Thursday, April 22, 2021

Municipal Healthcare Retirees kept in dark by UFT Leaders over coming forced medicare advantage plans

The negotiations are taking place in virtual secret. This lack of transparency is happening with the full knowledge of the various union leaderships, including the UFT. Retirees of the Professional Staff Congress (PSC), just this week, their Delegate Assembly passed a resolution calling for a moratorium on these negotiations and for ”voices of municipal retirees to be heard”.

We're hearing from UFT retirees who haven't been in touch as a

horror film of sorts unfolds for all municipal retirees under Medicare (65 and above) which can lead to them losing access to their doctors and paying high fees. The important thing to understand is that our own union leaders have been engaging in secret negotiations and are about to spring it all on us. At the most recent retiree chapter meeting, our Retiree Advocate/UFT caucus that is challenging the retiree Unity Caucus in the upcoming retiree election, had the item put on the agenda and Mulgew was one of the guest speakers.

Here are two reports from the UFT Retiree Chapter meeting, April 14, 2021:

Unity seems a little shaken that the MLC/Medicare negotiation is out of the bag. So, according to Mulgrew, anything the MLC negotiates will be the best thing ever, because anything he touches turns to gold. He is very smart! And according to Sorkin:
  • Yes, a Medicare Advantage plan is on the table... but don't you worry, you silly people! This is not yesterday's old-fashioned, crappy Medicare Advantage plan (the kind we always told you scary stories about); this is today's shiny!, brand new!, awesome! Medicare Advantage plan! What are you, an old fogey? Get with the program. This is modern! This is a "White glove, concierge service!
  • What's more, the plan is more of a PPO, rather than HMO plan. (You got that? The letters are different!)
  • Part B & IRMAA reimbursements are not on the table. Who told you that? That's a pernicious rumor. Pinky swear.
Do you feel reassured yet?
No I don't feel reassured. The other retiree added:
Mulgrew also said: Two years ago, we decided to be active consumers. We want access to the same or better health care! But now, because of the RFP, I can't talk too much. (What the f is a RFP? He used these initials a few times but never said what it stands for. Or did I miss something?)
If we do anything, you'll be in a better place! We will make it better. I guarantee. We will fight for you...Blah blah,, that's as far as I can go with the RFP....

Then Jeff Sorkin continued to "address some rumors that are out there".
Report above describes the main points he made. I especially chocked when he spoke of the Access to lifelong concierge services- assistance, guidance to manage chronic conditions. But it's not a Gatekeeper...
Some additional points I heard him say:
"You will be able to retain your current doctors". and "You'll have access to all doctors that take Medicare"
Can't this be contradictory??
"Nothing is finalized" Right. But it will be without any input from membership.

[Tom) Murphy ended with options, choices, enhancements. looking forward. The history of the UFT with the MLC is to enhance benefits, save money.
"Guarantee to keep your benefits or enhance them:
Now I know we're all reassured!

And an old friend commented:

Leave it to the municipal unions to agree back in 2018 to cut medical expenses for the city by $2 billion or so dollars by the end of the contract in 2021 and it looks like they are planning on turning us into a medicare advantage plan as opposed to regular medicare . This is a disaster for retirees - once it becomes an advantage plan you must see doctors in their network - kind of like the old HIP and every procedure will be looked. Dr. Mark doesn't take med advantage plans nor do lots of others because they pay doctors less then medicare does. I assume you know about Mike's (Schirtzer's - Retiree Advocate) resolution for the DA. They will sell it to the members as a benefit just like the ads on radio and TV do - lower premiums, eyeglass and dental coverage, etc. Of course what they won't say is that there will no longer be Part B reimbursement checks each year to cover medicare and also no more IRMAA for those paying a higher medicare premium because they earn over the threshold. It's really all about IRMAA - for recent single retirees who have retired with a pension of 80,000 or so and social security of 20,000 and TDA annual RMD's of lets say 40,000 they pay about $1800 for regular medicare and another $1800 for IRMAA so they would lose $3600 in rebates a year.
This is what RA sent out to members:
Retiree Advocate/UFT is sounding the alarm to all retirees and in-service members of a pending change to our health care. The City and MLC (Municipal Labor Committee) are in negotiations to give the administration of our health coverage over to a private insurance company. Two companies , Aetna and Emblem Health, are among the finalists. This would transfer the 250,000 municipal retires from our current traditional Medicare to a Medicare Advantage plan (a privatized Medicare). NYC has called for more savings not for retirees but for itself.

