STATE FARM GENERAL INSURANCE COMPANY, Plaintiff and Appellant, v. RICARDO LARA, as Insurance Commissioner, etc., Defendant and Appellant; CONSUMER WATCHDOG, Intervenor and Appellant.
D075529
COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE STATE OF CALIFORNIA
Filed 10/29/21
CERTIFIED FOR PUBLICATION
(San Diego Super. Ct. No.
Gibson, Dunn & Crutcher, Theodore J. Boutros, Jr., Kristin A. Linsley, Kahn A. Scolnick; Hogan Lovells, Vanessa O. Wells and Victoria C. Brown for Plaintiff State Farm General Insurance Company.
LevatoLaw and Ronald C. Cohen for California Business Roundtable as Amicus Curiae on behalf of Plaintiff.
California Appellate Law Group, Rex Heinke, Jessica Weisel; Akin Gump Strauss Hauer & Feld and Shawn Hanson for Personal Insurance Federation of California and National Association of Mutual Insurance Companies as Amici Curiae on behalf of Plaintiff.
Xavier Becerra and Rob Bonta, Attorneys General, Diane S. Shaw and Tamar Pachter, Assistant Attorneys General, Molly K. Mosley and Michael Sapoznikow, Deputy Attorneys General, for Defendant Ricardo Lara in his official capacity as Insurance Commissioner of the State of California.
Strumwasser & Woocher, Michael J. Strumwasser, Bryce A. Gee, Caroline C. Chiapetti; Harvey Rosenfield and Pamela Pressley, for Intervenor Consumer Watchdog.
INTRODUCTION
This appeal arises from an application by State Farm General Insurance Company (SFG) to increase its homeowners” insurance rates, under the prior approval system implemented by Proposition 103 (
SFG filed a petition for writ of mandate. The superior court determined
The Commissioner and CW (Appellants) appeal from the judgment and writ of mandate, contending the Commissioner properly interpreted the statute and regulation and had authority to set an earlier effective date and require refunds.2 SFG cross-appeals from the order directing remand to the Commissioner, which it argues is unnecessary in light of the impropriety of the retroactive rate and refund as well as a subsequent rate change for SFG.
We conclude the superior court correctly determined
FACTUAL AND PROCEDURAL BACKGROUND
A. Proposition 103
Proposition 103 was approved by voters in November 1988, and made “numerous fundamental changes in the regulation of automobile and other
With respect to rate setting, Proposition 103 had two main components. First, it imposed a rollback of rates to 20 percent less than their November 1987 levels, for one year after passage (through November 1989). (
Second, Proposition 103 implemented a “prior approval” system, which provided that as of November 1989, “insurance rates subject to this chapter must be approved by the commissioner prior to their use.” (
“No rate shall be approved or remain in effect which is excessive, inadequate, unfairly discriminatory or otherwise in violation of this chapter. In considering whether a rate is excessive, inadequate or unfairly discriminatory, no consideration shall be given to the degree of competition and the commissioner shall consider whether the rate mathematically reflects the insurance company“s investment income.”
The remainder of
Ratemaking (5th ed. 2016) p. 5 [describing income sources as “underwriting profit and investment income“].) Thus, Proposition 103 provides for lower premium rates when investment income is high, and higher rates when that income is low. This is consistent with a “total return” ratemaking approach, in which the premium an insurer can charge is a function of other available income sources, thus avoiding an unreasonable rate of return. That said, Proposition 103 did “not establish a detailed method of processing and deciding rate applications,” and “[m]uch [was] necessarily left to the [Commissioner] . . . .” (Calfarm, supra, 48 Cal.3d at p. 824.) The Commissioner promulgated regulations to implement Proposition 103, which we describe shortly.
Calfarm and 20th Century were early and significant decisions regarding Proposition 103, and specifically the rollback period. In Calfarm, the California Supreme Court “upheld, inter alia, Proposition 103“s provision requiring rate rollbacks.” (20th Century, supra, 8 Cal.4th at p. 240.) A few years later, in 20th Century, the Court upheld the “implementation of Proposition 103“s rate rollback requirement provision by the Insurance Commissioner.” (Ibid.)
B. Regulations
The regulations contain formulas for determining the “maximum permitted earned premium” and “minimum permitted earned premium” (
Projected yield is central to this appeal. This factor initially was based on “imbedded yield,” calculated using “the insurer“s net investment income.” (Register 92, No. 3, p. 728.30; Register 92, Nos. 15-17, p. 728.32; Register 95, Nos. 10-11, p. 728.26.) Effective 2007, the regulation was amended as follows:
” “Projected yield” means the weighted average yield computed using the insurer“s actual portfolio and yields currently available on securities in US capital markets. The weights shall be determined using the insurer“s most recent consolidated statutory annual statement, and shall be computed by dividing the insurer“s assets in each separate asset class . . . .”
Reserves are funds for expected liabilities (Werner and Modlin, at p. 317), while surplus is “available capital backing up premiums.” (20th Century, 8 Cal.4th at pp. 259, 290; see id. at p. 290 [surplus may “simultaneously support the insurance business and earn investment income“].) In the regulations, both are based on industry-wide averages. (
C. The NAIC and Insurer Reporting
The National Association of Insurance Commissioners (NAIC) is an organization of insurance regulators from each state that identifies best practices and promotes uniformity. The NAIC has financial statement forms (or “blanks“), instructions, and an Accounting Practices and Procedures Manual for insurer reporting.5 Relevant here, there is a blank for a combined annual statement for affiliated property/casualty insurers. The instructions provide that “[e]very group of affiliated insurers” that meet conditions described therein shall file a combined annual statement with the NAIC Support and Services Offices. They further indicate the statement“s “primary purpose” is “to provide the NAIC database with combined data for each group of affiliated insurers for use by the NAIC in statistical research and analysis.”
