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WHAT YOU SHOULD KNOW ABOUT HEALTH CARE INSURANCE REFORM
1. Your
union-negotiated health insurance plans are maintained.
Nothing in reform will take them away. Nothing in the
bill changes our right to bargain over health benefits.
Nothing in the
bill allows employers to drop benefits or change benefits outside the
collective bargaining process.
2. Benefits
provided under the terms of existing collective bargaining agreements
remain in effect until
the contract
expires.
3. The excise
tax, the tax on high-value health plans, will not take effect until
2018.
CWA and other labor unions successfully beat back
this measure, delaying the effective date by 5 years, reducing the
amount of plan costs that are taxable, and implementing adjustments to
account for older workforces. (more on this below)
4. Some reforms
that will apply to our plans in the future, include:
Plans are prohibited from excluding coverage for
treatments related to any pre-existing conditions
Plans are prohibited from imposing lifetime and
annual dollar limits on benefits payable.
Plans that cover dependent children must offer
coverage to unmarried children until their 26th birthday if they do not
have access to
coverage from their own employer.
Preventive care must be provided without deductibles
or copays.Limits waiting periods for coverage to 90 days from date of
hire.
5. Improvements
for retirees include:
Effective 1/1/11 Medicare covers preventive care and
screenings without deductible or copays.
The “doughnut hole” in the Medicare prescription drug
plan is closed gradually each year and completely by 2020.
A $5 billion trust fund is established to reimburse
retiree health plans a portion of the cost of
high cost claims
for retirees between the ages of 55 and 64.
A voluntary long-term care insurance program for
community-based living assistance services is
established.
The subsidy received by employers for providing
retiree drug benefits will no longer be
excluded from
taxable corporate income. Employers must account for the different tax
treatment
immediately.
6. Brings costs
under control to keep coverage affordable:
Eliminates a significant portion of the estimated
$1,100 that employers and workers pay each year to cover the cost of the
uninsured.
Emphasizes evidence-based care to improve quality and
control costs in Medicare, and to help manage chronic illnesses. These
system improvements are expected to be adopted by the private sector.
Cuts the deficit by $100 billion over 10 years and by
$1.2 trillion in the second decade, by reducing wasteful spending and
slowing the rise of healthcare costs.
7. How reform is
paid for:
Effective 2013, the Medicare Hospital Insurance tax
is raised by 0.9% on the wealthiest taxpayers (more than
$200,000/individual or $250,000/married couple).
Effective 2013, the Medicare Hospital Insurance tax
is applied to unearned income, investment income, dividends, royalties,
etc. of the wealthiest taxpayers.
Effective 2013, the current tax deduction for the
Medicare Part D subsidy for employers who maintain retiree prescription
drug plans is eliminated.
Effective 2018, an excise tax is applied to employers
whose health plans cost more than $10,200 for single coverage and
$27,500 for family coverage. The threshold dollar amounts will be
adjusted by the age and gender of the workforce to account for the
higher utilization experience by these groups. Retiree plans have
separate, higher dollar thresholds.
Effective 2011, an annual flat fee is assessed on the
pharmaceutical manufacturing sector.
Effective 2013, a tax is applied to on the sale of
medical devices.
Effective 2014 a flat fee imposed on the health insurance sector.
The Patient
Protection and Affordable Healthcare Act, more commonly referred to as
the "healthcare bill", has taken over a year to craft and has been a
lightning rod for political debate because it effectively reshapes major
facets of the country's healthcare industry.
Here are 10
things you need to know about how the new law may affect you:
1. Your Kids are
Covered
Starting this
year, if you have an adult child who cannot get health insurance from
his or her employer and is to some degree dependent on you financially,
your child can stay on your insurance policy until he or she is 26 years
old. Currently, many insurance companies do not allow adult children to
remain on their parents' plan once they reach 19 or leave school.
