County of Passaic v. Horizon Healthcare Services, Inc.
CourtNew Jersey Superior Court Appellate Division
Date FiledFebruary 8, 2023
DocketA-0952-21
StatusPublished
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Full Opinion
NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-0952-21
COUNTY OF PASSAIC,
Plaintiff-Appellant,
APPROVED FOR PUBLICATION
v. February 8, 2023
APPELLATE DIVISION
HORIZON HEALTHCARE
SERVICES, INC., d/b/a
HORIZON BLUE CROSS
BLUE SHIELD OF NEW
JERSEY,
Defendant-Respondent.
___________________________
Argued January 18, 2023 β Decided February 8, 2023
Before Judges Susswein, Berdote Byrne and Fisher.
On appeal from the Superior Court of New Jersey, Law
Division, Passaic County, Docket No. L-1385-21.
Kenneth D. McPherson, Jr., argued the cause for
appellant (Waters, McPherson, McNeill, PC, attorneys;
Kenneth D. McPherson, Jr., and Mark J. McPherson, of
counsel; Kenneth D. McPherson, Jr., and Natasha
Montalvo, on the briefs).
Patricia A. Lee argued the cause for respondent
(Connell Foley LLP, attorneys; Patricia A. Lee, of
counsel and on the brief).
PER CURIAM
Starting in 2002, plaintiff County of Passaic contracted with defendant
Horizon Healthcare Services, Inc. to manage the County's self-funded health
benefit plan; that relationship, in one form or another, lasted until December 31,
2019. The County filed this action in 2021, claiming, among other things, that
Horizon breached their contract by failing to implement certain modified
reimbursement rates. Horizon quickly β and successfully β moved to compel
arbitration based on a stipulation in their 2009 written agreement that "[i]n the
event of any dispute between the parties to this Agreement arising under its
terms, the parties shall submit the dispute to binding arbitration under the
commercial rules of the American Arbitration Association." In appealing, the
County asserts that the arbitration provision is unenforceable because it lacks
the explicit waiver of access to the courts prominently featured in the Supreme
Court's landmark decision in Atalese v. U.S. Legal Services Group, L.P., 219
N.J. 430 (2014). We reject this argument and affirm because, even though the
arbitration provision does lack such an explicit waiver, the County is a
sophisticated contracting party and is not β as in Atalese and other authorities β
an employee or consumer lacking sufficient bargaining power to resist the
extraction of an agreement to arbitrate.
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I
We start our analysis by recognizing that both the Federal Arbitration Act,
9 U.S.C. Β§Β§ 1 β 16, and the New Jersey Arbitration Act, N.J.S.A. 2A:23B-1 to -
36, express a general policy favoring arbitration "as a means of settling disputes
that otherwise would be litigated in a court." Badiali v. N.J. Mfrs. Ins. Grp., 220
N.J. 544, 556 (2015). The FAA, which is applicable here, declares that a written
arbitration provision encompassed by the FAA "shall be valid, irrevocable, and
enforceable, save upon such grounds as exist at law or in equity for the
revocation of any contract." 9 U.S.C. Β§ 2. The "save-upon" phrase at the end of
9 U.S.C. Β§ 2 opens the door to the application of "ordinary state-law principles
that govern the formation of contracts." First Options of Chi., Inc. v. Kaplan,
514 U.S. 938, 944 (1995). So, when determining the enforceability of an
arbitration agreement, like any other contract, our courts will consider whether
there was mutual assent, as impacted by notions of unconscionability, which
vary from case to case based on the parties' sophistication and the one-sided
nature of the negotiations. Muhammad v. Cnty. Bank of Rehoboth Beach, 189
N.J. 1, 15 (2006) (citing Sitogum Holdings, Inc. v. Ropes, 352 N.J. Super. 555,
564-66 (Ch. Div. 2002)).
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These basic principles are critical in determining whether there is merit to
the County's claim that Atalese bars enforcement of the arbitration agreement in
question. We hold β because the parties are sophisticated and possess relatively
equal bargaining power β Atalese's requirement of an express waiver of the
parties' right to seek relief in a court of law is inapplicable and the arbitration
agreement is enforceable.
