CTU-R Newsletter, April 2016

STRS and Health Care Update

News from St. Patrick’s Day STRS

Board Meeting

       At the March 17 STRS Board meeting that 279-R’s Dan MacDonald attended, the Member Benefits Department again presented reductions for the Board to consider in health care plans for 2017. The Department asked the Board to again consider and discuss the same 17 changes. The goal is to save money, and better align with the Healthcare Market Place with built-in safety nets of out-of-pocket maximums. Be aware that the discussion led to an OPERS (Ohio Public Employees Retirement System) approach, where all retirees under age 65 might have to use the Healthcare Market Place and purchase their own plan.

       Look these over carefully, because YOU are probably going to be impacted negatively. Tell your pleasure or displeasure to STRS at 1-888-227-7877.  Make sure you tell the representative you want a Board member to hear about your call. Some of the Board members are worried that several proposals will impact on a particular retiree. If you have several hitting you or a family member, you should call STRS as suggested above, or you can email a Board member. Mark Hill and Robert Stein are two vocal Board members amongst several that question the STRS departments’ proposals. Mark Hill can be emailed at hillma@strsoh.org and Robert Stein’s email is steinr@strsoh.org .

       The Board has been asked by STRS to vote on the proposals at the April 21, 2016 meeting.  If the Board agrees on all of these suggestions, this time the Board was told it would add three to four years of life to the healthcare plans instead of one to two as reported last month. Currently, the life of the healthcare funding is approximately 15 years. The “Impacts” and “Cost Reductions” below are from the STRS presentation, their figures.  

       The Board seemed in agreement with STRS in many of the proposals. The ones being questioned by Board members are numbers 3, 10, 12 (but it becomes unnecessary if 16 is approved), 15, 16, and 17.

       Here are the proposals:

1. Discontinue Alere non-Medicare disease management program. Impacts: 750 enrollees. STRS Cost Reduction:  $550,000.

2. Increase emergency room copay for Medicare plans from $65 to $75. Impact:  last year 50,425 visits to ER in 2015. STRS Cost Reduction: $504,000.

3.  Increase Health Care Assistance Program deductibles: in-network from $300 to $400 and out-of-network from $300 to $600. Impacts:  84 enrollees. STRS Cost Reduction:  Minimal.

4.  Move Medical Mutual non-Medicare enrollees residing outside of Ohio to Basic Plan administered by Aetna. Impacts: 2,300 enrollees. STRS Cost Reduction:  Minimal.

5. Increase urgent care copay from $35 to $40 in all plans.  Impact: last year 4,871 visits in 2015. STRS Cost Reduction:  Minimal.

6. Discontinue HealthSpan plans. Impacts: 360 non-Medicare and 1,526 Medicare enrollees. STRS Cost Reduction:  Minimal.

7. Discontinue coverage for proton pump inhibitors (PPIs); all are available over-the-counter (examples are Nexium and Prilosec). Impacts: 6,302 non-Medicare and 24,221 Medicare. STRS Cost Reduction: $6.4 million total ($1.3 non-Medicare & $5.1 million Medicare).

8. At retail, adopt preferred network with $10 additional copay at non-preferred pharmacies and narrow retail network for Medicare. Optimize pricing/discounts by excluding Walgreens (Medicare only, already excluded under non-Medicare) and make some independents and CVS non-preferred.  Impacts: 8,770 non-Medicare & 32,879 Medicare. STRS Cost Reduction:  $4.6 million total ($2.1 million non-Medicare & $2.5 million Medicare).

9. Increase the diabetic from ½ copay to full copay.   Impacts: 305 non-Medicare & 16,625 Medicare. STRS Cost Reduction: $1.03 million total ($80,000 non-Medicare & $995,000 Medicare).

10. Increase specialty drugs coinsurance percentage from 10% to 15%, and per-prescription maximum from $500 to $600. Impacts: 700 non-Medicare & 425 Medicare. STRS Cost Reduction: $600,000 total ($180,000 non-Medicare & $420,000 Medicare).

