Maine Education Ass'n Benefits Trust v. Cioppa

842 F. Supp. 2d 386, 2012 WL 363903, 2012 U.S. Dist. LEXIS 13061
CourtDistrict Court, D. Maine
DecidedFebruary 3, 2012
DocketNo. 1:11-cv-381-GZS
StatusPublished
Cited by2 cases

This text of 842 F. Supp. 2d 386 (Maine Education Ass'n Benefits Trust v. Cioppa) is published on Counsel Stack Legal Research, covering District Court, D. Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Maine Education Ass'n Benefits Trust v. Cioppa, 842 F. Supp. 2d 386, 2012 WL 363903, 2012 U.S. Dist. LEXIS 13061 (D. Me. 2012).

Opinion

ORDER ON MOTION FOR PRELIMINARY INJUNCTION

GEORGE Z. SINGAL, District Judge.

Before the Court is Plaintiffs’ Motion for Preliminary Injunction (Docket # 13). For the reasons explained herein, the Court DENIES the Motion.

I. LEGAL STANDARD FOR PRELIMINARY INJUNCTION

Plaintiffs, as the moving party, bear the burden of persuasion to show: “(1) the likelihood of success on the merits; (2) the potential for irreparable harm if the injunction is denied; (3) the balance of relevant impositions, i.e., the hardship to the nonmovant if enjoined as contrasted with the hardship to the movant if no injunction issues; and (4) the effect (if any) of the court’s ruling on the public interest.” Iantosca v. Step Plan Servs., Inc., 604 F.3d 24, 29 n. 5 (1st Cir.2010) (citation omitted). Likelihood of success on the merits is the “most important part of the preliminary injunction assessment.” Jean v. Mass. State Police, 492 F.3d 24, 27 (1st Cir.2007). Even if likelihood of success is low, a court might consider injunctive relief based on a very significant showing of irreparable harm. See Ty, Inc. v. Jones Group, Inc., 237 F.3d 891, 895 (7th Cir. 2001) (explaining that the preliminary injunction “process involves engaging in ... the sliding scale approach; the more likely the plaintiff will succeed on the merits, the less the balance of irreparable harms need favor the plaintiffs position”). However, a showing of irreparable harm must be “grounded on something more than conjecture, surmise, or a party’s unsubstantiated fears of what the future may have in store.” Charlesbank Equity Fund II v. Blinds to Go, 370 F.3d 151, 162 (1st Cir. [388]*3882004). Ultimately, the Court must “bear constantly in mind that an ‘[i]njunction is an equitable remedy which should not be lightly indulged in, but used sparingly and only in a clear and plain case.’ ” Saco Def. Sys. Div., Maremont Corp. v. Weinberger, 606 F.Supp. 446, 450 (D.Me.1985) (quoting Plain Dealer Pub. Co. v. Cleveland Typographical Union No. 53, 520 F.2d 1220, 1230 (6th Cir.1975)).

II. PROCEDURAL BACKGROUND

Plaintiff Maine Education Association Benefits Trust (“MEABT” or the “Trust”) originally invoked three counts of its Amended Complaint (Docket # 23) in support of its request for a preliminary injunction: (1) ERISA Preemption (Count I); (2) Unlawful Taking (Count II) and (3) Impairment of Contract (Count IV). In responding to Plaintiffs’ Motion for Preliminary Injunction, Defendant sought, by separate motion, to dismiss the ERISA Preemption claim and the Impairment of Contract claim. By separate order, the Court has determined that these claims, along with Count III, fail to state a claim and are subject to dismissal.

In light of that ruling, only Count II remains as a basis for the Motion for Preliminary Injunction.1 Thus, the Court necessarily limits its consideration of the Motion for Preliminary Injunction to the Unlawful Taking claim. In laying out the factual background, the Court does not repeat all of the factual background contained in its Order on the Motion to Dismiss. Rather, the Court focuses its factual discussion on the supplementary factual record filed in connection with the Motion for Preliminary Injunction to the extent that the record contains facts that are relevant to Count II.

III. FACTUAL BACKGROUND

A. MEABT & Its Health Insurance Plan

MEABT currently covers approximately 67,000 members (school employees and dependents) in an insured plan underwritten by Anthem Blue Cross Blue Shield of Maine (“Anthem”). There are about 180 school districts of varying size which provide insurance through the MEABT program. (DeWeese Decl. (Docket # 15) ¶ 4.) All told, the Trust insures employees in 99 percent of Maine’s school districts. (Diamond Decl. (Docket # 26) ¶ 5.) Eligibility for enrollment in the MEABT health insurance plan is determined by the collective bargaining agreements negotiated between local bargaining units and individual employers, predominantly school districts. The employees of an individual school district are eligible to participate in the MEABT plan if the largest collective bargaining unit in that school district is represented by the Maine Education Association (“MEA”). Once eligibility has been established, the school board and the employees decide together, by a collaborative vote, whether the employees will be offered the MEABT plan. Employees in bargaining units which have negotiated the right to enroll in the MEABT health insurance plan and who wish to become enrolled in the plan enroll directly with the plan’s insurer, Anthem. MEABT has no contracts with any individual educational institution, and those institutions are not considered to be sponsors of the plan. (Burke Decl. (Docket # 18) ¶¶ 14 & 15.) Rather, based on the district’s collective bargaining agreements, different school districts subsidize portions of the cost of health insur[389]*389anee for employees and their dependents at different rates.2 (Burke Decl. ¶ 18.)

Since the MEABT’s inception, the insurance coverage it has made available to the employees of educational institutions has been “community-rated.” That is, all negotiations for insurance coverage have been conducted with the express understanding that it would be priced on the basis of the total utilization costs for the entire group state-wide, without geographic variation or the consideration of individual employers’ demographic mix, prior utilization, or loss experience. (Burke Decl. ¶ 12.) The community-rated design of the MEABT plan has been widely known throughout the State of Maine for many years. (Burke Decl. ¶ 17.)

The decision to provide insurance coverage on a statewide, community-rated basis was a decision made by the Trustees in the exercise of their fiduciary responsibilities under the Trust, with the understanding that members of the statewide group who are actuarially better risks would help subsidize the premiums paid by other members who are actuarially less attractive to insurers. (Burke Decl. ¶ 12.) The community-rated plan design is intended to economically benefit employees of educational institutions in the State of Maine whose work forces are on average older and less healthy than other members of the group, and who reside in regions with higher health care costs. The MEABT regards this benefit as especially important since school employees in these areas — typically Northern and Eastern Maine — earn on average substantially less than their counterparts in Southern Maine. Thus, the design of the plan is intended, in part, to help mitigate that disparity. (Burke Decl. ¶ 13.)

On average, over the last four years, the loss ratio reported by Anthem’s MEABT plan has been 90.8 percent after premium refunds.3 (DeWeese Decl. ¶ 7.) This loss ratio reflects lower than average administrative costs that MEABT accesses because of its current size. (DeWeese Decl.

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842 F. Supp. 2d 386, 2012 WL 363903, 2012 U.S. Dist. LEXIS 13061, Counsel Stack Legal Research, https://law.counselstack.com/opinion/maine-education-assn-benefits-trust-v-cioppa-med-2012.