## Facts

- Anthem Health Plans of Maine, Inc. sold individual major-medical health insurance policies in Maine and filed 2009 proposed rates seeking an average increase of about 18.5%, including a 3% profit and risk margin.
- Under Maine’s prior-approval rate system, the Superintendent of Insurance reviewed whether proposed rates were excessive, inadequate, or unfairly discriminatory.
- After administrative proceedings, the Superintendent disapproved Anthem’s proposal as excessive and unfairly discriminatory and instead approved an average increase of 10.9% with a 0% projected profit and risk margin (break-even rates) for 2009.
- Anthem sought judicial review, arguing that a 0% margin produced “inadequate” rates under Maine insurance law and violated constitutional protections by denying a fair return.
- The Business and Consumer Docket affirmed the Superintendent’s decision.
- During the appeal, the 2009 rating year ended and later-year rates went into effect; Anthem lacked legal authority to bill subscribers retroactively to recover any claimed shortfall.

## Issues

1. Whether the appeal became moot because the challenged rates applied only to a past rating year and no court order could provide effective financial relief.
2. If not moot, whether the Superintendent could lawfully approve rates designed to allow the insurer to break even (0% profit and risk margin) for the year.
3. Whether any exception to mootness applied, including the “capable of repetition, yet evading review” exception.

## Decision

- The Maine Supreme Judicial Court dismissed the appeal as moot and did not reach the statutory or constitutional merits.
- The court concluded the controversy had lost its vitality because the challenged rating year had passed, new rates were in effect, and a favorable merits ruling could not provide effective financial relief.
- The court declined to apply mootness exceptions, citing the absence of effective relief and the changing legal environment affecting health insurance regulation.
- The court vacated the judgment below to the extent necessary to effectuate dismissal on mootness grounds.

## Legal Principles

- A case is moot when a court decision cannot provide any real or effective relief to the party seeking review.
- Courts generally will not decide abstract questions or issue advisory opinions in private litigation when the dispute is no longer live.
- Mootness exceptions (including “capable of repetition, yet evading review”) are discretionary and may be rejected where the record shows no effective remedy and the legal context is materially changing.

## Conclusion

The court ended the case on mootness grounds because the 2009 rate year had expired and Anthem could not obtain retroactive monetary relief, leaving no justiciable controversy for adjudication of the legality or constitutionality of zero-profit rate approval.


Anthem Health Plans of Me., Inc. v. Superintendent of Ins., 2011 ME 48 (Me. 2011)