Lake v. State Health Plan for Tchrs. & State Emps.

CourtSupreme Court of North Carolina
DecidedMarch 11, 2022
Docket436PA13-4
StatusPublished

This text of Lake v. State Health Plan for Tchrs. & State Emps. (Lake v. State Health Plan for Tchrs. & State Emps.) is published on Counsel Stack Legal Research, covering Supreme Court of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lake v. State Health Plan for Tchrs. & State Emps., (N.C. 2022).

Opinion

IN THE SUPREME COURT OF NORTH CAROLINA

2022-NCSC-22

No. 436PA13-4

Filed 11 March 2022

I. BEVERLY LAKE, JOHN B. LEWIS, JR., EVERETTE M. LATTA, PORTER L. MCATEER, ELIZABETH S. MCATEER, ROBERT C. HANES, BLAIR J. CARPENTER, MARILYN L. FUTRELLE, FRANKLIN E. DAVIS, ESTATE OF JAMES D. WILSON, ESTATE OF BENJAMIN E. FOUNTAIN, JR., FAYE IRIS Y. FISHER, STEVE FRED BLANTON, HERBERT W. COOPER, ROBERT C. HAYES, JR., STEPHEN B. JONES, MARCELLUS BUCHANAN, DAVID B. BARNES, BARBARA J. CURRIE, CONNIE SAVELL, ROBERT B. KAISER, JOAN ATWELL, ALICE P. NOBLES, BRUCE B. JARVIS, ROXANNA J. EVANS, JEAN C. NARRON, and all others similarly situated

v. STATE HEALTH PLAN FOR TEACHERS AND STATE EMPLOYEES, a corporation, formerly known as the North Carolina Teachers and State Employees’ Comprehensive Major Medical Plan, TEACHERS’ AND STATE EMPLOYEES’ RETIREMENT SYSTEM OF NORTH CAROLINA, a corporation, BOARD OF TRUSTEES of the TEACHERS’ AND STATE EMPLOYEES’ RETIREMENT SYSTEM OF NORTH CAROLINA, a body politic and corporate, DALE R. FOLWELL, in his official capacity as Treasurer of the State of North Carolina, and the STATE OF NORTH CAROLINA

On discretionary review pursuant to N.C.G.S. § 7A-31 of a unanimous decision

of the Court of Appeals, 264 N.C. App. 174 (2019), reversing and remanding an order

of summary judgment entered on 19 May 2017 by Judge Edwin G. Wilson, Jr. in

Superior Court, Gaston County. Heard in the Supreme Court on 4 October 2021.

Gray, Layton, Kersh, Solomon, Furr & Smith, P.A. by Michael L. Carpenter, Christopher M. Whelchel, Marcus R. Carpenter, and Marshall P. Walker; Tin, Fulton, Walker & Owen, PLLC, by Sam McGee; and The Law Office of James Scott Farrin, by Gary W. Jackson and J. Bryan Boyd, for plaintiff-appellants. LAKE V. STATE HEALTH PLAN

Opinion of the Court

Joshua H. Stein, Attorney General, by Ryan Y. Park, Solicitor General, and Marc Bernstein, Special Deputy Attorney General, for defendant-appellees.

The McGuinness Law Firm, by J. Michael McGuinness; and North Carolina Association of Educators, by Verlyn Chesson Porte, for amicus curiae North Carolina Association of Educators.

The Sumwalt Group, by Vernon Sumwalt; and AARP Foundation, by Ali Naini, for amicus curiae AARP and AARP Foundation.

EARLS, Justice.

