Winter 2004

UFT Secures Health Benefits

In late December, the UFT successfully resolved two issues which were threatening the health benefits of members - the scandalous DOE delay in getting new and returning members their health coverage, and the solvency of the PICA program which provides members with a number of specialized drugs.

In early December, several hundreds - and perhaps as many as a thousand - New York City public school employees were still not receiving their health insurance, as a consequence of sheer bureaucratic incompetence and inefficiency at the Department of Education. The UFT had raised this issue forcefully and repeatedly, most recently during health care negotiations with the city, but all to no avail. Finally, when the UFT announced its intentions to bring a lawsuit against the DOE, action was taken. In a matter of days the entire backlog of applications was processed and the DOE has now promised to stay current. Given the DOE’s action, the UFT no longer needed to file the lawsuit.

The DOE’s promise came in the wake of the agreement reached by the Municipal Labor Committee, which is chaired by UFT President Randi Weingarten, and the Bloomberg administration to maintain the city/MLC hospital and medical benefit programs. It averted bankruptcy of the special drug program PICA - which stands for Psychotropics, Injectables, Chemotherapy and Asthma drugs (and includes anti-depression medicine and insulin). The city had initially wanted $600 million in givebacks for budget savings. The city also was trying to shift health costs to active and retired members by eliminating Medicare Part B reimbursements, which would force members to pay premiums and assume a significantly larger share of medical costs. The unions wanted to save our basic health coverage, including PICA, which because of increasing drug costs and despite city funding increases of 8 to 10% a year was close to insolvent.

Under the agreement the city will give approximately $70 million to the unions by making an additional contribution of $100 per member and retiree to union welfare funds, which provide supplemental health and other benefits. The unions fought to maintain health coverage without annual premiums, and any members who opt for the HIP/HMO will continue to have a no employee-cost health plan.

• The unions in turn identified approximately $100 million of health care savings through increases in some existing co-payments that employees and retirees pay for drug and physician/hospital visits:
• Office visits copays now $10 will go up to $15 for primary care physicians, $20 for specialists;
• Annual deductibles for the use of non-participating providers will increase from the current $175 to $200;
• Current hospital in-patient copays of $200 will rise to $300;
• Emergency room copays will rise from $25 to $50.

All members will contribute an annual health plan administration fee of $35, similar to other public sector plans in New York State.

Finally, the agreement saves PICA, but copays for psychotropic, injectible and other specialized drugs will rise from the current two-tiered $0 or $6 to three-tiered $5, $15 or $35, depending on whether the drugs are generic or on a preferred list known as a formulary. There will also be some administrative savings through such items as a mandatory mail program.

Overall, the health care agreement is fair for both the city and its current and retired workers. It maintains the comprehensive health plans we have, with small increases in existing copays that haven’t risen in many years. Most importantly, we maintained the solvency of the city’s hospitalization and medical insurance program, along with prescription drug services.