Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC

Superior Court of Delaware·Decided July 9, 2024·No. N24C-01-006 PRW CCLD·Published

Opinion

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

)

)

PREMIUM CHOICE INSURANCE ) SERVICES, )

Plaintiff, )

v. ) C.A. No. N24C-01-006 PRW CCLD )

INNOVATIVE FINANCIAL GROUP ) HOLDINGS, LLC, and HUMANA, INC., )

Defendants. )

Submitted: July 3, 2024

Decided: July 9, 2024

MEMORANDUM OPINION AND ORDER

Upon Defendants Innovative Financial Group Holdings, LLC, and Humana Inc.’s Motion to Dismiss, GRANTED, in part, DENIED, in part.

Geoffrey G. Grivner, Esquire, Kody M. Sparks, Esquire, BUCHANAN INGERSOLL & ROONEY PC, Wilmington, Delaware; Benjamin N. Gluck, Esquire, Oliver Rocos, Esquire (argued), Barr Benyamin, Esquire, BIRD MARELLA LLP, Los Angeles, California, Attorneys for Plaintiff Premium Choice Insurance Services.

Alexandra M. Cummings, Esquire, Sara Carnahan, Esquire, MORRIS, NICHOLS, ARSHT & TUNNEL LLP, Wilmington, Delaware; Scott C. Solberg, Esquire, Gregory M. Schweizer, Esquire (argued), Caroline P. Malone, Esquire, EIMER STAHL LLP, Chicago, Illinois, Attorneys for Defendants Innovative Financial Group Holdings, LLC, and Humana Inc.

WALLACE, J.

This dispute arises from the unilateral and allegedly untimely termination of the parties’ contractual relationship. The central issue is, essentially, the extent to which Defendant Innovative Financial Group Holdings, LLC (“IFG”) had the opportunity for a do-over after submitting a plainly deficient termination notice. Regardless of the answer to that question, though, Plaintiff Premium Choice Insurance Services (“Premium”) has viable alternative claims to hold IFG liable. But no matter IFG’s potential liability, Premium’s claim against IFG’s indirect parent, Defendant Humana, Inc., is untenable.

IFG and Premium had a contractual agreement comprised of an interconnected statement of work (the “SOW”) and master services agreement (the “MSA” and together with the SOW, the “Agreement”). Pursuant to the Agreement, Premium could sell Medicare Advantage policies that large insurers offered through IFG—in other words, Premium and IFG are different levels of Medicare middlemen with IFG working more closely with insurers and Premium more closely with consumers. Under the Agreement, IFG retained three powers to end the relationship that are relevant here: (1) IFG could immediately revoke Premium’s authority to perform services on IFG’s behalf if IFG determined Premium’s performance was not “satisfactory”; (2) IFG could terminate the Agreement if Premium didn’t remedy an identified breach within 30 days of receiving notice of the breach; and (3) IFG could terminate the Agreement for convenience 90 days after providing notice to

Premium.

On November 20, 2023, IFG exercised a fourth option. In an email with the subject line “Termination of Agreement,” IFG informed Premium that it had “chosen to move in a new direction and will terminate [its] relationship with Premium Choice, all agents and downlines effective immediately.” The next day, after Premium pointed out the Agreement’s termination provisions, IFG sent a new notice claiming Premium’s performance was unsatisfactory and that Premium had 30 days to prove that it was fully complying with a nonspecific set of regulatory and contractual requirements. In that second notice, IFG confirmed it was immediately revoking Premium’s authority and would terminate the Agreement if Premium did not demonstrate its compliance within 30 days. Premium sued.

Premium brings alternative claims for breach of contract and breach of the implied covenant of good faith and fair dealing. The traditional breach-of-contract claim is premised on the fact that the November 20th email terminated the Agreement in violation of the Agreement’s terms. The implied covenant claim is premised on the fact that the November 21st notice was sent in bad faith as a post- hoc rationalization for the earlier attempt at termination. In the end, those claims won’t be able to stand together because if the November 20th email effectively terminated the Agreement, then the November 21st notice had no actual effect.

Though the parties don’t say as much, this case is about the effect of a

repudiation. On November 20, IFG repudiated the Agreement by unequivocally demonstrating its intent to cease performance. The effect of that act depends on Premium’s response. Premium could have elected to accept the repudiation, thus terminating the Agreement, and allowing Premium to sue for total breach; or Premium could have elected to reject the repudiation and keep the Agreement alive. Whether Premium can now pursue its breach-of-contract claim or its breach of the implied covenant claim turns on which option Premium elected. But that factual issue can’t be resolved at this stage, so the two causes of action survive for now to proceed as alternatives.

As a separate matter, Premium blames Humana for causing IFG to terminate the Agreement after Humana acquired IFG, which is the sole pled basis for its tortious interference claim. But Premium itself acknowledges that IFG breached for “business reasons,” and Premium doesn’t even hint at an illegitimate motive by Humana. It is clear, therefore, that the affiliate privilege applies, and Humana cannot be liable for tortious interference.

Accordingly, the Court GRANTS the Motion as to Count III (tortious interference) but DENIES the Motion as to Counts I and II (breach of contract and breach of the implied covenant).

I. BACKGROUND

A. THE PARTIES Premium is a California corporation with its principal place of business in California.1 IFG is a North Carolina limited liability company with its principal place of business in North Carolina.2 And Humana is a Delaware corporation with its principal place of business in Kentucky.3 B. THE AGREEMENT Premium is an insurance broker that specializes in Medicare Advantage policies.4 Due to its comparatively small size, Premium “works with middleman companies that are agents of national insurance companies,”—like IFG.5 IFG is a licensed agent of insurance companies that offer Medicare Advantage policies.6 In 2021, IFG and Premium entered a contract through which Premium would market and sell Medicare Advantage policies offered by IFG’s principals. 7 Premium was paid per policy sold, which amounted to approximately $1 million of

1 D.I. No. 1 (“Compl.”) ¶ 11.

2 Id. ¶ 12.

3 Id. ¶ 13.

4 Id. ¶ 20.

5 Id. ¶¶ 20-21.

6 Id. ¶ 21.

7 Id. ¶ 22.

income per month.8 In August 2022, Humana—one of IFG’s principals—acquired IFG.9 In October 2023, IFG and Premium re-upped their relationship through the Agreement.10 The Agreement had an initial one-year term.11 The Agreement required Premium to abide by all applicable laws, including specific Medicare- related regulations.12 Three of the Agreement’s provisions are particularly relevant here. First, MSA Section 14(b) governs termination of the Agreement. MSA Section 14(b)(i) provides in pertinent part: “[IFG] may terminate this Agreement and/or any SOW for convenience at any time upon ninety (90) days prior, written notice to [Premium] provided however that no termination for convenience shall become effective within a Blackout Period defined as extending from August 1st through January 1st in any calendar year.” The MSA explains the effect of a termination for convenience during a Blackout Period, but those details are of no moment here.

Next, MSA Section 14(b)(ii) provides in pertinent part: “Either Party will

8 Id. ¶ 23.

9 Id. ¶ 24.

10 Id. ¶ 25; see also D.I. No. 11 (“Mot.”), Ex. A. Exhibit A contains the MSA, the SOW, and the SOW’s four appendices. Hereinafter, citations and references to the Agreement documents in Exhibit A will use only each individual document’s title—i.e., MSA, SOW, App’x 1, App’x 2, App’x 3, and App’x 4. 11 MSA § 14(a).

12 Id. § 3(b); App’x 2 § 1(b); App’x 3 §§ 2(a), 3(q).

have the right to terminate this Agreement and/or any SOW . . . upon the failure by the other Party to remedy a breach of this Agreement within thirty (30) days’ after receiving written notice of such breach from the such Party [sic].”

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Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC, (Del. Ct. App. 2024).

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