Showing posts with label ARISE. Show all posts
Showing posts with label ARISE. Show all posts

Tuesday, January 13, 2026

Unity Caucus Favors Co-Pays: NYC Educators Penalized for Retiring - Sign the Petition

Tell Michael Mulgrew and Unity to stop charging retirees premiums while claiming our health plan is premium free. Let’s send Unity a message to respect us. Let’s tell them we demand what other unions have. The UFT Welfare Fund is sitting on over a billion dollars. Let’s tell them how we’d like it used. Let’s tell them that the very worst time to impose premiums on us is when we retire. Let’s tell them if other unions can better support retirees, we can too. DC37 doesn’t charge members for prescription insurance when they retire. Firefighter and police unions don’t do it. Sanitation, and other unions don’t do it.... Arthur Goldstein

 Sign the petition. 1,575 have signed in 24 hours -  let's hit 5k.

Imagine a world where UFT would fight like the Nurses Union. Those nurses don’t play around. They are standing on business!! I love it....Anon. FB quote 

ABC's Leah Lin tells it all: Paying more in retirement just doesn't make sense.  


Tuesday, Jan. 13, 2026
 
I just finished 3 months of physical therapy for my knee, twice a week, at $15 co-pay a pop -- that's $30X12 weeks = $330 for my "premium free" healthcare. Plus all the other doctors I go to --- It's probably close to $500 given visits for my cancer and diabetes (due to removal of over half my pancreas). Listen, I can handle it all financially at this point, but for many NYC retirees these co-pays are a real burden. I've even heard stories of people who expected to retire are forced to hold off. 
 
I'm proud of my colleagues at ABC are at least making a stink of this while other supposedly opposition groups are fundamentally silent. My sense is that the non-Unity leaders of the RTC, many of whom defended the new healthcare plan, seem reluctant to be openly critical.
 
Today is an RTC Executive Board meeting and I'm looking forward to some action beyond a lot of whining over Mulgrew not calling on them at the DA. I detect a hint of fear that if they are too publicly critical of  the Unity leadership and Mulgrew, who has elements of Trump-like vindictiveness, he may turn off the lights and heat to their offices at 52 Broadway. I'll bring candles.
 
Arthur Goldstein authored a summary cross posted on the https://stopchargingretirees.org/ site: Should NYC Educators be Penalized for Retiring? Do you want to pay at least $180 a month, forever, when you retire? If not, please sign and share our petition. Please sign our petition demanding UFT stop charging retirees, some of whom are already struggling to get by. Please tell your friends to sign and share widely.




 ------
Here's a message from on the new PPO Plan. I logged on and found that one of my diabetes meds is not on the forumulary as a 1MG but is as 2 MG. We were promised the new plan would not result in changes. 

 

York City Municipal Employees & Retirees

 

January 1st the new NYCE PPO plan was implemented for all active workers, and Pre-Medicare Retirees.   In a few weeks, we will roll out a survey to see if you are having any concerns that need to be addressed.  

January 1st also began the new Pharmacy Benefit Manager (PBM) for those in the NYCE PPO plan, or those who are on the City Drug plan, the optional rider.  The new PBM is "Prime Therapeutics" - no longer Express Scripts.  They are the MANAGER...   Think of them like the middle man to your drug access.  A simple way to understand their job - they get you access to the drugs..   You have the drug manufacturers, the PBM and the Pharmacy.  

 
 
 
 
This was prepared by Bob Pfefferman as a briefing report prior to a meeting with newly elected City Council member Virginia Maloney. He invites questions and comments. 
 

Briefing paper, January 7, 2026, V3

 

The unions’ claim that they can negotiate for current retirees is specious for all of the following:

 

·      There is no such thing as a collective bargaining certificate for retirees.

 

·      Except for UFT retirees, we have no say in electing the union leadership. Even then UFT retiree votes are capped at a certain number.