The
D. Background on SFG
SFG is a wholly-owned subsidiary of State Farm Mutual, which also has seven other property/casualty affiliates. These entities are sometimes
described here as “State Farm Group,” and most, including SFG, are domiciled in Illinois.6
SFG took its current form after 1998, when State Farm began the process of converting SFG to a California-specific company for non-automobile lines, to better manage “the unusual risks presented by California“s exposure to catastrophes,” while “segregat[ing] [that] exposure” and avoiding “cross-subsidiz[ation]” of California policyholders. As a result, SFG did not renew non-California homeowners” policies, and started offering coverage to California homeowners previously insured by a different State Farm entity. By the time of the rate hearing here, SFG insured approximately 20 percent of California homeowners. State-specific entities were also developed for Florida and Texas, with State Farm Fire and Casualty Insurance Company issuing policies in the remaining states.
SFG has its own board of directors and officers, with those individuals serving other State Farm entities as well. SFG also takes part in shared services agreements for functions including underwriting, collections, and legal, and does not have its own employees. SFG also receives reinsurance protection, a credit line, and coverage of California Earthquake Authority contributions from State Farm Mutual, and participates in a liquidity pool for affiliates that operates like a money market fund.
As for investments, State Farm has an investment department that has stated investment policies, and which develops a specific investment plan for each entity. The investment department recommended a 100 percent bond portfolio for SFG, based on its business needs and exposures, which was submitted to SFG“s investment committee and then its board. State Farm
Group has a significant stock portfolio, with approximately 40 percent of assets in stocks at the relevant time. Although many large insurers have intercompany pooling agreements, in which premiums and losses are pooled and distributed, SFG has no such arrangement. SFG maintains that it relies on its surplus to meet policyholder needs, and that State Farm Mutual does not have access to it.
SFG files its own annual statement. State Farm Mutual does so as well, and also files a combined annual statement with the NAIC for State Farm Group. The combined statement does not specify which affiliate owns which assets.
E. Rate Application and Hearing
In early 2014, the Commissioner approved a homeowners” insurance rate request submitted by SFG the previous year.7 That application identified a projected yield of 4.94 percent on $128.8 billion in invested assets. In December 2014, SFG submitted another application to increase rates, by 6.9 percent (later amended to 6.4 percent), effective July 15, 2015. SFG used its individual assets, and identified a projected yield of 2.40 percent on $5.7 billion in invested assets. CW intervened in the proceeding, and argued in part that SFG failed to use data required by regulation section 2644.20, thus understating projected yield and resulting in an excessive rate.8 On June 22, 2015, the Commissioner issued a Notice of Hearing, which stated in part:
“[E]ffective July 15, 2015, Applicant must reduce its rates by 6.6 [percent] or any other amount by which they are determined through this proceeding to be excessive. [¶] To the extent Applicant charges excessive rates after July 15, 2015 and before implementing any rate change ordered as a result of this proceeding, Applicant will owe refunds . . . .”
The notice also stated that one of the hearing issues was “if a rate increase is indicated effective July 15, 2015, whether and how much Applicant must pay as refunds and interest . . . between July 15, 2015 and the date Applicant implements the new rate.”
An administrative law judge (ALJ) held a lengthy rate proceeding, with written testimony, cross-examination, and exhibits. Witnesses included SFG executives, representatives from the California Department of Insurance (Department), and experts. We described some of the evidence regarding SFG“s operations above. Relevant here, a Department witness also acknowledged SFG was not in a pooling arrangement, and that if State Farm Mutual lost money in stocks, it “couldn“t just take particular earnings from [SFG“s] bonds” to cover its investment losses. The witness did question whether SFG chose its own investments, and opined it did “not seem reasonable that SFG would choose to invest 100 [percent] of its surplus in low-yielding bonds given all of the protection it has from its parent.” During the hearing, CW and the Department filed motions to strike portions of SFG“s evidence, arguing SFG was improperly seeking to relitigate the regulatory ratemaking formula. The ALJ granted the motions in part, striking evidence “offered for the purpose of using SFG“s individual annual statement to calculate Projected Yield.” The ALJ did allow certain evidence about SFG“s operations because it could be pertinent to a variance issue.
facts about SFG“s operations, including regarding the 1998 reorganization; SFG“s participation in shared services and reinsurance arrangements with its affiliates; and State Farm Mutual“s purported control of SFG.
The Rate Order required SFG to reduce its rates by seven percent (over 13 percent below the applied-for rate). In reaching this result, the Commissioner determined
The Commissioner further determined the rate formula “support[ed] [a] . . . decrease . . . retroactive to July 15, 2015.” He acknowledged SFG contested retroactive reduction, and explained, inter alia, that “maintaining [the initial effective date] to approve new rates retroactively” serves several purposes, including manageability; using an interim rate and refund were
consistent with the
F. Superior Court Proceedings
In November 2016, SFG filed a petition for writ of administrative mandate to the superior court, challenging the use of group data, arguing the rate was
In March 2018, the superior court issued its order, focusing on SFG“s position that the Commissioner “improperly attributed income to [SFG] from its affiliate“s assets,” and its arguments that the new rate was inconsistent with
The superior court began by describing
“insurance company“s” investment income.” The court then described the Commissioner“s reliance on
“Under
section 1861.05 , the rate must mathematically reflect State Farm“s investment income. Regulation section 2644.20 is consistent with the statute in that it requires the yield to be computed using [SFG“s] “actual portfolio.” . . . The Commissioner“s interpretation that the regulation allows him to use [State Farm Mutual]“s group yield instead of [SFG“s] investment income based on [SFG“s] actual portfolio is inconsistent with the statute. [SFG“s] actual portfolio consists almost entirely of bonds. [Citation.] However, the Commissioner used the combined assets for 9 affiliates to come up with a portfolio consisting of about 40 [percent] equities. [Citation.] Consequently, the decision must be set aside.”11
The superior court also rejected the Commissioner“s reliance on other
The court did not reach other issues raised by the parties, including the retroactive rate and refund, rejected SFG“s argument that the ALJ improperly excluded certain evidence, and remanded for further proceedings.
