United States v. Richard L. Rowe

999 F.2d 14, 17 Employee Benefits Cas. (BNA) 1010, 1993 U.S. App. LEXIS 18522, 1993 WL 265131
CourtCourt of Appeals for the First Circuit
DecidedJuly 22, 1993
Docket92-1959
StatusPublished
Cited by14 cases

This text of 999 F.2d 14 (United States v. Richard L. Rowe) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Richard L. Rowe, 999 F.2d 14, 17 Employee Benefits Cas. (BNA) 1010, 1993 U.S. App. LEXIS 18522, 1993 WL 265131 (1st Cir. 1993).

Opinion

BOUDIN, Circuit Judge.

Pursuant to a plea agreement, Richard Rowe pled guilty to numerous criminal charges stemming from his role in á fraudulent health insurance scheme whose victims were a number of small businésses and their *16 employees. 1 Rowe developed and administered a multi-employer health insurance plan which offered below-market rates for coverage comparable to that providéd by other insurance companies, and which was falsely represented as being a tax-exempt ERISA plan “approved” by the United States Department of Labor. Rowe and others involved in the scheme mismanaged the operation and converted plan assets and, as a result, many subscribers to the plan were left with unpaid medical bills.

Rowe was sentenced to an aggregate six-year term of imprisonment, to three years of supervised release, and ordered to pay up to $1,903,386 in restitution. He now appeals, challenging the following sentencing calculations: a two-level increase in his base offense level for victim vulnerability, U.S.S.G. § 3A1.1; a two-level increase for obstruction of justice, U.S.S.G. § 3C1.1; and a one-level upward departure for causing the loss of confidence in an important institution, U.S.S.G. § 2F1.1, application note 10(e). We set aside the enhancement for victim vulnerability and otherwise affirm.

Victim Vulnerability. Section 3A1.1 of the Sentencing Guidelines directs the sentencing court to increase a defendant’s base offense level by two levéis:

If the defendant knew or should have known that a victim of the offense was unusually vulnerable due to age, physical or mental condition, or that a victim was otherwise particularly susceptible to the criminal conduct....

The commentary to the guideline states that the adjustment applies “where an unusually vulnerable victim is made a target of criminal activity by the defendant.” U.S.S.G. § 3A1.1, application note 1. The commentary further explains that an adjustment fqr victim vulnerability is warranted where, for example, a defendant fraudulently markets an ineffective cancer cure or targets a handicapped person for robbery, but not where a fraud is aimed at the general public and “one of the victims happened to be senile.” Id.

The government made two arguments in the district court in support of the enhancement. First, it said that small businesses such as those solicited by Rowe are unable to obtain affordable health insurance for their employees, making them particularly susceptible to offers of low-cost health insurance. Second, the government argued that individual employees were rendered vulnerable once they developed medical problems because they then faced the choice of either continuing their payments to Rowe’s plan, despite its nonpayment or delayed payment of their medical bills, or else possibly losing their health insurance. Rowe contends that the district court erred in accepting these arguments as a basis for imposing an enhancement under section 3A1.1. He says that the district court should have required the government to produce evidence that the employers and employees were in fact unusually vulnerable instead of taking the government’s assertions at face value. We agree.

In our view, it may be fair to assume as a matter of reasonable inference that a number of the small businesses'to whom the insurance was sold were motivated by need as well as by the prospect of savings. It is even more likely that those subscribers who were already ill when the plan faltered would be inclined to remain longer with the plan for lack of alternatives. The district court in sentencing matters is not restricted to formal evidence, and the court’s factual inferences, as well as direct findings, are normally set aside only if “clearly erroneous.” See 9 Wright & Miller, Federal Practice and Procedure § 2573, at 689, § 2587 (1971 & 1993 Supp.).

Nevertheless, we think as a matter of interpretation of the guideline, cf. United States v. Sabatino, 943 F.2d 94, 102 (1st Cir.1991), that the enhancement does not apply in this case. In construing this guide *17 line, the circuit courts have been rather quick to reverse enhancements based on the victims’ class membership, without a showing of individual circumstances; and, in addition, the ease law has emphasized the need for “unusual[]” vulnerability and “particularf ]” susceptibility. U.S.S.G. § 3A1.1. 2 . In Wilson, the court reversed the enhancement for one who fraudulently solicited for- “relief’ funds in a town stricken by a tornado, saying:

[I]f we were to adopt the government’s position, virtually every defendant convicted of a crime involving fraudulent solicitation would be subject to an upward adjustment under § 3A1.1. Those who engage in this criminal activity usually target their solicitations at those they think most likely to respond to the requests for money., We do not think, however, that the Sentencing Commission intended on that account to impose an upward adjustment on virtually all defendants convicted of fraudulent solicitation.

913 F.2d at 138.

We think that even if we accept the government’s assumption that small businesses are often limited in their sources for securing insurance, this does not itself show that measure of “unusual” or “peculiar” vulnerability or susceptibility of victims needed to invoke the guideline. Apart from directing his of-, fers to the group “most likely to respond,” Wilson, 913 F.2d at 138, there is nothing in the record to suggest that Rowe focused special attention on precariously placed victims — conduct evincing the “extra measure of criminal depravity which § 3A1.1 intends to more severely punish.” United States v. Moree, 897 F.2d 1329, 1335 (5th Cir.1990).

We do not say that under the guideline special vulnerability may never be derived from class membership; as the commentary states, “marketing] an ineffective cancer cure” would qualify for enhancement. U.S.S.G. § 3A1.1, application note 1. But where there is only an ordinary measure of increased likeliness to respond in the solicited group; and no evidence that the defendant selected individual victims based on special susceptibility, we think the enhancement does not apply. It is hard to articulate a more precise standard where so much turns on degree. The emerging case law will- pick out the pattern.

As for the individual employees who later developed medical' conditions, we agree with the government' that it is probably safe to assume that these individuals hád more than the usual incentive to continue paying their premiums. There may well be among this group some who were especially stricken and unusually vulnerable, just as there may have been some small businesses truly desperate to obtain insurance. Although individuals who became ill after the insurance was sold were hardly a special target of Rowe’s initial solicitations, it may be that their subsequent inability to switch -plans contributed in some manner -to his profits.

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999 F.2d 14, 17 Employee Benefits Cas. (BNA) 1010, 1993 U.S. App. LEXIS 18522, 1993 WL 265131, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-richard-l-rowe-ca1-1993.