Court Opinion

ID: 9466095
Source: CourtListenerOpinion
Date Created: 2023-08-05 01:05:43.746627+00
Date Added: 2024-06-11T17:39:32.859179
License: Public Domain

PELL, Circuit Judge,
concurring.
The majority opinion in this case states that the sole issue is whether the change in administrators of a company’s hospital, medical, and surgical benefits program is a term and condition of employment under the National Labor Relations Act, subject to mandatory collective bargaining. If this were indeed all that is involved in the present case, I would regard it as clear that the mere change of the administrator was nothing more than the company exercising what I regard as its clear right to change its own agents and I would accordingly dissent.
A persuasive argument can be advanced that that is all that is involved. As the Board points out in its Decision and Order, the insurance plan provides that claims will be paid in the amount of the “usual and customary” fee for any particular claim item. Any claim in excess of the usual and customary figure will be referred to the joint insurance committee for resolution. For both administrator/processors the usual *181and customary figures are computed on a regular basis, and arrived at in a manner that insures that they bear a relationship to the fees actually charged by medical practitioners. The data from which these figures are generated is derived from the claims actually processed by the administrator. This is not insurance company money that is being paid out but is Keystone’s money and the administrator is nothing more than its title indicates. It is the channel through which the “usual and customary” fee is determined.
The cases in which the Board has found the identity of an administrator of a benefit plan to be the mandatory subject of bargaining have involved insurance carriers. Wisconsin Southern Gas Co., 173 NLRB No. 79 (1968); Bastian-Blessing Div., 194 NLRB No. 95 (1971), supplemental decision, 195 NLRB No. 167 (1972), enf’d, 474 F.2d 49 (6th Cir. 1973); and Conn. Light & Power Co., 196 NLRB No. 149 (1972), enf. denied, 476 F.2d 1079 (2d Cir. 1973). Even though the third of the above cases, Conn. Light & Power Co., involved an insurance carrier the Second Circuit refused to enforce the Board’s decision holding that the identity of an insurance carrier was a permissive not a mandatory subject of bargaining.
It is not clear to me from the record in the present case, however, whether the distinction that the Second Circuit made involves the only issue here. If the bargaining were solely as to the identity of the administrator, and the union did not bargain as to the actual benefits to be received under the insurance plan, admittedly a subject of mandatory bargaining, then it seems to me that this court should deny enforcement, or at the very least remand for a determination as to whether the real issue in negotiations was the identity of the administrator or whether it was the broader issue that the change in administrator affected the substantive terms of the benefit plan, such as how much reimbursement the employees would receive for a given treatment, as well as the promptness with which claims are processed, and the ease with which employees can file claims and obtain information on them.
The General Counsel argues that the change in administrators did result in a sufficient modification of the terms of the 1975 contract on the substantive matters. On the basis of the majority’s opinion that differing benefits, sometimes less, sometimes more, did result, I cannot strongly disagree with the result reached. I do strongly disagree, however, that the identity per se is a subject for mandatory bargaining. I regard cases such as Associated General Contractors v. NLRB, 465 F.2d 327 (7th Cir. 1972), cert. denied, 409 U.S. 1108, 93 S.Ct. 907, 34 L.Ed.2d 689 (1973), as being analogous to the present case. In that case this court held that the union violated § 8(b)(l)(B) by coercing an employer regarding its selection of its representatives for the purpose of resolving jurisdictional disputes. Yet an argument could be made, again in analogy with the present case, that one company representative of its own choosing might be very strict in resolving such disputes and another individual could be very liberal. The same would apply to the employer’s representative on certain jointly trusteed funds which was held in Carpenters, Local 964 (Contractors & Suppliers Assn.), 181 NLRB No. 154, supplemental decision, 184 NLRB No. 67 (1970), enf’d, 447 F.2d 643 (2nd Cir. 1971), to be a permissive subject of bargaining.
I think there could be no question, or at least I would so regard it, if the benefits to be paid were identical, as the term “usual and customary” fee would suggest, the mere fact that one administrator might process claims more promptly or less so than another administrator would have no more bearing on the company’s right to select its own representative than would the fact that one supervisor might process and decide grievances more promptly or differently than another would.
I am impressed also in the present case by the following: there is no contractual restriction on Keystone’s right to change administrators; Keystone had taken the position in 1975 that the union had no control over Keystone’s selection of its administra*182tor; Keystone did bargain with the union to impasse before changing administrators; there was no anti-union purpose involved; and the change was made for a legitimate business purpose — to save money. See University of Chicago v. NLRB, 514 F.2d 942 (7th Cir. 1975).
Unfortunately, this litigation also reflects the rather bizarre result that sometimes follows from intransigence during contract bargaining sessions. It seems quite apparent that the employees on the whole are provided with a better coverage plan under the change than was true under the predecessor administrator. This unfortunately, however, does not seem to be the way the game is played.
Notwithstanding all of these aspects of the case, I am ultimately, albeit somewhat reluctantly, persuaded by the thorough analysis of the majority opinion, and by the fact that it does curtail the overly-broad remedial order of the Board, that the unilateral change of the administrator did result in impact on terms and conditions of employment by the changes of benefits and therefore was the subject of mandatory bargaining. In reaching this result I am not relying upon the fact that there might be reasonable differences of a minor nature as to the amounts of “usual and customary fee” but rather on the fact that the record seems to show that there were substantial monetary scheduled differences between the amounts paid by Blue Cross and that paid by Metropolitan. I can only assume that the record does show that this was the basis on which the union continued to bargain to an impasse and adhered to the position that the administrator should not be changed. I would nevertheless have preferred to have remanded that issue to determine whether the union indeed was concerned about these various changes of benefits or was only attempting to prohibit the company from selecting its own representative for reasons never articulated.
In sum, I concur in the result reached in this case.