 

·      To my knowledge, neither OLR or the MLC have cited a specific section of the Taylor Law that 1096 violates.  Any legal memo the city or the unions have is not public so no one can comment. Would you accept an unsupported allegation like this in a high school debate class?

 

The unions don’t mean this as a policy discussion. It is meant to intimidate any city council member that asks too many questions and threaten with a primary challenge.

 

·      When a union does negotiate, at least in my local, 371, AFSCME (DC 37), the members approve the collective bargaining demands. No such vote was held.

 

·      The results of any collective bargaining from an AFSCME entity holding a collective bargaining certificate must be approved by the membership. No such vote has been held.

 

·      Christopher Marte’s office has cited a US Supreme Court ruling Chemical Workers V Pittsburg Glass, 1971, in which it ruled that retiree benefits are not negotiated by a union

 

·      Marte also points out that in the past DC 37 and the UFT have supported city council legislation protecting retiree health care and never cited the Taylor Law. Because unions cannot bargain for retiree health care, the city council must pass legislation to change it.

 

Status of Lawsuits (Brentkowski case; I don’t know how to spell it)

 

·      Marianne’s group filed a lawsuit in September 2021 saying that the city cannot only offer one health insurance plan for retirees and must offer traditional Medicare and a wrap around. They cited 12 “causes of action” why the city could not do what they wanted.

 

·      The trial judge ruled “irreparable harm” and issued a TRO. He only ruled on one of the 12 causes of action. The city appealed and four years later, the Court of Appeals overturned the trial judge’s ruling and sent it back to the trial judge for ruling on the other 11.

 

·      Should the city and/or the unions (one entity for this purpose) be so reckless as to try this again, the trial judge would likely issue another TRO and the city and the unions will be wandering in a judicial morass for another two or three years with an uncertain outcome.

 

·      Retiree will not accept a Medical Advantage Plan as the only option for health insurance. We will fight this politically and legally. The city council has already seen what we can do. Do you really want to try it again?

 

The Comptroller’s Audit

 

·      The audit confirmed what retirees have been saying since 2021: that the fund was knowingly misused by the MLC and OLR and lacks transparency.

 

·      OLR tried to cover this up by submitting false annual certifications to the Comptroller’s Office, asserting in writing that the Fund is in compliance with Directive 27 requirements, that Fund balances are accurate, and that the Fund will be used for its stated purposes.

 

·      The audit also found that HISF lacks transparency and has inadequate governance and decision-making capacity. HISF does not maintain meeting agendas, materials distributed at meetings, or records of discussions held at meetings—such as recordings, minutes, or notes—and stated that it relies on HISF’s monthly reports which include only the Fund’s revenue, expenses, and cash balance.

 

·      Furthermore, while the $600 million would have improved HISF’s financial position somewhat, it was not sufficient, on its own, to keep HISF solvent

 

·      As detailed in Table XV in the audit, OLR and the MLC did not report significant HISF liabilities as required by Comptroller’s Directive 27 and GSAB Statement No. 54.

 

Garrido Speaks Untruths

 

·      In February of 2021, Henry Garrido reported to his delegates (I am one) that he was shocked, absolutely shocked, to discover that the HISF was bankrupt and retirees would have a new, improved health plan.

 

·      I spent almost two years plowing through federal legislation and virtually nothing he said checked out. The HISF did not suddenly go broke, and the new plan was only better in the warped minds of Garrido and Michael Mulgrew.

 

·      For example, they touted free gym membership but never reported on how many retirees not currently belonging to a gym would enroll. I believe that the number would have been miniscule and almost everyone who would enroll would drop out after a few months of basically not using it. And which gym? Not Equinox.

 

The Management Benefits Fund offers gym reimbursement but it is capped at $50 per month. Someone claiming such a benefit has to keep records and file a claim.

