UNITED STATES OF AMERICA v. MICHAEL C. COYLE
NO. 94-2208
UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
Filed August 23, 1995
Argued July 17, 1995
Bеfore: SLOVITER, Chief Judge, SCIRICA, Circuit Judge, and AMBROSE, District Judge
Ainslie & Bronson
Philadelphia, PA 19107
Attorney for Appellant
Robert E. Goldman
Tammy E. Avery (Argued)
Office of United States Attorney
Philadelphia, PA 19106
Attorneys for Appellee
OPINION OF THE COURT
SLOVITER, Chief Judge.
Michael C. Coyle appeals his conviction and sentence on three counts of mail fraud,
I.
Facts and Procedural Background
Michael C. Coyle was the Chief Financial Officer for Health Corporation of America (HCA) from December 1986 through October 1990. HCA, a publicly traded corporation, was in the business of designing, operating and administering medical, dental and vision care plans. It had two subsidiaries: the North American Dental Administrators (NADA) and the Cytex Corporation. Through the assistance of Larry Smith, the principal of Eastern State Casualty Associates, HCA was awarded three contracts by the United Paper Convertors Local 286 Welfare Trust Fund to administer plans providing health care benefits to members of the Paper Convertors Local 286. These are employee benefit plans subject to Title I, as amended, of the Employee Retirement Income Security Act of 1974 (ERISA),
NADA administered the Fund‘s dental plans for members in New Jersey (New Jersey dental plan). Cytex administered the
HCA received monthly premiums from the Fund, which were calculated at a fixed rate per covered employee per month, and HCA made the payments to participating physicians, dentists аnd laboratories. The Pennsylvania dental contract covered about 2700 members while the New Jersey dental contract covered about 300. Under the contracts covering the vision care plan and the New Jersey dental plan, all premium payments not disbursed to participating physicians or laboratories or retained as administrative costs were to be returned to the Fund. There was no similar provision for refund of surplus premiums in the Pennsylvania dental contract although the contracts appear to have functioned similarly in all respects. In particular, there was no refund of any premiums under any of the contracts.
All three contracts contained provisions for assuring disclosure to and record inspection by the Fund, and required HCA to prepare and submit to the Fund annual reports containing complete and accurate accounting of all funds received and disbursements made.
Under ERISA, the Fund was required to file a federal Form 5500, also referred to as the “annual report,” showing financial information of, inter alia, assets and liabilities, income and expenses, including the amounts and purposes of
It was Coyle‘s responsibility to approve all disbursements to service providers on behalf of the Fund and to prepare or to direct the preparation of the financial reports submitted to the Fund. Pursuant to the Fund‘s request, Coyle prepared or supervised the preparation of the Schedules A for 1986, 1987 and 1988 which HCA transmitted to the Fund‘s accountants for inclusion with the federal Forms 5500.
Joseph R. Cusumano, the Chief Executive Officer of HCA until 1990, devised a scheme whereby HCA would conceal the true amount of disbursements and administrative costs, and thereby retain as administrative retention a higher amount than reported to the Fund or than permissible under at least some of the contracts and under New Jersey law. See Dental Plan Organization
When the scheme was uncovered, Coyle was indicted on charges of mail fraud, false statements on documents required by ERISA, and blackmail of Cusumano. By the time of Coyle‘s trial, Cusumano, who had been convicted by a jury in 1990 on a 49-count indictment for defrauding another welfare benefit plan, see United States v. Cusumano, 943 F.2d 305 (3d Cir. 1991), cert. denied, 502 U.S. 1036 (1992), was no longer involved with HCA. In fact, Cusumano testified for the prosecution at Coyle‘s trial in this case. The jury returned a verdict against Coyle on all counts, and Coyle was sentenced to twenty-seven months incarceration with three years supervised release and restitution of $298,330.00.
On appeal, Coyle challenges the sufficiency of the evidence on the mail fraud counts, the propriety of the jury instructions on the false statements and blackmail counts, and
II.
Mail Fraud Conviction
Coyle first argues that the evidence with respect to the mail fraud was insufficient for the jury to find that he engaged in a scheme intended to defraud the Fund or that the mailings of the Schedules A were in furtherance of the fraudulent scheme. When the sufficiency of the evidence at trial is challenged, we must view the evidence in the light most favorable to the government. Glasser v. United States, 315 U.S. 60, 80 (1942). A claim of insufficiency of evidence places a very heavy burden on the appellant. We must affirm the convictions if a rational trier of fact could have found defendant guilty beyond a reasonable doubt, and the verdict is supported by substantial evidence. United States v. Gonzalez, 918 F.2d 1129, 1132 (3d Cir. 1990), cert. denied, 498 U.S. 1107, and cert. denied, 499 U.S. 968, and cert. denied, 499 U.S. 982 (1991).
