St. Peter's University Hospital v. New Jersey Building Laborers Statewide Welfare Fund, A-1463-11T3, A-1464-11T3, A-1465-11T3; Appellate Division; opinion by Axelrad, P.J.A.D.; decided and approved for publication July 2, 2013. Before Judges Axelrad, Nugent and Haas. On appeal from the Law Division, Middlesex County, L-2666-10, L-2820-10 and L-4712-10. [Sat below: Judge Paley.] DDS No. 22-2-0502 [25 pp.]
St. Peter's University Hospital entered into an agreement with MagNet Inc., a preferred provider organization, under which the hospital agreed to provide medical services to eligible persons insured by group health coverage providers, such as defendants New Jersey Building Laborers Statewide Welfare Fund and its predecessor, defendant Local 594 Building Laborers Welfare Fund, which are employee welfare benefit plans that provide medical benefits to participants and their dependents, at a reduced rate of payment established by MagNet. The discount was conditioned on timely payment under the contract. If not timely paid, the hospital could bill and collect from the insurance provider and eligible person its customary rate for the services. MagNet and the fund entered into a subscriber agreement containing similar terms.