Perez

Perez v. Kaiser Foundation Health Plan

Good Law
Court of Appeal of CaliforniaMay 16, 2023A165140California5,786 words

Opinion

Opinion

Petrou, J.

BACKGROUND

Kaiser is a licensed health care service plan that provides or arranges hospital and professional health care services for plan members. Employers who offer Kaiser’s health care services must distribute a document titled “Evidence of Coverage” each year to Kaiser subscribers. The document provides enrollees or subscribers with information regarding their benefits, rights, and obligations as Kaiser members. The Evidence of Coverage includes an arbitration clause, stating “Any dispute shall be submitted to binding arbitration if,” as relevant here, the claim “arises from or is related to an alleged violation of any duty incident to or arising out of or relating to this Evidence of Coverage or a Member Party’s relationship to [Kaiser], including any claim for medical or hospital malpractice.” The clause further explains members — including a member’s relative — enrolled in Kaiser’s Evidence of Coverage “thus give up their right to a court or jury trial” unless the claim falls within certain exceptions not relevant here. Francis Coppola Winery, LLC (Coppola) employees may select Kaiser health care coverage through Coppola’s online benefits enrollment process. Employees…

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