In February 2019, the court entered judgment for SFG and issued a peremptory writ of mandate, requiring the Commissioner to set aside the Rate Order to the extent inconsistent with its March 2018 order and reconsider remanded issues. The Commissioner and CW appealed from the judgment and writ of mandate, and SFG appealed from the ruling directing remand to the Commissioner. The California Business Roundtable, Personal Insurance Federation of California, and National Association of Mutual Insurance Companies applied to file amicus curiae briefs on behalf of SFG. We granted the applications, and the parties filed responsive briefs.
DISCUSSION
I. Appeal From Judgment
Appellants argue
A. Applicable Law
1. Statutory and Regulatory Interpretation
” “When construing a statute, we must “ascertain the intent of the Legislature so as to effectuate the purpose of the law.” ” [Citations.] “In determining such intent, a court must look first to the words of the statute themselves, giving to the language its usual, ordinary import and according significance, if possible, to every word, phrase and sentence in pursuance of the legislative purpose.” [Citation.] At the same time, “we do not consider . . . statutory language in isolation.” [Citation.] Instead, we “examine the entire substance of the statute in order to determine the scope and purpose of the provision, construing its words in context and harmonizing its various parts.” [Citation.] Moreover, we ” “read every statute “with reference to the entire scheme of law of which it is part so that the whole may be harmonized and
“If the statutory language is clear and unambiguous, then we need go no further. [Citation.] If, however, the language is susceptible to more than one reasonable interpretation, then we look to “extrinsic aids, including the ostensible objects to be achieved, the evils to be remedied, the legislative history, public policy, contemporaneous administrative construction, and the statutory scheme of which the statute is a part.” ” (Hoechst Celanese Corp. v. Franchise Tax Bd. (2001) 25 Cal.4th 508, 519.)
“The rules governing interpretation of statutes generally apply also to initiatives and regulations.” (Spanish Speaking Citizens” Foundation, Inc. v. Low (2000) 85 Cal.App.4th 1179, 1214 (Spanish Speaking Citizens); see, e.g., Silva v. Humboldt (2021) 62 Cal.App.5th 928, 934 [if language is not ambiguous, we presume “voters intended the meaning apparent from that language,” and “may not add to the statute or rewrite it to conform to some assumed intent“].) A regulation also “must fit “within the scope of authority conferred” by the Legislature.” (Association of California Ins. Cos. v. Jones (2017) 2 Cal.5th 376, 390 (ASIC); ibid. [“[r]egulations that alter or amend the statute, or enlarge or impair its scope, are invalid“]; see In re Gadlin (2020) 10 Cal.5th 915, 926 [regulations must be ” “consistent and not in conflict with” ” statute]; Assoc. of Cal. Ins. Cos. v. Poizner (2009) 180 Cal.App.4th 1029, 1044 (Poizner) [accord].)
Courts take “ultimate responsibility for the construction of the statute,” while according “great weight and respect to the administrative construction.” (Yamaha Corp. of America v. State Bd. of Equalization (1998) 19 Cal.4th 1, 12 (Yamaha).) We discuss deference in more detail while addressing the parties” arguments post.
2. Standard of Review
The superior court applies independent judgment review to a rate order. (
“Interpretation of a statute or regulation is, of course, an issue of law for the court [citations], as is the question whether a regulation is consistent with the authorizing statute [citation]. Thus, we must review the interpretations of the [agency] and the trial court de novo, and come to our own independent conclusions on these issues.” (Spanish Speaking Citizens, supra, 85 Cal.App.4th at p. 1214; see Mercury, supra, 8 Cal.App.5th at p. 584 [“Engaging in our own independent judicial review, as we must, we will not defer to either the commissioner or the superior court“].)
B. Section 1861.05(a)
1. Statutory Language
We begin with the central statutory interpretation issue here: what it means to “consider whether the rate mathematically reflects the insurance company“s investment income.” (
Appellants argue this language is an “open-ended provision that must be implemented through regulations,” which does not dictate “how investment income is to be projected” and simply requires its consideration. SFG contends the phrase means “the proposed rate must be adjusted by the applicant“s projected investment income to meet the premium need—a straightforward mathematical offset,” and the Commissioner cannot “disregard the mathematical correlation of the rate to the insurance company“s investment income . . . .” We conclude “consider” cannot be read in isolation, and when we view it alongside “mathematically reflects” and “insurance company[]“—as we must—the only reasonable interpretation is that urged by SFG. As we shall explain, the statute requires the Commissioner to use the actual projected investment income of the applicant insurer.
a. “Consider”
“To “consider” means to “think about carefully” or to “take into account.” ” (Plantier v. Ramona Municipal Water Dist. (2019) 7 Cal.5th 372, 386 (Plantier), citing Webster“s 9th New Collegiate Dict. (1987) pp. 279-280; accord, Merriam-Webster“s Collegiate Dict. 11th Ed. (2019) pp. 265-266 (Webster“s Dict.).) Viewed alone, “consider” could imply a range of levels of review, from mere contemplation to full incorporation. But “consider” is not alone here; it is part of a directive that also requires “mathematical[] reflect[ion]” for an “insurance company[].”