Retiree Advocate/UFT called on Tom Murphy to place the issue before the Retired Teachers Chapter meeting last month. He did but we received a superficial explanation. Last week Retiree Advocate was fortunate to have Mike Schirtzer, a UFT Executive Board member, put a Retiree Advocate initiated resolution to the April 14 UFT Delegate Assembly. The resolution, one of many, was placed well into the agenda thus ensuring that  President Mulgrew  did not get to it, thereby delaying action on this vital issue.

This article from The City is setting off alarms among retirees with some calling for a rally or even a die in at MMC headquarters. I was thinking of a rally with our walkers, like The Producers. There are ineresting and alarming details in this article

Retired City Workers Recoil at Coming Cost-Saving Medicare Shift

Impending move to privately managed health plans could save taxpayers as much as $600 million annually — at a high cost to retirees, who may have to pay more for less care and fewer doctor choices, some warn.

Nearly 250,000 retired New York City employees and their spouses could have their health insurance changed to “Medicare Advantage” plans managed by private insurers as soon as July 1, New York Focus has learned.

Retirees, who are pushing to delay the switch, say they are worried that a switch away from their current Medicare plan could lead to dramatically higher out-of-pocket costs and a smaller network of providers.

“It’s a little frightening,” said Jane Roeder, a retired city administrator. “The word on the street is that these Advantage plans are fine as long as you don’t get sick, as long as you don’t need the chemotherapy that my friend is having right now, or radiation treatment, or infusion treatment, or skilled nursing.”

The proposed switchover follows a June 2018 agreement between the Municipal Labor Committee, a group that represents retired New York City employees, and the city Office of Labor Relations.

Under that pact, both sides agreed to reduce health care costs for retirees by $600 million a year relative to 2018 forecasts, starting in 2021. Switching to Medicare Advantage, also known as Medicare Part C, was one of eight possibilities proposed at the time.

Under Medicare Advantage, the city projects it would save that sum by paying a fee to a private insurance company to manage a Medicare plan. Documents reviewed by New York Focus indicate a deal is being negotiated between the city and private insurance companies seeking to administer the coverage.

The city currently reimburses retirees the cost of their premiums for Medicare Part B, which covers outpatient care, and also pays for a supplemental “Medigap” plan to insure for services not covered by traditional Medicare.

Premiums for Medicare Advantage are often lower than in traditional Medicare, but involve trade-offs that could affect retirees’ health and finances: a smaller network, and higher out-of-pocket costs, said Naomi Zewde, a professor of public health at CUNY who is a Roosevelt Institute fellow.

“The city is going to save money by making seniors pay more for their health care,” Zewde said. “These are people who worked an entire career under the promise that they would have good health care later on.”

Fewer Physicians

City retirees currently have access to the vast majority of physicians in New York. Medicare Advantage plans generally have fewer options: A 2017 national study from the Kaiser Foundation found that on average, Medicare Advantage plans offered access to just 40% of physicians in Queens.

Contract-related documents made public by the city Office of Labor relations suggest an increase of as much as $6,000 annually in potential out-of-pocket costs per retiree could be in store. Such costs are currently capped at $1,053 per year, according to Len Rodberg, a retired CUNY professor and health policy expert who would be affected by the potential change.

The documents show annual out of pocket costs could reach upwards of $7,000 for an individual — approaching the maximum allowed by Medicare under law.

“Basic city workers in the $30,000 to $50,000 [salary] range, their Social Security payments are smaller, their pension is smaller; they’re going to get hit badly by this,” Rodberg said.

Some budget watchdogs have highlighted retiree health care savings as necessary to bring $2.2 billion in annual city benefits spending under control.

“Health care savings are important. They’re essential to getting the city on solid fiscal footing, due to the rate at which these costs grow,” said Ana Champeny, director of city studies at the fiscally conservative Citizens Budget Commission. “It’s important to come to a consensus about how to control the costs, and how to possibly reduce the retiree health costs too.”

But retiree advocates say the deal in the works is too high a price for members to pay.

