Audit:Thousandsofdependents
ineligibleforhealthcoverage
ByDEBORAHSTAYMANand themareappealingthatloss.
SHERRYHALBROOK “Clearly,coveringthousandsofineligible
Approximately18,700dependents dependentshasbeenanincreasinglyheavy
o
t
e
s
coveredundertheNYSHealth andunfairburdenNYSHIPenrolleesand
InsuranceProgram(NYSHIP)were theiremployershavebeenshoulderingfor
N
removedlastsummerastheresultof toolong,”saidPEFPresidentKenBrynien.
anauditoftheeligibilityofcovered “Theeligibilityverificationprocesshasbeen
dependents.However,that’sjustthe arduousforsomeofourmembersbut,
dependentswhowereremoved ultimately,theresultingfairnessand
l
t
h
voluntarilyorduringanamnestyperiod savingsshouldbeworththateffort.”
in2009. Inits$4.3millioncontracttoperformthe
e
a Thousandsmoredependentsarebeing eligibilityaudit,Budcopromisedtosave
droppedfromcoverageinvoluntarily NYSHIPatleast$12.9millionbyremoving
H
becauseBudco,thecontractorhiredbythe
stateDepartmentofCivilService(DCS)to
er
w
ro
a
If
r
s
,
y
r
c
o
e
ineligibledependents.
conducttheaudit,receivedinadequateor
nodocumentationfromenrolleestoverify
r,
a
u
m
(
l
8
l
b
o
t
e
h
v
l
e
e
ie
d
s
v
t
f
e
a
ro
t
y
e
m
o
D
u
c
e
r
o
p
d
v
a
e
e
r
p
t
r
e
a
n
g
d
e
e
i
n
n
t
num
Ci
b
v
e
ilSe
Sofar,PEFhasnotbeentoldtheactual
thedependents’eligibilityforcoverage.
8
r
0
v
a
0
ic
.
)
m
e
4
.
0
a
t
9
t
o
-
a
9
5
0
n
p
5
e
.
9
w
m
,w
.
to
e
l
m
l
e
-
k
f
e
r
d
n
e
a
t
e
y
o
s
f
,
amountofsavings.Initially,thatsavingswill
beexperiencedbytheEmpirePlanand
HMOsthatinsuretheNYSHIPenrollees.
Thedeadlineforsubmittingproofof Theyareprojectingfewerclaimsfor2010,so
eligibilitywasextendedtoNovember25,2009.NYSHIPenrollees savingsarepassedontothestateandNYSHIPenrolleesaslower
onmilitaryleavewhosedependentshavenotbeenconfirmed annualpremiumrateincreases.
eligiblehavenotlostcoverageforthosedependents. TheEmpirePlanandHMOsarereviewingclaimspaidfor
AccordingtoBudco,morethan5,600covereddependentsof ineligibledependentsandrequestingrefundsfromtheenrollees
PEF-representedenrolleeshavebeenruledineligible,because whoclaimedthosedependents.Enrolleesmaybebilledfor
eithernodocumentationofeligibilitywasreceived,oritwas claimspaidonineligibledependentsgoingbacktoFebruary1,
incomplete.Theaffectedenrolleeswerenotified,andsomeof 2009.
Persistenceearnsnegotiatedwork
PEFendorsesDemocrat
scheduleatNYSPsychiatricInstitute
for24thADinFeb.9
specialelection
N
ByDEBORAHA.MILES persistenceofunionmemberstogeta
AnalternateworkscheduleattheNew writtenagreementwiththeagency. PEFhasendorsedDemocratand
YorkStatePsychiatricInstitutein “Manytimestheagenciesorfacilities formerNYCityCouncilFinanceChair
T
I
O
Manhattanismakinglifeeasierformost trytoimplementapilotprogramwithout DavidWeprininaspecialelectionbeing
ofthe30PEF-representednurseswho awrittenagreement,”saidPEFfield heldTuesday,February9,tofillamid-
workatthefacility. representativeJacquelineCataldo.“The termvacancyinthe24thAssembly
Afteranearly10-yearpushtoget winhereiswehaveawrittenagreement District.
eitheraflexiblescheduleoralternative anditlaysoutaprocedure.Ittakesinto ThestateAssemblyseat,which
S
’
S
T
A
workscheduleagreementbetweenPEF considerationalloftheunionprinciples representstheLittleNeckareaofQueens
andmanagement,theturningpoint thatwefightforallthetime,suchas County,wasvacatedbytheresignationof
S
E
cameinJune2009,whenmanagersat seniority.Andmanagerswon’tbeableto MarkWeprin,wholeftitafter15yearsto
theinstituteagreedonaplan.Itstarted discontinuethealternateworkschedule serveontheNewYorkCityCouncil.David
R
inOctoberwithmostnursesworkinga withouthavingdiscussionswithus.” andMarkWeprinarebrothers.Their
U
combinationof8-and12-hourshifts, “Thispositiveoutcomeisavictoryfor father,SaulWeprin,representedthe24th
N
andlovingit. ourmembersatNYSPsychiatric ADuntilhisdeathin1993.
YvonneSingletary,aPEFExecutive Institute,”saidPEFVicePresidentPat Theendorsementwasrecommendedby
Boardmemberandanurseatthe Baker.“Itshowsthesethingscanhappen thePEFRegion11PoliticalAction
institute,saidthetopiccameupatevery whenmembersstayrelentlessaboutan Committeeandconfirmedbytheunion’s
labor-managementmeeting. issueandcontinuetobringitto statewidePACinJanuary.
“Thereweretimeswhenwemadeup management.Itshowsmanagershowa February9specialelectionsalsowillbe
proposedschedulesandpresentedthem goodworkschedulecanbenefitthe heldtofillthreeothermid-termvacancies
tomanagerstoseeiftheywouldbe facility.” instateAssemblyseatsrepresenting
feasible,”Singletarysaid.“Thenwe Singletaryalsosaidingettingthe portionsofNassau,Suffolkand
wouldn’thearanything.Wefileda plansreadyforthealternativework Westchestercounties.Sofar,noPEF
grievanceyearsago.” schedule,nursesweregiventhe endorsementshavebeenmadeinthese
Thebigunionwininthiscaseis opportunitytoseewhatwasdoneon races.However,membersintheseareas
managersfinallyagreedtonegotiate.One differentshifts.Thishasresultedina shouldcheckwiththeirPEFregional
ofthedrivingforceswasthe greaterappreciationofeachother’swork coordinatorforanupdate.
implementationofthemandatory andhasbroughtahigherlevelof
–SherryHalbrook
P
o
a
v
g
e
e
rt
8
im
—
e
T
l
h
a
e
w
C
.B
om
ut
m
t
u
h
n
e
ic
o
a
t
t
h
o
e
r
r
F
w
eb
a
r
s
ua
th
ry
e
2010
solidarityamongmembers.
PEFInformationLine:1-800-553-2445
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28