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Unions win protections for members in health plan audits

Municipal unions won protections for members in the city's audit of family health-insurance plans.

On Aug. 21, after a court order obtained by the Municipal Labor Committee put a brake on the audit, the MLC Steering Committee approved an agreement with the city that addresses members' need for protections. The MLC represents city unions on health-care and other benefits.

The agreement establishes the following:

  • An amnesty provision waives penalties or criminal charges for policyholders who remove ineligible dependents from their coverage by Oct. 4. Originally, the administration tried to make members and retirees reimburse the city for improper medical expenses and threatened to prosecute anyone who balked at paying.

  • A three-step appeals process lets health coverage continue while members and retirees contest audit findings. The process includes filing an affidavit along with documents, a review by a city and MLC representative, and arbitration.

  • Privacy protections: The agreement requires that documentation submitted to verify dependents be destroyed after being reviewed. The city agreed that the outside auditor, Aon Hewitt, would be subject to stiff penalties if it fails to destroy documents after the audit. Aon must verify the destruction.

  • Deadline delayed to Oct. 4: In addition to the safeguards, the unions convinced the city to extend the deadline for complying with the audit to Oct. 4 from Sept. 20.
    Members should now comply with the dependent eligibility audit, said Willie C. Chang, Senior Director of Health Planning at the DC 37 Health and Security Plan. Chang, General Counsel Mary O'Connell and Research and Negotiations Director Evelyn Seinfeld provided important technical support to the MLC during the negotiations.

Anyone with questions or concerns about the verification process should call Aon at 1-855-596-7454.

— Public Employee Press, September 2013

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  Local 1455, District Council 37, 125 Barclay St., New York, NY 10007.