(2003)

88 Op. Att'y Gen. 11
Maryland Attorney General Reports·Decided January 27, 2003·Published

Opinion

Dear Mr. Steven B. Larsen

You have asked for our opinion concerning the effectiveness of a recent amendment of the law governing the conversion of a nonprofit health service plan to for-profit status. State law provides that such a transaction may be consummated only if the Insurance Commissioner ("Commissioner") finds that it is "in the public interest." Under a 2002 amendment to that law, sometimes referred to as the "anti-bonus provision", the Commissioner may not make the required finding if an officer of the nonprofit health service plan will receive special remuneration, other than compensation for continued employment, as a result of the transaction. You have asked whether you may apply the anti-bonus provision in considering an application for the conversion and acquisition of CareFirst, Inc. ("CareFirst") — an application that was initially filed prior to the addition of the anti-bonus provision to the State conversion law.

For the reasons set forth below, application of the anti-bonus provision to a transaction that was proposed prior to its enactment would not violate any State or federal constitutional rights of the parties to the proposed transaction. Thus, in our opinion, you should consider that provision in assessing whether the proposed CareFirst transaction is in the public interest.1

I
Conversion Law
In 1998, the General Assembly enacted a comprehensive statutory scheme to govern transactions that effect transfers of the assets or ownership of nonprofit health entities. Chapters 123, 124, Laws of Maryland 1998, codified at Annotated Code of Maryland, State Government Article ("SG"), 6.5-101 et seq. Among the transactions covered by this law are the conversion of a nonprofit health service plan to for-profit status and a sale or merger that transfers a plan's assets to a for-profit corporation. SG § 6.5-101(b).

Under this law, the Commissioner's approval is a prerequisite to a transaction involving a nonprofit health service plan. Specifically, the Commissioner must assess whether the transaction is "in the public interest." SG § 6.5-301(a). The law sets forth several criteria for that assessment. Among other things, the Commissioner is to determine whether steps have been taken to preserve public and charitable assets, whether the company exercised due diligence in negotiating the transaction, whether the transaction will have a significant adverse effect on health care services, and whether it is equitable to various stakeholders. SG §§ 6.5-301, 6.5-303(2).

Particularly pertinent to your question are two provisions designed to ensure that officers and directors of a nonprofit health service plan do not unfairly enrich themselves in connection with the transaction. These provisions are sometimes referred to as the "antiinurement" and "anti-bonus" provisions.

A. Anti-Inurement Provision

The conversion law provides that a transaction is not in the public interest unless

appropriate steps have been taken to . . . ensure that no part of the public or charitable assets of the acquisition inure directly or indirectly to an officer, director, or trustee of a [nonprofit health service plan]. . .

SG § 6.5-301(b)(3). This provision was part of the conversion law when it was originally enacted in 1998. Chapters 123, 124, Laws of Maryland 1998.

B. Anti-Bonus Provision

The conversion law also provides that a transaction is not in the public interest unless:

appropriate steps have been taken to . . . ensure that no officer, director, or trustee of the [nonprofit health service plan] receives any immediate or future remuneration as the result of an acquisition or proposed acquisition except in the form of compensation paid for continued employment with the acquiring entity.

SG § 6.5-301(b)(4). A parallel provision in the State insurance law2 directly prohibits an officer, director, or trustee from receiving such remuneration. Annotated Code of Maryland, Insurance Article ("IN"), § 14-139(b). Both of these provisions were the result of legislation enacted in 2002. Chapter 154, Laws of Maryland 2002.

II
The Transaction
A. Conversion and Merger of CareFirst

CareFirst, as well as certain of its subsidiaries, is licensed as a nonprofit health service plan in Maryland. See 87 Opinions of the Attorney General ___ (2002) [Opinion No. 02-019 (November 12, 2002)] ("2002 Attorney General Opinion"), slip op. at pp. 2-3. In November 2001, CareFirst entered into an agreement with WellPoint Health Networks, Inc. ("WellPoint") that sets forth what is essentially a two-step transaction: (1) the conversion of CareFirst and its subsidiaries to for-profit entities; and (2) the merger of a wholly-owned subsidiary of WellPoint with CareFirst and its subsidiaries. 2002 Attorney General Opinion at p. 3. This transaction fits the definition of an acquisition subject to the review and approval of the Commissioner under the conversion law. SG § 6.5-101(b), (g)(2), (j)(2). CareFirst and WellPoint filed an application seeking the Commissioner's approval on January 11, 2002.

B. Executive Bonus Provisions

CareFirst has entered into agreements with a number of its executives that provide special compensation to those executives in connection with a "change of control" of CareFirst.

1. Employment Agreement Provisions (1998-2000)

Between November 1998 and December 2000, CareFirst entered into employment agreements with its President and Chief Executive Officer and seven other high-ranking executives. Under those employment agreements, a "change of control" of CareFirst triggers special payments and benefits for those executives if certain conditions are met.

The payments are calculated as percentages of each executive's base salary, annual incentive bonus, and long-term incentive plan bonus. Other special benefits include supplemental health, insurance, and pension benefits, and the company's payment of an excise tax that would be assessed on the executives under an "excess parachute payments" provision of the Internal Revenue Code.

The employment agreements define the phrase "change of control" to cover a range of transactions or changes in the board of the company.3 While not every "change of control" would be subject to the Commissioner's approval under the State conversion law, there appears to be no question that the proposed CareFirst transaction satisfies both the definition of "change of control" in the employment agreements and the definition of an "acquisition" subject to the Commissioner's approval under the conversion law.

2. Merger Incentive Plan (2001)

In December 2001, CareFirst also adopted a "merger incentive plan," which authorized additional bonuses totaling approximately $25 million for the Chief Executive Officer and six other executives contingent upon a "sale or disposition" of the company and fulfillment of certain other conditions. That plan defined "sale or disposition" in terms similar to "change of control" in the employment agreements.4 At the same time, CareFirst created a "retention bonus plan" that provided for bonuses for various other executives upon the same contingency.

C. Consultant's Report

The Commissioner retained the law firm of Roger G.

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