Administrative Code 12-126 – Line by line
[This post was corrected. Harry Nespoli heads the Sanitation Workers. And the HIP payment level is $938, but comes out to $919, per month, after fees are deducted. Thanks to James Eterno’s sharp eyes.]
What is Mulgrew trying to do? You don’t have to look at the law and the analysis to know. He’s doing now what he’s been trying for the last two years: force retirees out of Real Medicare and into a privatized Medicare Advantage scheme.
It’s not just him, of course. He’s got full agreement with Harry Nespoli of the Sanitation Workers, who is the head of the Municipal Labor Committee (MLC). Because of weighted voting Mulgrew and Nespoli control about 2/3 of the MLC’s votes. But of course, the City is pushing for this big time. We saw the letter from the Office of Labor Relations, Renee Campion, but Mayor Adams, too. And all of NYC’s financial backers.
So they are all trying to get retirees into Medicare Advantage. We don’t really need to look at 12-126 to know what they are doing. But people are curious. Let’s look.
12-126
First, you can just read what James wrote. It’s pretty clear.
But let’s dig through the language.
The yellow and teal are existing language.
The City will pay the entire cost of health insurance for city employees, city retirees, and their dependents,
Translation: “the City pays”
Not to exceed one hundred percent of the full cost of HIP-HMO on a category basis
The amount the City pays is pegged to the cost of HIP. In fact, their’s a way of balancing between HIP and Emblem (old GHI) involved. But that pegging, that sets a maximum the city will pay. They won’t go higher. if you have a plan that costs $300 more than HIP or GHI, the City will pay as much as HIP costs ($919/month), but not the extra, that’s on you. So…
Translation: “an amount equal to the cost of HIP, (not more)”
“The City pays an amount equal to the cost of HIP”
And that’s ok for you and me, since that $919/month ceiling is pretty much what we need today.
The green is the UFT’s language, the proposed amendment:
…or in the alternative…
Wow! Today the City must pay what HIP costs, but for the future Mulgrew, Nespoli, and Adams want an alternative.
So watch what’s coming up. We are looking for the new amount that the City will be obliged to pay. But you know what? There is no minimum mentioned. Let’s read:
In the case of any class of individuals eligible for coverage by a plan jointly agreed upon jointly agreed up on by the City and the Municipal Labor Committee to be a benchmark plan for such class, not to exceed the full cost of such benchmark plan as applied to such class.
Class?
Class? What do they mean by class? It means that they want different rules for different groups of employees. They are proposing that we can be divided up – that benefits may differ group by group.
Think about that. Why are they having a hard time pushing retirees into Medicare Advantage? Because the retirees are standing up, together, united. But they are thinking, if we had different plans, and different benefits, and if they screwed us over at different times, picking off one group, then another – if they can divide us, maybe they can forestall any future righteous revolts.
Divide and conquer? Where are our unions, saying no to divide and conquer? Sadly, our leaders are saying yes. It’s up to us to correct them.
Benchmark?
Benchmark? The current benchmark is HIP. $919/month. The future benchmark? It could really be anything. As we see with the City’s letter (Campion to Nespoli) and as we will examine further, whoever negotiated for the unions in 2018 effectively ceded decision-making power to an arbitrator, Martin Scheinman, who has not been kind to workers (he was the one who said we shouldn’t have had to work through break in April 2020, but that the City didn’t have to pay us. When the City decided not to pay us part of our lump sums, money they had owed us for years, he was the one who said that’s okay, as long as you pay them later).
And how low could this benchmark be? The amendment doesn’t say. Maybe Mulgrew should tell us how low they are planning to lowball our healthcare?
Summary
The code today means:
“The City pays an amount equal to the cost of HIP”
The code if the Mulgrew/Nespoli/Adams amendment goes through will say:
The City pays the cost of HIP, and no more than that, or else some other amount – and that amount could be different for different groups of city workers, and there is no limit on how low those amounts might be.
When you call your city council member, please explain this to them as you urge them to protect workers and retirees, and reject the amendment.
Trackbacks
- NYC Educator: Beware The Zero-Sum Game - MFI NEWS
- Questions Planned for Tonight’s UFT Exec Board | JD2718
- Blame it on Bad Rollout | JD2718
- What the “Stabilization Fund” Stabilizes (and why Mulgrew needs to stop raiding it) | JD2718
- UFT Leadership Says Letting City Pay Less=Improved Health Care - Iscuk
- Mulgrew to Members: Prepare for Premiums – Analyzing the 1-18-2023 Delegate Assembly | New Action - UFT
JD2718 
As a retiree from the city of New York with 30 years of service. Entitles me to continue with medical coverage that I signed back in 1971! These benefits are due without removal to retirees! Under no circumstances there should cut back on health benefits especially on a fixed income!!!
Thank goodness for Judge Lyle Frank who’s strongly worded opinion last week in his ruling ordering a HOLD on the 7/10/23 deadline for NYC retirees to opt out of NYC’s Aetna Medicare Disadvantage Plan.
