CareFirst, Inc. v. Taylor

235 F. Supp. 3d 724, 2017 WL 75947, 2017 U.S. Dist. LEXIS 2984
CourtDistrict Court, D. Maryland
DecidedJanuary 9, 2017
DocketCivil No. CCB-16-2656
StatusPublished
Cited by36 cases

This text of 235 F. Supp. 3d 724 (CareFirst, Inc. v. Taylor) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
CareFirst, Inc. v. Taylor, 235 F. Supp. 3d 724, 2017 WL 75947, 2017 U.S. Dist. LEXIS 2984 (D. Md. 2017).

Opinion

MEMORANDUM

Catherine C, Blake, United States District Judge

Plaintiffs CareFirst, Inc. (“CareFirst”), CareFirst of Maryland, Inc. (“CareFirst [729]*729Maryland”), and Group Hospitalization and Medical Services, Inc. (“GHMSI”) (collectively, “plaintiffs”) have brought an action for declaratory and injunctive relief, claiming that certain administrative orders issued by Stephen C. Taylor, Commissioner of the District of Columbia Department of Insurance, Securities and Banking (“Commissioner Taylor” or “Commissioner”), violate and are preempted by federal law. They are suing Commissioner Taylor in his official capacity. Plaintiffs also have named as defendants the Insurance Commissioner of the Maryland Insurance Administration, Alfred W. Redmer, Jr. (“Maryland Commissioner”), in his official capacity, and the Chair of the Virginia. State Corporation Commission, James C. Dimitri (“Virginia Chair”), in his official capacity. Now pending are the Commissioner’s motion to transfer venue (ECF No. 20), the Commissioner’s motion to substitute party (ECF No. 19), the Commissioner’s motion to dismiss Count I of the complaint (ECF No. 37),1 and the plaintiffs’ motion for summary judgment as to Count I of the complaint (ECF No. 2). The motions have been fully briefed, and the court heard oral argument on November 10, 2016. (Mot. Hearing, ECF No. 50.) For the reasons discussed below, all four motions will be denied.

BACKGROUND

GHMSI is a congressionally chartered corporation that operates as a non-profit health services plan in Maryland, Northern Virginia, and the District of Columbia.2 (Mot. Summary Judgment, Burrell Aff. ¶ 5, ECF No. 2-2; see Mot. Summary Judgment, Gunderson Aff. ¶4, Ex.. A, ECF No. 2-4.) It is domiciled in the District of Columbia. (Mot. Summary Judgment, Burrell Aff. ¶10, ECF No. 2-2.) GHMSI holds a certificate of authority to operate in Maryland, where more- than 42% of its members and subscribers reside. (Id. ¶ 7-8.)

Congress chartered GHMSI in 1939. Pub. L. 76-395, 53 Stat. 1412, 1412 (1939). The charter provided that “[t]he corporation is ... authorized and empowered to take over, carry out, and assume all contracts, obligations, assets, and liabilities of a corporation ... organized and now doing business in the District of Columbia under the name of Group Hospitalization, Inc.” Pub. L. 76-395 § 9, 53 Stat. 1414. In 1993, Congress amended the charter to provide that “the District of Columbia shall be the legal domicile of the corporation” and that “[t]he corporation shall be licensed and regulated by the District of Columbia in accordance with the laws.and regulations of the District of Columbia.” Pub. L. 103-127 § 138, 107 Stat. 1336, 1349 (1993). In 1997, Congress again amended the charter, authorizing GHMSI to have a non-profit corporate member. Pub. L. 105-Í49, 111 Stat. 2684 (1997).

