Benefits Evolution, L.L.C. v. Atlantic Tool & Die Co.

2011 Ohio 4062
CourtOhio Court of Appeals
DecidedAugust 17, 2011
Docket25405
StatusPublished
Cited by3 cases

This text of 2011 Ohio 4062 (Benefits Evolution, L.L.C. v. Atlantic Tool & Die Co.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Benefits Evolution, L.L.C. v. Atlantic Tool & Die Co., 2011 Ohio 4062 (Ohio Ct. App. 2011).

Opinion

[Cite as Benefits Evolution, L.L.C. v. Atlantic Tool & Die Co., 2011-Ohio-4062.]

STATE OF OHIO ) IN THE COURT OF APPEALS )ss: NINTH JUDICIAL DISTRICT COUNTY OF SUMMIT )

BENEFIT EVOLUTION C.A. No. 25405

Appellee/Cross-Appellant

v. APPEAL FROM JUDGMENT ENTERED IN THE ATLANTIC TOOL AND DIE COURT OF COMMON PLEAS COUNTY OF SUMMIT, OHIO Appellant/Cross-Appellee CASE No. CV 2008-09-6839

DECISION AND JOURNAL ENTRY

Dated: August 17, 2011

CARR, Presiding Judge.

{¶1} Defendant-Appellant/Cross-Appellee, Atlantic Tool & Die Company (hereafter

“ATD”), has appealed from a decision of the Summit County Court of Commons Pleas that

entered judgment in favor of Plaintiff-Appellee/Cross-Appellant, Benefits Evolution, on its claim

for breach of contract. Benefits Evolution has filed a cross-appeal from the trial court’s decision

to award ATD damages on its counterclaim for breach of oral agreement. This Court affirms in

part and reverses in part.

I.

{¶2} ATD is a mid-sized, worldwide manufacturing company. Benefits Evolution is a

small company that operates as an insurance broker and administrator. In February 2007, ATD’s

Executive Vice President Mike Mehwald had lunch with Fred Jones. Mr. Jones, who was acting

as an independent agent of Benefits Evolution, told Mr. Mehwald about a program offered by

Benefits Evolution that would save ATD money on its health care costs. After their lunch 2

meeting, Mr. Jones emailed Mr. Mehwald with an outline of the health insurance plan offered by

Benefits Evolution. In this email, Mr. Jones explained that one of the ways that Benefits

Evolution is compensated is through a 25% fee of ATD’s savings.

{¶3} In April 2007, Dave Ewonce, President of Benefits Evolution, had several

meetings with ATD employees, including Mr. Mehwald and Ms. Jennifer Dumm, ATD’s human

resources partner. At these meetings, Mr. Ewonce explained Benefits Evolutions’ “Smart

Funding System,” which “involves transitioning from a traditional fully funded insurance system

to a high deductible, partially self-funded system.” Mr. Ewonce testified that at these meetings,

he told ATD about the various ways Benefits Evolution is compensated, including the Savings

Fee.

{¶4} Through the Savings Fee, Benefits Evolution would receive 25% of ATD’s

savings for the 2007-2008 plan year. Mr. Ewonce explained that the savings are calculated by

taking the renewal cost the customer would have paid by staying with its prior broker and

deducting the actual costs the customer incurred during the first plan year with ATD. Mr.

Ewonce testified that he told ATD at the meetings that the baseline number used in the Savings

Fee calculations is based on the renewal figure. Mr. Mehwald told Mr. Ewonce that they would

only agree to a 20% Savings Fee, rather than the usual 25%. Mr. Ewonce testified that despite

already having the 25% Savings Fee in writing, Benefits Evolution “made the change to accept

the 20.”

