Showing posts with label Michael Mulgrew. Show all posts
Showing posts with label Michael Mulgrew. 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

 

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

 



READ IN APP
 

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:

Sunday, September 28, 2025

UFT Healthcare Vote at the DA: Lots of Reasons to Vote NO or Table Till We Get Further Info - Role of United Health's 32% Denial Rate

BREAKING - ADAMS HAS DROPPED OUT AS I HAVE PREDICTED - HE WAS JUST WAITING FOR THE OFFERS FROM BILLIONAIRES TO KEEP GOING UP! ADAMS VOTERS - SWITCH YOUR VOTES TO CURTIS - I'D LOVE TO SEE HIM FINISH AHEAD OF CUOMO!  

  • According to the lead consultant pushing this plan, even inside the Downstate 13, the standards remain UHC’s standards. Emblem may process the paperwork, but the rules—the criteria, or standards, that decide whether your care is approved or denied—are UHC’s. This means the entire system, for every member, retiree, and family, is governed by UHC’s standards. That’s the Trojan horse in this plan.

YES VOTERS ON UFT HEALTHCARE  TOWING THE LINES

 

The 9 a.m. Shady Deal, Explained by Leah Lin: What every UFT member needs to know before the Delegate Assembly vote. --- The 4 Myths of Michael Mulgrew - and still counting


Sunday, Sept. 28, 2025

I notice that a batch of retiree delegates who are under 65 will be voting Yes because they think they will be protected if they move away from the metro area. Did they buy a broken used car from Mulgrew? And then there is the issue of AI determining denials. 

It is bullshit fear mongering from the leadership to claim turning this down will put an end to negotiations. Remember The Maine  - I mean the two rounds of Mulgrew's perfect and then more perfect Medicare Advantage - until they faded to awful.

Marianne on Friday night: https://www.youtube.com/live/ChY8_05d_80?si=MAH2fM2AQ9_J5LjT

My last piece had some info:

EONYC has done more research. 

Why UFT Delegates Must Vote 'No' on the NYCEPPO Plan if UnitedHealthcare Standards Are Applied To All

Trust in this plan continues to be frayed as union leadership refuses to share the unredacted contract and related documents. Now, the leading consultant pushing the plan shares a shocking revelation

Sep 28, 2025
 

A Trojan Horse in Our Healthcare?

The newly proposed NYCEPPO healthcare plan is being sold to active UFT members and pre-Medicare retirees as a way to improve benefits and save money at the same time. Union leadership and the city’s negotiating committee are distributing FAQs to calm legitimate concerns about the role UnitedHealthcare (UHC) will have in this plan given its well-documented record of claim denials.

The UFT’s FAQ in particular craftily tells members not to worry:

  • “EmblemHealth will do all prior authorizations in the Downstate 13 counties in New York State, which represents 90% of claims.”

  • “UnitedHealthcare, which will process the remaining 10% of claims, will follow the exact same standards that EmblemHealth adheres to, ensuring that prior authorizations are handled uniformly nationwide.”

This framing makes it sound like most members are protected from UHC—and only a small fraction of claims (10%) will ever touch them.

But this is deeply misleading.

  • Thousands of retirees and their families live outside the Downstate 13. For them, UnitedHealthcare will be their direct administrator and gatekeeper—not Emblem.

This is strange, even morbid, “double speak” because another selling point from the UFT leadership’s paid operatives is that retirees living out of state will have more options for doctors and providers. Yet, they seem to think UHC’s 32% denial rate is somehow not going to be a big deal for most of us since it’s only going to be experienced by the 10%, mostly retirees, who don’t live locally.

  • Some active members and other city workers also live and work outside these counties—they too will fall under UHC administration.

  • According to the lead consultant pushing this plan, even inside the Downstate 13, the standards remain UHC’s standards. Emblem may process the paperwork, but the rules—the criteria, or standards, that decide whether your care is approved or denied—are UHC’s.

This means the entire system, for every member, retiree, and family, is governed by UHC’s standards.

That’s the Trojan horse in this plan.


The Shocking Revelation

Buried within this proposal is a devastating emerging reality: if UnitedHealthcare (UHC) standards for care, prior authorizations, and denials are applied across the board, every member—active or retired, teacher or paraprofessional, therapist or counselor—will be subject to one of the most notorious denial machines in the insurance industry.

Is this speculation? No!

It’s written plainly in the leaked transcript from September 10th MLC healthcare presentation meeting. There we read and hear testimony and a Q&A between MLC leaders, the paid “independent” lead healthcare consultant from Segal, Chris Calvert, and other union leaders.

In this meeting, the lead consultant informs those gathered that even in regions where EmblemHealth is technically the administrator, the standards being enforced will be UHC’s standards.

In other words: every city worker and retiree will live under UnitedHealthcare’s rules, no matter where they live.