11.   Per an approved 2015 Board motion, staff is to annually align the next year’s prescription plan’s deductible and out-of-pocket (OOP) limits to the next year’s standard Medicare prescription plan. The deductible is to be set at 63% the standard Medicare prescription plan’s deductible rounded to the nearest $25 increment.  The out-of-pocket is set to match the Medicare standard prescription plan limit. [Dan’s Note: In other words it will probably cost you more.]

12. Discontinue Medicare Part B reimbursement for named survivors and beneficiaries who were age 65 by 2008 and either already a beneficiary or named as a beneficiary by 2008. Impacts: 7,859. STRS Cost Reduction:  $4.3 million.

13. Discontinue sponsored dependent for unmarried retired teachers. Impacts: 38 non-Medicare and 74 Medicare. STRS Cost Reduction:  Minimal.

14. Change dependent children rate to a per-child rate.  Impacts: 3,014 non-Medicare and 4 Medicare. STRS Cost Reduction:  Minimal: single-child families subsidizing multi-child families.

15. Reduce STRS Ohio non-Medicare subsidy multiplier from 2.1% to 1.9% per year of service.  Impacts: 24,380. STRS Cost Reduction: $24-$38 million.

16. Phase-out Medicare Part B reimbursement over 3 years; reduce by 1/3 (to no less than $29.90 minimum until completely discontinued in the third year).  Impacts: 85,709. STRS Cost Reduction:  $14 million.

17. Charge Medicare part B-only enrollees a $50 per month surcharge. Impacts: 11,680. STRS Cost Reduction: $7 million.

       The Retirement Board identified health care funding challenges as a key area of focus for 2016 during its annual planning meeting in January. As in years past, STRS Ohio staff works with the Board to set 2017 coverage features, program eligibility, and premium subsidies. These possible changes were presented in February, to consider for the 2017 plan year. The board is reviewing these options, as well as working with staff regarding how to extend the solvency of the health care program. More details and updates can be found on the STRS Ohio website at www.strsoh.org. STRS Ohio will continue to share information on these discussions, along with any actions taken, via the system’s website, newsletters and eUPDATE email news service.

Other STRS Board Activities

       The Investment Department reported that the February return for the Pension Fund was -0.2%.   For the fiscal year the fund is down -4.7%.  The pension fund is close to 69 billion dollars.

       The Finance Department presented a Mortality Experience study. The bottom line is that STRS retirees are living longer, and our longer lifespans will have a projected impact of $5 billion or more on additional funding liability needs. 

       The liability increase lowers the current funding ratio and extends the funding period by nine or more years. The bottom line (according to Dan): the market is down, liability is up, STRS is looking for ways to save money, and discussion will be starting on what “levers” to pull to bring money into the pension fund and/or eliminate money leaving the pension fund.

HealthSpan Goes OUT OF BUSINESS

       HealthSpan quits. On March 1, 2016, STRS was contacted by HealthSpan. As of September 1, 2016, HealthSpan will no longer be an insurance company to their subscribers under age 65. As of January 1, 2017, HealthSpan will no longer be an insurance company to their Medicare subscribers age 65 and over. The Federal government forced HealthSpan to stay in business for those subscribers in Medicare through December 31, 2016.  

       HealthSpan will cease to exist as of December 31, 2016. STRS will be sending letters to HealthSpan retirees toward the end of March 2016 into the beginning of April, with information and transition plans. HealthSpan STRS retirees will need to choose a new provider, or one will be chosen for them.

       As always, this was a very interesting STRS Board meeting! More was covered, but what I consider to be the essentials are here.

If You Have STRS Health Care Issues…

       If you have Express Scripts concerns, please call Express Scripts Customer Service at 1- 888-416-3326 or TDD 1-800-716-3231. Keep track of the date and time you called. Have your ID card available. If you can’t resolve your issue with your administrator by this contact, STRS can also provide assistance at 1-888-227-7877. Actually, any of the medical providers (Medical Mutual, Aetna Advantage, HealthSpan, etc.) should be contacted first, and if you are not satisfied, then call an STRS customer representative.

