Illinois workers’ union challenges state’s decision to reduce retiree health plan options

SPRINGFIELD, Ill. (WCIA) – The state employees union, AFSCME Council 31, has confirmed that it has filed a grievance challenging the state’s decision to reduce employee health insurance options to one. the retired state.

After 10 years of a state-administered benefits program, retirees will go from two or three choices in each county to one for the state.

Retirees continue to worry about the state contracting with Aetna and leaving them with no choice, especially the thousands of people who still don’t know if they will be able to continue seeing Carle’s doctors in January.

Now, not only is this a cause for concern for retirees, but AFSCME argues that the Illinois Department of Central Management Services (CMS) may have violated its employment contract with the union by eliminating the HMO insurance option.

AFSCME and the state agreed to save money a decade ago by separating retirees from the employee health plan and creating a new, cheaper program: Total Retiree Advantage Illinois Medicare Advantage Prescription Drug (TRAIL MAPD).

The benefit requirements for the new scheme were written into the employment contract that AFSCME entered into with the State. It is in effect until next summer and based on this contract, the union is challenging CMS’s decision to contract a single plan, according to Martha Merrill, director of research and benefits at AFSCME.

AFSCME is in initial discussions about the grievance with CMS at this point, Merrill said in a statement to WCIA.

“CMS has accepted AFSCME’s recommendation to strengthen the TRAIL program by establishing a union/steering committee to review the adequacy of the network and the administration of grievances should any issues arise.”

In other words, if this recommendation comes to fruition, the union would have a seat at the table if and when retirees struggle to access essential or even routine health care.

“As previously stated, the state fully recognizes our obligations under collective bargaining agreements,” CMS Deputy Director of Communications Cathy Kwiatkowski responded in an email Thursday.

“To the extent that our union partners have raised concerns about other aspects of the plans through a grievance, we are actively meeting with them to resolve these issues. In the event that a resolution is not reached, an independent arbitrator will ultimately decide whether or not the collective agreement has been violated.

It’s unclear whether Carle Physician Group — a network of more than 550 physicians and specialists — and Urbana’s Foundation Hospital would continue to see state retirees come in January even if CMS renewed a contract with United HealthCare or any another plan for that matter. Carle has seen retirees on the current retiree PPO plan, but Carle is outside of the United HealthCare network and does not contract with any Medicare Advantage plans outside of Health Alliance, which is part of Carle Health.

Representatives for Carle would not answer whether United HealthCare’s Medicare Advantage PPO plan patients would be able to see his doctors in the new year, calling the question hypothetical. However, retirees aren’t the only patients who can enroll in United HealthCare.

“For the past 10 years, without a contract, Carle has agreed to treat UHC Medicare Advantage PPO members out of concern and commitment to our patients. But this type of accommodation is not one we can do indefinitely, as relationships without a fair and equitable contract in place are more costly, harder to manage and less effective and Carle will not sacrifice the high quality care that patients expect from Carle’s providers,” a representative said, in a similar response to Carle’s explanation of not committing to treat in-state retirees enrolled in the Aetna plan alone next year.