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Unions file suit over health insurance benefits

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* From the Illinois Policy Institute’s news service

State employee unions have returned to court in an effort to lock in continued pay for the fiscal year, get medical claims paid, stop layoffs and retain step pay raises and semi-automatic promotions despite lack of a contract. […]

“The administration has received a copy of the complaint and is currently reviewing it,” Rauner spokeswoman Catherine Kelly said earlier this week. […]

“This possibility will inevitably deprive many participants of the insurance provided by their labor agreements and employment contracts,” according to [union] pleadings.

The unions seek relief by way of two strategies, the first being an impairment of contract argument and the other a request for an injunction to aid in arbitration of pending grievances.

The unions argue state employees shouldn’t be caught in the middle when elected leaders can’t agree.

State “employees are now pawns in the political dispute over the state budget,” the complaint said. “They and their families deserve better.”

* From AFSCME last week…

As you may have heard, late last week the state Department of Central Management Services (CMS) posted on its website a memo to group health insurance participants claiming that, due to the budget impasse, the state has neither the funds nor the legal authority to continue to pay medical claims incurred by participants in the self-funded medical and dental plans. The memo further stated that once the FY 16 budget is in place and funds have been appropriated, payment of medical and dental claims will resume.

While the memo mentioned only the self-funded insurance plans, the union subsequently learned that the Rauner Administration has halted premium payments to the HMO plans as well.

AFSCME received no prior notification of this sweeping change, but since the news became public, the union has been seeking to gather all of the relevant information. CMS has told the union that it is working with the health plans to mitigate the impact of this payment freeze on plan participants. It is our understanding that, for the time being, the HMO plans have agreed to continue to operate as normal without disruption, and that plan participants will be provided with medical treatment based on the usual schedule of co-payments.

The self-funded plans are also working with CMS to try to ensure uninterrupted medical care, but questions remain as to how individual doctors, hospitals and other medical providers in those plans will react to the state’s announcement. The group health plan is already many months in arrears in paying these providers and some say they simply cannot afford to continue to provide care without being paid.

We are very concerned that medical providers in the self-funded plans will begin to demand that employees or retirees pay the full cost of a service at the time of the treatment—especially as there is no sign that the budget impasse will be resolved in the near future.

If your physician or other medical or dental care provider insists on payment at the time of treatment, CMS recommends that you contact your health plan and ask for assistance in dealing with that provider. If the health plan cannot facilitate treatment, please send this information to AFSCME Council 31. E-mail the name of the medical provider and the date on which you were required to pay in full for medical or dental care to mperez@afscme31.org so that the union is able to document all problems that arise.

While it is not yet clear what the full implications of the Administration’s payment freeze will be on health plan participants, AFSCME is taking proactive legal action to seek to ensure that health coverage is not in any way interrupted or compromised. AFSCME and other unions have filed suit in circuit court seeking a court order that would require the state to pay claims from health care providers in the group insurance plan.

This health insurance crisis is but the latest harmful consequence of Governor Rauner’s failure to work constructively toward developing and enacting a FY 16 budget and the revenue measures needed to fund it. The governor continues to insist that unless state legislators enact measures to strip Illinois workers of their union rights, he will not make any effort to remedy our state’s steady slide toward fiscal disaster.

That’s the height of irresponsibility—jeopardizing the vital services that state government funds or provides, threatening the jobs of public-service workers, and now casting a cloud of uncertainty over the health coverage of state and university employees, retirees and our families—all in the name of creating leverage for the governor’s extreme political agenda.

But we’re not going to stand aside and let it happen. You can be confident in the knowledge that your union is doing everything possible to protect your health care, just as we have in ensuring that state employee paychecks are uninterrupted, and in working to combat closures and layoff threats. When the call goes out, be ready to do your part, too.

In unity,
Roberta Lynch
Executive Director

posted by Rich Miller
Monday, Sep 21, 15 @ 9:18 am

Comments

  1. As with the paying of state employees, “championing” the cause of payin’ workers for the work they’re doin’, I look forward the the attorneys for Governor Rauner to be on board, nay, leading the charge for health insurance being covered by federal judicial decree…

    Comment by Oswego Willy Monday, Sep 21, 15 @ 9:22 am

  2. You should consider not calling this a “news service.” It isn’t a news service. Illinois Policy Institute has received hundreds of thousands of dollars from Rauner and his backers. With these conflicts of interest, it isn’t a news outlet. It is an interested party.