The mail fraud statute,
Coyle argues that the Fund was not induced to enter into these contracts by fraud. The issue before us is not whether there was fraud in the inducement of the contract, but whether Coyle intentionally engaged in a scheme by which the Fund was defrauded of premiums under the guise of administrative costs. There is sufficient evidence that there was such a scheme, and that Coyle knowingly participated in it.
There was testimony that the amounts reported on the Schedules A which Coyle prepared for the Fund did not accurately reflect the administrative costs retained and the amounts paid to providers. App. at 259-64. Cusumano, who was intimately involved in the scheme, testified that “we reported improperly, with my full knowledge, and kept more dollars for administration than we were supposed to where we were compelled to by the New Jersey contract and kept more dollars in Pennsylvania by not paying the dentists as many dollars as we were supposed to pay them, through various functions, we kept an excessive amount of dollars for administration so that we could keep the company going.” App. at 54.
Cusumano also testified that Coyle was the HCA representative who dealt with the Fund. App. at 56. Moreover, it was Coyle who supervised the preparation of the Schedules A by
HCA accountant Keith Geyer explained that, rather than following standard accounting procedures, Coyle set an amount to report for administrative retention and directed him to subtract that amount plus the amount of Smith‘s commissions from the premiums received to arrive at the amount HCA reported as “claims paid.” Cusumano testified that a fair retention rate for administrative costs would have been at most in the low 20% of the total premiums received, App. at 60, and Alex Johns, a consultant hired by the Fund, testified that 10% was a fair rate. Agent Black produced documents evidencing that HCA‘s actual retention rate (including the amount paid in commissions) was between 30% and 70%. See App. at 251-64.
Coyle argues that the Fund Trustees were not deceived by HCA because they knew that HCA was not accounting to the Fund based on HCA‘s actual payments to the providers but was instead accounting to the Fund on the basis of the “usual, customary and reasonable” value of the providers’ services. Coyle notes that although Johns had advised the Trustees that the Fund might be entitled to a refund from HCA and that it should cancel its contracts with HCA, the Fund did not take that advice. In addition, Coyle argues that the government failed to produce any evidence that the Fund Trustees reviewed the Schedules A.
To the extent that Coyle is arguing the Fund was negligent in ignoring Johns’ advice and in failing to review the Schedules A, we reject the relevance of those allegations, even
Coyle also contends that even if the three Schedules A on which the three mail fraud counts are predicated were intended to conceal HCA‘s true profits from the Fund, the mailings did not further the scheme. The three mailings which formed the basis of
The federal mail fraud statute reaches only the use of the mails when that mailing is part of the execution of a fraud. Schmuck v. United States, 489 U.S. 705, 710 (1989) (citing Kann v. United States, 323 U.S. 88, 95 (1944)). However, the use of the mails need not be an essential element of the scheme. Id. (citing Pereira v. United States, 347 U.S. 1, 8 (1954)). It is sufficient if the mailings are “‘incident to an еssential part of the scheme’ or ‘a step in [the] plot.‘” Id. at 710-11 (quoting Badders v. United States, 240 U.S. 391, 394 (1916)). We have held that the mailings must be sufficiently closely related to the scheme to bring the conduct within the ambit of the mail fraud statute, United States v. Lebovitz, 669 F.2d 894, 896 (3d Cir.), cert. denied, 456 U.S. 929 (1982), and the “scheme‘s completion [must] depend[] in some way on the charged mailings.” United States v. Otto, 742 F.2d 104, 108 (3d Cir. 1984), cert. denied, 469 U.S. 1196 (1985). Even mailings made after the fruits of the scheme have been received may come within the statute when they are “designed to lull the victims into a false sense of security, postpone their ultimate complaint to the authorities, and therefore make the apprehension of the defendants less likely than if no mailings had taken place.” Id. (citation and quotation omitted).
Thus, the mailings were incident to an essential part of the scheme, i.e., concealing HCA‘s true profits. We hold that there was sufficient evidence to sustain Coyle‘s conviction on the three counts of mail fraud.
III.