2. You Can't be
Dropped
Starting this
fall, your health insurance company will no longer be allowed to "drop"
you (cancel your policy) if you get sick. In 2009, "rescission" was
revealed to be a relatively common cost-cutting practice by several
insurance companies. The practice proved to be common enough to spur
several lawsuits; for example, in 2008 and 2009, California's largest
insurers were made to pay out more than $19 million in fines for
dropping policyholders who fell ill.
3. You Can't be
Denied Insurance
Starting this
year your child (or children) cannot be denied coverage simply because
they have a pre-existing health condition. Health insurance companies
will also be barred from denying adults applying for coverage if they
have a pre-existing condition, but not until 2014.
4. You Can Spend
What You Need to
Prior to the new
law, health insurance companies set a maximum limit on the monetary
amount of benefits that a policyholder could receive. This meant that
those who developed expensive or long-lasting medical conditions could
run out of coverage. Starting this year, companies will be barred from
instituting caps on coverage.
5. You Don't
Have to Wait
If you currently
have pre-existing conditions that have prevented you from being able to
qualify for health insurance for at least six months you will have
coverage options before 2014. Starting this fall, you will be able to
purchase insurance through a state-run "high-risk pool", which will cap
your personal out-of-pocket expenses for healthcare. You will not be
required to pay more than $5,950 of your own money for medical expenses;
families will not have to pay any more than $11,900.
6. You Must be
Insured
Under the new
law starting in 2014, you will have to purchase health insurance or risk
being fined. If your employer does not offer health insurance as a
benefit or if you do not earn enough money to purchase a plan, you may
get assistance from the government. The fines for not purchasing
insurance will be levied according to a sliding scale based on income.
Starting in 2014, the lowest fine would be $95 or 1% of a person's
income (whichever is greater) and then increase to a high of $695 or
2.5% of an individual's taxable income by 2016. There will be a maximum
cap on fines.
7. You'll Have
More Options
Starting in 2014
(when you will be required by law to have health insurance), states will
operate new insurance marketplaces - called "exchanges" - that will
provide you with more options for buying an individual policy if you
can't get, or afford, insurance from your workplace and you earn too
much income to qualify for Medicaid. In addition, millions of low- and
middle-income families (earning up to $88,200 annually) will be able to
qualify for financial assistance from the federal government to purchase
insurance through their state exchange.
8. Flexible
Spending Accounts Will Become Less Flexible
Three years from
now, flexible spending accounts (FSAs) will have lower contribution
limits - meaning you won't be able to have as much money deducted from
your paycheck pre-tax and deposited into an FSA for medical expenses as
is currently allowed. The new maximum amount allowed will be $2,500. In
addition, fewer expenses will qualify for FSA spending. For example, you
will no longer be able to use your FSA to help defray the cost of
over-the-counter drugs.
9. If You Earn
More, You'll Pay More
Starting in
2018, if your combined family income exceeds $250,000 you are going to
be taking less money home each pay period. That's because you will have
more money deducted from your paycheck to go toward increased Medicare
payroll taxes. In addition to higher payroll taxes you will also have to
pay 3.8% tax on any unearned income, which is currently tax-exempt.
10. Medicare May
Cover More or Less of Your Expenses
Starting this
year, if Medicare is your primary form of health insurance you will no
longer have to pay for preventive care such as an annual physical,
screenings for treatable conditions or routine laboratory work. In
addition, you will get a $250 check from the federal government to help
pay for prescription drugs currently not covered as a result of the
Medicare Part D "doughnut hole". However, if you are a high-income
individual or couple (making more than
$85,000
individually or $170,000 jointly), your prescription drug subsidy will
be reduced. In addition, if you are one of the more than 10 million
people currently enrolled in a Medicare Advantage plan you may be facing
higher premiums because your insurance company's subsidy from the
federal government is going to be dramatically reduced.
provided by
investopedia
Alcatel-Lucent: Medicare Crossover
December 3, 2009
ATTENTION MEDICARE-ELIGIBLE UNITEDHEALTHCARE TRADITIONAL
INDEMNITY MEMBERS: TAKE ADVANTAGE OF HASSLE-FREE CLAIMS
PROCESSING.
