Kaplan v. CareFirst, Inc.

614 F. Supp. 2d 587, 2009 U.S. Dist. LEXIS 41461, 2009 WL 1353562
CourtDistrict Court, D. Maryland
DecidedMay 13, 2009
DocketCivil L-08-3512
StatusPublished
Cited by1 cases

This text of 614 F. Supp. 2d 587 (Kaplan v. CareFirst, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kaplan v. CareFirst, Inc., 614 F. Supp. 2d 587, 2009 U.S. Dist. LEXIS 41461, 2009 WL 1353562 (D. Md. 2009).

Opinion

MEMORANDUM

BENSON EVERETT LEGG, Chief Judge.

This action arises from a dispute surrounding post-termination payments allegedly due to Plaintiff Leon Kaplan (“Kaplan”) following his termination from Defendant CareFirst, Inc. (“CareFirst”) *590 on April 30, 2008. Kaplan raises one federal claim pursuant to § 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 (“ERISA”), and related breach of contract causes of action under Maryland statutory and common law. CareFirst now moves to dismiss the Complaint, asserting that this Court should abstain from hearing the case pursuant to the doctrine announced by the Supreme Court in Younger v. Harris. On April 4, 2008, the Court granted Mr. Tyler’s (“Tyler”) unopposed Motion to Intervene, and Tyler joined CareFirst’s Motion to Dismiss. After briefing was complete, the Court heard oral argument on April 16, 2009, and is now prepared to issue a decision. For the reasons stated below, the Court will GRANT the Defendants’ Motion to Dismiss.

I. INTRODUCTION

A. Regulatory Framework

CareFirst is a nonstock corporation, licensed as a “nonprofit health service plan” under Title 14, Subtitle I of the Maryland Insurance Article. As such, CareFirst is exempt from taxation and subject to extensive state regulation aimed at ensuring that CareFirst carries out its nonprofit purpose of “providing] affordable and accessible health insurance.” See Md. Ins. Code §§ 14-101, et seq. Tyler, in his capacity as the Maryland Insurance Commissioner, serves as the head of the Maryland Insurance Administration (“MIA”). The Commissioner is responsible for enforcing the provisions of the Insurance Article and may conduct examinations, investigations, and hearings as necessary to fulfill the purposes of the Article. Md. Ins.Code §§ 2-108 and 2-210. The Commissioner is also authorized to issue administrative orders enforceable by a court of competent jurisdiction. Md. Ins.Code §§ 2-201, 204. Any person aggrieved by a Final Order of the Commissioner may pursue an appeal to the Circuit Court for Baltimore City or, if the person is an individual, to the circuit court of the county where he or she resides. Md. Ins.Code § 2-215.

In 2003, the Maryland General Assembly enacted new provisions of the Insurance Article in order to regulate compensation for officers and employees of nonprofit health service plans. 1 See Md. Ins.Code § 14-139(c) and (d). Section 14-139(c) provides that a “director, trustee, officer, or employee” of a nonprofit health service plan “may only approve or receive from the assets of the corporation fair and reasonable compensation in the form of salary, bonuses, or perquisites for work actually performed for the benefit of the corporation.” The 2003 amendments authorize the Commissioner to issue orders prohibiting any payments that are determined to “exceed[ ] the amount authorized under the approved guidelines.” Md. Ins.Code § 14-139(d)(5).

B. Factual Background

CareFirst hired Kaplan as its Executive Vice President of Operations in December 2000, pursuant to the terms of an employment contract (the “Employment Agreement”). The Employment Agreement contemplated the award of substantial post-termination payments in the event Kaplan was fired without cause and not in *591 connection with a change in control, and covered some amounts payable under plans governed by ERISA. At the time of Kaplan’s termination, CareFirst was in the midst of an administrative proceeding concerning the legality of its proposed post-termination benefits and compensation payable to William Jews (“Jews”), the former CEO of CareFirst. In light of the pending proceedings, CareFirst delayed issuing post-termination payments to Kaplan until the Commissioner had ruled in the Jews matter. During that time, Care-First continued to pay Kaplan’s base salary and limited benefits as they came due.

On July 14, 2008, after conducting a four-day administrative hearing, the Commissioner issued a Final Order and Statement of Reasons, which determined that Jews was entitled to one-half of the proposed termination payments specified in his employment contract. 2 Jews noticed an appeal of the Commissioner’s decision to the Circuit Court for Baltimore County pursuant to § 14 — 139(h)(4). On August 11, 2008, Jews filed a complaint in this Court seeking a declaration that ERISA preempted the MIA’s Final Order and that the Commissioner’s application of § 14-139(c) violated the United States Constitution. On January 19, 2009, we dismissed Jews’ action on grounds that the Younger doctrine required the Court to abstain in deference to the administrative appeal pending in the Circuit Court for Baltimore County. See Jews v. Tyler, No. 08-2075 (D.Md. Jan. 19, 2009) (order granting motion to dismiss).

On September 24, 2008, CareFirst’s Compensation Committee reviewed the post-termination payments due Kaplan pursuant to the terms of the Employment Agreement and expressed concern over a potential violation of § 14-139(c). Consequently, CareFirst notified the Commissioner that Kaplan was seeking a substantial post-termination payment in excess of $6.7 million. See Docket No. 6, Exh. 5. The Commissioner decided to investigate the matter, in order (a) to analyze the terms and conditions of the compensation and severance provisions of Kaplan’s Employment Agreement, and (b) to determine whether the post-termination payment complied with § 14-139(c). See Docket No. 6, Exh. 8. During the investigation, the Commissioner held meetings with Care-First and Kaplan, received correspondence from both parties, and posed questions to counsel.

On January 26, 2009, the CareFirst Compensation Committee determined that a payment of approximately $2.7 million was consistent with the requirements of § 14-139(c). See Docket No. 6, Exh. 7. This amount included a continuation of Kaplan’s base salary for a period of two years, continuation of certain benefits for a period of twelve months, a portion of Kaplan’s target annual incentive plan (“AIP”) for 2008, Kaplan’s outstanding long-term incentive plan (“LTIP”) grants, and his deferred LTIP account. Id. The amounts that were not deemed “fair and reasonable” compensation pursuant to § 14-139(c) included Kaplan’s benefits under CareFirst’s executive retirement plan (“SERP”) and the balance of his AIP for 2008. Id.

On February 5, 2009, the Commissioner issued an Order authorizing CareFirst’s payment to Kaplan of the $2.7 million approved by the Compensation Committee. Docket No. 6, Exh. 8. The Commissioner agreed that CareFirst would violate § 14-139(c) if it were to pay Kaplan the remaining $4 million. Id. On March 6, 2009, Kaplan submitted a request for an administrative hearing challenging the Commis *592 sioner’s Order, as permitted under the Insurance Code and Maryland Regulations. See Md. Ins.Code § 2-210(a)(2)(ii); CO-MAR 31.02.01.03.

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Related

Maryland Insurance Commissioner v. Kaplan
75 A.3d 298 (Court of Appeals of Maryland, 2013)

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Bluebook (online)
614 F. Supp. 2d 587, 2009 U.S. Dist. LEXIS 41461, 2009 WL 1353562, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kaplan-v-carefirst-inc-mdd-2009.