False Statements Conviction
Counts Four through Eight charged Coyle with making false statements on documents required by ERISA in violation of
Whoever, in any document required by title I of the [ERISA] to be published, or kept as part of the records of any employee welfare benefit plan or employee pension benefit plan, or certified to the administrator of any such plan, [1] makes any false statement or representation of fact, knowing it to be false, or [2] knowingly conceals, covers up, or fails to disclose any fact the disclosure of which is required by such title or is necessary to verify, explain, clarify or check for accuracy and completeness any report required by such title to be published or any information required by such title to be certified, shall be fined under this title, or imprisoned not more than five years, or both.
Coyle does not argue that the government failed to prove that he made false statements knowing them to be false. Instead he argues that the district court erred in “refus[ing] to give the instruction proposed by the defense limiting the jury‘s consideration to only those factual disclosures on the Schedule A forms which were legally compelled.” Appellant‘s Brief at 20. In another, but related contention, Coyle argues that the indictment charged only one of the disjunctive methods of violating
Each of the five false statement counts alleges that Coyle “in a document required to be published by ERISA . . . and required to be kept as part of an employee welfare benefit plan by ERISA” unlawfully and knowingly caused the making of a false statement and representation of fact, and that those acts violated
We discern what appear to be several different threads to Coyle‘s challenge to his false statements conviction, none of which are convincing. We do not understand Coyle to argue that
We rejected Martorano‘s argument that
Although AMMA, unlike HCA, itself provided the medical services, it was HCA that undertook to design, contract for and administer the dental and vision care benefit plans for Local 286‘s Fund, and it was only HCA that maintained the records and was in the position to supply the Fund with the information to which
Coyle also seems to argue that the false statements can be excused because they were made in response to questions on Schedules A that apply only if the contracts were “experience-rated,” and Coyle contends the Fund‘s plans were not because they did not set group premiums by evaluating participant utilization of medical services. This is a red herring. Coyle admits that HCA completed the Schedules A on behalf of the Fund for the years in question as though the contracts were “experience-rated,” and that the figures for claims paid and administrative costs retained in the responses to those questions were false. Coyle‘s
Moreover, the Fund specifically requested that HCA prepare the Schedules A. HCA was obliged by the statute to certify the accuracy of its statements. See
Coyle offers no authority to support the implicit and rather bold proposition that one may make false statements or supply information to the government on required forms, but avoid liаbility if the false information voluntarily supplied may have been more than required. Such an argument would undercut one of the purposes of section 1023 of ERISA, which is to enable the Department of Labor to use the annual reports and the Schedules A to carry out its statutory responsibilities, including the
Coyle‘s other argument, i.e., that the instruction the court did give was erroneous because the indictment charged only one of the two methods of violating
To understand we return to the statute, and the disjunctive crimes set forth in
The district court‘s comprehensive charge correctly delineated both crimes. The court explained that the indictment charged Coyle, inter alia, with “false statements and concealment of facts in relation to documents required by [ERISA].” App. at 422-23 (emphasis added). After explaining that the jury must find that the Fund fell within ERISA, the court stated that the Government must prove beyond a reasonable doubt “that [1] the defendant made or caused the making of a false statement or representation of fact knowing it to be false or [2] knowingly concealed, covered up or failed to disclose any fact, the disclosure of which is necessary to verify, explain, clarify or
Coyle reads the statute to set out the following two methods of violation, i.e., “[t]he first method is by making a false statement of fact (or by covering up or failing to disclose such fact) the disclosure of which fact is required by Title I of ERISA,” Appellant‘s Brief at 19, and the second method is “making a false statement of fact, the disclosure of which is not required by ERISA, but is nonetheless necessary to verify, explain, clarify or check the accuracy or completeness of reports which are required to be filed.” Id. at 20. Coyle misreads the statute.
The court correctly told the jury that to estаblish a violation the government must prove (1) the knowing making of a false statement or representation of fact in an ERISA-required document or (2) the knowing concealment, cover-up, or failure to disclose any fact the disclosure of which is required or is necessary to verify, explain, etc. One violation deals with the making of a false statement, the other with the omitting or concealment of relevant facts. They are separated by an “or” with verbs on either side, i.e., “makes any false statement” or “knowingly conceals . . .” The statute would charge a violation in grammatical terms even if the language describing one or the
Coyle reads the statute to set out the following two methods of violation, i.e., “[t]he first method is by making a false statement of fact (or by covering up or failing to disclose such fact) the disclosure of which fact is required by Title I of ERISA,” Appellant‘s Brief at 19, and the second method is “making a false statement of fact, the disclosure of which is not required by ERISA, but is nonetheless necessary to verify, explain, clarify or check the accuracy or completeness of reports which are required to be filed.” Id. at 20. Coyle misreads the statute.
