TEXAS DEPT. OF INS. v. AMERICAN NAT. INS., CO.

No. 10-0374.

410 S.W.3d 843 (2012)

TEXAS DEPARTMENT OF INSURANCE, Honorable Mike Geeslin, Commissioner of Insurance and Honorable Danny Saenz, Senior Associate Commissioner, Petitioners, v. AMERICAN NATIONAL INSURANCE COMPANY and American National Life Insurance Company Of Texas, Respondents.

Supreme Court of Texas.

Decided May 18, 2012.

Rehearing Denied August 31, 2012.


Attorney(s) appearing for the Case

Arthur Cleveland D'Andrea , Assistant Solicitor General, Daniel T. Hodge , First Asst. Attorney General, William (Bill) J. Cobb III , Attorney General's Office, Deputy Atty. General for Civil Litigation, David C. Mattax , Director of Defense Litigation, Jonathan F. Mitchell , Solicitor General, Office of the Attorney General, J.R. Schneider Jr. , Assistant Attorney General, Lesli Gattis Ginn , Office of the Attorney General, David S. Morales , Office of the Attorney General of Texas, Deputy First Assistant Attorney General, Greg W. Abbott , Attorney General of Texas, Clarence Andrew Weber , Kelly Hart & Hallman LLP, Austin TX, James C. Ho , Gibson Dunn & Crutcher LLP, Dallas, TX, for Texas Department of Insurance.

Susan C. Conway , Boyce C. Cabaniss , Graves, Dougherty, Hearon & Moody, P.C., Dudley D. McCalla , Jackson Walker LLP, Will D. Davis , Thompson, Coe, Cousins & Irons, LLP, Austin, TX, Andrew J. Mytelka , Steven Carl Windsor , Greer Herz & Adams LLP, Galveston, TX, for American National Insurance Co.

Gregory S. Coleman , Christian J. Ward , Richard Bernard Farrer , Yetter Coleman LLP, Austin, TX, for Amicus Curiae Texas Health Insurance Pool.

Scott Masur McElhaney , Jackson Walker LLP, S. Vance Wittie , Sedgwick, Detert, Moran & Arnold LLP, Dallas, TX, for Amicus Curiae UnitedHealth Insurance Company.

Ron Beal, Professor & Attorney at Law, Waco, TX, pro se.

Jonathan D. Pauerstein , Alia Marissa Levine , Rosenthal Pauerstein Sandoloski Agather LLP, San Antonio, TX, for Amicus Curiae Property and Casualty Insurers Association of America.


Justice MEDINA delivered the Opinion of the Court.

The issue in this appeal is whether stop-loss insurance sold to self-funded employee health-benefit plans is "direct health insurance" or "reinsurance." The distinction is significant because direct insurance is subject to state insurance regulation, while reinsurance is not. Reinsurance is not regulated because it typically involves the reallocation of risk between two insurance companies rather than a consumer-insurance...

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