Graduate Health Systems, Inc. v. Pennsylvania Insurance Department

674 A.2d 367, 1996 Pa. Commw. LEXIS 127
CourtCommonwealth Court of Pennsylvania
DecidedApril 8, 1996
StatusPublished
Cited by13 cases

This text of 674 A.2d 367 (Graduate Health Systems, Inc. v. Pennsylvania Insurance Department) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Graduate Health Systems, Inc. v. Pennsylvania Insurance Department, 674 A.2d 367, 1996 Pa. Commw. LEXIS 127 (Pa. Ct. App. 1996).

Opinion

KELLEY, Judge.

Graduate Health Systems, Inc. (GHS) appeals from an order of the Commissioner of the Pennsylvania Department of Insurance (department) which affirmed a decision of the Pennsylvania Compensation Rating Bureau (bureau) denying GHS’s request for a workers’ compensation rate classification separate from its hospital subsidiaries. We affirm.

The Pennsylvania Manual of Rules, Classifications and Rates for Workers Compensation and for Employers Liability Insurance (manual) sets forth the classification of risks, underwriting rules, premium rates, and schedule or merit rating plan for insurance of employer and employees under the Pennsylvania Workers’ Compensation Act (Act), Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1-1041.4.1 The manual provides a general explanation of the classification system for risk. Reproduced Record (R.) at 117a-30a.2

GHS’s employees are classified as Code 961 — hospital. In 1990, GHS filed a request with the bureau for a rate classification separate from its hospital subsidiaries. The bureau’s classification and rating committee (committee) determined that GHS’s employees should be classified as Code 961 — hospital and not as Code 953 — clerical office employees or Code 951 — salesmen.

GHS appealed the committee’s decision to the Commissioner. A presiding officer was appointed and a hearing was held on July 20, 1992, attended by a representative from GHS and the bureau. Following the completion of the briefing schedule, the Commissioner issued an adjudication and order affirming the committee’s decision. In her adjudication, the Commissioner set forth the following relevant findings of fact:

1. Graduate Health Systems (hereinafter “GHS”) is a corporation in the business of providing management services to hospitals.
2. GHS is the parent company to Graduate Hospital, Mount Sinai Hospital, Community General Hospital, Zurbrugg Hospital and Riverside Hospital[3] (hereinafter “affiliated” or “subsidiary” hospitals) (N.T. 10,19-20).
3. GHS was established to provide those administrative services for its affiliates.
4. GHS was established for the purpose of providing the services in an economical fashion. (N.T., p. 26).
5. The business of GHS is the provision of administrative services to its subsidiary hospitals. (N.T., p. 77).
6. GHS has separate officers from the officers of Graduate Hospital (a corpora[369]*369tion) and Mount Sinai Hospital (a corporation) (N.T. 11).
7. GHS, as the parent, is the owner of the subsidiary hospitals and approves their budgets and boards of directors. (N.T., pp. 98, 99).
8. GHS appoints the directors of each of its subsidiary hospital corporations (N.T. 11).
9. GHS maintains a separate payroll from its subsidiary hospital corporations (N.T. 12).
10. GHS maintains a separate office building from its subsidiary hospital corporations except that it leases separate office space in the Mount Sinai Hospital (N.T. 13-14).
11. GHS files separate tax returns from its subsidiary hospital corporations (N.T. 15-16).
12. GHS provides financial, legal, fund raising and public relations services pursuant to management contracts with its subsidiary hospital corporations (N.T. 10, 17-18).
13. The services offered by GHS for its subsidiary hospitals are similar to those provided by the internal staff of free standing hospitals. (N.T., p. 28).
14. Many employment functions in a traditional freestanding hospital contribute to .the business administration of the hospital, not for direct care of the patients. (N.T. p. 27).
15. The services that GHS offers to its subsidiary hospitals are services which enable them to carry on their business. (N.T., p. 36).
16. The services that GHS provides to its subsidiaries are normal to a hospital operation. (N.T., pp. 62,110).
17. GHS has solicited management contracts with nonaffiliated hospital [sic] in the past (N.T. 32).
18. GHS has no management contracts with nonaffiliated hospitals (N.T. 26).
19. The affiliated hospitals are commonly owned by GHS (N.T. p. 25).
20. GHS is not a hospital, it provides no patient care, employs no physicians, does not house patients and is not licensed by the Commonwealth as a hospital (N.T. 13-15).
21. The purpose of the classification system is to group employers with similar operations into a single classification based on their field of business. (N.T., p. 49).
22. It is the business of the insured not the individual employments, occupations, or operations within the business that are classified. (N.T., p. 49).
23. Classification assignments are made according to the risk field of business not the potential risk of exposure to harm by the employees.
24. Classification Code 961, Hospital, is an all-inclusive classification meaning [sic] that it includes all employees of a hospital, even clerical.
25. The standard exception classifications that are allowed by most of the other classifications are not permitted by the all-inclusive classifications. Those standard exceptions are Code 951, Salesmen, and Code 953, Clerical Office Employees. (N.T., p. 55).
26.- The hospital classification includes not only the medical personnel but the support functions as well, such as laundry, security, food preparation, accounting, and bookkeeping. (N.T., p. 51).
27. The administration of the classification system is based on the presumption that similar employers will face the same types of hazards and risks and the rate will flow from there because it is based on the actual experience of the employers in that classification. (N.T., p. 85).
28. Commonly-owned .insureds are classified together, even though they may have separate functions, if their functions are an integral part of the overall business operations of the related entitites [sic]. (N.T., p. 102).
29. The rate for a classification reflects the loss experience of the employers in that classification. (N.T. pp. 83, 84, 85).

Based on these findings, the Commissioner concluded that when the totality of the circumstances is considered, it is clear that GHS and its affiliated hospitals are properly considered as a single enterprise and classi[370]*370fied as such. The Commissioner concluded further that this finding is consistent with the fundamental purpose of the classification system to group insureds into classifications so that the rate for each classification reflects the exposures common to such distinct business enterprise. Accordingly, the Commissioner held that GHS did not meet its burden of proving that its employees should be classified as Code 953 — clerical office employees or Code 951 — salesmen.

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Bluebook (online)
674 A.2d 367, 1996 Pa. Commw. LEXIS 127, Counsel Stack Legal Research, https://law.counselstack.com/opinion/graduate-health-systems-inc-v-pennsylvania-insurance-department-pacommwct-1996.