In order to fulfill its. obligations to policyholders, subscribers, and members, GHMSI maintains an accumulated surplus. (Mot. Summary Judgment, Burrell [730]*730Aff. ¶ 12-14, ECF No. 2-2.) In 2009, the Medical Insurance -Empowerment Amendment Act of 2008 (“MIEAA”) went into effect. D.C. Code §§ 31-3501 et seq. The MIEAA provides that, no less frequently than every three years, the Commissioner shall “review the portion of the surplus of [GHMSI] that is attributable to the District and may issue a determination as to whether, the surplus is excessive,” § 31-3506(e). If the Commissioner determines that the surplus is excessive, “the Commissioner shall order [GHMSI] to submit a plan for dedication of the excess to community health reinvestment in a fair and equitable manner.” § 31-3506(g)(l). After the District of Columbia enacted the MIEAA, Maryland and Virginia passed laws that authorized the Maryland Commissioner and Virginia Chair to take certain actions, including imposing a prohibition on the health service plan’s distribution or reduction of its surplus for .the benefit of residents in another state. See Md. Code, Ins. Art. § 14-124; Va. Code § 38.2-4229.2. In 2012, the Maryland Commissioner reviewed GHMSI’s 2011 surplus and entered a Consent Order concluding that the surplus was “adequate and ’... neither excessive nor unreasonably large.” (Mot. Summary Judgment, Gunderson Aff. ¶ 4, Ex. E, ECF No. 2-8.)

In December 2014, the Commissioner’s predecessor issued an order concluding that GHMSI’s surplus was excéssive and that 21% of the calculated excess (approximately $56 million) was attributable to the District of Columbia. (Id., Ex. B at 56, 64-65, ECF No. 2-5.) In February 2015, the Maryland Commissioner entered an order providing that “GHMSI is prohibited from reducing or distributing its surplus as a result of the [Department of Insurance, Securities and Banking (“DISB”)] order and is prohibited from submitting a plan to the D.C. Commissioner for .dedication of its excess of 2011 surplus attributable to D.C. until submitted, reviewed and approved by the [Maryland Insurance Administration].” (Id., Ex. F at 3, ECF No. 2-9.) The Virginia Chair issued an order providing:

Virginia law prohibits GHMSI from distributing or reducing its surplus (as ordered by DISB) “except with the approval of the [Virginia State Corporation] Commission after the examination required by this section.” In this regard and- at this moment, GHMSI has not sought—and the Commission has not provided—süch approval. Accordingly, GHMSI should not act to distribute or reduce its surplus unless approved as provided under Virginia law.

(Id., Ex. I at 8-4, ECF No. 2-12.) GHMSI submitted a plan in response to the order of the Commissioner’s predecessor in March 2015. (Id., Ex. J, ECF No. 2-13.) The plan asserted, in part, that GHMSI “remains under directly conflicting orders from Maryland and the District [of Columbia]” and urged that “the three. jurisdictions .,, consult, cooperate and coordinate on the matter of the Company’s surplus in a consistent way.” (Id. at 7.)

In .December 2015, Congress amended GHMSI’s charter as follows:

SEC. 747. (a) The Act entitled “An Act providing for the incorporation of certain persons as Group Hospitalization and Medical Services, Inc.”, approved August 11, 1939 (53 Stat. 1412) is amended ... by inserting after section 10 the following:
“SEC. 11. The surplus of the corporation is for the benefit and. protection of all its certificate holders' and shall be available for the satisfaction of all obligations of the corporation regardless of the jurisdiction in which such surplus originated or such obligations arise. The corporation shall not divide, attribute, distrib[731]*731ute, or reduce its surplus pursuant to any statute, regulation, or order of any jurisdiction without the express agreement of the District of Columbia, Maryland, and Virginia—(1) that the entire surplus of the corporation is excessive; and (2) to any plan for reduction or distribution of surplus.”
(b) The amendments made by subsection (a) shall apply with, respect to the surplus of the Group Hospitalization and Medical Services, Inc. for any year after 2011.

Pub. L. 114-113 § 747, 129 Stat. 2242, 2486 (2015).

In June 2016, Commissioner Taylor issued a decision and order rejecting GHMSI’s plan and reaffirming the planned dedication of surplus.

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235 F. Supp. 3d 724, 2017 WL 75947, 2017 U.S. Dist. LEXIS 2984, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carefirst-inc-v-taylor-mdd-2017.