIII. denies the the allegations of Paragraph VIII. IX. admits that it entered into agreements with various hospitals in conjunction with its continued efforts to ensure that subscribers receive the best possible medical care at the lowest possible cost. denies the remaining allegations of Paragraph IX. X. denies the allegations of Paragraph X. XI. denies the allegations of Paragraph XI. XII. denies the allegations of Paragraph XII. XIII. denies the allegations of Paragraph XIII. XIV. denies the allegations of Paragraph XIV. XV. admits that Plaintiffs are subscribers of health benefit policies. admits that Exhibit A is a copy of a membership certificate booklet issued to some of its subscribers. denies the remaining allegations of Paragraph XV. XVI. denies the allegations of Paragraph XVI. XVII. denies the allegations of Paragraph XVII. XVIII. denies the allegations of Paragraph XVIII. XIX. denies the allegations of Paragraph XIX. XX. denies the allegations of Paragraph XX. XXI. denies the allegations of Paragraph XXI. XXII. denies that Plaintiffs are entitled to attorneys' fees or costs. further affirmatively states that Miss. Code Ann. Section 11-53-59 has been repealed. denies the remaining allegations of Paragraph XXII. TWENTY -FOURTH DEFENSE denies every other allegation not specifically admitted in its Answer. Specifically, denies that Plaintiffs are entitled to the requested relief and damages or to any relief or damages whatsoever.WHEREFORE, respectfully requests the following relief:a.That Plaintiffs proposed action be dismissed, or in the alternative, transferred to County Circuit Court, or in the alternative;b. That after all due proceedings, there be a judgment entered in its favor and against Plaintiffs, dismissing Plaintiffs' demands with prejudice and at Plaintiffs' cost;c. That this Court award to all costs of defending this action including reasonable attorneys' fees; andd. That this Court grant all other relief that it deems just and proper.Dated this the day of , 20 . Respectfully submitted,_______________________________________ Attorney for Of Counsel: Telephone: MSB # Attorney for