    Comment by take that Monday, Sep 21, 15 @ 9:30 am

  3. Nice wish Willy. Obviously to anyone with a brain there’s little difference between the 2 issues, but I look for the Governor to be on the opposite side of this argument.

    Why? Because Rauner & the Courts have spent all of the FY16 revenue already. It’s not a good reason, but it’ll be the reason.

    Comment by Get a Job!! Monday, Sep 21, 15 @ 9:30 am

  4. For the sake of efficiency, perhaps St. Clair County Chief Judge Baricevic and Northern District Chief Judge Castillo should move into that big office on the second floor of the Dome that’s been empty since January.

    They’re running the show now, might as well make if official.

    Comment by Wordslinger Monday, Sep 21, 15 @ 9:32 am

  5. ===Why? Because Rauner & the Courts have spent all of the FY16 revenue already. It’s not a good reason, but it’ll be the reason.===

    Gov. Rauner has not spent any monies outside the K-12 education approp. The Courts really care less about the revenue or how it will get paid, the courts are saying “pay”.

    My hope is if this does continue “dueling” attorneys for the governor take both sides in front of a federal judge. If you’re going to make your administration a farce, you go for the big laughs.

    Comment by Oswego Willy Monday, Sep 21, 15 @ 9:36 am

  6. Most people predicted rauners actions will be decided in court

    Comment by Foster brooks Monday, Sep 21, 15 @ 9:37 am

  7. I have to wonder if there aren’t some Afordable Care Act penalties that might come into play with this action.

    Comment by A Jack Monday, Sep 21, 15 @ 9:45 am

  8. Going to the courts is the new norm in the Rauner era of government dysfunction.

    Comment by Norseman Monday, Sep 21, 15 @ 9:47 am

  9. Imagine working for an employer who may not pay your promised medical expenses in the middle of dealing with cancer or other serious health care issue. The government would definitely intervene if this were an employer in the private sector. When it is actually the government and the party that should be setting the example for the private sector it is doubly shameful. Getting a budget is overdue. It is time to focus on this single issue and forget about all the side agendas and political points.

    Comment by illlinifan Monday, Sep 21, 15 @ 9:49 am

  10. Rich-giving IPI any credibility when it comes to preserving the ability of public employees to provide health care for their family is a big mistake, come on man!

    Comment by Obamas Puppy Monday, Sep 21, 15 @ 9:51 am

  11. The so-called notice from CMS was a joke. You had to drill down so far into their website nobody would have found it unless forewarned.

    Comment by Norseman Monday, Sep 21, 15 @ 9:51 am

  12. I am wondering if it is fraud for the State to be collecting health insurance premiums from the employees and then not pay the claims.

    Comment by Huh? Monday, Sep 21, 15 @ 9:55 am

  13. After Ryan, Blagojevich, Quinn and Rauner, we obviously don’t need governors anymore. So I second wordslinger’s suggestion entirely.

    Comment by VanillaMan Monday, Sep 21, 15 @ 9:56 am

  14. ===Rich-giving IPI any credibility ===

    Oh, please. It was all factual. And, by the way, nobody “legit” covered the story.

    Take a breath.

    Comment by Rich Miller Monday, Sep 21, 15 @ 9:59 am

  15. Health insurance is a statutory right. The interesting twist on this, to me, is that the Govenor manufactured his own crisis. The GA sent him an approp to cover his legal obligation, but he vetoed it! This, againa to me, makes this a different case then if there was just no approp in the first place. It raises an i teresting question, can the Govenor veto approps and then claim lack of spending authority as a defense…. The veto may be considered intential refusal to comply with the law. While the veto is discretioanty, using it to creat your own crisis may not be. I.e you can not violaye the law because you took discretionary action to interfere with compliance. Interesting stuff on the balance of powers.

    Comment by Ghost Monday, Sep 21, 15 @ 10:07 am

  16. LOL. Several comments about IPI not having credibility and “It is an interested party.” Never a peep about AFSCME’s press releases.

    Comment by Robert the 1st Monday, Sep 21, 15 @ 10:08 am

  17. - Robert the 1st -

    AFSCME has yet to portray themselves in the role of a “news service” when they feel it can advance a “non-partisan” slant.