The case law supports this interpretation. As noted ante, the California Supreme Court has observed that
Accordingly, we reject the Commissioner“s contention that the only constraint under
We also disagree with CW that “consider whether” implies a ” “yes” or “no” answer,” such that the Commissioner just needs to affirm he considered investment income, and that SFG“s interpretation ignores the word “whether.” Viewed in context, “consider whether” reasonably reflects the Commissioner is reviewing a proposed rate, not setting it. (
b. “Mathematically Reflects”
We turn next to “mathematically reflects.” “Mathematically” means “rigorously exact: precise, certain,” while “reflect” in this context means to “make manifest or apparent” and to “mirror.” (Webster“s Dict., at pp. 765,
1046.) Viewed together and in context, these words mean the rate must correlate to the insurance company‘s actual projected investment income—meaning, in turn, the Commissioner must use data capturing that income in his review. This reading is consistent with the “excessive” and “inadequate” language in
Appellants’ arguments do not compel a different result. First, they contend the term “mathematical” does not preclude generic calculations. They explain some rate review factors already utilize industry-wide data and other non-company specific information, citing the generic calculations used for different asset classes in
Second, CW focuses on the Commissioner‘s role in administering
c. “Insurance Company”
We agree with the superior court that, on its face,
Sections 729, et seq. contains provisions for Commissioner examinations. (
Second, the Commissioner argues the California Supreme Court “upheld an enterprise-wide approach to . . . determining whether rates are confiscatory,” and Appellants note the Court stated the confiscation analysis “may implicate formulaic ratemaking [citation] using data reflecting the condition and performance of a group of regulated firms.” (20th Century, supra, 8 Cal.4th at pp. 258, 293.) The Commissioner contends these methods are “equally acceptable for . . . calculating investment income.” We disagree. For one thing, the reference to an “enterprise-wide approach” was to the “regulated firm,” as distinguished from specific insurance lines. (See Id. at p. 258 [confiscation ” ‘is an enterprise-wide issue, not one to be parsed on a line-by-line basis’ “]; id. at p. 293 [“confiscation is judged with an eye toward the regulated firm as an enterprise“].) More generally, even if enterprise- or group-wide approaches were “equally acceptable” for calculating investment income, this still would not aid Appellants. SFG does not contest the use of group-wide data, per se. Rather, they dispute it can be used for an insurer that does not share income with its group, an issue 20th Century did not address. (See California Building Industry Assn. v. State Water Resources Control Bd. (2018) 4 Cal.5th 1032, 1043 [“cases are not authority for propositions that are not considered“].)
In sum, the text of
2. Statutory Scheme
This interpretation is consistent with the broader statutory scheme. SFG and CW agree, and the Commissioner does not dispute, that the scheme implements a “total return” approach to ratemaking. As noted ante, the total return approach contemplates that if an insurer can earn profit from sources other than premiums—like investments—the premium that it can charge should be reduced. In turn, using the applicant insurer‘s actual investment portfolio in the ratemaking process ensures that the income credited to the insurer for purposes of this offset is actually available to it, thus avoiding arbitrarily high or low rates.
Accordingly, we disagree with CW that imposing requirements on the Commissioner‘s consideration of investment income is inconsistent with the statutory scheme. Specifically, CW argues there is no “right way” to get “actual” numbers, as ratemaking is “inherently prospective” and “necessarily encompasses a normative dimension . . . .” Thus, CW posits, the question is not whether the Commissioner used the “actual” number for SFG‘s future investment income, but whether he “selected from among the alternatives a reasonable way to reflect SFG‘s future investment income . . . .” We disagree. There is no dispute prior approval ratemaking is prospective or that the Commissioner has discretion in administering the process, but he must do so within the limits of the statute. (ASIC, supra, 2 Cal.5th at p. 390; Poizner, supra, 180 Cal.App.4th at p. 1048.) And the statute requires him to use the insurer‘s actual projected investment income—not to “select[] from among . . . [reasonable] alternatives.”14
3. Statutory Purposes
Requiring use of the insurer‘s actual projected investment income is also consistent with the purposes of Proposition 103.
Further, Proposition 103‘s focus on fairness to both consumers and insurers is reflected in
We therefore disagree with Appellants to the extent they suggest the goal of Proposition 103 was only to lower rates and prevent insurers from artificially raising them. Two related points also lack merit. Appellants contend Proposition 103 calls for liberal construal to promote its underlying purposes. (Prop. 103, § 8, subd. (a).) True, but those purposes extend beyond low rates. We also are not persuaded by CW‘s argument that “[f]orcing consumers to pay excessive rates would frustrate the purpose of protecting consumers from arbitrary insurance rates.” The argument assumes SFG‘s interpretation results in an excessive rate, which Appellants have not established.
4. Historical Context
Finally, CW contends the historical context supports Appellants’ position. CW explains it was an open question before Proposition 103 was enacted whether investment income would even be considered in setting rates, and
Historical context can be relevant to statutory interpretation (Spanish Speaking Citizens, supra, 85 Cal.App.4th at p. 1214), but CW does not establish it sheds any light here. Even if CW were correct that the historical materials support flexibility in ratemaking generally,
In turn, we decline to take judicial notice of the reports, as they are not relevant to disposition of this appeal. (Superior Court v. County of Mendocino (1996) 13 Cal.4th 45, 59, fn. 7 [denying judicial notice of irrelevant material].) Additionally, there is no indication the voters were presented with these reports, or even their subject matter. The ballot pamphlet, which is in the record, focused on reducing rates and imposing regulations—not ratemaking methodology. (See 20th Century, supra, 8 Cal.4th at pp. 269-270, fn. 8 [denying notice of flyers “purportedly” distributed to voters during Proposition 103 campaign, because party failed to persuade court that contents may be noticed]; cf. Legislature v. Eu (1991) 54 Cal.3d 492, 504-505 [appropriate to consider ballot pamphlets presented to voters in determining meaning of proposition].)