 

·      I then discovered that the new plan would be administered by a for-profit private insurance company accountable only to its shareholders. The newspapers over the past year or two have been bursting reporting on the fraud riddling these plans. In the 2006 amendments to the Medicare Act (best known for creating Medicare Part D), it was an experiment to see if private for-profit companies could deliver high quality health care and have cost-savings as well. It’s no secret that this experiment has failed.

 

·      Unanswered is why the union leadership was comfortable consigning retirees to a fraudulent system where the profits depended on denying care recommended by medical professionals.

 

·      Garrido got one thing right: the HISF was created to cover health insurance expenses for actives and retirees. I incorrectly thought it was created only for retiree health care.

 

·      I have an incurable but treatable neurological disease and I go three times a month for infusions. The price per infusion for the uninsured is $45K. Medicare pays about $7K. You can imagine the lack of enthusiasm that a private for-profit insurance company will have for such treatment.

 

Other reasons we need 1096:

 

·      The initial number cited by the city and the unions was $600M, however that was calculated. Henry Garrido reported to his delegates in the spring that because of DC budget actions that number was now $300M, however that was calculated.

 

·      Assuming that $300M has not vaporized further, we know from years of reports delivered to his delegates by Henry and from other sources that whatever number is being conjured by the MLC’s consultants, was going right back into the same slush fund bankrupted by the city and the unions.

 

The Thieves Have a Falling Out:

 

·      Now there is a falling out among the thieves over an alleged $4B, give or take $1B, in health care savings that the parties failed to generate in allegedly contractual commitments.

 

·      Henry Garrido has publicly and privately reported that he has in writing that the unions have been relieved of any commitment to save the $600M (or $300M. Or whatever number they are flying this week) by forcing retirees into a Medicare Advantage Plan. So the current $$$B squabble has absolutely nothing to do with retirees and we will not take the fall.

 

The Thieves Open The Backdoor

 

·      Frustrated by their unsuccessful attempt to steal health care directly from retirees, they have resorted to slapping $15 co-pays on every medical interaction after the deductibles are satisfied. This piles fees on top of one another so prevalent that retirees cannot afford them; you can’t tell where one stops and another starts.

 

·      The “lucky” ones have incomes so low that they are dual eligibles (Medicare and Medicaid) if you are callous enough to call being living in poverty “lucky.”

 

·      The rest of us have to pay deductibles that are not reimbursed, Rx drug co-pays that are not reimbursed, transportation, vision above what is reimbursed, dental above the cap, and front $2430.80 for 12 months’ premium before being reimbursed. This comes to about $5,000.

 

·      The 27% of city retirees who exist on pensions of $15K or less (even with a reasonable amount for social security added) simply can’t afford it. The 57% with pensions of $35K or less, with an appropriate amount for social security, aren’t doing so great either.

 

·      The contract for the wrap-around, currently GHI/Emblem Health Senior Care, will be re-bid this year. I an working on a table, not straightforward, showing how devastating the co-pays have become. I will forward when ready later this week.

 

·      I, personally, begin the year with 86 co-pays: 36 for the above mentioned infusions and 50 for weekly psychotherapy. That’s $1290 (minus the deductibles.) Now, I’m in physical therapy twice a week. This is a heavy hit. There is no indication that the unions will reduce the out-of-pocket in the bid document. I wonder who they think they represent: the taxpayers or their former members.

 

They have no shame:

 

·      DC 37 ought to be ashamed.  Most low-income retirees are their former members. They are stealing money from those who can least afford it to subsidize taxpayers. (If not for the co-pays, the premiums paid by the city likely would be higher.)

 

·      While DC 37 and other unions’ welfare funds provide an Rx benefit (with co-pays), many other retirees have to purchase city of New York Rx Part D with a 2026 monthly premium of $180 (some of which is reimbursed by the city or various union welfare funds). They also may face a Part D surcharge that is not reimbursed.

 

What can the city council do?

 

·      Enact 1096 which will end any discussion of a Medicare Advantage Plan or co-pays.