The court correctly told the jury that to establish a violation the government must prove (1) the knowing making of a false statement or representation of fact in an ERISA-required document or (2) the knowing concealment, cover-up, or failure to disclose any fact the disclosure of which is required or is necessary to verify, explain, etc. One violation deals with the making of a false statement, the other with the omitting or concealment of relevant facts. They are separated by an “or” with verbs on either side, i.e., “makes any false statement” or “knowingly conceals . . .” The statute would charge a violation in grammatical terms even if the language describing one or the
Coyle‘s theory of a variance between the indictment and the charge may stem from the fact that the indictment contained surplus language relating to facts the “disclosure of which is required” by ERISA, added to what we have referred to as the “making false statement” prong of
Coyle is not entitled to a reversal because of the inclusion of the unnecessary “disclosure of which is required” language which, at most, is mere surplusage. It is a long-standing principle of criminal procedure that “[a] part of the indictment unnecessary to and independent of the allegations of the offense proved may normally be treated as ‘a useless averment’ that ‘may bе ignored.‘” United States v. Miller, 471 U.S. 130, 136 (1985) (quoting Ford v. United States, 273 U.S. 593, 602 (1927)). Moreover, if the additional language created any confusion, the explanation following the “that is” language
Because Coyle contends there was a lack of proof that the factual disclosures were required, he frames an argument of a fatal variance between the indictment and the proof. This is a far cry frоm the classic fatal variance case on which Coyle relies. In Stirone v. United States, 361 U.S. 212 (1960), the Court held that the trial evidence and the instruction so broadened the possible bases for conviction that they “destroyed the defendant‘s substantial right to be tried only on charges presented in an indictment returned by a grand jury.” Id. at 217.
Here, the concealed facts were the very facts that were the subject of the false statements, i.e., the accurate facts as to payments to doctors and dentists and HCA‘s administrative costs. Thus, the court‘s instruction did not prejudice Coyle. See United States v. Pelullo, 964 F.2d 193, 216 (3d Cir. 1992). In order to convict Coyle for the crime charged, under both the indictment and the court‘s instructions the jury would have had to find that there were false statements made on the Schedules A. The indictment identified the false statements made in the
We reject Coyle‘s contention that the evidence was insufficient to sustain a conviction or that the district court erred in its instruction.
IV.
Blackmail Conviction
Coyle contends that the district court erred in its jury instruction on the blackmail charge. In so arguing, Coyle notes correctly that the case law on blackmail is “sparse.” Nonetheless, we find no ambiguity in the statutory language relevant here.
The blackmail statute provides:
Whoever, under a threat of informing, or as a consideration for not informing, against any violation of any law of the United States, demands or receives any money оr other valuable thing, shall be fined under this title or imprisoned not more than one year, or both.
Two blackmail letters were identified in the indictment and at trial the government produced evidence of a series of five letters written by Coyle to Cusumano beginning October 18, 1990 and continuing until October 29, 1990. They alternate between vague threats, accusations and demands. App. at 81-96.
In one of these letters, Coyle advised Cusumano that he had “been contacted by the FBI to discuss their investigation of the expense accounts you provided them earlier this year,” stated, “I really don‘t wish to be involved and hope to stonewall the request based on unavailability and a lack of a clear memory at this time,” and then -- in language that leaves no doubt as to its purpose -- stated, “Any attempt to tamper with my severance, deferred compensation or paid time off adjustment pay or any other moneys due me could reflect in my decision. I know you understand.” App. at 87-88.
Coyle engages in semantic sophistry when he argues that because the payment of the benefits was to come from HCA rather than Cusumano, he did not “demand” anything from Cusumano within the meaning of the statute. But the statute does not require that the quid pro quo be a two-party transaction. Coyle‘s offer “to stonewall” the FBI in exchange for receiving Cusumano‘s assistance in securing (or forbearance in interfering with) his severance pay from HCA falls within the language of the statute.
Coyle argues that the district court erred in denying his proposed instruction that he could not be convicted if he was
V.
Calculation of Sentence
Finally, Coyle raises two claims of error in the calculation of his sentеnce.
Coyle claims that the district court erred in enhancing his offense level by two points for abuse of a position of trust pursuant to U.S.S.G. § 3B1.3. A sentencing court must first determine whether the defendant held a position of trust, a purely legal question for which our review is de novo. United States v. Craddock, 993 F.2d 338, 340 (3d Cir. 1993). The second question, whether defendant abused his position in a way that
“[O]ne has been placed in a position of trust when, by virtue of the authority conferred by the employer and the lack of controls imposed on that authority, he is able to commit an offense that is not readily discoverable.” Id. at 342; see also United States v. Lieberman, 971 F.2d 989, 993 (3d Cir. 1992). In both Craddock and Lieberman this court affirmed the two-level enhancement, finding it significant that the defendants’ positions--a Western Union teller and a bank vice president, respectively--provided them with the “freedom to commit a difficult-to-detect wrong.” See Lieberman, 971 F.2d at 993 (citation and quotation omitted).