    You’re welcome.

    Comment by Oswego Willy Monday, Sep 21, 15 @ 10:10 am

  18. It is incredibly disconcerting. The caseworker who sits in front of me didn’t take her kid to the emergency room last night because of it. He’s fine today. Poor kid had his first migraine headache is my guess. Luckily his grandpa is a nurse and was not on duty. Grandpa spent the night and all is well. But my coworker was afraid to take him. THAT is why this is a huge concern. This could potential be disastrous for the state. What if a kid dies?

    Comment by Honeybear Monday, Sep 21, 15 @ 10:11 am

  19. ===Oh, please. It was all factual. And, by the way, nobody “legit” covered the story.===

    Except for the AP…

    http://www.chicagobusiness.com/article/20150918/NEWS02/150919802/unions-sue-for-continued-illinois-health-care-claim-payments

    Comment by Deep South Monday, Sep 21, 15 @ 10:17 am

  20. Meanwhile, Indiana picks up another 1,200 jobs as Subaru announces a $140 million investment at its Lafayette plant while Mitsubishi closes its Normal plant and lays off 1,300 workers. http://www.indystar.com/story/money/2015/09/21/sia-add-jobs/72557404/

    Comment by Interested Observer Monday, Sep 21, 15 @ 10:17 am

  21. - Interested Observer -,

    Mitsubishi themselves said why the plant is closing.

    Do you know why,

    Be very specific, Mitsubishi was…

    Comment by Oswego Willy Monday, Sep 21, 15 @ 10:19 am

  22. I think it is dishonest to hire people, tell them they have X benefits, and then just refuse to pay those benefits. They’ve already been paying 9 months late, so they have lots of Fiscal 15 health care bills left to pay. They won’t start on Fiscal 16 payments until next Spring, so even mentioning the Fiscal 16 budget is just deflection.

    FYI - I read somewhere that they are not forwarding the employee optional life insurance premium payroll deductions to the life insurance company. I consider this fraud - even more so than collecting health insurance ‘premiums’ and not paying benefits out of the self-insured health care funds. What’s to keep the life insurance company from cancelling our policies for non-payment? Suppose I die tomorrow, will my beneficiarys get the money I am paying for them to get?

    I feel like Gov Rauner is doing everything he an to ‘encourage’ his employees to quit, with no thought on the havoc that could ensure if many of them do so.

    Comment by thoughts matter Monday, Sep 21, 15 @ 10:27 am

  23. Misubishi was…

    …not selling any cars.

    Comment by Juvenal Monday, Sep 21, 15 @ 10:29 am

  24. Rauner simply does not respect state workers. “Let them eat cake”.

    Comment by Sam Stone Monday, Sep 21, 15 @ 10:31 am

  25. Anybody notice this includes a bid to block the layoffs due 9/30, including (as best I can tell) the State Museum?

    Comment by Threepwood Monday, Sep 21, 15 @ 10:40 am

  26. AFSCME has a contract — the courts seem to be the only branch of government that understands what a contract is.

    Comment by Facts are Stubborn Things Monday, Sep 21, 15 @ 10:42 am

  27. This type of issue is exactly why state employees need a union. My guess is this court case will end up being applied to non-union employees too. Just shows how unions help protect the standard of living for all workers.

    Comment by Johnnie F. Monday, Sep 21, 15 @ 11:04 am

  28. “The so-called notice from CMS was a joke. You had to drill down so far into their website nobody would have found it unless forewarned.” Norseman, I did drill down after I found out, & I still could not find any info. about the stopped payments to healthcare providers.

    Comment by Mama Monday, Sep 21, 15 @ 11:05 am

  29. How does the ’stop pay for healthcare’ affect people in the Medicare Advantage programs?

    Comment by Mama Monday, Sep 21, 15 @ 11:06 am

  30. Mama, it’s been reported that the Medicare Advantage providers have agreed to continue to “pay” claims. I share your concern since my wife is going to be required to give up a reliable payor, Medicare, for an unknown future in a Medicare Advantage program that’s operating on IOUs.

    Comment by Norseman Monday, Sep 21, 15 @ 11:16 am

  31. Have payments actually been withheld? Or, is this saber rattling?

    Comment by Keyser Soze Monday, Sep 21, 15 @ 11:28 am

  32. Well finally. This is what will have to be done on Rauner each and every time.

    I have no idea as to my status on this. I am retired and not an active state employee. I am Medicare age but not eligible for Medicare because I was hired before April 1, 1986. I am certain the head honchos again forgot about us and I am just as certain they don’t care.