“Somehow you’re going to save $600 million, and the 200,000 Medicare retiree recipients are going to somehow get no worse and maybe even better service?” said Stuart Eber, president of the Council of Municipal Retiree Organizations.

‘People Don’t Know’

The city Office of Labor Relations received eight proposals for Medicare Advantage plans, now winnowed down to two finalists: Aetna and Empire BlueCross BlueShield, multiple retirees said they’ve been informed by their unions.

Cost-cutting employers have been gravitating toward Medicare Advantage, created in 1997 under then-President Bill Clinton. As of 2018, 39% of New York State’s Medicare beneficiaries were enrolled in Medicare Advantage plans.

“Employers have been gravitating towards Medicare Advantage plans to save money on their retiree health obligations,” said Tricia Neuman, executive director of the Kaiser Family Foundation’s Program on Medicare Policy. “New York is not alone.”

Neuman notes that Medicare Advantage plans rely on a list of in-network doctors. “They’re likely to be more limited in their provider network than traditional Medicare coupled with a Medigap policy,” Neuman said.

Some union officials have attempted to obtain information on their future access to services such as lab tests and rehab facilities, to little success.

“We haven’t gotten specific answers to those questions, and because we’re not privy to the negotiations, we don’t know that they’re not an issue,” said Neal Frumkin, a retiree leader with DC 37, the city’s largest public employee union.

‘Fewer Services’

Achieving the $600 million savings could involve requiring pre-approval from insurers for certain procedures. “That would mean fewer services that would be covered by the plan, potentially,” Neuman said.

More than half of Medicare Advantage participants are enrolled in plans that require prior authorization for ambulance rides, mental health services, inpatient hospital stays and other services, according to a Kaiser analysis.

CUNY retirees are mobilizing against the Medicare Advantage shift, at least until more details are known. At the end of the April 5 meeting, over 93% of attendees voted to request a moratorium, saying that retirees “have not been provided adequate and timely information” about the details of the proposed change.

None of the unions represented among the Municipal Labor Committee’s officers responded to requests for comment, nor did the city Office of Labor Relations. They include the United Federation of Teachers, the Uniformed Sanitationmen’s Association, DC 37, the City Employees Union and the Council of School Supervisors and Administrators.

Frumkin said that DC37 president and Municipal Labor Committee co-chair Henry Garrido voiced his support for the proposed change at the union’s March executive board meeting.

“Garrido’s position is that it’s a must do because that savings is necessary to stabilize the health benefits for the entire city of New York; the city has to be able to afford to do what they’re doing,” Frumkin said.

“The argument that Garrido makes is that the city fiscally is in a dangerous place, therefore we are trying to come up with savings to enable them to get over this financial problem that they have.”



  1. I'm closing my eyes and trying to imagine how nice it would have been to ask what an RFP is. Or how smooth and sexy "white glove concierge service" feels (while you're bleeding dollars and trying to find a specialist). Or to have screamed "Medicare Advantage? Are you kidding me?!!!"

    But alas, it's just a fantasy because, incredibly, after thirteen months (that's 13) there is still ZERO member interaction during remote RTC meetings. ZERO. NADA. NOTHING.

    Thirteen months and a lifetime of Zooms. Thirteen months and the UFT IT department at your disposal. Still too complicated I suppose; haven't worked the bugs out. Don't worry kid, that color TV is just around the corner.

    No motions, no good and welfare, no resolutions, no chat, no debate, no questions, no answers, no satisfaction, no nothing. Just one big infomercial.

  2. Is IRMAA going to be affected, I didn't see mention of that.
    Also what can retirees do now. I'm thinking of calling and stopping my COPE payments??????

  3. Some think IRMMA is a target for sure -- It's really all about IRMAA - for recent single retirees who have retired with a pension of 80,000 or so and social security of 20,000 and TDA annual RMD's of lets say 40,000 they pay about $1800 for regular medicare and another $1800 for IRMAA so they would lose $3600 in rebates a year.

  4. It is deplorable that the UFT is keeping its members uninformed regarding proposed changes and worse the UFT is prejudiced in favor of the proposal as per comments from officials. The proposed Medicare Advantage plan is inferior to the current traditional plan and is not in the best interests of retiree members. I am appalled that the UFT would sell its members out when the city has been throwing money around to other programs. It is the UFT's obligation to protect its members with the current traditional Medicare option


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