 

Bob

917-733-0925

 

Thursday, November 6, 2025

Election Thoughts - Mamdani and ABC Organizing, Finally, a UFT Win in a Mayoral Race, My Interview with Daniel on the '75 UFT Strike

The most important outcome of the Mamdani win, and why he represents a threat to the right and the corporate Dems, is the potential for building a movement of people ready to act using the 100k volunteers for his campaign. 
 
Full disclosure: I was one and am ready to take more action if called upon. People are reminded of Obama in 2008 and the movement he built - and then let dissipate after he won and thus had no way to call out troops to battle the rise of the tea party in 2010. The Majority Report with Sam Seder, my fave, talked about this yesterday, speculating it was the influence of authoritarian Rahm Emanuel, the anti-left, corp Dem supreme who will run for president, who made sure the voice of the people wouldn't interfere with the usual suspects who want to run the world.
 
The theme of this post touches on a theory of organizing related to elements of the Mamdani campaign and how I relate it to the ABC campaign on the fly last year where I find certain similarities based on not prioritizing  personal and organizational ideologies over checking the pulse of those whose votes you are trying to get. I compare that approach to that of the legacy caucuses, and I include Unity, where the ideology of the leadership - and make no mistake, they all are leadership run, some for decades by the same people.
 
Mamdani is a socialist but he didn't run on his socialism, though his socialism certainly has influenced his thinking. But no matter the attacks, you won't see him trying to take over the means of production, though I wouldn't mind it if the entire healthcare industry was taken over - wait, wait - like the NY Health Act.
 
My contention here is that ABC was member-driven in the recent UFT election and expects to continue on that track. 
 
Thursday, November 6, 2025
 
Hey - big news -- the UFT leadership finally got one right - though it would have been nice to see an endorsement before the primary. But the way the endorsement went down has led many UFT members to object and there was a lot of push back from non-Mamdani supporters ---- and this dovetails with the theme of this election analysis: Listen to people first - check the pulse and be guided by what you hear. 
 
Mamdani is being credited, even by some on the right, with doing exactly that and shaping his campaign around listening. There is some irony in the out and out support for Mamdani 
 
YES, the UFT won one and let's give some credit for jumping on a DSA train despite the previous attacks (Will UFT Endorse Mamdani after their attacks on DSA).
 
Check out some of my commentary over the endorsement in July:
 
 
But first, a plug. 
 
The 1968 strike gets all the attention, but the 1975 strike was in many ways more consequential.
 
Here is a link to Sunday's interview with Daniel for "Talk Out of School" on WBAI. 
https://wbai.org/archive/program/episode/?id=61621. I finally listened to it this morning and I didn't make a total fool out of myself, so I'm sharing. 
 
It was my third strike with the UFT but my first as an activist. Sunday Daniel and I covered a lot of ground, including the opposition to Unity leading up to the strike, its impact - short and long term, my guess that the lessons were never to strike again, how the UFT descended from the most militant union in the early 60s, the 1995 and 2005 contracts, the divided opposition post-strike that continues today. Daniel's questions were excellent guides into a deep dive in my memory.

I still want to write in more detail using some of the resources from the 70s buried in my basement. 
Now on to some election thoughts related to our union work.
  
Mamdani Listened - Similar to ABC's Member-driven agenda -- 
 
Over a year ago, before anyone heard of Mamdani, A Better Contract/UFT decided to listen to the members and came under criticism from some members of the ARISE coalition. Ken Klippenstein touches on the Mamdani touch.

Ken Klippenstein - Mamdani's Magic

People’s comments were insightful for anyone who cared to listen. They were the message.

Zohran Mamdani won by literally meeting people where they’re at — in bodegas, subway stations, busy sidewalks, even at the New York Marathon. He met people on the streets, not to pitch them, but to listen and learn. These conversations informed his successful campaign more than his charm, social media prowess or any of the other superficial explanations major media are offering. ... 