In particular, NYC Retired Teachers are furious over the fact that they were swindled by their own UFT Union in backing the Medicare
Disadvantage Plan because they’re more interested in using a portion of the $600 million in “Savings” to NYC to increase pay for active NYC teachers. The retirees built the current system to ensure that they would have THE SAME HEALTHCARE BENEFITS THAT THEY HAD FOR LIFE UNDER TRADITIONAL MEDICARE.
Read the Federal investigators findings about the rejection rates
for routine medical care……..
which from Medicare Advantage Plans across the U.S.———which
in summary concludes that Medicare Advantage Plans ARE NOT IN THE BEST INTEREST OF RETIREES.
Ask yourself this: Who receives the Advantage ??——-NYC DOES.
Stand up for yourself and keep your Original Medicare and buy a
Plan “G” Medical Supplemental
policy as I just did using my AARP
membership to purchase a United Healthcare Med. Supp. for $241/mo. plus an RX PLAN for only
$41/mo. for total monthly cost of:
$282/mo to KEEP YOUR FREEDOM OF CHOICE TO SEE ANY HEALTHCARE PROVIDER YOU WANT WITHOUT HAVING TO PICK
FROM A LIST. Yes, you will lose the
IRMA Part B reform for your Part B
Monthly Cost which totals approximately $2,040 a year………
But How Can You Put A PRICE ON FREEDOM OF CHOICE ?
Many retirees can’t afford to pay
the $282/mo. have no choice but to be like sheep an join the MA Plan.
However, if you can afford the
$282/mo premium DO IT NOW.
——————————————————
FYI: An HMO is where you Must choose a PCP from a LIST OF PARTICIPATING PROVIDERS.
A True PPO such as what most of us have now have let’s you choose
ANY PROVIDER…….SO……
How can NYC’s new Aetna PPO PLAN HAVE A LIST OF PROVIDERS TO CHOOSE FROM?…………….
Because it’s an HMO BEING MARKETED AS A PPO.
HMO=choose from a list of participating providers and need
Prior Approval for almost all routine
Testing procedures. You have a non medical person deciding on your healthcare….NOT YOUR DR.
PPO= NO LIST OF PROVIDERS, TRUE FREEDOM OF CHOICE TO SEE ANY PROVIDER IN OR OUT OF ANY LISTS AT YOUR CONVENIENCE.
In Summary :
——————-The city and Aetna are giving out FALSE ADVERTISEMENTS IN STATING
“IN OUR PPO FOR NYC YOU CAN SEE ANY PROVIDERS YOU WANT,
——-AS LONG AS THEY ARE ON OUR LIST… PURE B. S. And FALSE.
Again, a True PPO DOES NOT HAVE ANY PROVIDER LIST, SO ASK YOURSELF: It’s called a PPO with a
List to choose from?
It’s a scam to get you to sign up for AETNA’s Medicare Disadvantage Plan, and good luck getting back
onto your Original Medicare Coverage that you’ve worked so hard to qualify for and Poof……
It’s Gone AS YOU SIGN WITH AETNA. DON’T GET DUPED BY
MAYOR ADAMS AND YOUR OWN
UNION(S)——Even if your Dr. of
30 years is “PARTICIPATING IN THE PPO” Aetna will still control your healthcare decisions.
Example: Your Dr. orders an MRI OF YOUR SPINE….YOUR STILL MUST GET PRE APPROVAL FROM A NON MEDICAL PERSON AT A FOR PROFIT PRIVATE INSURANCE COMPANY THAT IS ON THE NYSE WITH SHAREHOLDERS TO ANSWER TO…..Traditional Medicare
IS A FEDERAL NON PROFIT PLAN,
WITH YOUR HEALTH BEING THEIR ONLY GOAL.
OPT OUT NOW AND GET YOUR OWN MEDICARE SUPPLEMENT POLICY AND A PART “D” RX PLAN.
Sincerely,
Dr. Henry L. Palo,
Internal Medicine Provider
IN PRIVATE PRACTICE FOR
OVER 33 YEARS With Numerous
ACTIVE AND RETIRED NYC
PATIENTS.
A bill will have to be paid by some entity—-if Aetna doesn’t pay…….
then Y O U will pay the remaining full 20% amount due—yout $$$$.
Do you want to have to wait to see
if for profit Aetna will approve your claim or not ? If rejected, you must take your own time to appeal, while the Dr. may ask you to pay the balance due within 30 days while you and Aetna fight it out whether or not you will be reimbursed?
NO WAY FOR ME IN MY EARLY
‘70’s. PAY PRIVATELY WITH YOUR OWN M’CARE Supp. Policy.
What A Great Feeling Of Security IT IS When you walk in and sign in for your Dr’s appointment KNOWING THAT YOU ARE TOTALLY COVERED.
BE PROACTIVE, THIS IS YOUR HEALTH INSURANCE WE’RE TALKING ABOUT, NOT WHAT COLOR CAR TO CHOOSE.
TAKE NO ACTION AND EVENTUALLY YOU’ll BE AUTOMATICALLY ENROLLED IN
AETNA’s Medicare DisAdvantage Plan ONLY TO HAVE YOUR DR’s
REQUEST DENIED.