Anthem Health Plans of Maine, Inc. v. Superintendent of Insurance
18 A.3d 824
| Me. | 2011Background
- Anthem challenged the Superintendent of Insurance's 2009 rate decision for individual health policies, arguing a 3% built-in profit margin was required and 0% profit was improper.
- The 2009 rate decision approved a 10.9% average increase with 0% profit for Anthem; Anthem sought a 18.5% increase with 3% profit instead.
- During the pendency, 2010 rates were considered, resulting in an approved 0.5% profit margin for 2010.
- Anthem filed a Rule 80C petition in Superior Court seeking vacatur and remand for a 3% profit; case transferred to the Business and Consumer Docket and affirmed.
- The 2009 rate year had already passed, and Anthem could not recover higher rates from subscribers, raising mootness concerns.
- The Supreme Judicial Court dismissed Anthem’s appeal as moot, noting potential regulatory changes at federal and state levels and the absence of effective relief.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the case is moot. | Anthem argues the controversy remains live for guidance on future rate setting. | The matter is moot because the 2009 rate year has passed and no live relief is available. | Yes, moot; appeal dismissed. |
| Whether any mootness exception applies here. | If the issues are capable of repetition and evading review, the case should proceed. | No applicable exception; regulatory changes undermine recurrence or public concern justifying review. | No exception applies. |
Key Cases Cited
- Smith v. Hannaford Bros. Co., 2008 ME 8 (Me. 2008) (mootness exceptions and limited judicial resources)
- Lewiston Daily Sun v. Sch. Admin. Dist. No. 43, 1999 ME 143 (Me. 1999) (mootness and limited resources)
- Me. Sch. Admin. Dist. No. 37 v. Pineo, 2010 ME 11 (Me. 2010) (fleeting nature of administrative decisions; mootness exceptions)
- Me. Civil Liberties Union v. City of So. Portland, 1999 ME 121 (Me. 1999) (prudential limits on review where issues unlikely to recur)
