United States v. Sokolow

CourtCourt of Appeals for the Third Circuit
DecidedApril 18, 1996
Docket95-1292,95-1367
StatusUnknown

This text of United States v. Sokolow (United States v. Sokolow) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third 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. Sokolow, (3d Cir. 1996).

Opinion

Opinions of the United 1996 Decisions States Court of Appeals for the Third Circuit

4-18-1996

United States v. Sokolow Precedential or Non-Precedential:

Docket 95-1292,95-1367

Follow this and additional works at: http://digitalcommons.law.villanova.edu/thirdcircuit_1996

Recommended Citation "United States v. Sokolow" (1996). 1996 Decisions. Paper 201. http://digitalcommons.law.villanova.edu/thirdcircuit_1996/201

This decision is brought to you for free and open access by the Opinions of the United States Court of Appeals for the Third Circuit at Villanova University School of Law Digital Repository. It has been accepted for inclusion in 1996 Decisions by an authorized administrator of Villanova University School of Law Digital Repository. For more information, please contact Benjamin.Carlson@law.villanova.edu. UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT

___________

Nos. 95-1292/1367 ___________

UNITED STATES OF AMERICA

vs.

CRAIG B. SOKOLOW,

Appellant

Appeal from the United States District Court for the Eastern District of Pennsylvania (D.C. Crim. No. 93-cr-00394) ___________

Argued January 22, 1996 BEFORE: MANSMANN and SCIRICA, Circuit Judges, 0 and RESTANI, Judge, Court of International Trade.

(Filed April 18, 1996) ___________

John Rogers Carroll Johanna E. Markind Carroll & Carroll 400 Market Street, Suite 850 Philadelphia, PA 19106

Peter Goldberger (Argued) Anna M. Durbin Pamela A. Wilk 50 Rittenhouse Place Ardmore, PA 19003-2276

COUNSEL FOR APPELLANT

Michael R. Stiles United States Attorney Walter S. Batty, Jr.

0 * Honorable Jane A. Restani, Judge, United States Court of International Trade, sitting by designation.

1 Chief of Appeals Joseph T. LaBrum, III (Argued) Maryanne Donaghy Sarah L. Grieb Assistant United States Attorneys 615 Chestnut Street, Suite 1250 Philadelphia, PA 19106-4476

COUNSEL FOR APPELLEE

OPINION OF THE COURT ___________

RESTANI, Judge. Defendant Craig B. Sokolow ("Sokolow") appeals from his

conviction in the United States District Court for the Eastern

District of Pennsylvania following a two month jury trial. On

March 18, 1994, Sokolow was convicted of 107 counts of mail fraud

in violation of 18 U.S.C. § 1341 (1988), 17 counts of money

laundering in violation of 18 U.S.C. § 1957 (1988), and one count

of criminal forfeiture in violation of 18 U.S.C. § 982 (1988).

Following several sentencing hearings, the district judge

sentenced Sokolow to 92 months in prison, to be followed by three

years supervised release, and ordered a $50,000 fine, $6200 in

special assessments, $690,246.34 in restitution, and the

forfeiture of $2.1 million. On appeal, defendant challenges both

his conviction and sentencing. For the reasons stated herein, we

will affirm the conviction, sentencing, and the order of

forfeiture, but remand for reconsideration of the restitution

order.

I. BACKGROUND

2 The events leading to Sokolow's indictment and subsequent

conviction occurred between May 1, 1987 and July 23, 1990.

Sokolow, an attorney and licensed insurance agent, offered health

benefits plans to the public in Pennsylvania and several other

states through a series of corporations that he established and

controlled, but primarily through the National Independent

Business Association, Inc. ("NIBA").0 The plans were marketed to

small business employers, their employees, and their families.

Association Insurance Marketing, Inc. ("AIM"), a corporation

established and controlled by Sokolow, served as the primary

marketing arm of NIBA. Through AIM, Sokolow received commissions

on all premiums received for the sale of NIBA policies.

Prior to May 1987, NIBA members were fully insured by NIBA's

group insurance contract with World Life and Health Insurance

Company ("World Company"). On May 1, 1987, Sokolow replaced

World Life with Independence Blue Cross and Pennsylvania Blue

Shield to administer and process NIBA's health care claims.

Sokolow purchased stop-loss coverage from Blue Cross, whereby

NIBA assumed responsibility for the payment of NIBA members'

medical care claims up to the first $25,000. Blue Cross would

pay any remaining claims in excess of $25,000. The indictment

charged that Sokolow falsely represented to the public that NIBA

0 In 1984, Sokolow began offering his health benefits plan through the Pennsylvania Independent Business Association, Inc. ("PIBA"). NIBA was established as a successor to PIBA in 1987. In 1988, NIBA was succeeded by the American Independent Business Alliance, Inc. ("AIBA"), the association existing until the time of liquidation on February 15, 1990. For convenience, "NIBA" will be used throughout the opinion to refer to the various corporations.

3 was fully-insured by Blue Cross, when, in fact, it was a self-

funded plan, thus defrauding members of their premiums. In

addition, Sokolow allegedly used the Blue Cross logo on marketing

and billing materials, in violation of NIBA's agreement with Blue

Cross, to foster the impression that NIBA was the equivalent of a

Blue Cross fully-insured health benefits plan.

On June 30, 1988, Blue Cross terminated its service plan

with NIBA when Sokolow failed to pay approximately $2 million in

claims for which Blue Cross sought reimbursement. Sokolow then

contracted with another company for higher stop-loss coverage

that required NIBA to pay the first $50,000 of a member's medical

care claims. The indictment alleged that Sokolow again

misrepresented that NIBA was fully insured by the new coverage,

when, in fact, it was self-funded.

After receiving complaints concerning NIBA's claims

administration in late 1988, the Pennsylvania Insurance

Department (the "Department") began to investigate NIBA's

operations. The Department determined that Sokolow had been

operating NIBA as an illegal, unlicensed insurer in Pennsylvania.

Sokolow objected to the Department's inquiries on the basis that

NIBA was a Multi-Employer Welfare Arrangement ("MEWA") that could

file a benefits plan under ERISA and, thus, was not subject to

state regulation.0 The Department disagreed with Sokolow's

0 Although Sokolow represented to the Department that he could have filed the NIBA plan under ERISA, the evidence at trial indicated that Sokolow represented to Virginia and Maryland insurance regulators that the NIBA health plan was, in fact, filed as an ERISA plan with the United States Department of Labor, and, thus, not subject to state regulation. Trial

4 contentions and, on May 2, 1989, suspended NIBA's operations. On

August 31, 1989, the Commonwealth Court of Pennsylvania ruled

that NIBA did not constitute a valid MEWA plan, but was a

commercial enterprise "marketing insurance, without the benefit

of a licensed company status, while purporting to be a valid

ERISA plan, such that state licensing would not be necessary."0

Appellant's App. [hereinafter "App."] at 1193. Consequently,

NIBA was ordered liquidated by the commonwealth court on February

15, 1990.

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