       If you continue to have problems, please send Dan MacDonald an email with the name of the drug, its dosage, and your concern, or if it is one of the medical plans, share the name of your plan plus your concern. Email to macdonald.retired@hotmail.com and in the subject block put “Express Scripts” or the other provider. Be sure to include in the email a statement authorizing Dan MacDonald to act as your authorized representative. 

       If email is not available, please send a letter with your telephone number and concern to Dan MacDonald, 15889 Arbor Trail, Newbury, OH 44065.  Include in your letter that Dan MacDonald can act as your authorized representative. Dan will then call you.        Please note: In order for Mr. MacDonald to speak on your behalf with the 279-R Board, and STRS and its Board, a statement needs to be made for him to be your authorized representative, because of HIPAA (patient privacy) regulations.

…And Watch Those Timelines & Deadlines!

       Beware of timelines! Recently one of our 279-R members had an appeal denied because it wasn’t submitted in a timely manner. Your doctor’s office is usually part of the appeal’s process. Make sure the doctor’s office notifies you when the appeal information is sent. Keep track of dates of mailings and follow-up phone calls. These become important when you are denied because of “timeliness.”

Dan MacDonald

Legislative Report

A Day Late and a Dollar Short

       The saying “a day late and a dollar short” fits the mailing of the March Newsletter. It was written and edited on time and mailed properly, but the delivery to your residence by USPS left much room for improvement. Oh, well! The good news is, the AFT/OFT’s endorsed candidates, Hillary Clinton and Ted Strickland, won their primaries.  Also, the Health and Human Services Levy won.  Now on to the big dance in November: Election 2016.

       As there is relative calm in the Democratic Party camp, we look to the Republican Party for excitement, as it has a mess to deal with. The Republican Party Leadership watches in horror as the nightmare candidate seems to be on track to win the Republican Party’s nomination for President. And why is Republican Leadership surprised by this chain of events? The Republicans invented the “Southern Strategy” for angry white voters in southern states, welcomed the Tea Party into their fold, harbored the extreme religious right and militia types, causing the party to go bonkers.

       Hopefully, the Republican disaster will motivate progressive voters (such as the members of 279-R) to work hard for the election of progressive candidates who will work for the middle class.

       Recently, in the week before the Ohio Primary, 279-R members were asked by the CTU to work the phones for Hillary at the union office. Our Retired Teacher Activists (RTA) responded positively to the ask.  Thank you to all who worked at the phone bank. CTU President David Quolke and 2^nd Vice President Kurt Richards, who is the CTU political coordinator, were very appreciative of 279-RTA’s efforts making calls for Hillary.

       There is, however, a greater challenge looming for 279-R, Election 2016. Come late summer and into the fall, the need for volunteers will be great.  We must elect progressive candidates who will work to strengthen the middle class, and provide for retirement security.  Will you help seniors secure their retirements? Remember what is at stake: Social Security, Medicare and Medicaid, and more.

       Join your sisters and brothers of NEO-AFT Local 279-R, and volunteer to work the phone bank, do a union walk, or write postcards in support of our endorsed candidates in Election 2016.  If you attend the April or May General Meetings or the June Gala, volunteer sign-up sheets will be available. If you do not plan to attend any of these events but want to volunteer, call Tom Luvison at 216-702-5024.

Tom Luvison

Last Chance for Ohio ARA Tickets!

       If you want to help support the Education Fund of the Ohio Alliance for Retired Americans, this is your last chance to purchase a raffle ticket for the annual ARA raffle. First prize is $3000, second prize is $2,000, and there are five third prizes of $1,000 each. (Prizes will be apportioned to number of tickets sold.)

