Doe v. Kaiser Foundation Health Plan, Inc.

CourtDistrict Court, N.D. California
DecidedMarch 26, 2024
Docket3:23-cv-02865
StatusUnknown

This text of Doe v. Kaiser Foundation Health Plan, Inc. (Doe v. Kaiser Foundation Health Plan, Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Doe v. Kaiser Foundation Health Plan, Inc., (N.D. Cal. 2024).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 JOHN DOE, et al., Case No. 23-cv-02865-EMC

8 Plaintiffs, ORDER GRANTING DEFENDANTS' 9 v. MOTION TO COMPEL ARBITRATION 10 KAISER FOUNDATION HEALTH PLAN, INC., et al., 11 Docket No. 82 Defendants. 12 13 14 Plaintiffs are seven individuals. All are proceeding anonymously: John Doe, John Doe II, 15 Jane Doe, Jane Doe II, Jane Doe III, Jane Doe IV, and Jane Doe V. Plaintiffs have sued three 16 Kaiser entities: Kaiser Foundation Health Plan, Inc. (“KFHP”); Kaiser Foundation Hospitals 17 (“Kaiser Hospitals”); and The Permanente Medical Group, Inc. (“TPMG”). The three entities 18 shall be referred to collectively as “Kaiser.” 19 According to Plaintiffs, Kaiser installed code from six different third parties on its website 20 and two mobile applications (i.e., the Kaiser Permanente App and the Kaiser Permanente 21 Washington App), and that code allows the third parties “to intercept the content of [a website/app 22 user’s] patient status, identifying information, medical topics researched, choices made, 23 information shared and communications with their medical providers, including personally 24 identifiable medical information and other confidential information and communications, when 25 that information is in transit” (i.e., between the website/app user and Kaiser). FAC ¶ 4. The six 26 third parties at issue are: Quantum Metric, Twitter, Adobe, Bing, Google, and Dynatrace. 27 Currently pending before the Court is Kaiser’s motion to compel arbitration. The motion 1 accompanying submissions, as well as the oral argument of counsel, the Court hereby GRANTS 2 Kaiser’s motion to compel arbitration.1 3 I. FACTUAL & PROCEDURAL BACKGROUND 4 The evidence submitted by the parties reflects as follows. 5 A. Trust Enrollment Form 6 JD obtains health insurance through the Teamsters and Food Employers Security Trust 7 Fund (“Trust”). “During the annual open enrollment period for benefits, the Trust sends an 8 enrollment package to each of its members.” Osharow Decl. ¶ 3. The enrollment package 9 includes various documents, including a Trust Enrollment Form. See Osharow Decl. ¶ 3. A 10 member fills out the Trust Enrollment Form to enroll in a medical plan. See Osharow Decl. ¶ 4. 11 In February 2021, JD filled out the Trust Enrollment Form, seeking enrollment in a Kaiser 12 health plan. See Osharow Decl. ¶ 8. Since April 2021, JD has been continuously enrolled in the 13 Kaiser health plan. See Osharow Decl. ¶ 12. 14 The Trust Enrollment Form that JD signed was only one page in length. Right above the 15 signature line, there was a paragraph related to arbitration. It provided as follows: 16 Kaiser Foundation Health Plan, Inc. Arbitration Agreement 17 I understand that (except for [certain kinds of claims not applicable here]) any dispute between myself . . . on the one hand and Kaiser 18 Foundation Health Plan., Inc. (KFHP), any contracted health providers, [etc.] on the other hand, for alleged violation of any duty 19 arising out of or related to membership in KFHP, including any claim for medical or hospital malpractice . . . , for premises liability, 20 or relating to the coverage for, or delivery or, services or items, irrespective of legal theory, must be decided by binding arbitration 21 under California law and not by lawsuit or resort to judicial process, except as applicable law provides for judicial review of arbitration 22 proceedings. I agree to give up our right to a jury trial and accept the use of binding arbitration. I understand that the full arbitration 23 provision is contained in the Evidence of Coverage. 24 Osharow Decl., Ex. A (Trust Enrollment Form). The Evidence of Coverage is a document that 25 applies to all Trust enrollees in the health plan. 26 27 1 B. Evidence of Coverage 2 The Evidence of Coverage (“EOC”) for the relevant time period can be found at Exhibits 3 A-C of the Walker Declaration. For convenience, the Court focuses on the EOC in place at the 4 time that JD enrolled – i.e., Exhibit A (Kaiser Permanente Traditional HMO Plan, Evidence of 5 Coverage for Teamsters and Food Employers Security Trust Fund). 6 The Introduction section for the EOC describes the EOC as follows:

