Because Enrollment Process Was Handled By CalPERS, Statutory Requirements That Notice Of Arbitration Be Conspicuous in a Health Plan Did Not Apply.
Edward William Kuntz's wife, children, and estate sued Kaiser for Elder Abuse and other claims, and Kaiser move successfully to compel arbitration of the Elder Abuse claim and stay the other claims. This outcome was upheld by the Court of Appeals. Edward William Kuntz et al. v. Kaiser Foundation Hospital, et al., C087967 (3d Dist. 4/12/21) (Murray, Robbie, Krause) (certified for partial publication).
The first two section of the opinion are unpublished and the third section is published.
In the first two sections, the court agrees that the decedent was enrolled in the Kaiser plan, though no enrollment form was produced. Mr. Kuntz was enrolled through his wife's This conclusion was based on Kaiser enrollment record keeping and a declaration, evidence that apparently was not objected to. Furthermore, the court could find no legal requirement that enrollment could only be proven through an enrollment application form.
Mr. Kuntz was enrolled as a member of the Kaiser Health Plan, through his wife’s employment under a California Public Employees’ Retirement System (CalPERS) Group Coverage Agreement between Health Plan and the Board of Administration of CalPERS. The enrollment process was administered by CalPERS.
In the third section, the court addresses whether Health and Safety Code § 1361.1 requirements apply to CalPERS enrollments. Section 1361.1 requires that the enrollment form signed by the subscriber contain a prominently displayed arbitration notice, and such a notice did not exist here. However, the court agreed that Government Code § 22869 applied to CalPERS, which handled the enrollment process, and as a consequence, the materials disseminated by CalPERS were automatically deemed to satisfy the requirements of § 1361.1. Read the case and code sections, lest this be opaque.
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