Iowa Individual Health Benefit Reinsurance Association v. State University of Iowa, Iowa State University of Science and Technology, and University of Northern Iowa

CourtSupreme Court of Iowa
DecidedDecember 29, 2023
Docket22-1213
StatusPublished

This text of Iowa Individual Health Benefit Reinsurance Association v. State University of Iowa, Iowa State University of Science and Technology, and University of Northern Iowa (Iowa Individual Health Benefit Reinsurance Association v. State University of Iowa, Iowa State University of Science and Technology, and University of Northern Iowa) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Iowa Individual Health Benefit Reinsurance Association v. State University of Iowa, Iowa State University of Science and Technology, and University of Northern Iowa, (iowa 2023).

Opinion

IN THE SUPREME COURT OF IOWA

No. 22–1213

Submitted September 14, 2023—Filed December 29, 202

IOWA INDIVIDUAL HEALTH BENEFIT REINSURANCE ASSOCIATION,

Appellee,

vs.

STATE UNIVERSITY OF IOWA, IOWA STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY, and UNIVERSITY OF NORTHERN IOWA,

Appellants.

Appeal from the Iowa District Court for Polk County, Heather Lauber,

(summary judgment) and Celene Gogerty (summary judgment and trial), Judges.

Appeal and cross-appeal from a decision of the district court holding that

state universities were members of a statutorily created health benefit

reinsurance association and were required to pay assessments to the

association. AFFIRMED IN PART, REVERSED IN PART, AND REMANDED.

McDonald, J., delivered the opinion of the court, in which all justices

joined. Brenna Bird, Attorney General; Jeffrey S. Thompson, Solicitor General;

Tessa M. Register (argued), Assistant Solicitor General; David Faith (until

withdrawal), Deputy Attorney General; and Jordan Esbrook, Assistant Attorney

General (until withdrawal), for appellants.

Gregory M. Lederer (argued) of Lederer Weston Craig PLC, West Des

Moines, for appellee. 2

MCDONALD, Justice. In 1995, the legislature passed the Individual Health Insurance Market

Reform Act. 1995 Iowa Acts ch. 5, §§ 3–13 (codified at Iowa Code chapter 513C

(1997)). The stated purpose of the Act was “to promote the availability of health

insurance coverage to individuals” and to “improve the overall fairness and

efficiency of the individual health insurance market.” Iowa Code § 513C.2 (2013).

To advance that purpose, the Act created a nonprofit corporation, the Iowa

Individual Health Benefit Reinsurance Association (IIHBRA). Under the law, “[a]ll

persons that provide health benefit plans in this state . . . shall be members of

the association.” Id. § 513C.10(1)(a). All members of IIHBRA are required to

provide IIHBRA with information regarding their earned premium and associated

losses. Id. § 513C.10(3). IIHBRA is statutorily authorized to assess its members

based on that information and to use the assessments to help equalize gains and

losses of its members. Id. §§ 513C.10(4)–(7).

At all times relevant to this litigation, the State University of Iowa (UI), Iowa

State University (ISU), and the University of Northern Iowa (UNI) provided

self-funded health benefit plans to their respective employees. In 2011, IIHBRA

assessed the universities, but the universities refused to pay the assessment. The universities contended that, among other things, they were not members of

IIHBRA subject to assessment and that the statute, as applied to them, violated

article VII, section 1 of the Iowa Constitution, which prohibits the state from

acting as a surety for another.

IIHBRA sued the universities for the unpaid assessments. Following a

bench trial on a stipulated record, IIHBRA was awarded over $4 million as

damages for unpaid assessments. The universities filed this appeal. They

contend the district court erred in concluding they were subject to assessment. They also contend the statutory scheme, as applied to them, violates article VII, 3

section 1 of the Iowa Constitution. IIHBRA filed a cross-appeal. IIHBRA contends

the district court erred in not awarding it additional damages, including late

payment fees and its costs and attorney fees incurred pursuing this litigation.

I.

IIHBRA initiated this suit in November 2013. IIHBRA sought to compel the

universities to provide their earned premium and associated loss information

and sought to collect unpaid assessments for the years 2010 and 2011. On the

universities’ motion, the district court dismissed the case on the ground that

IIHBRA did not have the statutory authority to sue its members. This court

reversed the judgment of the district court and remanded the case for further

proceedings. Iowa Individual Health Benefit Reins. v. State Univ. of Iowa (2016

IIHBRA), 876 N.W.2d 800, 812 (Iowa 2016).

In that decision we provided an overview of the statutory scheme:

The purpose and intent of this chapter is to promote the availability of health insurance coverage to individuals regardless of their health status or claims experience, to prevent abusive rating practices, to require disclosure of rating practices to purchasers, to establish rules regarding the renewal of coverage, to establish limitations on the use of preexisting condition exclusions, to assure fair access to health plans, and to improve the overall fairness and efficiency of the individual health insurance market.

Id. at 802–03 (quoting Iowa Code § 513C.2). We explained in detail how IIHBRA

was formed and how it operated, see id. at 802–04, and we need not repeat that

discussion herein. We held that IIHBRA had “the capacity to sue its members to

compel reporting and to collect assessments owed under chapter 513C.” Id. at

809. We specifically declined, however, to “reach the question whether the

universities [were] members of the IIHBRA, an allegation the universities

accepted as true for purposes of the motion to dismiss,” and we stated the parties “may litigate that issue on remand.” Id. at 804 n.2. We also declined to reach the 4

universities’ constitutional argument arising under article VII, section 1 of the

Iowa Constitution because the universities raised the constitutional argument

for the first time on appeal. Id. at 812. We concluded the “universities may raise

that constitutional issue on remand.” Id.

We remanded the case to the district court in April 2016. On remand,

IIHBRA filed an amended petition. In the amended petition, IIHBRA sought to

compel the universities to provide premium and loss information for the years

2011–2014 and sought to recover any unpaid assessments for those same years.

In response, UNI and ISU filed counterclaims against IIHBRA. Between

1997 and 2010, UNI and ISU provided self-funded health benefit plans to their

employees. Between 1997 and 2010, UNI and ISU acted as members of IIHBRA

and paid assessments to IIHBRA in the amount of $856,546.58 and

$2,421,036.60, respectively. In their counterclaims, UNI and ISU claimed that

they were mistaken to pay the assessments, that IIHBRA lacked the authority to

collect these assessments, that IIHBRA was unjustly enriched by UNI and ISU’s

payments, and that IIHBRA should have to repay the assessments UNI and ISU

voluntarily paid for thirteen years.

UI did not assert a similar counterclaim because it had not paid any assessments between 1997 and 2010. During that time, UI contracted with an

insurer to provide health benefit plans to its employees. UI’s insurer, as the

provider of the health benefit plan, rather than UI, was a member of IIHBRA. In

2010, UI switched to a self-funded health benefit plan. UI took the position that

it was not a member of IIHBRA as defined in section 513C.10(1)(a). It was at this

time that UNI and ISU also claimed they were not members of IIHBRA.

After the filing of the amended petition, answers, and counterclaims, the

case inexplicably languished for years.

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Iowa Individual Health Benefit Reinsurance Association v. State University of Iowa, Iowa State University of Science and Technology, and University of Northern Iowa, Counsel Stack Legal Research, https://law.counselstack.com/opinion/iowa-individual-health-benefit-reinsurance-association-v-state-university-iowa-2023.