On appeal from the Superior Court, Law Division, Essex County.
Before Judges Petrella, Havey and Brochin.
The opinion of the court was delivered by
Plaintiff, Newark Board of Education (Board), is enrolled in the New Jersey State Health Benefits Plan which provides basic and major medical health insurance coverage to State employees and employees of participating local governments, including school districts. See N.J.S.A. 52:14-17.35 and -17.36. The self-insured plan is controlled by the State Health Benefits Commission (Commission) within the Division of Pensions, Department of Treasury, N.J.S.A. 52:14-17.27, and administered by Blue Cross/Blue Shield and Prudential Insurance Company (administrators) under contract with the Commission.
By leave granted, the Division appeals from a summary judgment entered in the Law Division, compelling the Division to disclose as a public record the aggregate claims dollars paid to the Board's employees for the school year 1989-90 and from July 1, 1990 to the date of judgment, December 8, 1993. The central issue is whether the claims-information data constitutes a "public record" under New Jersey's Right-to-Know Law, N.J.S.A. 47:1A-2 or under principles of common law. We conclude that the data constitutes a public record under both the Right-to-Know Law and common law, and affirm.
The Board pays its insurance premiums for its employees to the Division. Employee claims are processed by a claims administrator whose data is computerized and maintained according to the social security number of each subscriber. Claims data is fed into a computer master file kept by the administrators. The Division has access to the master file through a modem. The master file is assigned one of two possible codes - State or local. The claims data is filed so that the computer operator can retrieve data using the appropriate code.
According to the Board, during the 1990-91 school year it paid the Division in excess of $25,000,000 in premiums for coverage for its employees. On May 21, 1991, the Board wrote to the Division asking for information concerning its participation in the State plan. Specifically, it requested disclosure of the total payments made by it for the 1989-90 school year and for the period from July 1, 1990 to May 21, 1991. It also requested a breakdown of the total claims paid by the Division, through the administrators, to Board employees for the same time period, and a computation of total "administrative charges" assessed against the Board during that period. The Division responded by letter dated May 28, 1991, stating that "claims data is tracked only by group - State or Local. The claims experience of individual participating employers is not available." On November 19, 1991, the Board's counsel again wrote to the Division and asked that it reconsider its decision denying the Board the benefits information. The Division considered the letter a request for an appeal from a State agency and forwarded the matter to the Office of Administrative Law.*fn1
The Board thereupon filed this action in lieu of prerogative writs demanding disclosure of the benefits information. The Board claims that the data sought is a public record pursuant to both New Jersey's Right-to-Know Law, N.J.S.A. 47:1A-2, and common-law principles.
The facts, developed during discovery, are not in dispute. According to Patricia Chiacchio, employed by the Department of the Treasury and Acting Secretary of the Commission, because the computer master file is assigned only two possible codes - State or Local - the data sought by the Board cannot be readily retrieved because the claims information is not segregated or coded by individual local employer. Ms. Chiacchio also states that "it is impractical" to obtain local employer claims experience by totaling the claims of each employee "because it would necessitate retrieving each employee's claim file individually, which would not only be extremely time consuming and costly (approximately $6,000 per 500 [employees]), but, because of the demand on computer time and capacity, would . . . [disrupt] . . . the operation of the claims system." She also explains that the processing of individual employee information "would not yield reliable data" because the data may be "grossly understated," erroneous social security numbers may be supplied by the employer, and there is significant employee turnover among local employers.
Dennis Murray, is an Account Executive employed by Prudential, one of the administrators of the State plan. He testified in his deposition that total claims by the Board's employees for the 1989-90 school year could be produced by obtaining a computer tape of the employees' social security numbers and "running" it against the entire State Health Benefits Plan computer master file. The process would extract "total claim dollars" for that group. In fact, according to Murray, Prudential had produced this type of claims experience for other clients. Karen Roberts, a Senior Systems Analyst with Prudential, testified that similar reports had been produced for Bergen County in 1992 and that the Prudential program was capable of producing claims data for individual persons. Similarly, Blue Cross/Blue Shield representatives testified that prior to January 1991, Blue Cross produced these types of reports for other employers and that the only bar against producing such information was the contract with the State that prohibits Blue Cross from distributing the information. What would be needed, according to the Blue Cross/Blue Shield representatives, is the employees' social security numbers in order to access and retrieve the information from the computer master file.
In granting summary judgment to the Board, Judge Weiss required the Division to make available to the Board all premium payments and claims information for the pertinent time period. He found that the information sought constituted "records which are required by law to be made, maintained or kept on file," N.J.S.A. 47:1A-2, because the information was necessary in order for the Commission to prepare an annual report required by N.J.S.A. 52:14-17.27. The Judge also determined that the Board was entitled to the information under its common-law right to inspect because the Board acted in good faith and its interest in access to the records outweighed any public interest in confidentiality. The Judge also found that it was "feasible" for the Commission to produce the data "subject to the Board reimbursing the producing party the cost of reproducing the information." However, the Judge denied summary judgment as to the Board's demand for the aggregate administrative charges assessed against it because of fact issues concerning the manner in which the charges were computed.
The Division advised us during oral argument that it is willing to furnish the total figures concerning the Board's payment of premiums during the pertinent time period. Thus, the narrow issue is whether the claims-data information is a ...