UnitedHealthcare offers a service to help streamline
claims processing for Medicare-eligible Traditional
Indemnity coverage participants: Medicare crossover billing.
Medicare crossover billing is a process by which Medicare
pays for claims first, and then those claims are
automatically forwarded electronically to UnitedHealthcare
for processing. What does this mean for you? Less wait time
in the processing of your claims and less paperwork —
Medicare and UnitedHealthcare do all of the work!
To initiate the process, and/or for more details on how
the Medicare crossover billing works, call UnitedHealthcare
Member Services at 1-800-577-8567. The customer service team
can take your Medicare Health Insurance Claim Number (HICN)
over the telephone to start the process.
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Alcatel-Lucent: Medco's Low-Cost
Generic Drug Program
June 19, 2009
To: All Alcatel-Lucent Active and
Represented Retirees
It has come to my attention that not
everyone is aware of Medco's Low Cost
Generic Drug Program. Back in March of
this year, Alcatel-Lucent, Medco and the
Joint Healthcare Cost Containment
Committee (JHCC) were pleased to
announce the availability of over 400
generic drugs for $10 or less for a
90-day supply through Medco's Mail Order
Pharmacy.
Attached is a
list of over 400 generic drugs that
cover such therapeutic categories as
Arthritis/Pain, Asthma/Respiratory,
Blood Pressure/Heart Health,
Cholesterol, Diabetes, Mental Health and
many more.
This is a great way to save money,
ensure that your prescription cost is
competitive, and be able to have all of
your prescription information in one
location to help monitor drug
interactions. To find out if a 90-day
supply of your generic medication is
available for $10 or less, you can visit
Medco online at
www.medco.com/lowcostgenerics or
call the toll-free number on the back of
your prescription drug ID card.
In Unity,
Martha Flagge
CWA Staff Representative
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Alcatel-Lucent: Results of the 2009
Retiree Healthcare Negotiations for Plan
Year 2010
June 19, 2009
To: All Alcatel-Lucent Local Presidents
and Formerly Represented Retirees
The Joint Retiree Healthcare Committee (JRHC)
has completed annual negotiations in regard
to the Formerly Represented Retiree
Healthcare Plan for 2010. Each year, as
negotiated in 2004, the JRHC reviews Retiree
healthcare costs reported by the Company to
have exceeded the negotiated Retiree
Healthcare Caps for that year. The
Committee is required to "True Up" the
balance of the excess cost by making changes
to the Medical and/or Prescription Plan
Designs, as well as Provider-recommended
programs designed to help save future costs
for the Plans and for the Retirees. The
JRHC must also consider possible increases
to Retiree contributions.
The projections for Plan Year 2010 showed
a shortfall/true up of $23,400,000. Medco
negotiated contract savings reduced that
shortfall/true up by $14,800,000.
Retiree Contributions (premiums)
– This year I am happy to report that the
premiums the retirees pay for their
healthcare will remain the same as last year
and NOT increase the half percent as called
for in the contract. As we did in 2008 and
2009, the Unions were successful in holding
contributions steady for pre-65 Retirees at
8.5% – Single and 17% – Family. The
contributions for post-65 Retirees will be
remain the same as they were in 2009 at 5.5%
– Single and 11% – Family. The cost
to the Plan is $2,300,000.
Medicare Part B Coordination
– Alcatel-Lucent will be partnering with
Medco to provide Medicare Part B
coordination of benefits for certain drugs
and supplies that are covered under Medicare
for retirees and their dependants who are
Medicare Part B eligible. Some of the
prescriptions that are typically covered by
Medicare Part B are diabetes supplies (test
strips, meters), specific medication used to
aid tissue acceptance from organ
transplants, certain oral medications used
to treat cancer, and a full range of ostomy
supplies. Retirees will be receiving
communications from Medco that will outline
the program. For those drugs and supplies
that are covered under the Medicare Part B
Program, the co-pays that the retirees would
have been required to pay will be waived.