The video stood out from usual campaign content in how little of it focused on the candidate. He didn’t “approve this message.” There were no gotchas, no fact checking his opponents, no issue-oriented rejoinders. Virtually every shot focused on the interviewee rather than Mamdani, whose face you could not even see at times. He just stood there, quietly listening to what people had to say. 

As Mamdani sees it, facing the public, even if it might heckle you, is part of the job of being an elected official. Obvious as this may seem, it is a more genuine and humble attitude ofthe Washington national figures who believe that their role as philosopher kings is to reign over and above the public. 

Mamdani’s view of a politician’s job contrasts sharply with the political establishment’s zero tolerance attitude toward risk.  Mamdani’s magic is his understanding that the masses are the message.

Yes. Fundamentally, Mamdani didn't emphasize his own ideology, though that played a part in his activism, but listened to people - yes, even those who voted for Trump.

Horrors. 

How often was ABC attacked by ARISE for "listening to people who voted for Trump" -- we were accused of trolling. And yes, there are some people (a few it seems) who may be Trump backers, and at times there may be some tension, but so far they don't feel shunned. ABC people seem to believe that the way to build a winning coalition if you aim to win an election in the UFT, is to be broad-based and non-judgemental.

Yet Mamdani, the darling of the leftists in ARISE, did the very same thing and built his campaign around the issues people were telling him concerned them.  Trust me, they will not learn a lesson. The ideology of most people on the left is baked into their DNA.

In the recent UFT election and beyond, an ARISE steering committee member and a caucus co-chair has persistently criticized ABC for not taking political positions on certain issues ABC deemed divisive and outside the bounds of a UFT election sphere - it was termed being "apolitical" rather than what it was -- member driven. 
 
In other words, we would focus our campaign on what we detected in the pulse of rank and file in our schools and out surveys - our colleagues - and beyond. Rather than apolitical, we would try not to let our personal ideological views take precedence.  The election results showed that was a potential winning strategy when we got 32% in a 3-way race, especially notable for a group of individuals that had existed for only a few months.
 
My criticism of the ARISE coalition and how they operated was that they took an opposite tack -- the ideologies of the leadership of the 3 groups in the coalition -- MORE, New Action and Retiree Advocate - would drive their campaign. If you weren't somewhere on the left, you wouldn't be very comfortable - and they did pretty much attract the left to run with them and in the election, leftists in the UFT were more likely to vote for ARISE. And 14% of the voters did vote for them. Does 14% give us an accurate picture of the left in the UFT? Since only 28% voted think of what that 14% represent. 
 
 
 Part 2

Well, I'm glad my usual pessimism didn't work out as I guessed 
43% Mamdani
39% Cuomo
18% Sliwa
 
The Sliwa collapse was significant and those votes had to go to Cuomo, so think of this -- Cuomo was probably in the low thirties and there may have been a late Trump bump. 
  
 
 
Yes Mamdani went over 50%, but barely and the combined vote against him would have made this a nail biter in a two person race. 
 
 
 
My Rockaway neighborhood in Belle Harbor voted 10% for Mamdani, surpassed by Breezy Point's 7%, 186 votes, and I think I convinced a bunch of friends. That little blue area in Rockaway is Arverne (53%) Edgemere (57%) where I canvassed with 40 other mostly local volunteers. Note the solid Cuomo blocks in Staten Island through south Brooklyn, though Bay Ridge went for Mamdani and the northeastern Queens block. Also note the east side of Manhattan. My Murray Hill area went 59-36 for Cuomo. My politics are not safe anywhere.
 
I pushed back against the NYC Retiree attacks and pro-Cuomo position. He had stated he was opposed to Medicare Adv --and I trust a socialist on that issue more than his opponents. But now is a time to try to get our issue in front of him as 1096 will expire on Jan. 1 and a new bill will be needed. Some of his allies on the City Council do back the bill. However, DC37 and the UFT are opposed and he does owe them -- I have a lot more to say on the election but I have to catch the ferry for my painting class at the UFT - I'm shlepping a bunch of acrylic paints and art supplies - this artistic stuff can tire one out.
 
