Greg Abbott, Attorney General of the State of Texas v. Blue Cross and Blue Shield of Texas, Inc. Group Life and Health Insurance Company Group Medical and Surgical Services Rio Grande HMO, Inc. Healthcare Benefits, Inc. Dental Benefits, Inc. Motiva, Inc. Comstar Communications, Inc.

CourtCourt of Appeals of Texas
DecidedJuly 30, 2003
Docket03-98-00558-CV
StatusPublished

This text of Greg Abbott, Attorney General of the State of Texas v. Blue Cross and Blue Shield of Texas, Inc. Group Life and Health Insurance Company Group Medical and Surgical Services Rio Grande HMO, Inc. Healthcare Benefits, Inc. Dental Benefits, Inc. Motiva, Inc. Comstar Communications, Inc. (Greg Abbott, Attorney General of the State of Texas v. Blue Cross and Blue Shield of Texas, Inc. Group Life and Health Insurance Company Group Medical and Surgical Services Rio Grande HMO, Inc. Healthcare Benefits, Inc. Dental Benefits, Inc. Motiva, Inc. Comstar Communications, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Greg Abbott, Attorney General of the State of Texas v. Blue Cross and Blue Shield of Texas, Inc. Group Life and Health Insurance Company Group Medical and Surgical Services Rio Grande HMO, Inc. Healthcare Benefits, Inc. Dental Benefits, Inc. Motiva, Inc. Comstar Communications, Inc., (Tex. Ct. App. 2003).

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN

NO. 03-98-00558-CV

Greg Abbott, Attorney General of the State of Texas, Appellant

v.

Blue Cross and Blue Shield of Texas, Inc.; Group Life and Health Insurance Company; Group Medical and Surgical Services; Rio Grande HMO, Inc.; Healthcare Benefits, Inc.; Dental Benefits, Inc.; Motiva, Inc.; Comstar Communications, Inc.; Arizona/Texas International, Inc.; Custom General Agency, Inc.; and Texcare HMO, Inc., Appellees

FROM THE DISTRICT COURT OF TRAVIS COUNTY, 345TH JUDICIAL DISTRICT NO. 9613907, HONORABLE JOSEPH H. HART, JUDGE PRESIDING

OPINION

The Texas Attorney General, appellant, brought suit in district court1 against appellee

Blue Cross and Blue Shield of Texas, Inc. (“Blue Cross/Texas”) and others2 opposing a proposed

1 This suit was originally brought in the name of a predecessor to the present attorney general. We have substituted the current holder of that office as the correct party to this proceeding. See Tex. R. App. P. 7.2(a). 2 The Attorney General also sued Group Life and Health Insurance Company, Group Medical and Surgical Services, Rio Grande HMO, Inc., HealthCare Benefits, Inc., Dental Benefits, Inc., Motiva, Inc., ComStar Communications, Inc., Custom General Agency, Inc., and TexCare HMO, Inc., described by the attorney general as “wholly-owned, for-profit subsidiaries of [Blue Cross/Texas], operating under the aegis of [Blue Cross/Texas], which hold assets for or on behalf of [Blue Cross/Texas],” and Arizona/Texas International, Inc., West Texas Health Plans, L.C., d/b/a merger between Blue Cross/Texas and Healthcare Service Corporation of Illinois, doing business

as Blue Cross and Blue Shield of Illinois (“Blue Cross/Illinois”), asserting, inter alia, that Blue

Cross/Texas is a common-law charity that must preserve its assets for charitable purposes and the

merger is prohibited by the Texas Non-Profit Corporation Act.3 After trial and after the district court

apprized the parties by letter of his decision, but before the court rendered a final judgment, the

parties partially settled their dispute, allowing Blue Cross/Texas and Blue Cross/Illinois to merge

and agreeing that, if Blue Cross/Texas is held to be a common-law charitable corporation, the

merged entity will ultimately pay to one or more charitable trusts or foundations designated by the

attorney general the sum of $350,000,000 plus interest.4 The district court’s final judgment holds

that Blue Cross/Texas is not a charity. The Attorney General appeals, presenting one issue to this

Court: whether the district court erred in holding that Blue Cross/Texas is not a common-law

charitable corporation.5 We will affirm the district-court judgment.

