Horizon Blue Cross Blue Shield v. State

39 A.3d 228, 425 N.J. Super. 1, 26 N.J. Tax 575, 2012 WL 715965, 2012 N.J. Super. LEXIS 30
CourtNew Jersey Superior Court Appellate Division
DecidedMarch 7, 2012
StatusPublished
Cited by65 cases

This text of 39 A.3d 228 (Horizon Blue Cross Blue Shield v. State) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Horizon Blue Cross Blue Shield v. State, 39 A.3d 228, 425 N.J. Super. 1, 26 N.J. Tax 575, 2012 WL 715965, 2012 N.J. Super. LEXIS 30 (N.J. Ct. App. 2012).

Opinion

The opinion of the court was delivered by

CARCHMAN, P.J.A.D.

Plaintiff Horizon Blue Cross Blue Shield of New Jersey appeals from a judgment of the Tax Court denying its claim for a refund of $145,000,000, concluding that the Premium Tax Cap Statute (PTC), N.J.S.A 54:18A-6, as amended by Assembly Bill A4401 (A4401), L. 2005, c. 128, was not unconstitutional as a denial of due process or equal protection, a bill of attainder, or special legislation. By its terms, A4401 eliminated the tax cap on premiums received by health service corporations (HSCs) when at all relevant times, plaintiff was the only HSC in New Jersey. Among its other claims, plaintiff charged that it was singled out for retaliation after it refused to convert to for-profit status.

We conclude that plaintiffs claims are without merit. A4401 was rationally related to the legislative goals of raising revenue to reduce a budget deficit as well as to eliminate a loophole in the tax law whereby HSCs had a lower effective tax rate than other health insurance carriers. We further conclude that plaintiffs claim of retaliation is likewise without merit, and the trial judge properly denied plaintiffs motion for additional discovery and properly granted defendants’1 motion for summary judgment.

Accordingly, we affirm.

I.

A.

These are the relevant facts adduced from the record. In 1938, [11]*11the Legislature authorized the establishment of HSCs.2 L. 1938, c. 366. HSCs are charitable and benevolent institutions exempt from all state and local taxes other than real estate equipment tax. N.J.S.A 17:48-18. In that same year plaintiffs predecessor, the Hospital Service Plan of New Jersey, was authorized to operate as an HSC, and as we have noted, plaintiff and its predecessor is and has been the only HSC to operate in New Jersey. To qualify as an HSC, a corporation must be “organized, without capital stock and not for profit, for the purpose of (1) establishing, maintaining and operating a nonprofit health service plan and (2) supplying services in connection with (a) the providing of health care or (b) conducting the business of insurance as provided for in this act.” N.J.S.A. 17:48E-le.

HSCs were created to provide hospital and medical care on a pre-paid basis. The distinguishing features between HSCs and insurers are: the nature of the agreements between HSCs and the providers concerning the payments for services; the limitations on the ability of HSCs to rate or reject unhealthy risks; and the nonprofit status of HSCs.

When enacted in 1945, the Corporation Business Tax Act (CBT), N.J.S.A. 54:10A-1 to -41, exempted insurance companies. Rather, those companies were subject to the PTC, which also was enacted in 1945. Prior to its 2005 amendment, the PTC provided:

In the event that the taxable premiums collected ... during any year ending December 31, exceed twelve and one-half percentum (12 1/2) of the total premiums collected by the company and all of its affiliates during the same year on all policies and contracts of insurance whenever and wherever issued, the taxable premiums of such company shall not exceed a sum equal to twelve and one-half percentum (12 1/2%) of such company’s total premiums collected during the same year on all policies and contracts of insurance....

An insurance premium tax (IPT) was utilized because often the net income of insurers was difficult to determine, in part because of the need for reserves to cover future unknown events and the [12]*12year-to-year fluctuation in income. The statutory cap was known as the l/8th Rule. Plaintiff, as an HSC, was initially not subject to the IPT; however, under the Health Maintenance Organizations Act, N.J.S.A. 26:2J-3 to -47, HMOs were subject to the CBT.

In 1985, plaintiff, as an HSC, was required to serve as the insurer of last resort for the state. L. 1985, c. 235. That obligation was modified in 1992 when the Legislature required all health carriers in New Jersey to participate in the individual market. In 1992, plaintiff became subject to the IPT; it remained exempt from the CBT. As part of its fiscal year 2005 budget, the Legislature required HMOs to pay a one-time, one percent assessment on their net written premiums to fund charity care payments to hospitals. In the same budget, the Legislature requested that the State treasurer prepare a report setting forth other sources of funding for charity care and examining the equities of the overall health insurance tax system. One specific request was for the treasurer to examine “loopholes” in the PTC by which “certain insurance entities either pay no tax or less tax than other similar insurance entities,” and to review ways to remedy these “inequities.”

The report issued by the treasurer found that plaintiff, with total premiums of approximately $2,628,000,000 in 2003, paid an effective tax rate of less than 0.1 percent, as opposed to insurers, which paid an effective tax rate of approximately 1.1 percent. Plaintiff was taxed under the IPT l/8th Rule only on premiums from large groups, at the rate of 1.05 percent, unlike insurers, which were also taxed on their individual and small group business.

At the same time, the Legislature was addressing the annual state budget and considering new sources of revenue as there was an estimated $4,000,000,000 budget gap. One measure considered was Assembly Bill A2917, which had been introduced in May 2004, and which proposed granting the Commissioner of Banking and Insurance the authority to allocate certain excess surplus of HSCs to hospitals to pay for charity care. That measure did not pass. [13]*13The bill targeted some $300,000,000 in plaintiffs reserves, but was deemed to be illegal in the opinion of the State treasurer.

A4401, as originally introduced, would have eliminated the l/8th rule for both insurers and HSCs doing business in the state. However, on the day the Assembly Budget Committee met to discuss the bill, it announced that A4401 had been amended to exclude only HSCs, rather than all insurers, from the l/8th Rule. Representatives from several insurance companies appeared and, based on newly amended proposed legislation, withdrew from the committee proceedings, while plaintiffs representative then addressed the committee:

I would like to express our concern with this legislation. The Bill, as introduced, was ... approximately 20 pages that leave an impact across the industry. The one provision that remains is a provision that only impacts Horizon____[Tlhe provision that remains originally impacted a number of other domestic insurers____They were all cut out, so the bill now only impacts Horizon____I’m not quite sure why that is the ease.

A4401 was enacted and signed into law by the Governor on July 2, 20053 It created a subsection b to N.J.S.A 54:18A-6 providing: “On and after January 1, 2005 the provisions of subsection a. of this section shall not apply to a health service corporation established pursuant to the provisions of P.L.1985, c. 236 (C.17:48E-1 et seq.).” It also created a subsection b(2) to N.J.S.A. 54:18A-9 to require that HSCs pay IBT on all premiums as of January 1,2005.

[14]*14Concurrently, the Legislature enacted L. 2005, c. 129, N.J.S.A

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39 A.3d 228, 425 N.J. Super. 1, 26 N.J. Tax 575, 2012 WL 715965, 2012 N.J. Super. LEXIS 30, Counsel Stack Legal Research, https://law.counselstack.com/opinion/horizon-blue-cross-blue-shield-v-state-njsuperctappdiv-2012.