 

Monday, October 13, 2025

A Better Contract (ABC) to Hold Big, Beautiful Mass Meeting, Oct. 23, 7 PM: Over 700 registered so far

Capacity is limited at 1000, so claim your spot. 
 
 

October 13, 2025
 
I haven't posted much about ABC since the election ended in June. While some expected to win despite having to compete with the 3-caucus ARISE coalition, they were also excited at the 32% result for a group no one had heard of a few months before while the long-time caucuses in ARISE could manage only 14%. These results seemed proof of concept that drove ABC -- that the legacy caucus model in the UFT has failed to capture the support of the rank and file. 
 
We can even apply the legacy model to the victorious Unity Caucus, 60 years in power and only gaining a 54% vote, their lowest total ever - in actual hard numbers, a hard minority of the total membership. 
 
An ABC-type group is the future - I'm not claiming that the current version of ABC is going to be that group but some version of it -- and the important point is that ABC is open to all UFT members, even those in caucuses.
 
I think ABC as formed at this point has potential but it must grow and expand its outreach. How to do that is still up in the air and open for discussion. If you don't want to be a formal caucus than what form does it take and how to ensure a level of democracy but also a method of making decisions and carrying them out?

Oy. My sense at this point is based on the people ABC has attracted so far -- creative, competent, dynamic - a willingness to think out of the box. But without some way of making decisions, some of that energy gets dissipated. What I have found interesting is the informal leadership -- the people who rise to the occasion when needed. I hate to formalize things --- because when you do, potential leaders can get stifled. 
 
ABC, unlike other groups in the UFT, consists overwhelmingly of actively working UFTers and they felt they needed a break after a brutal election season. (Retirees are a smaller portion of ABC than they are in ARISE). 
 
The firings of ABCers at the end of June and into this school year (The Friday Night Unity Purge/Massacre) and the Pissgate (Misogyny at the UFT Delegate Assembly) June DA created a lot of internal discussion, as did the recent healthcare changes. There is a retiree group within ABC and it is growing but the perception is that RA and NAC have a bigger group based on the fact that 140 retiree ran with them. But then again retirees in the UFT voted 3-1 for the ABC slate in the election. ABC retirees are caught betwixt and between, unhappy with Unity and unhappy with the current RA/NAC leadership of the Retiree Chapter, as Arthur expressed in his weekend post: 
I agree with much of what Arthur says, though not so much with his attempts to reach out - As a member of RA Organizers, I understand the mentality there and I don't see many signs of wanting to share power with others. I've given up trying. They are enjoying being in charge of RTC and while Unity initially saw them as a threat, I sense that the Unity hierarchy, while still wanting to take back the chapter in 2027 (they won a slim majority of retiree votes in the recent election), are not too upset or threatened. So far the biggest threat took place a year ago at the first RTC meeting under the control of RA when Bennett had Marianne as his guest, which freaked Unity out (UFT Retired Teacher Chapter Meeting Takeaway).
 
ABC came together as an election slate and questions remained as to its future. Not wanting to be like a formal caucus leads to questions of exactly what form would a group like ABC take. A difference between ABC and the legacy caucuses is a willingness to take the discussion out of the backroom and open up the debate outside voices with a mass meeting on Oct. 23. (I believe we dropped the ball after months of successful mass meetings by not holding them regularly during the election.)
 
I believe over 700 have already registered, so hop on board.
 
 
 
Here are the Ed Notes posts on the election:
 

Thursday, October 2, 2025

I'm hungry and ornary - Educators of NYC/The Wire Expose on Flaws in New UFT Health Plan - happy break the fast

Mulgrew basically threw a shark into a baby pool.  What is the matter with him?... An Active Delegate

Speaking of sharks, I can't wait to get to that herring in cream sauce. I invited a non-Jewish friend over to observe how Jews eat dairy after a fast. Reading the piece below, my hunger only helps me get more pissed off - and not only at the Unity gang, who act like they have for 60 years - new faces, old places.

