When Maine’s Superintendent of Insurance told the state’s largest health insurer that it could not profit in 2009, her decision ended up on appeal before the Maine Supreme Judicial Court, sitting as the Law Court, in Anthem Health Plans of Maine, Inc. v. Superintendent of Insurance. As part of its annual rate approval process, Anthem had requested a 3% profit and risk margin on its individual lines of health insurance in Maine. Superintendent Mila Kofman denied this request under her statutory authority to deny any rate increase proposals that are “excessive, inadequate or unfairly discriminatory.” The Superintendent held that a profit and risk margin for 2009 would be inappropriate because of the “unique economic situation resulting in extreme financial hardship for subscribers” coupled economic situation resulting in extreme financial hardship for subscribers” coupled with the “extreme financial health of the company.” Anthem argued that a 0% profit and risk of margin was “inadequate” within the meaning of title 24-A, section 2736(2) of the Maine Revised Statutes Annotated. By the time the case was argued before the Law Court on November 10, 2010, Anthem’s opportunity for relief had passed. The company lacked any legal authority to retroactively charge its subscribers additional premiums and the issue became one of mootness. The court declined to apply one of the three mootness exceptions, citing the possibility of changes to health care laws at both the federal and state levels as cause for judicial restraint, and dismissed the appeal as moot.
David E. Sorensen,
Anthem Health Plans of Maine, Inc. v. Superintendent of Insurance: Judicial Restraint or Judicial Abdication?,
Me. L. Rev.
Available at: https://digitalcommons.mainelaw.maine.edu/mlr/vol64/iss2/13