Here is one of the exchanges where Calvert admits to the UHC standard being applied to all:

Here’s what’s being said:

  • Alan Klinger, the MLC and UFT lawyer, who also is the MLC’s appointee to the joint tripartite committee with the City, interrupts Calvert seeking to clarify that in the downstate 13 region, prior authorizations (the approvals you need before certain care or procedures are covered) will go through Emblem. He goes on to say, that if a union local’s administrators have concerns, they go through Emblem, which manages this process locally.

  • Chris Calvert responds by emphasizing that the standards being applied will be UnitedHealthcare’s standards—so no matter where a member lives, the rules are the same. But for downstate 13 specifically, the actual reviews and management of those prior authorizations will be carried out by Emblem, not directly by UnitedHealthcare.

In short:

  • Standards = UnitedHealthcare rules (applied to everyone).

  • Administration in downstate 13 = handled by Emblem (the local entity).


UnitedHealthcare’s Track Record: Profits Over Patients

UnitedHealthcare is not a neutral player or some benevolent caretaker. It is the largest corporate health insurer in the United States and has a documented, checkered history of putting profits above people. It leads private insurers with a 32% denial rate. According to an American Medical Association survey, doctors have ranked UHC as the insurer with the most prior authorization hassles, with 72% of physicians giving UHC a “high” or “extremely high” burden rating.

  • AI-Driven Denials: Investigations and lawsuits show UHC uses algorithms to prematurely cut off rehab, skilled nursing, and home care—even when doctors say patients need more time.

The same MLC meeting revealed that AI is very much part of this new agreement.

  • Ongoing Litigation: Class actions accuse UHC of violating federal law by systemically denying medically necessary care. Testimony from insiders revealed denial quotas built into policy. It also is under multiple investigations for fraud and overbilling.

  • A Pattern of Abuse: Reports nationwide show seniors denied cancer drugs, patients forced out of hospitals too soon, and families buried in appeals.

  • Multiple Federal Investigations: UnitedHealth Group is currently facing both civil and criminal investigations by the U.S. Department of Justice (DOJ) for fraud and overbilling.

UnitedHealthCare is not who we want controlling our care, nor setting the criteria.


What This Means for Members and Retirees

If delegates approve this plan:

  1. Doctors and patients lose authority. UHC’s criteria, not medical judgment, will determine treatment.

  2. Retirees are exposed. Thousands living outside Downstate 13 will deal directly with UHC—and face its merciless denial machine without a buffer.

  3. Everyone potentially faces the same denials. Inside Downstate 13, Emblem is only administering UHC’s rules. Members will still suffer the same rejections and delays.

  4. Vulnerable populations are targeted. Retirees, post-surgical patients, lowest paid city workers and children with special needs will be most harmed by premature cut-offs and denials.

  5. Members drown in bureaucracy and red tape. Appeals, phone calls, and paperwork, stress will replace care. Those without stamina or know-how will simply go without.


Real Lives, Real Consequences

This isn’t abstract. Imagine:

  • A retired teacher recovering from hip replacement is cut off from rehab after just a week, even though her doctor prescribes three. She either pays thousands out of pocket or risks lifelong mobility issues.

  • A child of a UFT paraprofessional loses access to speech therapy because UHC’s standard says “progress plateaued.”

  • A city worker battling cancer is forced to switch procedures mid-treatment because UHC refuses to cover the one that her doctor believes will work for her.

These are not “hypotheticals.” They are documented cases from UHC’s history. And they could be our reality if this plan is approved.


The Bigger Issue: Trust and Transparency

Equally troubling is how this plan is being sold.

  • Leadership knows UHC’s record.

  • They know thousands of retirees live outside Downstate 13.

  • They know even within Downstate 13, UHC’s standards will rule.

And yet, instead of being upfront, they’ve chosen to spin, minimize, and mislead. That erodes trust. And it betrays the union’s responsibility to protect its members’ and their families’ health.


UFT Delegates’ Responsibility

Delegates are not voting on a simple healthcare plan change. They are voting on whether to hand the criteria of members’ care to UnitedHealthcare.

It’s one of the most consequential votes they will cast.

They are voting on whether retirees and families must fight an insurance giant for every day of rehab, every specialist visit, every procedure, every medication.

They are voting on whether to let leadership’s spin override the lived reality of denials, lawsuits, and suffering.

This is not about numbers on a spreadsheet or “cost savings”. It is about people’s lives.

It cannot be overstated: being under UHC’s standards is, indeed, A MAJOR CHANGE.

We did not have their standards dictating our city premium-free plan for the last several decades. This is not keeping things virtually “unchanged” while making improvements and saving money as the paid operatives for Michael Mulgrew’s Unity leadership caucus tell us.