Thursday, Oct. 2, 2025

Daniel Alicea has been doing the work that others should have been doing. I sat next to him at the DA on Monday and he kept muttering all meeting about the flaws, while surrounding Unity gang shushed us when I tried to get exactly what he was saying. And when I got home I realized that after hearing the Unity cheers and dancing in the aisles after RTC Chapter Leader Bennett Fischer voted YES without consulting his chapter or even the 300 delegates elected with him, I realized what damage that vote may cause. 

But I get it - a consistent mentality. on the part of a segment of the opposition over decades that wants to try to play nice with Unity -- reminds me of the current leadership of the Democratic Party always trying to play nice with the Republicans and not wanting to see them as enemies, just like to these oppo people Unity is not an enemy of democracy and the way they run the union, actually anti-union. But you know what? If another issue came up the same people will do the same thing. They never learn.

They want us to focus on Trump and ally with a union leadership that has been part and parcel of the weak Democratic Party leadership that has helped bring us Trump. Yes, Randi resigned recently and Mulgrew endorsed Mamdani but keep a close eye on them and see a union leadership that strives to save the city money on our backs has really changed.  

I admit to not doing that work that Daniel and so many others had been doing in the ABC chats since the Aug. 28 first healthcare committee meeting and for that they've been attacked by the Unity lites. But I am acting under the assumption not to trust the union leadership to present things in an honest way. So I was an automatic NO, especially considering the lies and misinformation coming from Mulgrew over MedAV - you know, it was just a different name from Medicare and you can't ask your docs if they belong because the big beautiful plan doesn't exist yet - until he tried to shove down our throats an even more big beautiful plan which is would still be favoring if we hadn't won the RTC election. 

Now I know some of our leaders are patting themselves on the back for our reso calling for a vote at the DA - which we knew is stacked by Unity - instead of the membership so we would have time to study the plan in depth ---- btw -- they would say we are under time constraints to start it Jan. 1 -- do you think these constraints are an accident?
 
Below Daniel finds the chinks in the redactions which Mulgrew told us was read by his lawyers -- all of whom tried to kill the lawsuits to protect us. 
 
Remember the lies about the stabilization fund, which it seems will be vacated in this plan..
 
Water under the bridge I guess, unless there is a law suit to stop  or delay it.

I wonder when we will ever learn.
 
See Marianne, who comes under severe attack by both the Unity gang AND some of our so-called allies, breakdown the MLC: https://youtu.be/pBKF2GTWYhg?si=NSPbjs3PpGlcCo59  
 
Norm
 
We've read the fine print. And we're right. The contract says: ”Emblem will utilize UMR systems and follow UMR protocols for the provision of UM services.” We unpack what it means for denials & claims
͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­͏     ­





Disclaimer
The views expressed by our individual authors are their own and may not reflect the views of the EONYC community. Just as we may not all agree with the editorial views expressed as the collective Educators of NYC community.

Behind the Gates: How UMR Takes Over Utilization Management In Our Health Plan — and Why the AI & 'Clean Claim' Clauses Should Sound Alarms

We've read the fine print. And we're right. The contract says: ”Emblem will utilize UMR systems and follow UMR protocols for the provision of UM services.” We unpack what it means for denials & claims

 



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UMR Health Plan: Addiction Treatment Coverage In NC

Meet United Medical Resources (UMR). They’re not a household name, but under the new NYCEPPO plan, UMR will become the central authority deciding what care you can and cannot get. Acting as the Third Party Administrator for UnitedHealthcare and Emblem, UMR will be the interface every member has to go through for nearly all preauthorizations, claims, and medical approvals.

It’s important to know: