Consumers for Affordable Health Care, Inc. v. Superintendent of Insurance

2002 ME 158, 809 A.2d 1233, 2002 Me. LEXIS 181
CourtSupreme Judicial Court of Maine
DecidedOctober 16, 2002
StatusPublished
Cited by10 cases

This text of 2002 ME 158 (Consumers for Affordable Health Care, Inc. v. Superintendent of Insurance) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Consumers for Affordable Health Care, Inc. v. Superintendent of Insurance, 2002 ME 158, 809 A.2d 1233, 2002 Me. LEXIS 181 (Me. 2002).

Opinion

ALEXANDER, J.

[¶ 1] Consumers for Affordable Health Care, Inc. (CAHC), appeals from a judgment of the Superior Court (Kennebec County, Marden, J.) affirming the Superintendent of Insurance’s determination of the value of Blue Cross and Blue Shield of Maine related to its conversion from a nonprofit medical and hospital service organization to a domestic stock insurance company controlled by Anthem Insurance Companies (Anthem). CAHC contends that the Superintendent (1) erred in setting the time at which valuation is determined, and (2) found a fair market value of the aggregate equity of Blue Cross and Blue Shield of Maine that is not supported by substantial evidence in the record. Anthem challenges CAHC’s standing to bring this appeal and argues that the appeal is *1236 moot. We reach the merits of the appeal and affirm the judgment of the Superior Court.

I. CASE HISTORY

[¶ 2] Blue Cross and Blue Shield of Maine (BCBSME) was originally incorporated as a charitable institution to provide nonprofit hospital and medical service plans. 2 See P. & S.L. 1939, ch. 24; P. & S.L. 1943, ch. 21; P.L.1993, ch. 702, § A-19; P.L.1997, ch. 344, § 9. Such nonprofit hospital and medical service organizations may convert to a domestic stockholder owned insurance company with the approval of the Superintendent of Insurance. 24 M.R.S.A. § 2301(9-D) (2000). The approval is conditioned on several factors, including valuation of the corporation and payment of the value of the charitable interest in the converted corporation into a charitable trust. 24 M.R.S.A. § 2301(9-D), (E)(3), (I).

[113] In the late 1990s, BCBSME’s Board of Directors decided that BCBSME should convert to a domestic stock corporation and be sold. After soliciting statements of interest from several potential buyers, the Board determined that Anthem offered what the Board viewed as the strongest proposal.

[¶ 4] Anthem agreed to acquire substantially all of the assets and assume substantially all of the liabilities of BCBSME in a negotiated Asset Purchase Agreement. This agreement contemplated payment of $120 million, with net proceeds of $81.69 million after adjusting for certain of BCBSME’s liabilities and the estimated transaction costs. The Asset Purchase Agreement was approved by the Board on July 13, 1999. BCBSME then retained Houlihan Lokey Howard & Zukin Financial Advisors, Inc. (HLHZ), to perform an appraisal of the company for consideration by the Superintendent of Insurance. HLHZ appraised BCBSME’s fair market value at $102.5 million as of July 13, 1999, the date of the Asset Purchase Agreement.

[¶ 5] On September 15, 1999, the Board approved a plan, pursuant to 24 M.R.S.A. § 2301(9-D), to convert BCBSME from a nonprofit hospital and medical service organization to a domestic stock insurance company named AHS Liquidating Corporation (AHS Liquidating). The conversion plan and the HLHZ appraisal was then filed with the Maine Bureau of Insurance for approval of the conversion and acquisition. The plan indicated that upon the sale of its assets to Anthem, AHS Liquidating would liquidate and dissolve, with its assets placed into a charitable trust for the benefit of the Maine Health Access Foundation, Inc. (Foundation). 3 The conversion plan anticipated that the role of the trust would be “to fund health care programs that will meet the unmet health care needs of the citizens of Maine.”

[¶ 6] Approval and valuation proceedings were initiated in November 1999. The Superintendent of Insurance granted CAHC and others intervenor status in the proceedings.

[¶ 7] During the hearings, the Superintendent heard testimony from over twenty *1237 witnesses, including several experts on the issue of valuation. Two finance experts from HLHZ explained their valuation process and how they arrived at the $102.5 million appraisal. The Superintendent also heard and received testimony from two other valuation experts for BCBSME and one valuation expert for CAHC. An expert for the Attorney General also filed an opinion reviewing the HLHZ appraisal and a fairness opinion filed by a BCBSME expert.

[¶ 8] Several experts concluded that the HLHZ appraisal applied appropriate methodologies and arrived at a reasonable valuation. Those experts indicated that the value of BCBSME had declined subsequent to the July 13, 1999, appraisal. Two experts stated that the adjusted fair market value of BCBSME was less than the $81.69 million Anthem had agreed to pay to initiate the Foundation.

[¶ 9] CAHC’s expert stated an opinion contrary to the other expert opinions. He testified that while the methodologies utilized by HLHZ were reasonable, he believed that a revaluation of BCBSME would yield a higher valuation because, in part: (1) HLHZ applied too high a discount rate in its discounted cash flow analysis; (2) BCBSME had less business risk than implied in the HLHZ analysis; and (3) BCBSME likely had a higher market share subsequent to the appraisal. The CAHC expert also testified that (1) he had never done a fair market value appraisal of an insurance company or a managed care company; (2) he had been involved only once in the preparation of a written fairness opinion; and (3) he did not do an independent valuation analysis of BCBSME.

[¶ 10] The Superintendent issued an eighty-five page opinion on May 25, 2000, approving the conversion. The Superintendent relied upon HLHZ’s $102.5 million appraisal, adjusted by $18.1 million for the actual losses suffered by BCBSME through the end of 1999, as well as the $3.9 million transaction expenses incurred by BCBSME during the conversion process. With these adjustments, the Superintendent found the fair market value of the Foundation’s aggregate equity interest in AHS Liquidating to be $80.5 million. Because the determined fair market value was less than the $81.69 million that Anthem had agreed to provide to the Foundation in the amended Asset Purchase Agreement, the Superintendent approved the transaction as fair and ordered the payment of not less than $81.69 million to the Foundation.

[¶ 11] Following the issuance of the Superintendent’s decision, Anthem and BCBSME waited 10 days, as required by 24-A M.R.S.A. § 222(4-A)(C) (2000), 4 then closed their transaction on June 5, 2000. Upon closing, and after the dissolution of AHS Liquidating, Anthem made the required distribution of $81.69 million to the *1238 Foundation and assumed the liabilities of AHS Liquidating.

[¶ 12] The day after the closing, June 6, 2000, CAHC filed its petition for review of final agency action, pursuant to M.R. Civ. P. 80C, seeking reversal of the portion of the Superintendent’s decision that established the value of the outstanding stock of AHS Liquidating Corporation. 5 After hearing, the Superior Court affirmed the decision of the Superintendent.

[¶ 13] The Superior Court found reasonable the Superintendent’s interpretation that 24 M.R.S.A.

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Bluebook (online)
2002 ME 158, 809 A.2d 1233, 2002 Me. LEXIS 181, Counsel Stack Legal Research, https://law.counselstack.com/opinion/consumers-for-affordable-health-care-inc-v-superintendent-of-insurance-me-2002.