    Comment by Fedralist Monday, Sep 21, 15 @ 11:58 am

  33. Its just a matter of time before the courts order revenue increases to pay for the court-ordered spending. Problem solved!

    Comment by PublicServant Monday, Sep 21, 15 @ 12:02 pm

  34. =It is incredibly disconcerting. The caseworker who sits in front of me didn’t take her kid to the emergency room last night because of it. He’s fine today. Poor kid had his first migraine headache is my guess. Luckily his grandpa is a nurse and was not on duty. Grandpa spent the night and all is well. But my coworker was afraid to take him. THAT is why this is a huge concern. This could potential be disastrous for the state. What if a kid dies?=
    The parent didn’t take the child to the hospital? Sounds like neglect to me. Many the parent should take his skills to the private sector.

    Comment by DonaldTrump Monday, Sep 21, 15 @ 12:05 pm

  35. I too will be enrolling into the MA plan beginning in January and scared as to how this is affected. The only thing going is they do get our Part B premiums. I know I could go to a MA plan through United without paying any extra premium other than my Part B and have coverage. I know I can’t do it without threatening my retiree coverage. My point is United covers people through an MA plan with only Part B premiums so their continuing coverage for state retirees with just the premium should not be a huge issue.

    Comment by Illinifan Monday, Sep 21, 15 @ 12:06 pm

  36. As a retiree, you don’t have to take the MA plan the state is forcing you into. You can just say I don’t want the state insurance and stay on Medicare with buying a supplement in the open market. Yes, it will cost you more, but possibly the knowledge that your medical bills will be paid will be more benefit than the ‘free’ medical coverage from the state. When the state went to the MA plan for retirees, the retirees all got shafted. you lost your low or no cost supplement to medicare that only had to pick up the remaining 20% of the medicare approved amount that medicare didn’t pay.

    Comment by anon Monday, Sep 21, 15 @ 12:32 pm

  37. Don’t know why Archbishop Cupich is weighing in with the unions. How many union teachers are teaching in the Chicago Catholic Schools? I think none.

    Comment by Anonymous Monday, Sep 21, 15 @ 1:13 pm

  38. Illinifan & anon:

    I question your perception of Medicare supplemental insurance vs the State’s Medicare Advantage. First, under Advantage, Medicare pays insurers the monthly Part B premium deducted from your SS payment PLUS an extra bonus amount (which has been reduced in recent years to help subsidize Obamacare). Second, since there’s only 1 insurer rather than 2 (or 3 if Part D is separately insured) handling any claim, any premium charged to you should be substantially less than for equivalent supplemental insurance.

    Also, gotta wonder if the federal Medicare administration is going to allow the State to just stop paying it’s part of the premiums …

    Comment by Curmudgeon Monday, Sep 21, 15 @ 1:15 pm

  39. Dajvu. Rich Miller predicted the courts would determine the state budget. Sad, but true.

    Comment by pool boy Monday, Sep 21, 15 @ 1:16 pm

  40. DonaldTrump, not sure what you mean. I can assure you my colleague is an excellent mother and not neglectful by any means. Kid did not have a fever just severe headache behind the eyes, nausea and out the other end. Ordinarily she would have taken him to the emergency room. But not knowing what her insurance status was she didn’t. She made the right call but my point is still the same. (Besides her dad came over to check on her son) But what were you trying to say with the private sector. Try again

    Comment by Honeybear Monday, Sep 21, 15 @ 1:24 pm

  41. In the private sector if premiums were being paid but claims were not being paid and in a timely manner, I believe The Illinois Department of Insurance would be involved rather quickly. But ok to do this to state employees? I have to agree with previous post. How convenient for the governor. He vetos, then says claims can’t be paid because no appropriations. Just another way to stick it to the state employees.

    Comment by Clodhopper Monday, Sep 21, 15 @ 1:27 pm

  42. @ ajack….I’ll bet there are some affordable care act penalties

    Comment by Flynn's mom Monday, Sep 21, 15 @ 1:40 pm

  43. Clod hopper it begs the question - Why hasn’t the Department of Insurance gotten involved with the non-payment of insurance claims for state employees?