{¶5} Ms. Dumm testified that ATD decided to explore a relationship with Benefits

Evolution after receiving its $3.05 million renewal quote from its broker, Medical Mutual of

Ohio (hereafter “MMO”), which was an increase of $600,000. On May 8, 2007, Mr. Ewonce

emailed ATD copies of several agreements, including the Consulting Agreement. In this email, 3

Mr. Ewonce told Ms. Dumm that the baseline and percentage of savings calculations still needed

to be added. According to the agreement, Benefits Evolution would become ATD’s broker of

record and implement its “Smart Funding System.” Benefits Evolution would also serve as

ATD’s third-party claims administrator through a subcontract with ClaimLinx. In the

compensation section of the Consulting Agreement, section 3.2 states that Benefits Evolution

would be paid “a percentage of Employer’s overall savings as a result of implementation of the

Funding System, as more fully described in Attachment A hereto.”

{¶6} ATD reviewed the Consulting Agreement, met with Benefits Evolution about it,

and requested specific changes be made, to which Benefits Evolution consented. After the

changes were made, Benefits Evolution was designated as ATD’s broker of record in accordance

with the Consulting Agreement on May 15, 2007. Mr. Ewonce sent a sample Attachment A on

May 18, 2007, which demonstrated in detail, using a sample company, how the Savings Fee

would be calculated. Mr. Ewonce testified that before the 2007-2008 plan year began, he

provided ATD with their projected savings and the projected Savings Fee Benefits Evolution

would expect.

{¶7} The 2007-2008 plan year began on July 1, 2007. ATD and Benefits Evolution

had weekly meetings for the first few months of the plan year, but neither the Consulting

Agreement nor Attachment A was ever discussed.

{¶8} ATD received Attachment A on July 22, 2007. Mr. Ewonce testified that this

delay was for two reasons. First, Benefits Evolution had not determined who it was going to use

for insurance. Second, Mr. Ewonce testified that Benefits Evolution “didn’t have [the final MMO

renewal] number solidified yet either, which we needed to calculate the baseline.” 4

{¶9} Attachment A includes the actual Savings Fee calculation, which indicated a $3.0

million MMO renewal number as the baseline number. Ms. Dumm testified that she understood

how the $3.0 million baseline number was derived. Ms. Dumm and Ms. Kathy Keating, ATD’s

office manager, reviewed the document and Ms. Dumm discussed it with Mr. Ewonce. Ms.

Keating asked that a change concerning a “claims run-out period” in Attachment A be made.

However, no one at ATD ever requested any changes be made to the Savings Fee calculation.

{¶10} Mr. Ewonce testified that in December 2007, Ms. Keating asked him how plan

costs would change if they added or subtracted ninety people. Mr. Ewonce sent the sample

calculations in February 2008, after the company had all the relevant numbers. In March 2008,

Benefits Evolution fired ClaimLinx and began handling ATD’s claims.

{¶11} Mr. Ewonce testified that when he met with Ms. Dumm, Ms. Keating, and Mr.

Mehwald in June 2008, the Savings Fee that Benefits Evolution was expecting was discussed,

and no one from ATD questioned it. Also in June 2008, Benefits Evolution and ATD agreed to

continue their relationship. Benefits Evolution was designated as ATD’s broker for the 2008-

2009 plan year and started enrolling ATD’s Ohio locations for the new benefits. However,

shortly thereafter, ATD terminated Benefits Evolution and returned to its prior broker. Mr.

Mehwald admitted that he did not inform Benefits Evolution that it was being terminated, even

though he knew it was meeting with all the Ohio employees. ATD then asked Benefits

Evolution to stay on for July 2008, even though the plan year ended. Benefits Evolution agreed,

but ATD admits that it did not pay Benefits Evolution for that month.

{¶12} After ATD terminated Benefits Evolution, Mr. Ewonce demanded to be paid the

Savings Fee as required by the Consulting Agreement. ATD refused and insisted it never agreed

to the fee and that there was no contract. Mr. Ewonce testified that throughout their working 5

relationship, no one from ATD objected to the Savings Fee or the use of the MMO renewal quote

as the baseline until Mr. Ewonce tried to collect the Savings Fee. Ms. Dumm admitted that

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