C. Regulation section 2644.20
We now turn to the heart of this matter: whether the Commissioner‘s interpretation and application of
1. Regulation Language and Application
Accordingly, in applying
The Commissioner‘s arguments to the contrary lack force. In the Rate Order, he found “no conflict between the terms ‘insurer‘s actual portfolio’ and ‘consolidated statutory annual statement’ because Applicant‘s consolidated annual statement is Applicant‘s actual portfolio on a group basis.” CW echoes this argument here. But the regulation calls for the “insurer‘s actual portfolio,” not the “insurer‘s actual portfolio on a group basis.” (
SFG contends, and we agree, that the Commissioner‘s interpretation is further undermined by his use of individual statements for insurers operating outside of groups.16 The Commissioner acknowledges he “has interpreted
assets, but the Commissioner‘s claim that SFG‘s argument “does not apply to most of the industry” is somewhat misleading. The insurers not sharing assets do collectively comprise a large portion of the market.
Appellants’ remaining arguments here lack merit. First, they dispute the relevance of the lack of a pooling arrangement. They argue SFG is controlled by State Farm Mutual, and State Farm investments are under common control. They also argue transactions between entities are permitted subject to
These arguments ignore corporate formalities and amount to speculation. (Cf. Mesler v. Bragg Management Co. (1985) 39 Cal.3d 290, 301 [corporate form “will be disregarded only in narrowly defined circumstances and only when the ends of justice so require“]; Flocco v. State Farm Mut. Auto. Ins. Co. (D.C.App.2000) 752 A.2d 147, 155 [rejecting arguments that “State Farm Mutual and State Farm Fire [were] one and the same” and
challenging “separate corporate existence” of latter; noting status as wholly owned subsidiary did “not provide a sufficient basis for such a finding“].) State Farm assists with investment planning, but it is SFG‘s investment committee that reviews the plan and its board that approves it. Appellants identify no affiliate transactions, “change[s] [to] the corporate structures,” or even “rebalanc[ing],” since SFG‘s reorganization in 1998 to reflect intermingling of assets.
Nor do Appellants accurately characterize affiliate transactions (much less corporate reorganizations, which typically require more than “a little paperwork“). Far from mere reporting requirements, the law imposes guidelines on such transactions and permits disapproval by the Commissioner; similar laws apply in Illinois, where SFG is domiciled. (See Fremont Indemnity Co. v. Fremont General Corp. (2007) 148 Cal.App.4th 97, 126 [
Second, Appellants argue SFG‘s focus on projected yield runs afoul of
bar is “simply to assure . . . the [ALJ] does not entertain the question whether the premises underlying the rate regulations as to rollbacks are sound“].) SFG does not dispute the validity of
Finally, we disagree with the Commissioner that affirming the judgment effectively invalidates
2. Regulatory Purposes
Appellants contend that use of group-level data under
As an initial matter, the purported objectives identified by Appellants rest on a statutory meaning and purpose we have rejected: that
Appellants’ specific contentions also lack force.
First, Appellants contend rate manipulation is a problem, explaining multi-state insurers have the incentive and the means to avoid recognition of investment income, such as by “artificially rais[ing] rates [through] altering corporate structures and investment holdings.” In turn, they contend, using group-level data reduces rate manipulation opportunities, consistent with the purposes of Proposition 103.
These contentions resemble their claims about SFG‘s purported lack of independence, and likewise amount to speculation. In essence, their position appears to be that any insurer group not openly sharing assets is doing so for nefarious purposes. For example, CW cites the Rate Order finding that insurers “may transfer assets between affiliates . . . as State Farm Mutual undoubtedly did when it reconfigured SFG in 1998,” and suggests the goal was “to evade effective rate regulation,” not to manage risk. But
Appellants also do not establish that limiting rate manipulation was a purpose of Proposition 103. They cite its purpose section, which reflects it was meant to ensure fair and reasonable rates, and the Commissioner‘s broad discretion in adopting regulations to administer the initiative. But the initiative provided for the prior approval system, pursuant to which insurance companies can apply for rate changes and the Commissioner can review them—not the kind of open-ended enforcement power the Commissioner appears to be asserting.
As for those insurers that do pool income, their prevalence does not compel a different result. There is no dispute regulations are “not invalid merely because they are to some extent underinclusive or overinclusive,” as the Commissioner asserts, but regulations still must be applied consistent with the authorizing statute. The cases the Commissioner cites are inapposite. (See Warden v. State Bar (1999) 21 Cal.4th 628, 633-634, 649, fn. 13 [rejecting argument that state bar MCLE exemptions violated equal protection, just because classifications might be imperfect]; Agric. Labor Relations Bd. v. Superior Court (1976) 16 Cal.3d 392, 410-411 [zoning plan is not “unconstitutional merely because certain property owners can show that it causes them unnecessary hardship“].)
