Court Opinion

ID: 9755176
Source: CourtListenerOpinion
Date Created: 2023-08-28 20:29:02.263229+00
Date Added: 2024-06-11T07:28:04.266891
License: Public Domain

PATRICIA BRECKENRIDGE,
Judge, concurring in part, dissenting in part.
I concur in section I of the principal opinion, but dissent from section II.
*530This case requires the Court to determine whether the Board of Police Commissioners (Board) has provided health insurance coverage to retired St. Louis police officers as required by section 84.160.8(3), RSMo Supp.2006.1 I agree with the principal opinion and Judge Limbaugh’s dissent that the statute requires the Board to provide the police department’s retirees a health insurance plan without charge. I also agree with the principal opinion’s finding in section I that the actual health insurance plan provided by the Board is insufficient to satisfy the intent of the legislature in enacting section 84.160.8(3).2 But I dissent from section II because I disagree as to the level of coverage that must be provided. Contrary to the holding of the principal opinion in section II, the language of the statute does not require that retired officers receive the same level of coverage as active officers. Nevertheless, the statute requires health insurance coverage greater than that provided by the Board’s plan. Accordingly, I would reverse the judgment of the circuit court and remand.
Discussion
Section 84.160.8(3) states that the Board “[sjhall provide health, medical, and life insurance coverage for retired officers and employees of the police department.” In determining the obligation imposed on the Board by this statute, this Court applies the primary rule of statutory construction that the intent of the legislature is ascertained “from the language used” in the statute by giving the words of the statute “their plain and ordinary meaning.” Huber v. Wells Fargo Home Mortg., Inc., 248 S.W.3d 611, 614 (Mo. banc 2008).
While the language of sections 84.160.8(3) and 84.160.8(1)3 is indeed similar, as noted by the principal opinion in section II, the two subsections merely state that the Board must provide health coverage to both active duty officers and retired officers. There is nothing in the language of the statute to suggest that the level of coverage provided to each group must be the same or even substantially similar. To so hold requires the addition of words that do not exist in the statute. This Court “cannot supply that which the legislature has, either deliberately, or inadvertently, or through lack of foresight, omitted from the controlling statutes.” State ex rel. Mercantile Nat. Bank at Dallas v. Rooney, 402 S.W.2d 354, 362 (Mo. banc 1966). The Court “must be guided by what the legislature said, not by what the Court thinks it meant to say.” Metro Auto Auction v. Dir. of Revenue, 707 S.W.2d 397, 401 (Mo. banc 1986).
Had the legislature intended for retirees to receive the same level of benefits as active duty officers, it was capable of writing such a statute. In fact, the legislature did so with respect to health insurance coverage for school district retirees, requiring that they have the option “to receive benefits at the same rate” as active employees.4 Section 169.590, RSMo Supp. *5312007. No such language appears in section 84.160.8, and the principal opinion is in error in construing section 84.160.8(8) as though it does. Indeed, not even the Appellants argued the subsections require the same coverage for active and retired officers prior to the Court raising that as a possible statutory interpretation during oral argument.5
Although the legislature has not required the Board to provide retirees with the same level of health coverage it provides active officers, its intent is clear-to ensure that the members of a valued group of public servants, St. Louis’ retired police officers, are provided with health insurance. Therefore, it is necessary to determine whether the Board has satisfied that statutory mandate. Appellants argue that the evidence shows that it has not. I agree.
Seven witnesses testified at trial, two for the Appellants and five for the Board, as to the terms of the “basic plan” now being offered to retirees by the Board. While there was testimony that the “basic plan” fits within the definition of a “comprehensive” health insurance policy in the technical meaning of that word, to wit, it provides coverage for several different types of medical expenses, Appellants’ challenge to the plan is not about the nature of the services covered. Instead, it is the level of financial coverage for those services that is claimed to be deficient. On that issue, not one of the seven witnesses was aware of another health insurance plan that provides as sparse a benefits package. While isolated components of the “basic plan” may be found in other plans, all the witnesses agreed that the combination of the components in the “basic plan” provides a level of health insurance benefits below all other known health insurance plans.
Susan Carpenter, a certified employee benefit specialist, testified that she was unaware of any group health benefits plan with as high a deductible that was not accompanied by a another feature to ameliorate the financial impact on the insured. She was also not aware of any group health benefits plan with as high a limit on annual in-network, out-of-pocket expenses as the “basic plan.” Richard Frank, personnel director for the City of St. Louis, provided similar testimony to that offered by Ms. Carpenter. Samuel Steiner, the department’s benefits consultant, testified that he could not recall any plan, that was “as bad in terms of the scope and quality of benefits” as those provided by the “basic plan.” Stephen Zoll, an employee of Blue Cross, testified on behalf of the Board that he could not think of any plan in particular that offered as “skinny” a benefits package as the “basic plan.” Finally, the department’s supervisor of compensation and benefits, Monica Green, testified that, while she knew of two plans with deductibles in the same range, she did not know if they otherwise offset out-*532of-pocket costs and this made it impossible to meaningfully compare these plans to the proposed base plan. She also said she knew of no other health benefit plans this meager.
In enacting section 84.160.8(3), the legislature did not intend to authorize the Board to provide retirees with a health insurance plan so deficient that it is virtually impossible to find as poor coverage elsewhere on the market. This plan fails to provide a minimally acceptable level of coverage. The Board has, thus, failed to comply with the mandate of the statute.
In his dissent, Judge Limbaugh argues for an interpretation whereby the Board can satisfy its statutory obligations if (1) it provides some health coverage to retirees without charge and (2) the coverage provided is not “illusory.” It finds that the Board has met those requirements because, while “not the most generous in terms of deductibles, co-pays, and prescription drug benefits,” the “basic plan” does offer “comprehensive medical coverage.”
In Missouri cases, insurance policies or individual provisions thereof have been described as “illusory” in two situations. The first is where the title of a type of insurance coverage is misleading as to the actual benefits conferred under the policy. The expected benefits, then, have been described as “illusory.” This is most commonly found in the context of underin-sured motorist (UIM) coverage, where a layperson may expect a UIM policy to “cover the gap” in the situation in which the insured’s total damages exceed a negligent driver’s insurance policy limit but that is not, in fact, what the policy operates to do. See Zemelman v. Equity Mut. Ins. Co., 935 S.W.2d 673 (Mo.App.1996). See also Melton v. Country Mutual Ins. Co., 75 S.W.3d 321 (Mo.App.2002) (structure of UIM policy made it impossible to receive the policy limit of $50,000).
The second situation is one in which a court has the task of interpreting an ambiguous provision in an insurance contract. In so doing, the courts have favored interpretations that do not render another portion of the policy “illusory” or that might dilute or eliminate coverage. See, e.g., Cano v. Travelers Ins. Co., 656 S.W.2d 266, 271 (Mo. banc 1983); Columbia Mut. Ins. Co. v. Morris, 887 S.W.2d 675, 678 (Mo. App.1994); Krombach v. Mayflower Ins. Co., 785 S.W.2d 728, 735 (Mo.App.1990).
These cases are not authority for the dissent’s application of an “illusory” standard in this case. As noted above, the coverage offered by the plan fails to comport with the intent of the legislature in enacting section 84.160.8(3). Accordingly, I cannot concur with Judge Limbaugh’s dissent that the coverage, while low, is adequate to meet the statute’s requirements.
Conclusion
The “basic plan” crafted by the Board is so wanting in quality that it fails to meet the obligations of section 84.160.8(3). The judgment of the circuit court should be reversed and remanded.

. All statutory references are to RSMo Supp. 2006, unless otherwise noted.

. The Board offers two health insurance options to retired officers and employees: the "basic plan,” which is provided for free, and the “buy-up” plan, which is available for a $251 per month premium. It is the basic plan that is at issue here. For a listing of some of the provisions of the two plans, see the principal opinion at note 1.

. The Board ”[s]hall provide or contract for ... insurance benefits providing health ... coverage for officers and employees of the department.”

. Section 169.590 provides, in part:
1. Any insurance contract or plan ... which provides group health insurance or benefits for employees who are members of any retirement system established pursuant to this chapter shall contain provisions that permit:
*531(1) Any employee who retires, or who has retired, and is receiving or is eligible to receive retirement benefits under this chapter to remain or become a member of the group ... and to receive benefits at the same rate as all other members of the group;

. At oral argument, when asked specifically if the retirees should be provided with the same insurance that active officers are provided, the Appellants’ attorney responded in the negative and stated further that “I don’t believe that we have ever argued that.” Indeed, in reviewing Appellants’ briefs in this case, no argument to that effect can be found. During Respondent’s appearance before the Court, however, this Court raised the possibility of interpreting the subsections to require the same coverage due to the use of very similar language. Only after this suggestion did Appellant argue on rebuttal that, given the historical nature of the coverage provided under the two subsections, such an interpretation would be appropriate.