¶1 In this case, a class of more than 220,000 former State employees (the Retirees)

sued the State of North Carolina and various officials and agencies (the State) after

the General Assembly enacted a statute that eliminated their option to remain

enrolled in a premium-free preferred provider organization health insurance plan

which allocated eighty percent of the costs of health care services to the insurer and

twenty percent to the insured (the 80/20 PPO Plan). According to the Retirees, the

State had undertaken a contractual—and thus constitutional—obligation to provide

them with the option to remain enrolled in the 80/20 PPO Plan or one of equivalent

value, on a noncontributory basis, for life. In response, the State argues that it never

promised the Retirees the benefit of lifetime enrollment in any particular premium-

free health insurance plan and that, even if it had done so, the noncontributory plan

the State continues to offer provides the Retirees with a benefit of the same or greater

value than the one available to them prior to 2011, when the statute eliminating the

noncontributory 80/20 PPO Plan option was enacted (the 2011 Act). LAKE V. STATE HEALTH PLAN

¶2 The trial court agreed with the Retirees and entered partial summary

judgement in their favor. A unanimous panel of the Court of Appeals reversed and

remanded for entry of summary judgment in favor of the State. See Lake v. State

Health Plan for Tchrs. & State Emps., 264 N.C. App. 174, 189 (2019). On

discretionary review before this Court, we must answer a threshold question that

divided the lower tribunals and which the parties vigorously contest: Did the State

assume a contractual obligation to provide the Retirees the benefit of lifetime

enrollment in the premium-free 80/20 PPO Plan or its substantive equivalent, such

that the Retirees possessed a constitutionally protected vested right?

¶3 This Court has stated and reaffirmed that “[a] public employee has a right to

expect that the retirement rights bargained for in exchange for his loyalty and

continued services, and continually promised him over many years, will not be

removed or diminished.” Bailey v. State, 348 N.C. 130, 141 (1998) (quoting Simpson

v. N.C. Local Gov’t Emps.’ Ret. Sys., 88 N.C. App. 218, 224 (1987), aff’d per curiam,

323 N.C. 362 (1988)). We have recognized that this right protects state employees’

pensions and also encompasses other forms of benefits. See, e.g., N.C. Ass’n of

Educators v. State, 368 N.C. 777 (2016) (NCAE) (holding that teachers possessed a

protected right in their status as “career teachers”). It is understandable that the

Retirees—who, before 2011, were eligible to remain enrolled in the 80/20 PPO Plan

without paying a premium—would perceive being required to pay a premium to LAKE V. STATE HEALTH PLAN

remain enrolled in the 80/20 PPO Plan as diminishing their bargained-for rights. For

the reasons explained below, we agree with the trial court that the Retirees enjoyed

a constitutionally protected vested right in remaining enrolled in the 80/20 PPO Plan

or its substantive equivalent on a noncontributory basis.

¶4 Nonetheless, the Retirees are entitled to receive only the benefit of the bargain

they struck with the State and nothing more. To prevail on their claims arising under

Article I, Section 10 of the United States Constitution (the Contracts Clause), the

Retirees must also demonstrate that the General Assembly “substantially impaired”

their contractual rights when it eliminated the option of enrolling in the premium-

free 80/20 PPO Plan. Bailey, 348 N.C. at 151. And even if the Retirees meet this

burden, the State must be afforded the opportunity to show that the impairment was

“reasonable and necessary to serve an important public purpose” and was thus not in

violation of the Contracts Clause. Id. at 141 (citing U.S. Tr. Co. of N.Y. v. New Jersey

(U.S. Trust), 431 U.S. 1 (1977)).

¶5 These latter two questions—whether a contract has been “substantially

impaired” and whether any such impairment is “reasonable and necessary”—are

particularly fact-intensive. Answering them requires a careful examination of the

plans made available to the Retirees when their respective rights to health insurance

coverage vested and a comparison of those plans to the ones the State currently offers.

Although the 2011 Act plainly requires the Retirees to pay a premium to remain LAKE V. STATE HEALTH PLAN

enrolled in a plan previously offered on a noncontributory basis, many variables

besides a premium—such as the size of a plan member’s deductibles and co-pays, and

the scope of coverage the plan affords—affect the value of a health insurance plan.

Furthermore, in a rapidly changing world of dramatic medical advances and

evolutions in how health care is financed, including changes to the State’s overall

health insurance offerings that provide new options for retired state employees, it

would be unreasonable to expect that the State would maintain the precise terms of

the plans it offered in an entirely different era.

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