7 This Evidence of Coverage (“EOC”) describes the health care coverage of “Kaiser Permanente Traditional HMO Plan” provided 8 under the Group Agreement (“Agreement”) between Kaiser Foundation Health Plan, Inc. (“Health Plan”) and the entity with 9 which Health Plan has entered into the Agreement (your “Group”).

10 This EOC is part of the Agreement between Health Plan and your Group. The Agreement contains additional terms such as Premiums, 11 when coverage can change, the effective date of coverage, and the effective date of termination. 12 13 Walker Decl., Ex. A (EOC at 17). 14 “Member” is defined in the EOC as “[a] person who is eligible and enrolled under this 15 EOC, and for whom we have received applicable premiums.” Walker Decl., Ex. A (EOC at 19). 16 “As a Member, you are selecting our medical care program to provide your health care.” Walker 17 Decl., Ex. A (EOC at 27). 18 The EOC contains a lengthy section on benefits. See Walker Decl., Ex. A (EOC at 35). 19 It also contains a section on dispute resolution, including binding arbitration (as referenced 20 in the Trust Enrollment Form). The arbitration clause states:

21 For all claims subject to this “Binding Arbitration” section, both Claimants and Respondents give up the right to a jury or court trial 22 and accept the use of binding arbitration. Insofar as this “Binding Arbitration” section applies to claims asserted by Kaiser Permanente 23 Parties, it shall apply retroactively to all unresolved claims that accrued before the effective date of this EOC. Such retroactive 24 application shall be binding only on the Kaiser Permanente Parties. 25 Walker Decl., Ex. A (EOC at 72). 26 The scope of arbitration is described as follows:

27 Any dispute shall be submitted to binding arbitration if all of the  The claim arises from or is related to an alleged violation of 1 any duty incident to or arising out of or relating to this EOC or a Member Party’s relationship to [KFHP], including any 2 claim for medical or hospital malpractice . . . , for premises liability, or relating to the coverage for, or delivery of, services 3 or items, irrespective of the legal theories upon which the claim is asserted. 4  The claim is asserted by one or more Member Parties against 5 one or more Kaiser Permanente Parties or by one or more Kaiser Permanente parties against one or more Member 6 Parties.

7  Governing law does not prevent the use of binding arbitration to resolve the claim. 8 9 Walker Decl., Ex. A (EOC at 72).2 10 In addition, the EOC contains a subsection on privacy practices. This subsection also 11 refers a Member to a document that elaborates on privacy practices and that is available online at 12 kp.org. See Walker Decl., Ex. A (EOC at 81). 13 Finally, the EOC contains a subsection on online tools and resources that a Member may 14 use. It states in relevant part:

15 Here are some tools and resources available on our website at kp.org: 16  How to use our Services and make appointments 17  Tools you can use to email your doctor’s office, view test results, refill prescriptions, and schedule routine appointments 18  Health education resources  Preventive care guidelines 19  Member rights and responsibilities

20 You can also access tools and resources using the KP app on your smartphone or other mobile device. 21 22 Walker Decl., Ex. A (EOC at 82). Hence, the EOC makes express reference to the Kaiser website 23 and mobile applications. 24 C. Website and Mobile Application 25 Within Kaiser’s website and mobile application, there are specific “Terms and 26

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Bluebook (online)
Doe v. Kaiser Foundation Health Plan, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/doe-v-kaiser-foundation-health-plan-inc-cand-2024.