       Fighting for senior rights and retirement security, the ARA is a voice for retirees and seniors like us, who helped build a strong middle class through our labor and sacrifice. The Ohio ARA is affiliated with the AFL-CIO, and represents about 450,000 retirees and senior workers. It is a resource for seniors who want the political truth.  

       If you haven’t purchased a ticket yet, please consider doing so. Send a check ($10 per ticket) by April 7, made out to the Ohio ARA Education Fund, and a note with the name, address, and phone number of the ticket buyer, to: 279-R, ATTENTION: Tom Luvison, The Halle Building, 1228 Euclid Avenue #600, Cleveland, OH 44115. We will mail your stubs to you. The drawing is Tuesday, April 12, 2016. Thank you for your support!

Membership Report

     Thank you for your help: 279-R met our goal of 1,300 members. There are now 1,311 paid members in the database! Because it’s late in our membership year, which runs from September 1, 2015 to August 31, 2016, we are offering a great deal.  For just $70, people who have not joined yet can join for the rest of this year and all of next year, until August 31, 2017: a two-year deal.

          Please call us at the membership line, 216-482-2281, to let us know about any problems you are having with your membership, membership cards, mailings, and change of address or phone number.

Linda Opaluch

Which Way in 2016: Some Food for Thought

       President Franklin D. Roosevelt was a bold, unapologetic liberal. To cut the 1930s joblessness and help deal with the Great Depression, he raised taxes on corporations and the richest Americans, and provided social safety nets for the poor and elderly, and created job programs for other Americans.

       The results: decades of America being the preeminent global economic superpower, with widespread unionization, high taxes on wealth, and a productive, prosperous, expanding middle class.

       Then beginning in the 1980s, America tried “trickle-down” economics, tax cuts for the wealthy and corporations, and cuts to social programs.

       The results: decades of unprecedented levels of income inequality benefitting only the top 1%-2%, a decline in unionization, the shrinking of the middle class, and more Americans living in poverty.

       Which way is America headed in 2016?

 Sunshine

Eleanor Avery’s sister, Caroline Campbell (our 279-R travel agent), is recuperating at home after a hospital stay. Send get-well wishes to Caroline at 15812 Judson Drive, Cleveland, OH 44128.

Dorothy Phillips, a former Melodeer, is at home recuperating from surgery. She would appreciate get-well cards at 1914 Poplar Avenue #801, Memphis, TN 38104.

Gretta Thomas is in rehab. She would appreciate get-well cards at 1540 East 193 Street, Apt. B 226, Euclid, OH 44117.

James Hayes, former 279-R Scholarship Committee Chairperson, is ill. Send get-well cards to him at 6759 Mayfield Road, Apt. 515, Mayfield Hts., OH 44124.

Robert Wendt, former 279-R Legislative Liaison, is recovering from a heart attack. Send get-well cards to him at 6556 Sutton Drive, North Olmsted, OH 44070.

Lucy Quolke broke several bones resulting from a fall. Send get-well cards to her at 6166 Hilary Drive South, North Royalton, OH 44133.

Ernestine Watson is recuperating from a fall. Send get-well cards to her at 529 Moss Landing Drive, Antioch, TN 37013.

Marva William’s spouse passed recently. Send sympathy cards to Marva at 2690 Green Road, Beachwood, OH 44122.

Sylvia, daughter of Maria Cullen and niece of Paula Bonacci, passed recently. Send condolences to Maria at The Welsh Home, 22199 Center Ridge Road, Rocky River, OH 44116, and to Paula at 2640 Carmen Drive, Rocky River, OH 44116.

Emma Jones, wife of Isaiah Jones, passed in December. Send condolences to Isaiah at 16257 Northvale Blvd., East Cleveland, OH 44112.

Lori Mosee, daughter of Dorcas Mosee, passed recently. Send condolences to Dorcas at 3605 Normandy Road, Shaker Hts., OH 44120.

Theresa Ormandy 216-741-6764

Please call the Sunshine Committee when there is an illness or death in our 279-R family.  However, please DO NOT CALL the committee with other questions, issues or information.