    Comment by Huh? Monday, Sep 21, 15 @ 2:17 pm

  44. @DonaldTrump
    Maybe you should act your age for once if that’s not too difficult for you to do at this time. Retire already.

    Comment by Anonymous Monday, Sep 21, 15 @ 2:35 pm

  45. The state is already 9 months behind on the bills.

    Comment by Liberty Monday, Sep 21, 15 @ 2:36 pm

  46. @ Anonymous 1:13 “Don’t know why Archbishop Cupich is weighing in with the unions. …”

    Perhaps it’s because the Catholic church teaches that a just society upholds the dignity of labor. See this analysis of the Pope Francis’ views on the subject:

    http://americamagazine.org/content/all-things/pope-francis-dignity-labor

    Comment by olddog Monday, Sep 21, 15 @ 3:30 pm

  47. One of a series of suits to come. Maybe they should agree that one judge hears them all, and she appoints a manager to make payments following judicial guidelines — oh wait — we don’t do bankruptcy here. /s

    Comment by walker Monday, Sep 21, 15 @ 3:32 pm

  48. Can you imagine what it must be like to work for The Illinois Department of Insrance. The agency that audits insurance companies, monitors, assist with complaints, enforce insurance laws, issue licenses and I am sure many other things. Then those very employees are treated this way. I can’t wrap my head around it.

    Comment by Clodhopper Monday, Sep 21, 15 @ 4:06 pm

  49. “One of a series of suits to come. Maybe they should agree that one judge hears them all, and she appoints a manager to make payments following judicial guidelines — oh wait — we don’t do bankruptcy here. /s”
    ———-

    Actually, I could see the (federal) courts appointing a “Special Master” (or equivalent) if it became apparent that there was just zero possibility of resolution.

    BUT (and it’s a biggie), it’s going to be over a lot more areas than just revenues. It’s not ‘Bankruptcy’ (because that’s not legally possible), but one might be hard pressed to tell the difference.

    This could (and probably would) go into all sorts of areas far beyond just increasing revenues. Certainly expenditures, and likely even policy. That’s why the judiciary will be sooooo reluctant to go there.

    First off, in this type of scenario, there’s likely to be an abrupt end to ANY new programs, or even expansion of existing programs. And that would likely include the transfer of existing programs/expenses to local governments.

    The simplest way to put it is: “We’re raising taxes to get your state fiscal house in order - PERIOD! Nothing gets added or expanded until that objective is completed.”.

    And they might very well put a ’sunset’ on the tax increase once the courts are satisfied the books are balanced. And that could be years.

    There’s a whole lot of potential spin off effects with having the courts involved in the taxation and budgeting process. And nobody has sufficiently thought those effects through.

    Comment by Judgment Day Monday, Sep 21, 15 @ 4:16 pm

  50. Unless my reading of the statutes is flawed, the Department of Insurance has no regulatory authority over State health insurance plans.

    Comment by Arthur Andersen Monday, Sep 21, 15 @ 4:20 pm

  51. I assumed they had no authority. Why else would there have been no action by that agency. But to me personally I have difficulty with the double standard. Insurance laws that protect. However, it seems a certain segment of the Illinois population is not covered or protected under the law. That is all, will get off my soap box now

    Comment by Clodhopper Monday, Sep 21, 15 @ 4:39 pm

  52. Well, I guess I don’t have enough stress fighting cancer. Can’t wait to be told to pay for chemo and surgery upfront in order not to die. Of course it’s one way for Governor Rauner to weed out a number of us pesky state employees.

    Comment by State Worker Monday, Sep 21, 15 @ 4:39 pm

  53. As was pointed out by an earlier poster, has no one noticed that these amendments brought Friday also included language to stop the impending September 30 layoffs, and in turn postpone the closure of the museum and the shooting complex? Also, as I understand it, postpone the impending CPO layoffs? Will this mean that business goes on as usual at the museum and the shooting complex on October 1?

    Comment by Down South Monday, Sep 21, 15 @ 5:34 pm

  54. It might be helpful for The Governot & Gang to read / view Jamie Simon’s comments on Meet the Press about ‘my way or the highway’ approach to ‘governing’. Probably won’t make any difference, after 9 months, but one can always hope.

    Comment by sal-says Tuesday, Sep 22, 15 @ 3:48 am

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