Hawes v. Colorado Division of Insurance

32 P.3d 571, 2001 Colo. J. C.A.R. 668, 2001 Colo. App. LEXIS 167, 2001 WL 83173
CourtColorado Court of Appeals
DecidedFebruary 1, 2001
DocketNo. 99CA2435
StatusPublished
Cited by1 cases

This text of 32 P.3d 571 (Hawes v. Colorado Division of Insurance) is published on Counsel Stack Legal Research, covering Colorado Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hawes v. Colorado Division of Insurance, 32 P.3d 571, 2001 Colo. J. C.A.R. 668, 2001 Colo. App. LEXIS 167, 2001 WL 83173 (Colo. Ct. App. 2001).

Opinion

Opinion by

Judge KAPELKE.

Appellants, Taylor Hawes and the Colorado Health Care Conversions Project (CHCCP), appeal from the final order of the Colorado Commissioner of Insurance (Commissioner) approving the conversion of Rocky Mountain Hospital and Medical Services, Ine., W/h/a Blue Cross Blue Shield (Blue Cross), from a nonprofit hospital, medical-surgical and health service company to a for-profit corporation. Hawes and CHCCP challenge only that part of the Commissioner's order that determined the fair market value of Blue Cross. We affirm.

The facts are essentially undisputed. As a result of increasing financial difficulties, Blue Cross sought to convert to a stock insurance company under the conversion statute, § 10-16-824, C.R.S.2000. As part of this process, Blue Cross had to submit a plan of conversion to the Commissioner for approval. See § 10-16-824(8), C.R.8.2000.

A plan of conversion must "[s]pecify a reasonable treatment for the benefit of the citizens of the state of Colorado of the value of the corporation...." Section 10-16-324(4)(e)(I), C.R.98.2000. Such treatment is "reasonable" if "consideration, determined by the commissioner to be equal to the fair market value of the corporation, is conveyed or issued to one or more qualifying entities." Section C.R.8.2000. Caring for Colorado Foundation (the Foundation), an independent, tax-exempt, social welfare organization, was the qualifying entity designated by the plan to receive that consideration.

After submitting its plan, Blue Cross solicited proposals for its acquisition, and a controlled auction ensued. Anthem Insurance Companies, Inc., and Anthem West, Inc. (collectively Anthem), submitted the prevailing bid. Thereafter, Anthem and Blue Cross entered into an "Alliance Agreement" in which Anthem agreed to purchase Blue Cross for $140 million. The agreement included a so-called "fiduciary out" clause, which preserved Blue Cross' right to negotiate and to consider any other unsolicited, superior offer.

[573]*573Thereafter, Blue Cross submitted its plan for conversion to the Commissioner. This plan reflected the Alliance Agreement and the $140 million sale price. At that time, Blue Cross also submitted a plan for acquisition of all its newly issued stock by Anthem pursuant to § 10-8-604, C.R.S8.2000.

However, before the scheduled hearing on the plan was held, a competing bidder offered to acquire Blue Cross for $155 million. Anthem responded by offering a guaranteed minimum $155 million to the Foundation, or alternatively, $160 million on the condition that the "fiduciary out" clause be eliminated. The day before the hearing, Blue Cross accepted Anthem's offer for $155 million.

The Commissioner conducted a public hearing on the plan pursuant to § 10-16, 324(7), C.R.S.2000. At the hearing, the plan of conversion was orally supplemented to reflect the new agreement. Hawes, a Blue Cross subscriber, and CHCCP, a coalition of nonprofit organizations, entered their appearance after being granted full party status by the Commissioner over Anthem's objection.

Following the two-day evidentiary hearing, and after considering expert testimony and volumes of financial reports regarding the value of Blue Cross, the Commissioner approved the plan. In doing so, the Commissioner concluded that the $155 million amount equaled or exceeded the fair market value of Blue Cross so as to constitute "reasonable treatment" for purposes of § 10-16-324(4)(e)(T).

After the purchase was consummated, Hawes and CHCCP filed this appeal under §§ 10-16-324(15) and 24-4-106(11), C.R.S. 2000, challenging only the Commissioner's ruling on the fair market value of Blue Cross.

I.

Initially, Anthem contends that Hawes and CHCCP lack standing to appeal the Commissioner's order. Alternatively, Anthem asserts that, even if Hawes and CHCCP may properly appeal from the Commissioner's order approving the plan of conversion, only the Foundation has standing to challenge the valuation of Blue Cross. We disagree with both contentions.

Under § 10-16-824(15), the Commissioner's final action may be appealed by "any person that was a party to the agency proceeding and was adversely affected or aggrieved by the final agency decision." For purposes of judicial review of an agency action, a party is "aggrieved" if the party has "suffered actual loss or injury" or is "exposed to potential loss or injury to legitimate interests. ..." Section 24-4-102@8.5), C.R.98.2000.

To determine if Hawes and CHCCP have standing, we must ascertain whether they have alleged an injury in fact to an interest that, as a matter of law, is protected under the relevant statutory scheme-here the conversion statute. See Cloverleaf Kennel Club, Inc. v. Colorado Racing Commission, 620 P.2d 1051 (Colo.1980). In the context of an agency action, however, the injfury-infact element of standing may be satisfied by a showing that the administrative action threatens to cause an injury. See Public Service Co. v. Trigen-Nations Energy Co., 982 P.2d 316 (Colo.1999).

In addition to imposing the "reasonable treatment" requirement, the conversion statute specifically provides that a plan for conversion must not be prejudicial to the sub-seribers of the corporation or to the citizens of Colorado. Section § 10-16-824(4)(b), C.R.S.2000. The plan must also be "fair and reasonable and not contrary to the law or to the interests of subscribers ... or the public." Section 10-16-824(9)(b), C.R.S.2000.

Here, in granting Hawes and CHCCP full party status, the Commissioner specifically found that they were persons potentially affected or aggrieved by the proceedings. Hawes represents the interests of individual policy holders and the public to ensure they were not adversely affected by the conversion. CHCCP represents a variety of nonprofit and public interest organizations that are potential recipients of the conversion funds, since those funds ultimately will be distributed by the Foundation. Indeed, the Commissioner expressly found that the CHCCP could be adversely affected if the Foundation were not sufficiently funded.

[574]*574On the record before us, we conclude that Hawes and CHCCP have established protected interests under the conversion statute and have sufficiently alleged the threat of injury resulting from the Commissioner's valuation of Blue Cross to give them standing for this appeal. See Public Service Co. v. Trigen-Nations Energy Co., supra.

IL.

Hawes and CHCCP contend that the Commissioner's determination that $155 million equaled or exceeded the fair market value of Blue Cross was erroncous and contrary to law. Specifically, they contend that, despite the existence of evidence supporting lower valuations of Blue Cross, its fair market value was conclusively determined by the amount of the highest bid, $160 million. We are not persuaded.

As noted above, in determining whether a plan of conversion complies with the "reasonable treatment" requirement of § 10-16-824(4)(e)(I), the Commissioner must ascertain the fair market value of the converting entity. This determination of fair market value is a finding of ultimate fact as it involves a conclusion of law or a determination of a mixed question of law and fact. See Board of Assessment Appeals v.

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Related

Hawes v. Colorado Division of Insurance
45 P.3d 763 (Colorado Court of Appeals, 2002)

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Bluebook (online)
32 P.3d 571, 2001 Colo. J. C.A.R. 668, 2001 Colo. App. LEXIS 167, 2001 WL 83173, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hawes-v-colorado-division-of-insurance-coloctapp-2001.