A Better Path Forward

Rejecting this plan does not mean rejecting cost savings or efficiency. It means demanding a plan that:

  • Keeps doctors and patients—not insurers or city bureaucrats —at the center of decision-making.

  • Provides transparency and honest communication with members.

  • Protects retirees, especially those outside Downstate 13.

  • Respects the union’s duty to safeguard both wages and health benefits.


Bottom Line: Vote NO

The NYCEPPO plan is being presented as a step forward. But it is, in fact, a step backward—a Trojan horse that hands our care to UnitedHealthcare.

  • UnitedHealthcare sets the standards for everyone.

  • Retirees and active members outside Downstate 13 are fully exposed.

  • Inside Downstate 13, Emblem, the local regional administrator, simply enforces UHC’s rules for care.

  • The FAQ spin is a distraction, not a protection.

Delegates must see through the misleading promises and protect the membership.

For the teachers recovering from surgery. For the retirees fighting cancer. For the families raising children with special needs. For every member who depends on the union to safeguard their health.

  • Vote NO on the NYCEPPO plan if UHC’s standards apply. Because our health is not negotiable.


  •  

    And so has Wanda Williams 

 

A risky City Hall health care change



By WANDA WILLIAMS

PUBLISHED: September 24, 2025 at 5:00 AM EDT


I’ve spent decades fighting for New York City’s municipal workers, and let me tell you something every New Yorker should know: the city can’t function without us.

Municipal workers are the cops, firefighters, and EMTs who respond in an emergency. They are the teachers who educate your kids and the social workers and health professionals who connect people to care. They’re the sanitation workers who keep streets clean, the crews who maintain our parks, and the staff who operate our public libraries.

They are New York’s most vital organ. And right now, City Hall is trying to gut our health care.

For decades, nearly 750,000 city employees, retirees, and their families have depended on the comprehensive health care plan New York City provides.

But the city wants to dramatically change the health care coverage we rely on and push everyone into a new “self-insured” plan with zero input from the people who will live with the consequences of these changes.

Officials claim this change will save $1 billion a year. But here’s the truth: you can’t cut that much money without cutting care. The math doesn’t add up.

City leaders promise workers won’t lose anything. They even claim there will be a broader network of providers, less out of pocket costs and improved benefits. Too good to be true? It is. Every retiree who lived through the recent fight over Medicare Advantage knows better. When the city tried to force retirees onto private plans, we saw the potential consequences: smaller doctor networks, higher copays, more prior authorization hurdles, and fewer hospitals willing to take the plan.

That’s not savings, that’s just cost shifting. And it means municipal workers and their families will pay more for less. They claim that the $1 billion in savings will come from cutting payment to hospitals. Many NYC hospitals can’t afford reduced reimbursement and those that can are dealing with dramatic cuts in federal funding. What happens when the hospitals don’t agree? Do they go out of network? Does the city increase out of pocket costs?

Even worse, by “self funding” the coverage the new plan strips away the protections of New York State law, which guarantee coverage standards, state oversight and enhanced consumer rights. Under the new plan, if something goes wrong, workers and retirees won’t have the same appeal rights or oversight that they have today.

To make matters worse, they have picked UnitedHealthcare, the poster child for excessive claim denials, delays in payments, and smaller networks, to take over. Among other atrocities, UnitedHealthcare is under criminal investigation by the federal government for Medicare fraud and overbilling. While it is being portrayed as an Emblem-United partnership, make no mistake, this is a United contract and their goal will be maximizing their profits.

This new plan will be bad for municipal workers, and the way the city is handling the transition has been even worse.

There was transparency about how the decision was made and no clear explanation of how the city expects to save a billion dollars without gutting benefits. Just a backroom deal and a press release.

This isn’t the first time City Hall has tried to balance its budget on the backs of workers. And it’s not the first time New Yorkers have said “no.”

In the 1970s, workers fought against dangerous hospital conditions. Recently, retirees successfully pushed back against the forced switch to Medicare Advantage. Time and time again, when the city has tried to chip away at health care, New Yorkers have stood up and stopped it.

Why? Because we know what’s at stake. Health care isn’t just a line in a budget. It’s life and death.

If the city wants to talk about health care savings, it needs to do so in the open and with public input. It needs comptroller oversight, input from the people whose lives will be affected, and above all else, it needs to stop pretending that slashing $1 billion won’t result in less access to health care.

Changing the health care plan for 750,000 people is no small undertaking. The city plans to implement this change in the next 4 months, a dangerously tight timeline.

The city may see numbers on a balance sheet. But I see people: the sanitation worker clearing snow at 3 a.m., the teacher staying late to help a student, the EMT racing to save a life. They have earned comprehensive health care.

The city needs to honor their commitment and maintain the plan that municipal employees rely on.

Williams is a former union leader and a board member of HandsOffNYCare.