S.D. Life & Health Guaranty Assoc. v. S.D. Bankers Benefit Plan Trust

993 N.W.2d 543, 2023 S.D. 31
CourtSouth Dakota Supreme Court
DecidedJuly 5, 2023
Docket29895
StatusPublished

This text of 993 N.W.2d 543 (S.D. Life & Health Guaranty Assoc. v. S.D. Bankers Benefit Plan Trust) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
S.D. Life & Health Guaranty Assoc. v. S.D. Bankers Benefit Plan Trust, 993 N.W.2d 543, 2023 S.D. 31 (S.D. 2023).

Opinion

#29895-r-JMK 2023 S.D. 31

IN THE SUPREME COURT OF THE STATE OF SOUTH DAKOTA

****

SOUTH DAKOTA LIFE & HEALTH GUARANTY ASSOCIATION, Appellee,

v.

SOUTH DAKOTA BANKERS BENEFIT PLAN TRUST, Appellant.

APPEAL FROM THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT HUGHES COUNTY, SOUTH DAKOTA

THE HONORABLE M. BRIDGET MAYER Judge

MICHAEL L. SNYDER CHARLES D. GULLICKSON MITCHELL A. PETERSON of Davenport, Evans, Hurwitz & Smith, LLP Sioux Falls, South Dakota Attorneys for appellee.

TERRA M. LARSON MICHAEL F. SHAW of May, Adam, Gerdes & Thompson, LLP Pierre, South Dakota Attorneys for appellant.

ARGUED AUGUST 31, 2022 OPINION FILED 07/05/23 #29895

KERN, Justice

[¶1.] Until 2019, the South Dakota Bankers Benefit Plan Trust (Trust) was

statutorily required to be a member of the South Dakota Life and Health Guaranty

Association (Association). The Association covers impaired and insolvent insurers’

obligations to their insureds by assessing Association members. In 2017, the

Association assumed liability for an insolvent insurer. The Association established

a five-year assessment schedule to cover the insolvent insurer’s obligations. The

Trust paid three years but protested having to pay the last two because they were

assessed after its membership in the Association ended. The Association denied the

Trust’s protests.

[¶2.] The Trust appealed to the South Dakota Division of Insurance, which

scheduled a hearing in front of the Office of Hearing Examiners (Examiner). The

Examiner determined that the Association had no legal authority to assess the

Trust for the last two assessments because they were authorized and called after

the Trust ended its membership in the Association, and the Employee Retirement

Income Security Act of 1974 (ERISA) preempted the State’s laws requiring trusts to

make payments for assessments.

[¶3.] The Association appealed the Examiner’s decision to the circuit court,

arguing that the Association had legal authority to assess the Trust under State law

and its plan of operation, and ERISA does not preempt any state insurance law

making the Trust liable for the assessments. The circuit court reversed the

Examiner’s order and adopted the Association’s arguments. The Trust now appeals

-1- #29895

from the circuit court’s order requiring the Trust to pay the two assessments along

with prejudgment interest. We reverse.

Facts and Procedural History

[¶4.] Both parties have stipulated to the material facts underlying this

appeal as first recounted in the Examiner’s findings of fact. The Association is an

organization that exists to pay benefits and continue coverages of impaired and

insolvent insurers through assessments that it levies upon its member insurers,

subject to limitations delineated in SDCL chapter 58-29C. South Dakota Bankers

Benefit Plan Trust is a Multiple Employer Welfare Arrangement (MEWA) under

ERISA § 3(40). The Trust is also a self-funded Multiple Employer Trust (MET)

pursuant to SDCL 58-18-88. The Trust provides and maintains an employee

welfare benefit plan for eligible employees of employers that are active members of

the South Dakota Bankers Association. It describes its purpose as “assum[ing] the

financial risk of providing health care benefits to its members by maintaining stop-

loss coverage and adequate reserves to cover any potential losses, as well as making

participating employers assessable in the event of insolvency.”

[¶5.] Before July 1, 2019, the Trust was required under SDCL 58-18-88(6) to

participate in and be a member of the Association. However, on July 1, 2019, a

legislative amendment to SDCL 58-18-88 took effect and eliminated the Trust’s

mandatory membership in the Association. Consequently, the Trust ended its

membership.

[¶6.] At issue in this appeal is whether the Trust is obligated to pay

assessments issued by the Association after the Trust ceased being a member. The

-2- #29895

assessments arose from the insolvency of the insurers Penn Treaty Network

American Company and its subsidiary American Network Insurance Company

(collectively Penn Treaty). Penn Treaty was declared insolvent pursuant to an

order of liquidation entered by the Commonwealth Court of Pennsylvania on March

1, 2017, approximately two years before the Trust ended its membership with the

Association. That same day, the Association accepted liability for and reinsured the

obligations it incurred as a result of Penn Treaty’s liquidation. The Association

decided to spread the obligatory payments, resulting from the liquidation, over five

years rather than requiring its members to pay a one-time lump-sum payment. 1

Had it wished to, the Association asserts that it could have legally assessed a one-

time lump-sum payment in 2017 pursuant to SDCL 58-29C-51(O) and SDCL 58-

29C-52(A). 2

1. The Association authorized yearly assessments for its total obligation. The first of five yearly assessments was authorized in a resolution passed unanimously by the Association’s Board of Directors on April 5, 2017. In part, this resolution stated:

The Board hereby authorizes and approves a Class B assessment of its member insurers having health premiums in South Dakota for the time periods specified herein in the amount of $8,800,000 less the amount of PTNA and ANIC assets allocable to the Association as reasonably determined by the guaranty associations’ Penn Treaty Task Force, its consulting actuaries, LTC Re, and the Executive Director of the Association. The Board notes that the current estimated amount of estate assets allocable to the Association is $3,176,000 and may be subject to change.

2. During oral arguments, the Trust expressed doubt over whether the Association could have assessed a one-time lump-sum payment for the entire obligation amount. The Trust directed this Court to SDCL 58-29C- 52(E)(1)(a), which provides that “the total of all assessments . . . may not in (continued . . .) -3- #29895

[¶7.] To satisfy its obligations over the five years, as planned, the

Association began authorizing yearly assessments to be paid by its members. 3 The

Association authorized and called assessments in 2017, 2018, and 2019. The Trust

paid all three without objection. 4 However, after the Trust ended its membership in

the Association, it protested having to pay the Association’s 2020 assessment, which

was authorized on December 20, 2019, and called on January 22, 2020. On January

28, 2020, in response to the called assessment, the Trust sent the Association a

letter outlining its objection to paying the assessment. The Association responded

in a letter dated February 7, 2020, stating its understanding that the Trust was still

________________________ (. . .

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Bluebook (online)
993 N.W.2d 543, 2023 S.D. 31, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sd-life-health-guaranty-assoc-v-sd-bankers-benefit-plan-trust-sd-2023.