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WASHINGTON (AP) Thousands of workers at health care giant Kaiser Permanente have voted again to remain with the Service Employees International Union rather than switch to a smaller rival.

The National Labor Relations Board says Kaiser workers in California voted 58.4 percent to 40.6 percent in favor of the 1.9-million-member SEIU over the National Union of Healthcare Workers.

The vote was a replay of an election from nearly three years ago. But the previous result which SEIU also won was thrown out after federal officials said SEIU committed violations.

The new union was launched by former SEIU leaders who were ousted from the larger union in a bitter power struggle. Both unions have spent millions battling over about 45,000 Kaiser workers. It was the largest union election since the 1940s.