Mader v. Health Care Authority

70 P.3d 931, 149 Wash. 2d 458
CourtWashington Supreme Court
DecidedJune 5, 2003
DocketNo. 72273-1
StatusPublished
Cited by55 cases

This text of 70 P.3d 931 (Mader v. Health Care Authority) is published on Counsel Stack Legal Research, covering Washington Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mader v. Health Care Authority, 70 P.3d 931, 149 Wash. 2d 458 (Wash. 2003).

Opinion

Alexander, C.J.

We are called upon to determine whether Washington State’s health care authority properly determined that part-time community college instructors Eva Mader and Teresa Knudsen (petitioners) were ineligible for employer contributions to their health care coverage during the summer quarter in 1999. We hold that the Health Care Authority (HCA) erred in focusing on petitioners’job titles and quarterly contracts, instead of employing an individualized approach based on petitioners’ actual work circumstances, when determining their eligibility for employer contributions to their health care coverage. Because of the error, we remand to the HCA for a determina[462]*462tion, consistent with this decision, of petitioners’ eligibility. In addition, we conclude that the class definition is unclear, and we remand to the superior court to clarify the definition of the class.

I. Facts

At all times material to this appeal, petitioners Eva Mader and Teresa Knudsen (also known as Boyden) were part-time community college instructors in this state. Since 1978, Mader has regularly taught two German language classes at North Seattle Community College (NSCC) in the fall, winter, and spring quarters. In each of the past 21 years, Mader was informed that NSCC would not contribute to her health care coverage during the summer quarter because she did not teach a class or classes during that quarter. As a result, Mader was faced each year with either paying a premium for health care coverage during the summer quarter or going without employer-based health care insurance during that period.

Teresa Knudsen has worked as a part-time instructor of English and literature for the Community Colleges of Spokane (CCS) since 1984. Beginning in 1988, she consistently taught more than half-time in the fall, winter, and spring quarters, with the exception of the fall quarter in 1994. Knudsen also taught a summer quarter course in 1997 and 1998. Each summer, including those in which she taught a course, Knudsen was informed that she was not eligible for employer contributions to her health care coverage. Knudsen also received a letter of reasonable assurance from CCS in the spring of 1998 which “guaranteed” her at least 66 percent1 of a full-time work load for the fall quarter of 1998. Certified Appeal Board R. (AR) at 244. It was signed and returned prior to the end of the spring quarter in that year. She received a similar letter in the spring of 1999 and signed the “offer for fall 1999 employment” on June 18, 1999. AR at 348.

[463]*463The record discloses that Mader’s and Knudsen’s circumstances are not unique. Many part-time community and technical college instructors are deemed ineligible for employer contributions to their health insurance during the summer quarter. Although each employee is given the opportunity to self-pay, some do not maintain coverage due to the cost. In recent years, Mader paid for her summer health care coverage at a cost to her of approximately $750 each summer. In 1999, Knudsen paid approximately $830 for her summer health care coverage.

On December 3, 1998, Mader and Knudsen together sought a determination from the HCA, the agency responsible for the eligibility requirements for health care coverage of state employees, that they and other “similarly situated [part-time] community college employees” were entitled to state-paid health benefits during the summer quarters. AR at 14. The deputy program manager of the Public Employees’ Benefits Board (PEBB), an arm of the HCA, responded to their request by a letter in which she indicated that the HCA could not declare an individual eligible for benefits without direction from that person’s employer. The deputy program manager stated:

the individual community colleges determine their own employee definitions through a bargaining process. The bargained definitions and faculty contracts direct the employment practices at each institution, and the institutions then apply the benefit eligibility category from our WACs they believe to be most appropriate. The Health Care Authority does not have any authority to oversee employment contracts or bargaining decisions made at the individual institutions; therefore, we are unable to declare an individual employee eligible for benefits without direction from their employer.

AR at 34.

Mader and Knudsen appealed the deputy program manager’s decision to the administrator of the HCA. They maintained that they were “entitled to state-paid health benefits during the summer months” based on the plain language of the HCA’s regulation set forth in WAC 182-12-115(4) or (5). AR at 3. The presiding officer who considered their appeal [464]*464permitted the State Board for Community and Technical Colleges to intervene.

The presiding officer thereafter issued a decision in which she denied the petitioners’ claim of eligibility for employer contributions to their health care coverage during the summer quarter of 1999.2 The presiding officer indicated that because Mader and Knudsen signed contracts for each quarter in which they taught classes, the proper regulation for determining their eligibility for employer contributions to their health care coverage was WAC 182-12-115(5). That regulation requires a part-time faculty member who works on a quarter/semester to quarter/semester basis to work at least half-time for two consecutive quarters/semesters in order to be eligible for employer contributions to health care coverage. WAC 182-12-115(5). Based on a determination that the petitioners had not worked at least half-time during the summer of 1999, the presiding officer concluded that petitioners were not eligible for the employer contributions they sought.

Mader and Knudsen, together, sought judicial review of the HCA decision in King County Superior Court. The superior court granted review3 and certified the matter as a class action upon the motion of Mader and Knudsen and with no opposition from the HCA.4 The class was ultimately defined by the superior court as

[465]*465[a]ll present or former part-time “academic employees,” as that term is defined in RCW 28B.50.489(3), who worked for the Washington State community or technical colleges and received employer-paid health coverage during the spring quarter or semester of a year, but were considered to have worked less that [sic] half of a full-time workload during the subsequent summer quarter and who therefore did not receive employer-paid health coverage in the summer. Subject to the applicable statute of limitations, the class includes all such academic employees, past, present, and future.

Clerk’s Papers (CP) at 265.

The superior court divided the class into three subgroups, as follows:

1. Part-time community and technical college instructors who sign quarterly contracts and receive employer-paid health coverage during the Spring Quarter, but who do not sign a quarterly contract and do not work in the Summer Quarter and do not receive health benefits in the Summer Quarter because they are considered to work less than half of a full-time workload.
2.

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Bluebook (online)
70 P.3d 931, 149 Wash. 2d 458, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mader-v-health-care-authority-wash-2003.