Third, Appellants contend use of group-level data improves manageability, by eliminating disputes over whether entities should be treated as groups and avoiding the need to examine corporate affairs and transactions. But their preceding arguments reflect they contemplate few, if any, good faith disputes; they simply assume group treatment is always valid, and they have not established this. Their specific contentions also lack merit. They contend the NAIC set an “objective standard” for determining if affiliates are sufficiently related to file a combined statement, thus eliminating disputes about group treatment. The purpose of the NAIC form is to provide “combined data . . . for use by the NAIC in statistical research and analysis.” We are unconvinced that such a standard, objective or otherwise, can be dispositive of whether group assets reflect an “insurance company‘s investment income” under
3. Deference to Commissioner
Appellants further contend we should also accept the Commissioner‘s interpretation and application of
a. Applicable Law
Additional legal background is helpful. There are two categories of administrative rules, quasi-legislative and interpretive. (Yamaha, supra, 19 Cal.4th at p. 10.) A quasi-legislative rule “represents an authentic form of substantive lawmaking,” in which the “agency has been delegated the Legislature‘s lawmaking power” and the scope of judicial review is narrow. (Ibid; Id. at pp. 10-11 [requiring quasi-legislative rules to come within designated authority, and be “reasonably necessary” to implement the
statutory purpose]; see ASIC, supra, 2 Cal.5th at pp. 396-397.) An interpretive rule “represents the agency‘s view of the statute‘s legal meaning and effect,” and “commands a commensurably lesser degree of judicial deference.” (Yamaha, at p. 11; ASIC, at p. 397 [court “must also consider whether the administrative interpretation is a proper construction of the statute“].)
There are “two broad categories of factors relevant to a court‘s assessment of the weight due an agency‘s interpretation: those ‘indicating that the agency has a comparative interpretive advantage over the courts,’ and those ‘indicating that the interpretation in question is probably correct.’ ” (Yamaha, supra, 19 Cal.4th at p. 12; see ASIC, supra, 2 Cal.5th at p. 390.) “In the first category are factors that ‘assume the agency has expertise and technical knowledge, especially where the legal text to be interpreted is technical, obscure, complex, open-ended, or entwined with issues of fact, policy, and discretion. A court is more likely to defer to an agency‘s interpretation of its own regulation than to its interpretation of a statute, since the agency is likely to be intimately familiar with regulations it authored and sensitive to the practical implications of one interpretation over another.’ ” (Yamaha, supra, 19 Cal.4th at p. 12.)
The “second group of factors . . . includes indications of careful consideration by senior agency officials . . . , evidence that the agency ‘has
b. Analysis
As an initial matter, Appellants contend
Turning to the factors impacting deference to agency interpretations, we begin first with agency expertise and knowledge. Although there is no dispute regarding the Commissioner‘s expertise here, it is not dispositive. Quackenbush is instructive. There, the Court of Appeal declined to defer to the Commissioner‘s regulatory interpretation in affirming a mixed judgment that effectively precluded a rollback year refund. (Quackenbush, supra, 77 Cal.App.4th at pp. 69, 71-72; ibid. [addressing treatment of loss adjustment expenses under
Second, the Commissioner emphasizes
Appellants identify nothing in the 2007 regulation revision process reflecting careful consideration of the disputed “consolidated statutory annual statement” language. Indeed, neither the Notice of Proposed Rulemaking nor Final Statement of Reasons discuss this language specifically, even though they do generally address changes to projected yield, including the use of the insurer‘s actual portfolio. And when a public commentator suggested consolidated statement data might be inappropriate in certain situations, the Commissioner simply referred the commentator to “other comments in this rulemaking file regarding use of combined data“—none of which addressed consolidated statements.20 For analogous reasons, we agree with SFG that the Commissioner‘s effective disregard for the “actual portfolio” language in his regulatory interpretation arguments likewise does not “reflect the type of ‘thoroughness . . .’ and ‘validity of . . . reasoning’ that supports judicial deference.” (Yamaha, supra, 19 Cal.4th at p. 14.)
PacifiCare Life & Health Ins. Co. v. Jones (2018) 27 Cal.App.5th 391, cited by the Commissioner, does not aid Appellants. In rejecting a facial challenge to a regulation under the Unfair Insurance Practices Act, the court there noted the Commissioner engaged in a formal rulemaking process and this “careful consideration,” along with his expertise, supported deference. (Id. at p. 417.) The present case involves application of a regulation, and there is no indication of careful consideration of the language at issue. (Cf. Spanish Speaking Citizens, supra, 85 Cal.App.4th at pp. 1186, 1195, 1198 [regulations regarding automobile insurance rating factors were “adopted after years of study and debate,” including appointment of an “actuarial advisory committee” and release of an 18-month impact analysis].)
Third, Appellants argue the Commissioner has consistently applied the current version of the regulation since its adoption in 2007, and SFG has identified no evidence of inconsistent treatment. The Commissioner also notes he is required to use a “single, consistent methodology,” and maintains he does so. (See
Moreover, our starting point is not 2007. The Commissioner first issued regulations under Proposition 103 in 1991, and between a minor revision the following year and 2007, projected yield was calculated using “imbedded yield” based on the insurer‘s “net investment income“—with no reference to a “consolidated statutory annual statement.” (Register 92, No. 3, p. 728.30; Register 92, Nos. 15-17, p. 728.32].)22 The 2007 rulemaking file generally addressed reasons for the change, as noted above. But the point is there was a change, which not only underscores the lack of consistent application, but also reflects a lack of contemporaneous enactment. (Cf. Yamaha, supra, 19 Cal.4th at p. 13 [factors for deference include whether interpretation was “contemporaneous with legislative enactment of the statute being interpreted“].) Accordingly, we also reject any reliance by Appellants here
D. Conclusion
Having determined the Commissioner‘s interpretation and application of
II. Retroactive Rate and Refund, and Cross-Appeal From Remand Order
We now turn to the errors urged by SFG: that the Commissioner erred in ordering a retroactive rate and refund, and that the superior court erred in ordering a remand.24 We agree with SFG in both respects.
A. Commissioner‘s Retroactive Rate Order
SFG argues that under the prior approval system, it was required to pay the approved rate pending approval of a new one, thus precluding retroactive rates and related refunds. Appellants maintain the rate was not impermissibly retroactive, and the refund was proper regardless. We conclude the statutory prior approval requirement is prospective in operation and inconsistent with retroactive rates and refunds.