To be sure, our Supreme Court has not expressly limited Atalese's
insistence on an express waiver of the right to seek relief in a court of law. But
the clues are there. For example, in reaching its conclusion, the Atalese Court
relied on the Consumer Fraud Act, N.J.S.A. 56:8-1 to -227, which declared that
consumer contracts be "written in a simple, clear, understandable and easily
readable way." 219 N.J. at 444 (quoting N.J.S.A. 56:12-2). Throughout the
Atalese opinion, the Court mentioned that the arbitration provision was
contained in a consumer contract, and, in its holding, the Court emphasized that
an arbitration provision must "be sufficiently clear to place a consumer on notice
that he or she is waiving a constitutional or statutory right." 219 N.J. at 443
(emphasis added). And, later, in Kernahan v. Home Warranty Adm'r of Fla.,
Inc., 236 N.J. 301, 320 (2019), the Court observed that in Atalese "[t]he
consumer context of the contract mattered."
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Atalese, as well as other decisions from our Supreme Court, focus on the
unequal relationship between the contracting parties or the adhesional nature of
the contract when holding that an arbitration agreement could not be enforced
without an express waiver of the right to seek relief in a court of law. As the
United States Court of Appeals for the Third Circuit has recognized, our
Supreme Court has adopted the stricter approach found in Atalese "only in the
context of employment and consumer contracts." In re Remicade Antitrust
Litigation, 938 F.3d 515, 525 (3d Cir. 2019). This observation is certainly
correct. See, e.g., Flanzman v. Jenny Craig, Inc., 244 N.J. 119, 124 (2020)
(employment contract); Kernahan, 236 N.J. at 307 (consumer contract); Morgan
v. Sanford Brown Institute, 225 N.J. 289, 294 (2016) (consumer contract);
Atalese, 219 N.J. at 435 (consumer contract); Leodori v. Cigna Corp., 175 N.J.
293, 295 (2003) (employment contract); Martindale v. Sandvik, Inc., 173 N.J.
76, 81 (2002) (employment contract); Garfinkel v. Morristown Obs. & Gyn.
Assocs., 168 N.J. 124, 127 (2001) (employment contract).1 All these decisions
reveal the Court's concern about the nonexistence of a waiver of the important
1
Delaney v. Dickey, 244 N.J. 466, 471 (2020) involved an arbitration agreement
between a law firm and a sophisticated businessman. That decision, however,
turned on the law firm's professional and fiduciary obligations and not on the
content of the agreement.
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right to seek relief in a court of law in contracts involving consumers and
employees, who are not "necessarily versed in the meaning of law-imbued
terminology about procedures tucked into form contracts." Kernahan, 236 N.J.
at 319 (citing Atalese, 219 N.J. at 442).
This concern for those not versed in the law or not necessarily aware of
the fact that an agreement to arbitrate may preclude the right to sue in a court or
invoke the inestimable right of trial by jury, on the other hand, vanishes when
considering individually-negotiated contracts between sophisticated parties β
often represented by counsel at the formation stage β possessing relatively
similar bargaining power. Although our Supreme Court has not expressly
declared it, and although we too have not said as much in any published opinion, 2
we are satisfied, as the court of appeals recognized in Remicade, 938 F.3d at
526 β and as we now so hold β that an express waiver of the right to seek relief
in a court of law to the degree required by Atalese is unnecessary when parties
to a commercial contract are sophisticated and possess comparatively equal
bargaining power. The parties here were represented by counsel at all relevant
stages of their negotiations and during the formation of the relevant contract
2
We have, however, said so in unpublished opinions that lack precedential
authority. R. 1:36-3.
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documents over the course of their seventeen-year relationship and understood
the difference between the right to seek relief in a court of law and being
relegated to arbitration under AAA's commercial rules. We thus agree with the
trial judge that the arbitration provision was enforceable notwithstanding its lack
of an express waiver of the County's right to seek relief in a court of law.
II
The County poses two additional arguments about the enforceability of
the arbitration provision. The first of these is its argument that Atalese's express
waiver requirement should apply in this and all other settings because "state law
[must] be arbitration neutral." We find insufficient merit in this argument to
warrant discussion in a written opinion. R. 2:11-3(e)(1)(E).