The Plan will pick up the cost of the
co-pays. The estimated savings to
the Plan is $1,000,000.
Prescription Drug Program
– The current Four Tier Plan design will
revert back to a Three Tier Plan design.
The co-pays for prescription drugs will be
as follows: Retail $10/$33/$55 and Mail
Order $25/$82.50/$137.50. Chemotherapy
drugs will be included in the co-pay
structure. In addition, the Generic and
Preferred Drug Step Therapy Programs will
add to new therapeutic categories. There
will be an expansion to the Prior
Authorization and Quantity-Duration
categories as well. The estimated
savings to the Plan is $1,547,000.
Medical Plan Design Changes
– The Mental Health and Chemical Dependency
out-of-pocket maximum will be combined with
the Medical out-of-pocket maximum and the
three free visits will be eliminated. What
this means is that there are no longer two
out-of-pocket maximums that must be met.
The Mental Health and Chemical Dependency
out-of-pocket expenses will apply towards
the Medical out-of-pocket maximum.
The cost to the Plan was neutral.
Air Ambulance benefit has been improved
to eliminate the cap of $5,000. The
cost to the Plan was neutral.
In addition to the projected savings
derived from the Plan changes, the Trustees
of the Taft Hartley Trust for Formerly
Represented Retirees have authorized that
$8,353,000 of Trust assets be utilized to
offset the remaining shortfall/true up.
Once again I would like to thank you for
your support and understanding as the Union
makes these difficult and necessary
decisions. If you have any questions,
please don't hesitate to e-mail me at
mflagge@cwa-union.org.
In Unity,
Martha Flagge
CWA Staff Representative
MF:drk
opeiu-2, afl-cio
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Lucent: 2007 JRHC Healthcare
Negotiations Summary
June 18, 2007
Meetings of the Joint Retiree Healthcare
Committee to negotiate possible changes to
the Retiree healthcare plan design and/or
healthcare premiums, were initiated in March
2007 and were to conclude no later than June
15, 2007. Once again the Company expected
the JRHC to solve for the "True-Up" from
2006 healthcare claims, in addition to the
projected shortfall for 2008.
The Union again pushed back and advised
the Company that the contract language
required the JRHC to address only the 2006
True-up and not the 2008 projected
shortfall. Negotiations continued and
on June 15, 2006 the Parties reached
agreement on recommend changes to the
Retiree Healthcare Plan. The changes
include the following:
Prescription Drug Plan
- Change co-pays from $10/$25/$35/$40
(retail) and $25/$62.50/$87.50 /$100
(mail order) to $10/$25/ $35/$50
(retail) and $25/$62.50/$87.50/$125
(mail order).
Medical
- Increase POS out-of-pocket maximum
from $1,250 to $1,500; and
- Change Traditional Indemnity
deductible to 2.5% of pension.
Premiums
- Decrease post-3/1/90 post-age 65
premiums from 6.5%/13% to 6.0%/12% (no
.5% increase as is currently required
under the Lucent contract; and
- Maintain post-3/1/90 pre-age 65
premiums at 2007 level of 8.5%/17% (no
.5% increase as is currently required
under the Lucent contract language.
While the changes for the 2008 Plan Year
do include a slight increase in the fourth
tier of the Prescription Drug Plan, as well
as an increase to the POS out-of-pocket
maximum, changing the Traditional Indemnity
deductible from $150 + 1% of Pension to a
flat percentage of 2.5% of Retirees'
pensions will equalize the impact across all
pension levels. In addition, premiums
were lowered for the Post-65 Retirees and
premiums for pre-65 Retirees will not
increase in 2008.
CWA JRHC Committee Members:
Martha Flagge
CWA Representative
Brian Reilly
President, CWA Local 1062 |
