Board of Education v. New Jersey Department of Treasury, Division of Pensions

678 A.2d 660, 145 N.J. 269, 1996 N.J. LEXIS 944
CourtSupreme Court of New Jersey
DecidedJuly 15, 1996
StatusPublished
Cited by10 cases

This text of 678 A.2d 660 (Board of Education v. New Jersey Department of Treasury, Division of Pensions) is published on Counsel Stack Legal Research, covering Supreme Court of New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Board of Education v. New Jersey Department of Treasury, Division of Pensions, 678 A.2d 660, 145 N.J. 269, 1996 N.J. LEXIS 944 (N.J. 1996).

Opinion

The opinion of the Court was delivered by

STEIN, J.

Respondent, the Board of Education of Newark (Board), 1 is a participating employer in the State Health Benefits Plan (Plan). In 1991, the Board requested that appellant, the State Health Benefits Commission (Commission), provide it with information on *272 medical claims paid by the Plan on behalf of the Board’s employees. The Commission denied the request and the Board brought this action under the Right-to-Know Law, N.J.S.A 47:lA-2, and under the common-law right to inspect public documents. The Law Division granted summary judgment to the Board on both grounds, and the Appellate Division affirmed. 279 N.J.Super. 489, 653 A.2d 589 (1995). We granted leave to appeal. 142 N.J. 440, 663 A.2d 1351 (1995).

I

The Plan is a self-insured program that provides health insurance to workers employed by participating public entities, including local governments and their subdivisions. It is managed by the Commission, which functions within the Division of Pensions of the Department of the Treasury. Private health insurance companies, Blue Cross/Blue Shield and Prudential Insurance Company, administer the Plan under contract with the Commission. Participation in the Plan by local government employers is voluntary. The Plan is said to be “community-rated,” which means that the risk is analyzed and the premiums are set based on the overall loss experience of all the participants, instead of calculating different premiums for each employer based on its individual risk. See City of Vineland v. State, 95 N.J.A.R.2d 275, 277 (1995) (discussing Plan’s community-rating system); see generally In re Blue Cross & Blue Shield, 239 N.J.Super. 434, 439, 571 A.2d 985 (App.Div.1990) (explaining community-rating concept).

In fiscal 1990, the year preceding the Board’s request for information, the Plan covered over 270,000 public workers employed by 912 local government employers and the State. Premiums are paid by participating employers to the Division of Pensions. Claims are paid by the Plan’s private administrators, which are reimbursed by the State. The individual employees’ records are maintained by claims administrators at Blue Cross/Blue Shield and Prudential in a computerized data base. The Commission has access to the data base by modem. The files are listed by the *273 social security numbers of the individual employees, and are assigned a code denominating the file as belonging either to a State or local government employee. The data base is not otherwise subdivided and the individual computer files do not indicate to which employer a particular employee belongs.

During the 1990-91 school year, the Board paid the Division of Pensions more than $25,000,000 in premiums for health insurance coverage for its employees. Currently, the cost exceeds $40,000,-000. Counsel represents that, other than salaries, health benefits constitute the largest single expenditure in the Board’s budget. On May 21,1991, the Board wrote the Division asking for various financial statistics concerning the Board’s participation in the Plan, including premiums paid by the Board, claims paid for Board employees, and administrative charges paid by the Board. The Board sought the information so that it could determine whether its continued participation in the Plan was an effective use of its funds allocated to employee health benefits. The Commission denied the Board’s requests. With regard to the benefits paid, the Commission stated: “The claims experience of individual participating employers is not available.”

The Board brought this action in lieu of prerogative writ to compel the production of the requested information. The complaint alleges that the Board has a right to the information under New Jersey’s Right-to-Know Law, N.J.S.A. 47:lA-2, and under the common-law right to inspect public documents. In the interim, the Commission has agreed to provide only the information concerning the premiums paid by the Board.

Initially, the Law Division denied cross-motions for summary judgment and called for discovery on the issue of the feasibility and cost of extracting the Board’s claims experience data from the master data base of all employees covered by the Plan. Depositions were taken of Prudential and Blue Cross/Blue Shield personnel involved in administering the Plan. The facts that emerged are not in dispute.

*274 The testimony established that extracting the claims history of individual employers from the master data base is feasible. To enable the private administrators to extract from the data base the claims paid for Board employees, the Board must supply a computer tape containing all of its employees’ social security numbers. A computer program would be written that would search the master data base for the individual files that contain a social security number appearing on the Board’s list. The program would then extract the claims paid for each individual and add them together to generate the total amount of claims paid for all Board employees. The confidentiality of the individual records would be preserved, because only the total claims figure would be supplied to the Board.

Indeed, the Law Division found that both Prudential and Blue Cross/Blue Shield have produced that type of report for other employers in the past, and that writing the necessary program to extract the information is a routine matter. Claims reports are generated for corporate accounts on a regular basis. Until 1991, claims reports were prepared for participating public employers in the Plan as well. As examples, the court noted reports that had been generated for AT & T and for the County of Bergen. The court found that the private administrators stopped providing claims history reports only because a 1991 modification of their contracts with the Commission prohibited them from doing so.

The record contains differing estimates of the cost and reliability of the finished report. A representative of the Commission testified that the cost would be $6,000 per 500 employees and that the accuracy of the result would be impaired by erroneous social security numbers and turnover in the Board’s workforce. Prudential’s computer systems manager assigned to the Plan estimated an aggregate cost of $10,500 for the period from the beginning of the 1989 school year to the date of the request in May 1991 covering only the claims records administered by Prudential. The Blue Cross/Blue Shield account executive for the Plan testified *275 that, prior to 1991, claims history reports had been produced for other employers at a charge of $1,000 per month of claims.

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678 A.2d 660, 145 N.J. 269, 1996 N.J. LEXIS 944, Counsel Stack Legal Research, https://law.counselstack.com/opinion/board-of-education-v-new-jersey-department-of-treasury-division-of-nj-1996.