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Health insurance change upsets school retirees

District says cost of coverage driving decision

June 8, 2013
By CHRIS KNIGHT , Adirondack Daily Enterprise

SARANAC LAKE - Retired Saranac Lake Central School District employees are upset over a proposed change in their health insurance coverage.

Dozens of retired teachers and other district employees showed up at Wednesday night's school board meeting to speak out against a plan to change their heath insurance from the current Classic Blue Indemnity Plan to the Blue PPO-J plan. Both plans are offered by Excellus Blue Cross Blue Shield.

School officials say the change to the PPO-J plan would save the district a significant amount of money on what's become its biggest expense. Employee health insurance costs represent about 20 percent, or $5.5 million, of the district's total $28 million budget.

But retirees and union leaders say the district has reneged on the health care coverage options it promised to offer employees in their most recent contract negotiations. Retirees are concerned because the new plan will cost them more out-of-pocket and requires pre-approval for certain medical procedures. They also say they should have been notified of the proposed change in coverage sooner, before it was on the board's agenda for approval Wednesday night.

"People were concerned that it had popped up out of nowhere," Ed McCarthy, who retired in 2004 after a 37-year teaching career in the district, told the Enterprise Thursday. "They thought it had been agreed to back in November at the time of the (contract) settlement, and for it to appear this way without any prior notice, I know people were upset."

The district's three-year contract with the Saranac Lake Teachers Association, approved in November, gave SLTA members the option of switching to the PPO-J plan, which is less expensive for the district, or staying with the Blue Indemnity plan. Although the SLTA doesn't represent retirees, McCarthy said they were under the impression that retirees would also be given the same choice.

"We weren't in the negotiations," McCarthy said, "but we were told that what current teachers would be receiving, the retired teachers would get similar kinds of things, equal and same to them, and this appears to be a change."

Cathy Morris, who served as a teaching assistant in the district for 22 years, said she retired this past year so she could go out under the prior contract.

"I made a decision to retire when I did so that I would go out under the benefits of the old contract," she said. "I personally feel I'm entitled to that health insurance."

SLTA Co-President Don Carlisto, a middle school teacher, said the change the school board is considering would affect future retirees, including two SLTA members who are retiring this year. It should be discussed during contract negotiations, he said.

"The plan that we allowed into our contract, we're not disparaging that plan," he said. "What we're saying is it's in our plan as a choice. I think for our future retirees, they're thinking of this as more of a trust issue. Here are some benefits that were fairly negotiated, and now we're told that maybe those benefits that they've counted on and agreed to fairly won't be there."

The resolutions the school board considered Wednesday night would have switched all the district's retired employees, not just retired teachers, from the Blue Indemnity to the PPO-J plan. They were ultimately tabled.

Superintendent Gerald Goldman told the Enterprise the PPO-J plan is cheaper for the district, by about $2,600 for a family policy and about $1,000 for an individual policy. He noted that most retirees who worked for the district for more than 17 years don't make any contributions toward their health insurance premiums.

"The bottom line is the district has to pursue aggressive ways to reduce its health care costs," Goldman said. "The district's position going forward is probably going to be that we have a right to move retired teachers into this plan. If we didn't have to negotiate this with the (active) teachers we wouldn't have given them a choice either. We would have moved all of them to PPO-J."

Goldman said he wouldn't be surprised if the dispute sparked a grievance, an appeal to the state Public Employment Relations Board or even a lawsuit. A representative of the New York State United Teachers union was in Saranac Lake this week to meet with local union leaders and the district's retirees.

NYSUT spokesman Carl Korn said Friday that his union "always seeks to work out problems in a collaborative, win-win way, but if that's not possible, we are going to leave no stone unturned to protect the benefits of our members and retired members."

Goldman noted that about 50 current teachers have already switched to the PPO-J plan. The district provided incentives for them to do so, namely by setting lower premium contributions for the cheaper plan. All of its active Civil Service Employees Association workers - including custodians, bus drivers, secretaries, teaching aides, food service workers and maintenance staff - switched to the PPO-J plan as part of the three-year contract they signed in September.

What is it about the PPO-J plan has the retirees concerned?

"For those people that are healthy and well, PPO-J is fine," McCarthy said. "For those that do have health issues, there are more copays you'd be paying each time you go. Another concern is that people would have to get pre-approval for certain medical procedures."

"If you see a doctor like once a month, the copays are going to run you more than what the deductible runs you now," Morris said. "If you don't see a doctor often, then it's probably to your benefit. The fact that it also doesn't have a maximum out-of-pocket expense - if you have cancer, you could incur thousands and thousands of dollars in medical bills that won't be covered by your insurance."

Goldman argues that the plans are relatively identical.

"The big difference is on PPO-J you have copays, most of them are about $20," he said. "You have to pre-authorize CT scans, MRIs and X-rays, but that's a pretty common practice these days for doctors to need pre-authorization to order those sorts of expensive imaging tests."

Asked why the retirees weren't notified that the board was considering the change, Goldman said "In hindsight, the board probably wishes that it had publicized this a little bit more.

"The board didn't pass it because so many teachers showed up and were very vocal in their opposition to it," he said. "Many felt like they didn't think they know enough about it, so we scheduled an information session on it."

Representatives of Excellus will be hosting a workshop later this month on the proposed change, Goldman said. He said a spreadsheet comparing the two plans will also be mailed to retirees before that meeting.

Goldman said he expects the proposed switch will be brought back before the school board for approval sometime in July.

Goldman is retiring at the end of the month. He's currently on the Blue Indemnity plan and contributes 25 percent toward his premiums. When he retires, he said he'll be on the PPO-J plan and will contribute 15 percent.

Contact Chris Knight at 891-2600 ext. 24 or cknight@adirondackdailyenterprise.com.

 
 

 

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