1. Applicable Law
“[S]tatutes ordinarily are interpreted as operating prospectively in the absence of a clear indication of a contrary legislative intent.” (Quarry v. Doe I (2012) 53 Cal.4th 945, 955 (Quarry).)
“In
“[T]he presumption that legislation operates prospectively rather than retroactively is rooted in constitutional principles.” (Myers v. Philip Morris Companies, Inc. (2002) 28 Cal.4th 828, 841; see McClung v. Employment Development Dept. (2004) 34 Cal.4th 467, 475 [“[e]lementary considerations of fairness dictate that individuals should have an opportunity to know what the law is and to conform their conduct accordingly“].)
“Ambiguous statutory language will not suffice to dispel the presumption against retroactivity; rather ’ “a statute that is ambiguous with respect to retroactive application is construed . . . to be unambiguously prospective.” ’ ” (Quarry, supra, 53 Cal.4th at p. 955.)
2. Analysis
a. Statutory Language
The prior approval requirement is set forth in
We disagree with Appellants that language in
Construed in context, this language simply reflects that when a rate
b. Statutory Scheme
Prospective application of prior approved rates also is consistent with the distinction between the prior approval period and the rollback year, which did incorporate retroactive refunds.
As the California Supreme Court explained in 20th Century, the rollback year was a “temporary regulatory regime . . . evidently designed to allow the setting up of a permanent regulatory regime to follow . . . .” (20th Century, supra, 8 Cal.4th at p. 243.) The Court emphasized, “So far as the ratemaking formula functions in the rate rollback, . . . it has nothing to do with the ‘prior approval’ system. . . . That the two regimes are distinct is apparent in Proposition 103. It remains such in our construction of the initiative in Calfarm.” (20th Century, at pp. 288-289.)
During the rollback year, an insurer who felt the 20 percent rollback was confiscatory could apply for higher rates and start charging them, but if the Commissioner later determined they were excessive, the insurer “had to refund with interest any premiums collected in excess of the rates ultimately approved.” (Calfarm, supra, 48 Cal.3d at p. 815; id. at p. 825 [elaborating that if application were filed during rollback, insurer could “begin charging that higher rate pending approval,” while after that period, rates “must be approved by the commissioner prior to their use, but . . . the commissioner can approve an interim rate pending her final decision“; “[i]f the commissioner finds the initiative‘s rate, or some other rate less than the insurer charged, is fair and reasonable, the insurer must refund excess premiums . . . with interest“].) The rollback regulations addressed refunds. (
We reject Appellants’ suggestion that Calfarm and 20th Century support the use of refunds generally under Proposition 103. Those decisions concerned the substantive rate rollback, and the rollback regulations, respectively, and the Court took care to distinguish the prior approval period as a separate regime. (Calfarm, supra, 48 Cal.3d at p. 825 and fn. 17; 20th Century, supra, 8 Cal.4th at pp. 242-243, 288-289.) Mercury, cited by Appellants, did not involve refunds and is otherwise distinguishable. (Mercury, supra, 8 Cal.App.5th at p. 589 [rejecting attempt to limit 20th Century‘s “deep financial hardship” test for confiscation to rollback period, noting “[n]othing in the Supreme Court‘s extended discussion . . . suggests that it would apply only to a retrospective price control rather than a prospective price control“].)
c. Case Law from Other Contexts
We agree with SFG that authority from other contexts supports the conclusion that the retroactive rate and refund were impermissible. For example, in Bowen v. Georgetown University Hospital (1988) 488 U.S. 204 (Bowen), the United States Supreme Court held the Secretary of Health and Human Services had no authority to issue retroactive Medicare cost-limit rules that required providers to return sums. (Id. at pp. 208-216.) The Court stated that “[e]ven where some substantial justification for retroactive rulemaking is presented, courts should be reluctant to find such authority absent an express statutory grant.” (Id. at pp. 208-209.) A rule against retroactive ratemaking in California‘s public utility setting similarly “prevents [a regulator] from forcing a [regulated entity] to disgorge the proceeds of rates that have been finally approved and collected.” (The Ponderosa Telephone Co. v. Public Utilities Com. (2011) 197 Cal.App.4th 48, 62; see, e.g., Pacific Tel. & Tel. Co. v. Public Utilities Com. (1965) 62 Cal.2d 634, 649-650 [accord; striking refund order issued at end of rate investigation, for period of investigation].) We recognize these are different statutory and regulatory schemes, but other statutes can be instructive and these serve that role here. (See, e.g., Calfarm, supra, 48 Cal.3d at p. 825, fn. 16 [noting “analogous area of public utility regulation“].)
SFG also directs us to cases addressing the exclusivity of California rate approval proceedings, in which the courts reasoned, in part, that insurers are
d. Appellants’ Remaining Arguments
Appellants’ remaining arguments lack merit. First, we reject their reliance on the California Supreme Court‘s observation in Calfarm that the Commissioner‘s “power to grant interim relief . . . may fairly be implied” from the “remain in effect” language. (Calfarm, supra, 48 Cal.3d at p. 825.) The Court was addressing the rollback period, and specifically insurers’ ability to obtain relief for potentially confiscatory rates. (Ibid.) The “remain in effect” language could reasonably have a different interpretation in that context, where there were rates in use that had not yet been approved. Although the Court did allude to the possibility of interim relief in the prior approval period, it did so in terms of “interim rates” (Ibid.)—implying the use of a temporary rate, not, as we discuss post, mere notice that a refund might be imposed in some amount (much less the “immediate[] reduct[ion]” the Commissioner now claims he could impose).