In the second, the County contends that the arbitration provision should
not have been enforced because it was not contained in the parties' most recent
agreement, only an earlier agreement. This, too, is without merit. The record
reveals that the parties maintained a lengthy contractual relationship that
commenced with their September 2002 agreement. After operating for seven
years under that initial agreement, the parties executed in December 2009 a new
Administrative Services Agreement (ASA) that contained the arbitration
provision as well as a Schedule A, which reflected the annual costs associated
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with the plan. For the ten years that followed, the parties never revisited the
terms of the ASA; instead, Schedule A was updated and executed each year, and
each updated Schedule A stated that it "incorporate[d] the terms and conditions
of the [ASA]." We are satisfied β particularly when considering, once again, the
sophistication of the parties and their reliance on counsel β that no Schedule A
entered into after formation of the ASA conflicted with or overrode the
arbitration provision contained in the ASA.
III
The County lastly argues that, as a result of being "intimidated" by
Horizon's "unfounded threats" of judicial bias, the trial judge "adopt[ed] an
overcompensating disposition favoring Horizon in order to be spared charges of
bias." We reject this as well.
To explain, the record reveals that when counsel argued the motion to
compel arbitration, the judge noted that a close relative was employed by the
prosecutor's office 3 and was possibly covered by the health plan in question.
Horizon's counsel stated that she "d[id]n't think there is any kind of conflict"
3
The judge later advised he had served as acting prosecutor in Passaic County
until June 30, 2009, during the period covered by the 2002 agreement between
the parties, a period that the parties recognize is largely irrelevant to the issues
raised in this suit.
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and "doubt[ed] . . . there[] [are] going to be any issues" once she discussed it
with her client. The judge responded that he would give Horizon's counsel the
opportunity to consider the matter, although he did not think it would "affect
[his] judgment one way or the other." The judge also then said that he had
advised counsel of the possible conflict
for the sake of transparency, to make sure that that's out
there because I don't want anybody to come back later
on and say that I was influenced by that fact. I know I
won't be because it really doesn't involve individual
claims. It's something more substantial than that, but I
just wanted to be sure. Do the other sides have any
problem with it?
The County's attorney immediately responded, "No, Judge, we don't."
Later, as part of the judge's invitation for the parties to express any
concerns, Horizon's attorney advised that her client "does not believe" that the
information provided about a possible conflict warranted the judge's recusal,
although Horizon did state that it "reserve[d] its right in the future should any
additional circumstances arise which may indicate a prejudice to Horizon due to
venue in the County of Passaic." The County responded that Horizon's attempt
to reserve its rights on this issue was improper and "offensive" because it left
the recusal issue "hanging over the [c]ourt's head." In response to that, the next
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time the motion was argued Horizon's attorney clarified Horizon's position that
the "reservation" of its rights
was about venue, it was not about Your Honor. It was
not about any kind of judicial bias. It was just in
relation to the County of Passaic, the issues with respect
to employee benefits of County employees and the
unforeseen future if the matter were to ever go to a jury
and that's why the comment was about venue. It was not
about judicial bias.
[Emphasis added.]
Never once did the County ask the judge to step aside for any reason,
including the reason now put forth: that Horizon bullied the judge about an
accusation of bias and that the judge compensated for this by ruling in Horizon's
favor. Having never sought the judge's recusal either before, during or after the
judge ruled on the arbitration motion, it is inappropriate for the County to now
argue that the judge may have been influenced by what Horizon said about
possibly challenging the fact that the case had been venued in Passaic County.
To the extent the law would recognize the County's "compensatory bias" theory,
see State v. Holland, 449 N.J. Super. 427, 443 (App. Div. 2017) β a question we
need not decide β the County should have raised that issue in the trial court and
not, for the first time, here.
***
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The order under review β insofar as it granted Horizon's motion to compel
arbitration β is affirmed. That order, however, mistakenly dismissed the
amended complaint rather than merely staying the action. See Antonucci v.
Curvature Newco, Inc., 470 N.J. Super. 553, 567 (App. Div. 2022). We, thus,
affirm and remand for entry of an order vacating the dismissal but staying the
action pending the completion of the arbitration proceedings.
Affirmed and remanded. We do not retain jurisdiction.
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