In this case, Coyle‘s position as Chief Financial Officer of HCA afforded him the authority to conceal HCA‘s true profits and the evidence fully supports the conclusion that the Fund‘s reliance on his accounting expertise allowed him to commit a “difficult-to-detect” wrong. Coyle‘s arguments that the government was obliged to offer proof that he was in some way a fiduciary or that the Trustees were naive are unavailing. The district court‘s imposition of the two-level enhancement was proper.
Coyle also challenges the calculation of fraud loss. Because Coyle is challenging the district court‘s legal interpretation of “fraud loss,” our review is plenary. United States v. Badaracco, 954 F.2d 928, 936 (3d Cir. 1992).
Coyle recognizes that the government‘s figure may accurately mеasure the magnitude of HCA‘s misrepresentation of its actual costs. He argues that it does not measure any loss suffered by the Fund because the Fund could have at most renegotiated lower premium contracts and that the amount of fraud loss should be reduced by the percentage of the loss which derives from the Pennsylvania dental contract because there was no obligation to refund premiums under that contract.
“As in theft cases, [fraud] loss is the value of the money, property, or services unlawfully taken.” U.S.S.G. § 2F1.1, comment. (n.7); see also United States v. Mummert, 34 F.3d 201, 204 (3d Cir. 1994). Our precedents establish that “fraud ‘loss’
In Badaracco, we recognized that certain breaches of fiduciary duty comparable to embezzlement may justify estimating fraud loss by using the “gross gain” alternative, as expressly authorized in Application Note 8. 954 F.2d at 938. In Badaracco, a bank president used his position to approve financing for real estate developments on the condition that the borrowers distribute subcontracting work to companies in which he or members of his family had a financial interest. The district court calculated the fraud loss by adding together the value of the contracts awarded to defendant‘s family companies. Defendant apрealed, claiming that the court should have calculated the loss based on the net profit earned by the family companies rather than the face value of the contracts. Id. at 936.
In affirming this aspect of the sentence, we referred to our opinion in Kopp, where we declined to accept an automatic equation between loss in fraud cases and in theft cases. In
For similаr reasons, we hold that it was appropriate for the district court to adopt “amount taken” or “gross gain” as the measure of fraud loss, i.e., the difference between the amount reported and the amount retained. Inasmuch as this encompasses “gross gain,” we reject Coyle‘s contention that the amount of fraud loss should be reduced by the amount of administrative retention attributable to the Pennsylvania contract even though there was no explicit requirement that surplus funds be returned in that contract. The circumstances of this scheme have a strong resemblance to embezzlement, and HCA‘s position vis-a-vis the Fund had elements strongly comparable to those of Badaracco‘s relationship to the bank. Thus, the district court‘s use of the $298,330 fraud loss figure was in keeping with the applicable guidelines, and the district cоurt‘s decision to increase Coyle‘s base offense level by eight was not error.
VI.
Conclusion
For the foregoing reasons, we will affirm the judgment of conviction and sentence imposed by the district court.
TO THE CLERK:
Please file the foregoing opinion.
_________________________
Chief Judge
A P P E N D I X
Whoever, in any document required by title I of the [ERISA] to be published, or kept as part of the records of any employee welfare benefit plan or employee pension benefit plan, or certified to the administrator of any such plan, [1] makes any false statement or representation of fact, knowing it to be false, or [2] knowingly conceals, covers up, or fails to disclose any fact the disclosure of which is required by such title or is necessary to verify, explain, clarify or check for accuracy and completeness any report required by such title to be published or any information required by such title to be certified, shall be fined under this title or imprisoned not more than five years, or both.
Whoever, in any document required by title I of the [ERISA] to be published, or kept as part of the records of any employee welfare benefit plan or employee pension benefit plan, or certified to the administrator of any such plan, makes any false statement or representation of fact, knowing it to be false, or knowingly conceals, covers up, or fails to disclose any fact [1] the disclosure of which is required by such title or [2] is necessary to verify, explain, clarify or check for accuracy and completeness any report required by such title to be published or any information required by such title to be certified, shall be fined under this title or imprisoned not more than five years, or both.