Second, Appellants contend the refund actually was prospective, citing a discussion from 20th Century. That discussion, like the rest of the case, concerns the rollback period, and does not apply here. We explain. The Court observed that “rate regulations as to rollbacks may properly be considered prospective,” stating, in part: “The ordering of a refund of rates is ‘akin to a reduction in rates,’ when, as here, the rates in question were charged ‘pending a determination of [their] legality . . . .’ [Citations.] It follows that the ordering of a refund of rates is itself prospective.” (20th Century, supra, 8 Cal.4th at 281, italics added.) In the prior approval system, rates are not “pending a determination of . . . legality.” They have been approved.
The Court then noted that even if the rollback regulations “might be deemed ‘retroactive,’ they cannot be deemed impermissibly so“—contrasting
Third, Appellants cite the Werner ratemaking treatise to contend ratemaking is prospective when, as here, it is based on “past experience to estimate the premium needed for a prospective policy period,” whereas it would be retrospective if based on “actual experience during the policy period.” But the treatise focuses on ratemaking methodology generally, not retroactivity under California law. And, regardless, both prospective and retroactive ratemaking use data; the difference is what the data is used for. (See 20th Century, supra, 8 Cal.4th at p. 252 [“Because the ‘prior approval’ system concerns rates for the future, its orientation is necessarily prospective. Hence, for review of rates thereunder, the ratemaking formula relies much on projections. [Citations.] [¶] By contrast, because the rate rollback concerns rates for a period that has passed, its orientation is retrospective. Hence, for review of rates thereunder, the ratemaking formula relies much on actual historical data.“].) To the extent the Commissioner used past data to impose a rate for a “period that has passed“—as he did here—the resulting order is retroactive. (Ibid.)
Finally, Appellants contend the Notice of Hearing, issued June 22, 2015, “provisionally advis[ed] [SFG] that its existing rates were excessive, and that it could be required to issue refunds on excess premiums collected after July 15, 2015.” The Commissioner contends, in turn, that SFG had options besides
The cases cited by the Commissioner are of no assistance. In In re Marriage of Economou (1990) 224 Cal.App.3d 1466, the Court of Appeal affirmed an order requiring the husband to pay retroactive support, based on his fraudulent conduct. (Id. at p. 1477.) The court explained child support can be retroactive and spousal support is subject to modification, citing applicable statutes, and the family court had given notice retroactivity might be considered. (Id. at pp. 1477-1478.) Here, there is no legal basis for a retroactive refund in the first place. Pitts v. Perluss (1962) 58 Cal.2d 824 is likewise distinguishable. (Id. at pp. 827-828, 835 [regulation for unemployment compensation disability insurance not retroactive simply because it impacted existing plans; expressly noting no penalty “attaches to any past act” and companies just had to “discontinue . . . noncomplying plans or establish complying ones“].)26
B. Superior Court‘s Remand Order
In its cross-appeal, SFG argues the superior court erred by remanding to the Commissioner, as there is nothing left for him to determine. We agree.
1. Additional Facts
In March 2018, the superior court entered its minute order setting aside the rate determination and remanding for further proceedings, including on the retroactive rate and refund issue. In May 2018, the Commissioner approved SFG‘s application for a new rate, set to take effect on July 15, 2018. That July, SFG moved for reconsideration of the remand order under
2. Analysis
As a preliminary matter, it is unnecessary to resolve SFG‘s argument that the superior court erred by denying its reconsideration motion. CW states the issue is irrelevant (while maintaining the court did not err), explaining remand can only be denied if the Commissioner lacked authority to set a retroactive rate. The Commissioner does not substantively address the reconsideration motion at all. We conclude the need for remand, if any, is independent of the reconsideration motion, and the record reflects no such need exists here.
The propriety of administrative proceedings on remand turns on whether anything remains for determination by the agency. (See Tripp v. Swoap (1976) 17 Cal.3d 671, 677 [no need for remand regarding disability benefits, as there “was no issue remaining on which the trial court could invade the director‘s discretion“], overruled on other grounds in Frink v. Prod (1982) 31 Cal.3d 166, 180; Ross Gen. Hosp., Inc. v. Lackner (1978) 83 Cal.App.3d 346, 354 [concluding hospital facility regulation was invalid as applied and directing department to issue certificate of exemption to hospital; when administrative record “requires as a matter of law that a particular determination be made, the court may order that the agency carry out its legal obligation“].)27
Here, remand is unnecessary because no further rate determination is needed. There are three time periods: (i) from July 15, 2015, the rate commencement date under the Rate Order, through December 8, 2016, the date the Rate Order became effective; (ii) between December 8, 2016 and July 15, 2018, the date SFG‘s newly approved rate took effect, during which SFG charged rates consistent with the Rate Order; and (iii) after July 15, 2018. For the first period, we concluded above that the retroactive rate and related refund were invalid, obviating the need for recalculation. For the second period, SFG represents it cannot recover amounts lost due to applying
Appellants’ arguments for remand are not persuasive. First, they argue remand is needed so the Commissioner can determine a rate and refund amount for the first period. This argument falls with our determination that the retroactive rate and refund were impermissible. Second, the Commissioner cites
DISPOSITION
The judgment is affirmed as to the superior court‘s ruling that the Commissioner‘s rate determination must be set aside. The judgment is reversed to the extent the superior court remanded to the Commissioner for further proceedings. The superior court is directed to enter a new and different judgment: (i) granting SFG‘s petition for writ of administrative mandate; and (ii) directing the Commissioner to set aside the Rate Order in its entirety. SFG shall be awarded its costs on appeal.
HUFFMAN, Acting P. J.
WE CONCUR:
GUERRERO, J.
DO, J.
