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SOLGER v. WAL-MART STORES, INC.

Nos. 97-2876, 97-3752.

144 F.3d 567 (1998)

Susan SOLGER, Appellant, v. WAL-MART STORES, INC. ASSOCIATES HEALTH AND WELFARE PLAN, Appellee. Susan SOLGER, Appellee, v. WAL-MART STORES, INC. ASSOCIATES HEALTH AND WELFARE PLAN, Appellant.

United States Court of Appeals, Eighth Circuit.

Decided May 14, 1998.

Attorney(s) appearing for the Case

Brent L. Mills, Tulsa, OK, argued (Steven D. Gunderson, Fayetteville, AR, on the brief), for appellant.

Michael R. Jones, Mountainburg, AR, argued (N. Donald Jenkins, Mountainburg, AR, on the brief), for Appellee.

Before FAGG, ROSS, and BOWMAN, Circuit Judges.

BOWMAN, Circuit Judge.

Wal-Mart's employee health insurance plan imposes a $5,000 cap on coverage of treatment of temporomandibular joint (TMJ)2 conditions. Susan Solger, a Wal-Mart employee, asked Wal-Mart to precertify coverage of treatment for a condition resulting from the partial disintegration of two TMJ implants she had received before she began working for Wal-Mart. The proposed treatment consisted of surgery on Solger's TMJs,...

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