HMO Blue, West Texas, and Mid-Con Health Plans, L.C., d/b/a HMO Blue, SouthWest Texas (also referred to in the pleadings as Mid-Con Health Plans, Inc.), described as “for-profit joint ventures in which [Blue Cross/Texas] has various partnership or other business interests, and each holds assets for or on behalf of [Blue Cross/Texas].” Before trial, the Attorney General nonsuited West Texas Health Plans and Mid-Con Health Plans. The remaining original defendants are appellees in this Court. Appellees’ interests do not diverge and, for convenience, we will refer to them collectively as “Blue Cross/Texas.” 3 See Tex. Rev. Civ. Stat. Ann. arts. 1396-1.01; 1.02A(1)-(3); 5.03 (West 1997). 4 The original “Plan and Agreement of Merger” between Blue Cross/Texas and Blue Cross/Illinois was signed July 9, 1996, and was to become effective when the appropriate state authorities in Texas and Illinois had issued certificates of merger. The settlement agreement between the Attorney General and Blue Cross/Texas was signed September 17, 1998. 5 The parties’ district-court pleadings, their briefs in this Court, their stipulations, and the district court’s final judgment, findings, and conclusions use the terms “charity,” “public charity,” “common-law charitable corporation,” “common-law charity, “and “charitable organization”

2 FACTUAL BACKGROUND

For all practical purposes, the concept of what is now generally known as group

health insurance began in 1929 when representatives of Baylor Hospital in Dallas created a prepaid

hospital service plan known as the “Baylor Plan.” Initially devised to provide group hospital

insurance only to Dallas public school teachers seeking treatment at Baylor Hospital, the Baylor Plan

proved successful and was extended to provide coverage to other employment groups seeking

treatment at other hospitals. The Baylor Plan apparently operated without any state regulation; by

contract the individual participants would pool a small sum of money each month from which the

hospital expenses of all contributors would be paid. See 25 Years of Progress in Hospital Care

Prepayment, American Hospital Association (1955) (The 25th Anniversary Year Brochure).

In 1939, the 46th Texas Legislature acted to allow corporations to provide group

hospital services. Act of May 2, 1939, 46th Leg., R.S., ch. 1, §§ 1-16, 1939 Tex. Gen. Laws 123,

repealed by Act of June 7, 1951, 52d Leg., R.S., ch. 491, § 4, 1951 Tex. Gen. Laws 868, 1095.

(“House Bill 191”). House Bill 191 authorized corporations to be created “for the purpose of

establishing, maintaining and operating a nonprofit hospital service plan, whereby hospital care may

be provided by [the] corporation through an established hospital or hospitals. . . with which [the

corporation] has contracted for such care . . . .” Id. § 1 at 123. H.B. 191 was effective May 10, 1939.

Id. at 126. Corporations organized pursuant to House Bill 191 were to be subject to the supervision

interchangeably. As used by the district court and the parties, we understand all such terms to mean the same thing: an entity subject to the application of the doctrine of cy pres. Such will also be their meaning in this opinion.

3 of the State Insurance Commission and Board of Insurance Commissioners. See id. §§ 3, 7-8, 12-13,

15 at 124-26.6

Less than two weeks later, on May 23, 1939, articles of incorporation for Blue

Cross/Texas were signed.7 The articles were approved by the Texas Secretary of State, who issued

Blue Cross/Texas’s corporate charter on June 2, 1939. Blue Cross/Texas operated continuously until

its merger with Blue Cross/Illinois in 1998. Under the terms of the merger, Blue Cross/Illinois is

the surviving merged entity.

Throughout its almost sixty-year existence, Blue Cross/Texas’s only purpose was to

operate a nonprofit hospital service plan under chapter 20 of the Texas Insurance Code or its

predecessor. See Tex. Ins. Code Ann. arts. 20.01-.21 (West 1981 & Supp. 2001).

STANDARD OF REVIEW

The parties disagree as to the standard this Court should follow in reviewing the

district-court judgment. The district court filed findings of fact and conclusions of law. See Tex.

R. Civ. P. 296-298. The Attorney General argues that this case was tried on stipulated facts and

should be reviewed as an “agreed case.” See Tex. R. Civ. P. 263. “An agreed statement of facts

under rule 263 is similar to a special verdict; it is the parties’ request for judgment under the

applicable law.” State Farm Lloyds v. Kessler, 932 S.W.2d 732, 735 (Tex. App.—Fort Worth 1996,

6 The Texas Department of Insurance and the insurance commissioner now perform the duties of the State Insurance Commission and Board of Insurance Commissioners. See Act of May 27, 1991, 72d Leg., R.S., ch. 242, art. 1, § 1.01, 1991 Tex. Gen. Laws 939, 939.

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