In Re Aetna, Inc. Securities Litigation

617 F.3d 272, 2010 U.S. App. LEXIS 17002, 2010 WL 3156560
CourtCourt of Appeals for the Third Circuit
DecidedAugust 11, 2010
Docket09-2970
StatusPublished
Cited by89 cases

This text of 617 F.3d 272 (In Re Aetna, Inc. Securities Litigation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Aetna, Inc. Securities Litigation, 617 F.3d 272, 2010 U.S. App. LEXIS 17002, 2010 WL 3156560 (3d Cir. 2010).

Opinion

OPINION

ROTH, Circuit Judge:

Plaintiff shareholders appeal the District Court’s order dismissing this securities fraud class action under the Private Securities Litigation Reform Act, 15 U.S.C. § 78u-5(c)(1), which contains a safe harbor for forward-looking statements. We find the alleged misrepresentations which form the basis of plaintiffs’ claims are protected by the safe harbor because they are forward-looking and immaterial as a matter of law. We will therefore affirm the order of the District Court.

1. Factual and Procedural Background

Lead plaintiff Varma Mutual Pension Insurance Company seeks to represent a class of investors who purchased securities of Aetna, Inc., between October 27, 2005, and July 27, 2006. The Consolidated Class Action Complaint names as defendants Aetna and four of its officers employed at the time of the alleged fraud: John Rowe, Ronald Williams, Alan Bennett, and Craig Callen. 1 Aetna, a Pennsylvania corporation with operations in multiple states, provides medical insurance and health care benefits to more than 14 million customers.

The complaint alleges a fraudulent scheme wherein defendants misled investors about Aetna’s pricing of insurance policies and then sold shares'of Aetna’s stock before the scheme was revealed to the public. In' particular, plaintiffs claim that defendants falsely characterized Aetna’s pricing of medical insurance premiums as “disciplined,” which, plaintiffs claim, refers to a conservative underwriting practice of setting premiums in a fixed proportion to expected future medical costs. Within the health care industry, this proportion is known as the “medical cost ratio” (MCR). 2 According to plaintiffs, investors rely on MCR as an indicator of profitability.

Plaintiffs claim the fraud began in September 2005, whenAetna allegedly relaxed its underwriting criteria in an effort to underprice competitors and gain market share. Plaintiffs claim that defendants *275 knew this would adversely affect Aetna’s MCR and stock price so that defendants concealed the relaxed underwriting criteria by publicly touting a “disciplined” pricing policy. In February 2006, Rowe, Bennett and Callen sold substantial holdings of Aetna stock on the open market at prices that plaintiffs claim were artificially inflated by the fraud. 3 In April and July 2006, Aetna reported two consecutive quarterly increases in MCR, which plaintiffs attribute to Aetna’s supposedly secret policy of underpricing premiums.

During the class period, the price of Aetna’s stock fell from $52.48 to $33.25. The loss of shareholder equity occurred when the alleged underpricing was revealed by Aetna’s reporting of quarterly MCR data. Plaintiffs claim that defendants’ statements about “disciplined” pricing artificially inflated Aetna’s stock by leading investors to believe that MCR would be lower and that profitability would be higher.

To corroborate their allegations, Plaintiffs cite contemporaneous reports by financial analysts and journalists who speculated that Aetna was boosting its market share by underpricing premiums. Plaintiffs also proffer confidential witness statements by Aetna employees who claim to have implemented the relaxed underwriting criteria. Other confidential witnesses stated that they personally observed the individual defendants’ hands-on managerial style, from which plaintiffs impute actual knowledge that Aetna was underpricing premiums.

A. Defendants’ Statements

The complaint identifies numerous statements which allegedly misled investors; all statements pertain to Aetna’s “disciplined” pricing of medical insurance premiums. We summarize the relevant statements below.

On October 27, 2005, Rowe stated on an analyst conference call, “Regarding pricing, we continue to adhere to a disciplined pricing policy of achieving premium yields that are in line with medical cost trends.” During the same call, Williams stated, “[W]e are pricing very clearly in line with our medical cost trend.... [W]e have a very strong amount of pricing discipline .... What we are doing is making certain that we are pricing appropriately as best we can, to be certain that we’re meeting our shareholder expectations.”

On February 9, 2006, Rowe and Williams participated in another analyst conference call; plaintiffs claim that “Rowe continued to stress Aetna’s ‘disciplined approach to pricing’ while Williams emphasized Aetna’s commitment to ‘profitably grow market share and earnings’ through ‘disciplined pricing’ and noted that ‘[o]ur pricing discipline is unchanged.’” Plaintiffs claim that Rowe and Williams misled investors by publicly touting a “disciplined” pricing policy while secretly underpricing premiums to boost market share.

Plaintiffs claim that in April 2006, when Aetna reported financial results for the first quarter, it concealed the alleged underpricing by falsely attributing an increase in MCR to higher medical expenses:

This increase in the medical cost ratio for the first quarter of 2006 reflects a percentage increase in per member medical costs that outpaced the percent *276 age increase in per member premiums, due to higher medical cost trends for inpatient and outpatient facility and physician services offset by a moderation in medical cost trend for ancillary and pharmacy services.

Aetna Form 10-Q (Apr. 27, 2006). Plaintiffs claim that this disclosure was misleading because the increase in MCR was caused by the underpricing of premiums, not by higher medical expenses.

On April 27, 2006, Williams discussed Aetna’s first quarter results on an analyst conference call and stated, “[W]e continue to adhere to our pricing discipline.” On the same call, Bennett stated, “[W]e expect a quarterly pattern to reflect a slightly higher MCR in the second quarter compared to the first-quarter level.” Plaintiffs claim that Williams’ statement was false because Aetna’s pricing was not disciplined and that Bennett’s statement was misleading because he knew underpricing would cause the second quarter MCR to increase substantially, not slightly. On April 28, 2006, Aetna’s stock price fell by more than 20%, causing a market capitalization loss of $5.4 billion.

On May 1, 2006, Williams discussed Aetna’s first quarter MCR performance on an analyst conference call and stated:

In addition, some have questioned our membership growth and said that we must be pricing aggressively....
Of the 82,000 total fully insured additions, 15,000 are Medicaid Advantage, 4,000 were in student health, 14,000 in SRC and 23,000 in individual. That leaves growth of 26,000 members from our main customer markets of national, middle and small group. This is solid and balanced growth that is representative of our dedication to pricing, as well as the broad diversification of markets we are actively pursuing.

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617 F.3d 272, 2010 U.S. App. LEXIS 17002, 2010 WL 3156560, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-aetna-inc-securities-litigation-ca3-2010.